The Many Faces Of Cosmetic Surgery
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Cosmetic Surgery: What’s The Truth?
In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:
- About 48% said “Everyone should be able to get what they want, assuming informed consent”
- About 28% said “It can ease discomfort to bring features more in line with normalcy”
- 15% said “They should be available in the case of extreme disfigurement only”
- 10% said “No elective cosmetic surgery should ever be performed; needless danger”
Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion
So what does the science say?
The risks of cosmetic surgery outweigh the benefits: True or False?
False, subjectively (but this is important).
You may be wondering: how is science subjective?
And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.
Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):
- Regret rate for elective cosmetic surgery in general: 20%
- Regret rate for knee replacement (i.e., not cosmetic): 17.1%
- Regret rate for hip replacement (i.e., not cosmetic): 4.8%
- Regret rate for gender-affirming surgeries (for transgender patients): 1%
So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!
In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.
Sources for the above numbers, by the way:
- What is the regret rate for plastic surgery?
- Decision regret after primary hip and knee replacement surgery
- A systematic review of patient regret after surgery—a common phenomenon in many specialties but rare within gender-affirmation surgery
But it’s just a vanity; therapy is what’s needed instead: True or False?
False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.
How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.
- In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
- In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.
Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:
Does cosmetic surgery improve psychosocial wellbeing?
Some people will never be happy no matter how many surgeries they get: True or False?
True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:
❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.
For several reasons, it is important to recognise BDD in cosmetic surgery settings:
Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.
Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞
~ Dr. David Castle et al. (lightly edited for brevity)
Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.
Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.
After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.
And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:
Take care!
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The Twenty-Four Hour Mind – by Dr. Rosalind Cartwright
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We’ve reviewed books about sleep before, and even about dreaming, so what does this one have to offer that’s new?
Quite a lot, actually! Before Dr. Cartwright, there were mainly two models of sleep and dreaming:
- The “top-down” model of psychoanalysts: our minds shape our dreams which in turn reveal things about us as people
- The “bottom-up” model of neuroscientists: our brains need to go through regular maintaince cycles, of which vivid hallucinations are a quirky side-effect.
And now, as Dr. Cartwright puts it:
❝I will lay out a new [horizontal] psychological model of the twenty-four hour mind; that is, how the predominantly conscious (waking) and unconscious (sleeping) forms of mental behavior interact through the brain’s regular, but differently organized, states of waking, sleeping, and dreaming.❞
This she does in the exploratory style of a 224-page lecture, which sounds like it might be tedious, but is actually attention-grabbing and engaging throughout. This book is more of a page-turner than soporific bedtime reading!
Bottom line: if you’d like to know more about the effect your waking and sleeping brain have on each other (to include getting in between those and making adjutments as appropriate), this is very much an elucidating read!
Click here to check out The Twenty-Four Hour Mind, and learn more about yours!
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Tech Bliss – by Clo S., MSc.
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The popular idea of a “digital detox” is simple enough, “just unplug!”, they say.
But here in the real world, not only is that often not practical for many of us, it may not always even be entirely desirable. The Internet (and our devices with all their bells and whistles) can be a source of education, joy, and connection!
So, how to find out what’s good for us and what’s not, in our daily digital practices? Clo. S. has answers… Or rather, experiments for us to do and find out for ourselves.
These experiments range from the purely practical “try this to streamline your experience” to the more personal “how does this thing make you feel?”. A lot of the experiments will be performed via your digital devices—some, without! Others are about online interpersonal dynamics, be they one-on-one or navigating a world in which it seems everyone is out to get us, our outrage, and/or our money. Still yet others are about optimizing what you do get from the parts of your digital experience that are enriching for you.
As the title suggests, there are 30 experiments, and it’s not a stretch to do them one per day for a month. But, as the author notes, it’s by no means necessary to do them like that; it’s a workbook and reference guide, not a to-do list!
(On the topic of it being a reference guide…There’s also an extensive tools directory towards the end!)
