5 cosmetic procedures to avoid

There are a multitude of cosmetic operations and procedures designed to rejuvenate or enhance our face and bodies. The gamut runs from least invasive, like Botox or Fillers, to full fledged operations, like facelifts or breast augmentation. Each of these options have pros and cons, but all generally offer advantageous perks.

However, here are 5 cosmetic procedures that should be avoided, for various reasons.

1. Silicone injections anywhere

Injected silicone is permanent and not absorbed or excreted by the body. Seen by some as an advantage for long-lasting results, the issue arises when the silicone migrates or works its way to the skin's surface. It causes irritation and infectious granulomas that are unsightly and can be treated only by surgical excision. Common areas treated are the lips and buttocks for augmentation. Removal of the silicone can create deformities that require more reconstructive surgery. Even medical grade silicone injections create these problems, which can arise many years later. Industrial silicone, which is not sterile or refined, has been used illegally by shady, unlicensed injectors with disastrous outcomes. Rule of thumb, stay away from any product advertised as permanent.

2. Thread lifting for Facelift

Thread lifting is a procedure in which barbed sutures are inserted beneath the skin of the face in a manner to lift skin as done for a traditional facelift. Advertised as "non-invasive" with "no down time," the procedure can cause significant problems. Often, the skin can bunch up in an extremely awkward fashion. If the sutures are placed too superficially, they can become exposed, and work their way through the skin. Removal is difficult because of the barbs in the suture, grasping the tissue like tiny fish hooks.

3. Buccal fat removal from the cheeks

In an effort to slim the cheek regions of the face and create a "pouty" appearance, pillows of fat residing in the cheeks are surgically removed from inside of the mouth. Initially popular among fashion models and actresses, the procedure has gained popularity among women trying to appear thinner. However, the face ages because the skin starts to sag and we actually lose fat from our faces, giving a deflated, older appearance. This procedure unnecessarily speeds this process, and if overdone, can cause an unattractive gaunt look.

4. Facelift involving aggressive maneuvers

The modern facelift has actually evolved into a less extreme operation, involving shorter incisions and less dissection in an effort to produce a more natural, pleasing result. Some surgeons advocate aggressive maneuvers in certain patients with prominent structures in the neck, like fat or salivary glands. Over-resection of fat can create skin irregularities or other deformities, creating an unnatural contour. Removal of salivary glands from the central neck below the chin has been linked to increased risk of facial nerve injury and bleeding. Aggressive resection can create a skeleton look that is also unnatural.

5. Experimental procedures that lack scientific proof or FDA approval

New discoveries in medicine and especially cosmetic surgery are exciting and often garner much attention by the public and press. Unfortunately, sometimes new procedures hyped by the media have not been proven entirely safe or effective. Stem Cell Therapy is an excellent example. While scientific expectations are promising, like some day being able to replace vital organs or limbs, that day is not here yet. Further experimentation and development must be done and then more research needed to prove its safety.

Certain practitioners are advocating a procedure using platelets obtained from patient's blood and then injecting them into the face. This so called "Vampire Facelift" supposedly increases collagen in the skin and acts like a filler and rejuvenates the face. The problem is that it is not FDA approved because there is no scientific evidence that it works! Promises of a slow but certain fountain of youth are unproven.

The world of plastic surgery offers many proven options to battle Father Time, however it is important to understand the capabilities and ramifications of any of these procedures because they are elective and thus medically unnecessary. Be certain to consult with a board certified plastic surgeon, and don't be afraid to ask lots of questions.

Robert Tornambe, MD is a New York City Plastic Surgeon and Medical Advisor for Trueself. Certified by the American Board of Plastic Surgery, Dr. Tornambe has been practicing plastic surgery for more than 25 years. He is a fellow of the American College of Surgeons, was featured in NYMAG's "Best Doctors" issue, and was the Chief of Plastic Surgery at NYC's Cabrini Medical Center for 20 years.

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