1. The "Vampire Face Lift"
What Allure says: This ghoulish-sounding treatment for the signs of aging was introduced in 2009 and has since been mentioned on 200,000 Web pages. It involves injecting the patient's own pale yellow blood plasma around the eyes and mouth, borrowing a technique used to promote healing after orthopedic surgery. It's not actually a face-lift, and it's not FDA approved for use in the face. There are no independent studies proving its cosmetic benefits, though some doctors believe the growth factors in plasma can gradually stimulate collagen production. For results that will be noticed immediately, doctors often add Juvéderm, a hyaluronic acid filler, to the plasma, creating confusion about which substance is doing the plumping. Since plasma extraction can add more than $1,000 to a filler bill, many dermatologists now recommend that patients stick with a wrinkle-fighting method that's proven to work, such as a filler used on its own.
What I think: There's no proof adding blood to the filler does anything, so just get the filler and save yourself the blood draw (and some serious cash).
2. The Stem Cell Facelift
What Allure Says: They may be the great hope of modern medicine, but stem cells—those blank slates of the body that can turn into nerves, bones, or cartilage—have yet to revolutionize aesthetic surgery. It's been a decade since scientists discovered that fat happens to be loaded with the cells. Almost immediately, surgeons began to claim—with no proof—that the stem cells in fat improved skin quality and started calling fat injections a stem-cell face-lift, says Rod J. Rohrich, chair of plastic surgery at the University of Texas, Southwestern, in Dallas, and the coauthor of a recent paper on the subject. But the idea that fat injections could replace a traditional face-lift is "high on marketing and short on science," Rohrich says. "Stem cells have great promise, but there is so much conjecture." Currently, there is no FDA-approved device to separate stem cells from fat and no consensus on the number of cells needed for rejuvenation or how many treatments are necessary. "We don't even know if stem cells are critical—or if they are doing anything at all," says Rohrich.
What I Think: Kind of like the vampire facelift - there's no proof the stem cells do anything. The fat cells can replace lost volume and are a valuable adjunct to traditional facelifts, but they can't replace them. Sorry, but as of now, when you have sagging jowls and a turkey neck, the only solution is a real facelift.
3. Scultpra and Artefill for Lips
What Allure Says: Approved in 2004 for patients with facial wasting (a hollow-cheeked appearance usually associated with HIV infection), Sculptra is a chemical that can be injected into the face to stimulate collagen growth. "You put it in and watch it grow over a period of months," says Claudio DeLorenzi, a plastic surgeon in Kitchener, Canada, who says the best results are seen in the temples and cheeks. But one place it should never be used, says DeLorenzi, is in the lips: "It can result in ugly bumps and lumps, or the lips may end up a size that no one counted on." Similarly, Artefill, a mixture of Plexiglas-like beads and cow collagen, is approved only for filling smile lines. As the collagen is absorbed, the body forms scar tissue around the beads, DeLorenzi explains. "In the lips, this can result in clumps and nodules, and there is no way to get rid of the stuff other than to cut it out." Cosmetic surgeons often disagree, but on this subject they are virtually unanimous: Only temporary fillers such as Juvéderm and Restylane should be used in the lips.
What I Think: I agree that Juvederm is the best for temporary lip augmentation, but I would add that soft silicone lip implants are a great option for patients that want a permanent solution.
4. Silicone Cheek Implants
What Allure Says: The news for women who want to add volume to their cheeks is good: Facial fillers have all but replaced the silicone implants that were standard in the '90s. Back then, implants were anchored below the skin, adding plumpness that in some cases, like that of surgical early adopter Jocelyn Wildenstein, verged on the extreme. "Implants can migrate and cause infection and nerve injuries, and the aesthetic result is difficult to reverse," says Stafford Broumand, an associate clinical professor of plastic surgery at Mount Sinai Medical Center in New York City.
5. Fat Injections For Breasts
What Allure Says: There's a good reason "fat injection" is the latest catchphrase in cosmetic breast augmentation. The results look good and feel natural, and unlike a scalpel, the needles leave no scars. But there are often downsides. Multiple procedures may be necessary and, with few exceptions, provide, at most, a one-cup-size enlargement. A study by Mihye Choi, an assistant professor of plastic surgery at NYU School of Medicine, found that half the volume created by shots of fat disappears into the body within months. More worrisome, there is concern that, years later, stem cells in the fat might stimulate cancer.
What I Think: I agree and would add that fat grafting can also leave breasts looking and feeling lumpy. I also agree that the future of augmenting anything - the face, breasts and butt - is fat grafting, but in 2016 and for breasts, we're just not there yet. For now, stick with safe, proven and soft (!) breast implants.
6. Butt Implants
What Allure Says: Brazilians are famously adventurous when it comes to surgery—they invented the "full-body lift," after all—but the nation's thong-wearing beachgoers have turned their backs on butt implants. "Even in the hands of expert surgeons, the reoperation rate for gluteal augmentation with implants is 13 to 25 percent," says John Sherman, a surgeon at Weill Cornell University Medical College in New York City who surveyed studies on the subject. "You're putting an implant in a place where there is no anatomical pocket and then constantly sitting on it," says Sherman, who does not perform the surgery. Risks include infection, wound opening, loss of feeling, and extrusion. As a result, fat injections in this part of the body have become more common.
What I Think: Totally agree. It's also hard to place the implant low enough to look good without injuring the sciatic nerve, so the implants are often placed too high, creating a "double bubble" look that is not attractive. Fat grafting (the Brazilian Butt Lift) is much better and "kills two birds with one stone" by also improving the area of the body that is liposuctioned in order to obtain the fat for grafting.
7. Zerona, the fat removing laser
What Allure Says: This high-tech slimming technique promises to help patients lose inches without the drudgery of dieting, with maybe just a little unpleasant tingling. The patient lies on a table—20 minutes on the back, 20 on the stomach—while a red laser flashes from the machine's arms to target and drain fat deposits below the skin. When combined with diet, exercise, and supplements that flush fluid from the body, some people do lose body fat—a half-inch here, a half-inch there—but not the rolls of fat that many want to get rid of. Nobody can say for sure how much is caused by the lasers and how much is the result of diet and exercise (although the laser on its own caused fat loss in a Zerona-sponsored clinical trial). For patients who report no benefit at all from a full course of six sessions costing $1,700,Zerona is, in the words of one critic, "a wallet-ectomy."
What I Think: If there really was a light that you can shine on yourself and lose fat, don't you think everyone would be doing it? Enough said.
Now don't get me wrong, I love technology and science, but that doesn't mean I jump on the bandwagon of the latest and sexiest thing out there. New procedures are constantly being introduced and it's my job to keep up. That's why I read journals and attend meetings. Once I'm convinced a new treatment is effective, safe and reasonably priced, I'll offer it to my patients. So, if you see something we offer, you know you can trust it.