Celebrities have been expressing plastic surgery regrets.
Some—but not all—cosmetic procedures can be reversed or toned down.
To avoid patient regret, surgeons stress the importance of thorough, pre-surgery consultations.
Plastic surgery trends are similar to fashion trends—they can be timeless or temporary. Recently, some celebrities with plastic surgery have expressed feeling outdated.
Plastic surgeons say celebrity regrets highlight the importance of surgeon-patient conversations before a procedure, and the need to “temper” fads by keeping alterations realistic and expectations reasonable.
Stafford Broumand, MD, a board-certified plastic surgeon with 740 Park Plastic Surgery in New York, compares plastic surgery trends to ever-changing blue jean styles that aren’t refundable: “If you have all straight leg pants that are low rise, in the end, you'll need high rise pants that are bell bottoms,” he says.
Not all plastic surgeries can be reversed, and when possible, reversals aren’t easy or perfect. With that in mind, Broumand says it is of utmost importance for surgeons and patients to fully discuss expectations before the procedure.
“There's no time like the present to get it right,” says Broumand.
The importance of pre-surgery discussions
When it comes to cosmetic procedures, “getting it right” requires thorough preliminary discussions with patients.
“There's a lot more that goes into it; there are a lot more layers [than people realize],” Broumand says.
“It's like going to a class—you lecture for an hour, they take notes, and then they go back and study,” he adds. “There's a lot to be absorbed, and we want our patients to understand that they should mull things over, review it, and feel comfortable with it.”
Some important questions to ask patients in a pre-surgery consult (or class) include:
“What are your expectations from the surgery?” and “Are these expectations reasonable?”
Understanding—and setting—reasonable expectations is important because if a patient has an idea that the procedure will make them look one way, and it makes them look another, they may not be happy with the result.
“What is your motivation for getting the surgery?”
Understanding motivation is important because while a person who truly desires plastic surgery may be happy with the result, someone who is doing it for ulterior motives (like revenge or pressure) might not.
A good plastic surgeon only conducts procedures “when in line with personal desire,” not other people’s motives, says Darren Smith, MD, a board-certified plastic surgeon in Manhattan.
“There are tremendous pressures, especially on women, to look a certain way for personal or professional reasons, and plastic surgery can be seen as enabling that,” adds Smith. “When done for the right reasons (personal joy rather than in response to external pressures), plastic surgery is very personally empowering, it can be a way to realize one’s identity.”
Other important things to educate patients on beforehand include:
Potential complications or risks
The expected final look
These can all vary based on the procedure and the patient’s unique body, so it is important to talk to them one-on-one. How many pre-surgery discussions you have with a patient and how long they last can likewise vary from patient to patient and their wants or concerns.
With everything plastic surgery, “there’s not a one-size fits all,” says Broumand.
Can plastic surgeries be reversed?
Some plastic surgeries can be reversed or toned down. For example, surgeries that involve fat transfers—like some types of breast augmentations and the recently trending Brazilian Butt Lift (BBL), which involves liposuctioning fat from other parts of the body and implanting it on the butt, to create an intensified hourglass shape—may be adjusted by removing some of the fat with liposuction.
Surgeries that involve strictly fat removal, like buccal fat removal, may be mediated with fat transfer or fillers. Breast augmentations that involve implants may be adjusted by surgically removing the implants.
These kinds of reversals aren’t simple and don’t apply to every procedure. Further, it’s unlikely that a procedure can be reversed to the point where the patient’s body looks as it did when au naturale.
“A lot of women who've had Brazilian butt lifts, it's not so easy to reduce that volume and make it look great,” Broumand says.
His practice does not perform Brazilian Butt Lifts (BBLs), but the trend appears to be going out of style, he adds. If a patient wants a BBL removed, surgeons can use liposuction to remove some of the fat and smooth over the area, he says.
Hyaluronic acid fillers can be removed (dissolved) and are a good route for people who are looking to “test out” changes (largely facial) without making a forever commitment, says Broumand. Other types of fillers or injections like Botox (which takes time to dissipate after discontinuation) cannot be removed, he adds.
When not to operate on a patient
An ethical plastic surgeon may refrain from operating on patients who are pressured to get a procedure by someone else, have unrealistic expectations of the result, or suffer from conditions like body dysmorphic disorder (BDD).
Body dysmorphic disorder is a condition where a patient sees their body differently from reality, and this distorted reality impacts their ability to live normally, according to Johns Hopkins Medicine. It can be a result of or precursor to an eating disorder. For example, a person with BDD in an already-slim body may ask for a procedure to make them thinner.
“They'll come in and say, ‘I need liposuction,’” Broumand says. “That's a discussion we have to have with them—it's not often, but it does happen—where I'll say, ‘How you perceive yourself is not the reality.’”
Broumand does not operate on patients who present with body dysmorphic disorder for both ethical and logistical reasons (for some of these people looking for fat removal, there is no fat for him to remove anyway, he says).
“It’s not: do plastic surgery on everyone; it’s really: do the right thing on everyone,” Broumand says.