In short: this is a great book for optimizing your online experience—whatever that might mean for you personally; you can decide for yourself along the way!
Click here to get a copy of Tech Bliss: 30 Experiments For Your Digital Wellness today!
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End the Insomnia Struggle – by Dr. Colleen Ehrnstrom and Dr. Alisha Brosse
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We’ve reviewed sleep books before, and we always try to recommend books that have something a little different than the rest, so what makes this one stand out?
While there is the usual quick overview of the basics that we’re sure you already know (sleep hygiene etc), most of the attention here is given to cold, hard clinical psychology… in a highly personalized way.
How, you may ask, can they personalize a book, that is the same for everyone?
The answer is, by guiding the reader through examining our own situation. With template logbooks, worksheets, and the like—for this reason we recommend getting a paper copy of the book, rather than the Kindle version, in case you’d like to use/photocopy those.
Essentially, reading this book is much like having your own psychologist (or two) to guide you through finding a path to better sleep.
The therapeutic approach, by the way, is a combination of Cognitive Behavioral Therapy (CBT) and Acceptance-Commitment Therapy (ACT), which work very well together here.
Bottom line: if you’ve changed your bedsheets and turned off your electronic devices and need something a little more, this book is the psychological “big guns” for removing the barriers between you and good sleep.
Click here to check out End the Insomnia Struggle, and end yours once and for all!
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Avoiding/Managing Osteoarthritis
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Avoiding/Managing Osteoarthritis
Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation).
Inflammatory vs Non-Inflammatory Arthritis
Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.
Some forms, such as rheumatoid arthritis, are of the inflammatory kind. We wrote about that previously:
See: Avoiding/Managing Rheumatoid Arthritis
You may be wondering: how does one get non-inflammatory inflammation of the joints?
The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause.
So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can; it’s just not the prime focus.
So, what should we focus on?
First and foremost: avoiding wear-and-tear if possible. Naturally, we all must live our lives, and sometimes that means taking a few knocks, and definitely it means using our joints. An unused joint would suffer just as much as an abused one. But, we can take care of our joints!
We wrote on that previously, too:
See: How To Really Look After Your Joints
New osteoarthritis medication (hot off the press!)
At 10almonds, we try to keep on top of new developments, and here’s a shiny new one from this month:
- Methotrexate to treat hand osteoarthritis with synovitis (12th Oct, clinical trial)
- New research has found an existing drug could help many people with painful hand osteoarthritis (24th Oct, pop-science article about the above, but still written by one of the study authors!)
Note also that Dr. Flavia Cicuttini there talks about what we talked about above—that calling it non-inflammatory arthritis is a little misleading, as the inflammation still occurs.
And finally…
You might consider other lifestyle adjustments to manage your symptoms. These include:
- Exercise—gently, though!
- Rest—while keeping mobility going.
- Mobility aids—if it helps, it helps.
- Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility.
- Only you can decide where to draw the line when it comes to that trade-off.
You can also check out our previous article:
See: Managing Chronic Pain (Realistically!)
Take good care of yourself!
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In Defense of Food – by Michael Pollan
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Eat more like the French. Or the Italians. Or the Japanese. Or…
Somehow, whatever we eat is not good enough, and we should always be doing it differently!
Michael Pollan takes a more down-to-Earth approach.
He kicks off by questioning the wisdom of thinking of our food only in terms of nutritional profiles, and overthinking healthy-eating. He concludes, as many do, that a “common-sense, moderate” approach is needed.
And yet, most people who believe they are taking a “common-sense, moderate” approach to health are in fact over-fed yet under-nourished.
So, how to fix this?
He offers us a reframe: to think of food as a relationship, and health being a product of it:
- If we are constantly stressing about a relationship, it’s probably not good.
- On the other hand, if we are completely thoughtless about it, it’s probably not good either.
- But if we can outline some good, basic principles and celebrate it with a whole heart? It’s probably at the very least decent.
