Sheer Balance

by Brett Blumenthal

My heart goes out to the family of 18 year old Stephanie Kuleba, who died Saturday, 24 hours following breast surgery. Doctors believe she died as a result of a rare reaction to anesthesia called malignant hyperthermia.  Although Stephanie’s surgery was considered corrective, aimed at fixing an inverted nipple and asymmetrical breasts, the story reminded me of why I find plastic surgery so upsetting.

Let’s take Stephanie out of the equation and speak about plastic surgery from an enhancement perspective.  According to the American Society for Aesthetic Plastic Surgery, 7,882 girls under 18 had breast augmentation surgery in 2007…more than doubling the 3087 who had it in 2006.   Additionally, the number of breast enlargements within this age group has risen nearly 500% over the past decade — a sharper climb than the 300% increase among all age groups.  From an overall perspective, demand for cosmetic plastic surgery continues to increase among all age groups, with Americans spending $11.5 billion for 11 million cosmetic procedures in 2006.  This is a 48% increase over the number performed in 2000, according to the National Clearinghouse of Plastic Surgery Statistics.  Although there are many individuals who don’t have complications from plastic surgery, the risks are undeniably still quite high, and unfortunately, although corrective, Stephanie’s surgery and untimely death reminds us of these risks.

I can only imagine, if you are disfigured, are in a terrible accident or are born with birth defects, that electing to have plastic surgery can be a life-changing and wonderful solution.  It may help you to overcome psychological and self-confidence issues.  It may make you more functional.  It may even make you more comfortable in your every day life (let’s think breast reduction).  However, electing to have surgery, just to have surgery, when there is nothing wrong with you seems like a very, very short-sighted, and risky decision.

To quote Dr. Richard D’Amico, president-elect of the American Society for Plastic Surgery (ASPS), “The human body makes no distinction when the scalpel hits.  The difference with elective cosmetic surgeries is that patients generally start out being healthy.”  I think that says a mouthful.  If you are healthy…why would you ever open yourself up to the possibility of infection, medical issues, or even worse, death, for the sake of having less fat, bigger breasts or a smoother face?  I’m lucky…I know…I’m healthy and don’t have anything drastically wrong with my appearance, causing me to feel desperate for a solution.  But so many individuals who are in the same situation, still elect to have surgery to change their ‘imperfections’. 

In response to Stephanie’s death, a plastic surgeon in Woodbury stated that a girl will come in with her parents, who are buying her a breast augmentation as a birthday or high school graduation gift.  What?  Really?  What happened to the trip to Paris?  The ridiculously expensive new car?  The good ol’ fashioned Graduation Party or Sweet Sixteen? 

I guess I shouldn’t be so surprised.  When I was in Graduate school, I met several beautiful, highly intelligent, undergraduate women who had breast implants that increased their breast size from a B cup to a C or D.  These girls were 18 years old!  I could not understand how they could possibly feel so badly about themselves that they chose to have surgery to make their breasts bigger.  Moreover, I could not believe that their parents allowed or supported this.  What kind of message does it send young girls, who already may have self-esteem issues, that they should have breast implants?  How can a mother or father support their daughter in changing herself for the sake of such superficial reasons?  Isn’t it important for parents to build their children’s self esteem rather than encouraging them to believe that there is something wrong with them?  That they aren’t good enough the way they are?  But even more importantly, how can any parent allow their child to go under the knife with the known risks of complications, infection, disfigurement or even death?  I just don’t understand it.

Today, there seems to be more and more pressure to look perfect.  Television shows that romanticize plastic surgery don’t help.  Further, half of Hollywood seems to be getting some sort of work done these days with 55 year old women looking like they are only 32 years old.  This teaches kids that it is cool or trendy to have plastic surgery.  Unfortunately, it is the rarity versus the norm that the downsides of plastic surgery are emphasized.  Although death is extreme and rare, there are plenty of cases where other complications can occur: disfiguring…dissatisfying results, causing one to look ‘worse’…severe medical issues…and the list goes on.

Surgery is surgery.  Whether it be for cosmetic enhancement or to help save your life, it has risks.   If there isn’t anything wrong with you and if you aren’t sick, putting yourself at risk for the sake of vanity just doesn’t seem to make sense.  In short, it seems pretty…well…vain.  Maybe if society and media weren’t so judgmental about how people should look, and instead, emphasized an individual’s inner beauty, we would live in a more beautiful world.

• Necrosis or Tissue Death: Risks increase dramatically if you’re a smoker. That’s because smoking affects blood supply to the tissues. By definition, the surgeon is cutting into those tissues, and if the blood supply is already compromised, necrosis is more likely to occur.
• Hematoma: A collection of blood, occurs more in men than in women because beard follicles in the face mean there are more capillaries–and therefore an increased blood supply in that area.
• Infections
• Death: Toxic levels of anesthetics have been known to cause respiratory failure in some patients. In some rare instances, high levels of topical lidocaine have led to death.

Injections:

• Imitation Botox, or other imitation fillers not approved by the FDA, have left patients in comas for up to several years, and eventually dead
• Droopy eyelids
• Paralysis

Nose surgery:

• Infection
• Small burst blood vessels resulting in tiny, permanent red spots
• Incomplete improvement requiring additional surgery

Liposuction:

• Asymmetry
• Rippling or bagginess of skin
• Pigmentation changes
• Skin injury
• Fluid retention
• Excessive fluid loss leading to shock
• Iinfection
• Burning caused by the heat from the ultrasound device

Breast enlargement:

• Surgical removal or replacement of the implants
• Deflation
• Formation of scar tissue around the implant, which may cause the breast to feel tight or hard
• Bleeding or infection
• Increase or decrease in sensitivity of nipples or breast skin (occasionally permanent). Loss of sensation in the nipple in particular occurs anywhere from 10% to 70% of the time, says Dr. Nahai, president of the American Society for Aesthetic Plastic Surgery (ASAPS) depending on the type of procedure.
• Some women have reported symptoms similar to those of immune disorders with silicone implants. Ask your doctor about these and other concerns
• Breast reductions, where the nipple and areola are totally removed and reattached as skin grafts.

Eyelid surgery:

• Temporary blurred or double vision
• Infection and Bleeding
• Swelling at the corners of the eyelids
• Dry eyes
• Formation of whiteheads
• Slight asymmetry in healing or scarring
• Difficulty in closing eyes completely (rarely permanent); Pulling down of the lower lids (may require further surgery)
• Blindness (extremely rare)

Face lift:

• Injury to nerves that control facial muscles or feeling
• Infection
• Bleeding
• Poor healing
• Excessive scarring
• Asymmetry of or change in hairline.