The Pros and Cons of Controversial Cosmetic Surgery

Beauty is only skin deep, but it may depend on the size of a scalpel. Or perhaps a needle. People are turning to medical professionals in growing numbers to enhance their appearance. According to a 2016 American Society of Plastic Surgeons report, minimally-invasive procedures are up 180 percent since 2000, yet some cosmetic procedures may raise a few more eyebrows than others—no pun intended. Vegas Seven caught up with some local experts to sort it all out and get the 411 on some of the controversies surrounding these elective surgeries.

The professionals: Obstetrician-gynecologist Dr. Haydee Docasar, facial plastic surgeon Dr. Paul Lanfranchi, nurse practitioner at Simply Radiant Peggy Pruchnicki and medical director at Las Vegas Laser & Lipo Dr. Edward Zimmerman. (Editor’s Note: In most cases, each pro wasn’t 100 percent for or against a procedure, and they often offered insight on both sides.)


Labiaplasty


A procedure in which the labia (the folds surrounding the vagina) are tightened or partially removed to improve appearance, comfort or function.

Pro

“There are women who need it, so I would never judge anyone for having it done. Anything that makes you more comfortable with your body is always a good thing. It has its place. Some women are just born with large labia that hang down. Kind of like men and their scrotums, some are tighter and firmer than others. For other women, as they age, it loosens up and gravity pulls it down a little bit. Anytime you have children vaginally, that will also change it. Labiaplasty definitely has its place.” –Pruchnicki, nurse practitioner

Kind of like men and their scrotums, some are tighter and firmer than others.–Peggy Pruchnicki

Con

“Overall, I’m for it. We’ve done it more for women who have pain because sometimes the extra tissue actually causes discomfort. But there are a lot of risk factors related to bleeding, infection and scarring that can happen after the procedure. Sometimes when women do it just for cosmetic results and don’t really have a lot of extra tissue, they’re going to have a higher risk for those complications. You have to make sure you have a good candidate—patients who have an issue or just want to look a little bit better versus those who have body dysmorphic syndrome, where it’s not that bad, but they visualize themselves completely differently.” –Dr. Docasar


Injectables


Used by injection to augment tissue, often to help shape, contour and/or enhance parts of the face.

Pro

“There are people who come in and were born with hallowed temples, flat cheeks, a nose that’s not big enough for their face or a receding chin. In the old days, that would fall into the realm of the reconstructive plastic surgeon. Now with our fillers, we can ameliorate that and lift a heavy burden from those people. They can have a nose that people won’t notice because it fits their face. We can bring a chin forward without moving a piece of bone.

Filler is like bacon in my practice. Everything tastes better with bacon, and most things look better with filler. When you take a balloon and inflate it, it looks firm. As we get older, we all lose one to three CCs of facial volume for every year we walk the planet from the age of 25. As the balloon deflates, the wrinkles show.” ­–Dr. Zimmerman

Filler is like bacon in my practice. Everything tastes better with bacon, and most things look better with filler.–Dr. Zimmerman

“I use fillers and I use Botox. I want to age gracefully. I don’t want to look tired. Botox can make you look less angry because it takes away those lines between your eyes and softens the forehead to make you look more friendly and less upset. Filler takes away that tired look where your cheeks look sunken, your eyes look droopy or you get a downturning of the mouth. So I’ll use fillers a lot to bring the corners of the mouth up—and take away that tired, sad look.

I worked on a woman who had Bell’s palsy, which causes one side of the face to droop. We’ll put fillers in the droopy side and make it look like the other side. She’s so happy now. She’s having her picture taken with her grandchildren. It’s turned her life around.” –Pruchnicki

Con

“Injectables, meaning fillers and Botox, are, in my opinion, grossly overused. Because any physician or nurse can do injectables, it’s grown so fast and so large, everybody and anybody with a license is doing it. Most of these individuals are not formally trained in aesthetics. Their products tend to be a bit cheaper, and people will shop for the lowest price filler. We use fillers and Botox when it’s complementary to the procedures we do—face-lift, neck lift, blepharoplasty [which is a surgery to repair droopy eyelids]—as the icing on the cake, not the cake.” ­–Dr. Lanfranchi

So if you’re doing three or four syringes, some of these girls can have not only thinning of the lip area, but sometimes product can come out and [cause] disfiguration.” –Dr. Docasar

“In the face, you’ve got a lot of nerves and a huge blood supply. So if somebody doesn’t know what they’re doing, they can actually thrombose one of the vessels and produce decreased blood flow to the rest of the area. In very severe cases, you can actually get necrosis [death of cells in an organ or tissue] of parts of the face. If you interfere with one of the facial nerves, you can get drooping of the eyes and lips.

Lips are a huge thing right now. Doing one syringe of a filler can look nice, plumping up what you naturally have. Anything in excess is never good. So if you’re doing three or four syringes, some of these girls can have not only thinning of the lip area, but sometimes product can come out and [cause] disfiguration.” –Dr. Docasar


 Surgery for those Under 21


Once primarily an anti aging tool, cosmetic surgery and procedures are becoming more popular with youngsters as a beauty treatment, from boob jobs to nose jobs and everything in between.

Pro

“We judge people. Anything that’s asunder, our brain picks up. Does an ear stick out? Does a nose twist to one side or have a hump in it? Can we bring the cheeks forward so the eyes or chin don’t look so sunken? Those are all things we can do very easily in the office with minimal trauma. We can change lives in a very positive fashion. These kids, even their parents, have tears of joy. It’s very gratifying to help these folks. Certainly people who have cleft palates, who require surgery, it’s a major change and improvement to go out in society and feel whole.” –Dr. Zimmerman

We judge people. Anything that’s asunder, our brain picks up.–Dr. Zimmerman

“Where do you draw the line? The reason you wait until about 16 for rhinoplasty is because the facial bones are mature at that time. If [an issue] is functionally causing a significant detriment to somebody’s life and daily living, it’s a medical problem and you have to address it. But if it’s obviously cosmetic, you just be a good partner and tell them you’ll see them at the appropriate age: 15 or 16.” –Dr. Lanfranchi

Con

“Big, full lips are a trend right now. Kylie Jenner, Jennifer Lopez—they all have these full, beautiful lips. I’ve had fairly young women requesting bigger and bigger lips, where I’ve felt it’s gotten out of control. And I’ll tell them this is the last time we’re doing it and to wait six months to a year before we do anything else.” –Pruchnicki

The youngest I’ve seen is 15 or 16 and mostly for breast augmentation. I personally do [discourage it].–Dr. Docasar

“The youngest I’ve seen is 15 or 16 and mostly for breast augmentation. I personally do [discourage it]. As a teenager, they’re just developing their hormones. Their estrogen levels aren’t that high, and estrogen and progesterone would actually help with breast development. So you want to wait until their hormone levels have peaked because that’s when they’re going to reach their maximum size as far as natural breast development. You want that to happen before putting something else into their breast.” –Dr. Docasar

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