The style is very casual and readable throughout. His conclusions, by the way, can be summed up as “Eat real food, make it mostly plants, and make it not too much”.
However, to summarize it thusly undercuts a lot of the actual value of the book, which is the principles for discerning what is “real food” and what is “not too much”.
Bottom line: if you’re tired of complicated eating plans, this book can help produce something very simple, attainable, and really quite good.
Click here to check out In Defense of Food, for some good, hearty eating.
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The Ultimate Booster
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Winning The Biological Arms Race
The human immune system (and indeed, other immune systems, but we are all humans here, after all) is in a constant state of war with pathogens, and that war is a constant biological arms race:
- We improve our defenses and destroy the attackers; the 1% of pathogens that survived now “know” how to counter that trick.
- The pathogens wreak havoc in our systems; the n% of us that survive now have immune systems that “know” how to counter that trick.
Vaccines are a mighty tool in our favor here, because they’re the technology that stops our n% from also being a very low number.
With vaccines, we can effectively pass on established defenses onto the population at large, as this cute video explains very well and very simply in 57 seconds:
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The problem with vaccines
The problem is that this accelerates the arms race. It’s like a chess game where we are able to respond to every move quickly (which is good for us), and/but this means passing the move over to our opponent sooner.
That problem’s hard to avoid, because the alternative has always been “let people die in much larger numbers”.
Traditional vs mRNA vaccines
A quick refresher before we continue to the big news of the day:
- Traditional vaccines use a disabled version of a pathogen to trigger an immune response that will teach the body to recognize the pathogen ready for when the full version shows up
- mRNA vaccines use a custom-made bit of genetic information to tell the body to make its own harmless fake pathogen and then respond to the harmless fake pathogen it made.
Note: this happens independently of the host’s DNA, so no, it does not change your DNA
See also: The Truth About Vaccines
Here’s a more detailed explainer (with a helpful diagram) using the COVID mRNA vaccine as an example:
Genome.gov | How does an mRNA vaccine work?
However, this still leaves us “chasing strains”, because as the pathogen (in this case, a virus) adapts, the vaccine has to be updated too, hence all the boosters.
This is a lot like a security update for your computer’s antivirus software. They’re annoying, but they do an important job.
No more “chasing strains”
The press conference soundbite on this sums it up well:
❝Scientists at UC Riverside have demonstrated a new, RNA-based vaccine strategy that is effective against any strain of a virus and can be used safely even by babies or the immunocompromised.❞
Read in full: Vaccine breakthrough means no more chasing strains
You may be wondering: what makes this one effective against any strain?
❝What I want to emphasize about this vaccine strategy is that it is broad.
It is broadly applicable to any number of viruses, broadly effective against any variant of a virus, and safe for a broad spectrum of people. This could be the universal vaccine that we have been looking for.
Viruses may mutate in regions not targeted by traditional vaccines. However, we are targeting their whole genome with thousands of small RNAs. They cannot escape this.❞
Importantly, this means it can be applied not just to one disease, let alone just one strain of COVID. Rather, it can be used for a wide variety of viruses that have similar viral functions—COVID / SARS in general, including influenza, and even viruses such as dengue.
How it does this: the above article explains in more detail, but in few words: it targets tiny strings of the genome that are present in all strains of the virus.
Illustrative example: if you wanted to block 10almonds (please don’t), you could block our email address.
But if we were malicious (we’re not) we could be sneaky and change it, so you’d have to block the new one, and the cycle repeats.
But if you were block all emails containing the tiny string of characters “10almonds”, changing our email address would no longer penetrate your defenses.
Now imagine also blocking strings such as “One-Minute Book Review” and “Today’s almonds have been activated by” and other strings we use in every email.
Now multiply this by thousands of strings (because genomes are much larger than our little newsletter), and you see its effectiveness!
Great! How can I get this?
It’s still in the testing stages for now; this is “breaking news” science, after all.
The study itself
…is paywalled for now, sadly, but if you happen to have institutional access, here it is:
Take care!
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