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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Learn to Age Gracefully
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13 Things Mentally Strong Couples Don’t Do – by Dr. Amy Morin
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The saying “happy wife; happy life” indeed goes regardless of gender. One can have every other happiness, but if there’s relational trouble, it brings everything else down.
This book is not intended, however, only for people whose relationships are one couple’s therapy session away from divorce. Rather, it’s intended as a preventative. Because, in this as in every other aspect of health, prevention is better than cure!
It is the sign of a strong couple to be proactive about the health of the relationship, and work together to build and reinforce things along the way.
The style of this book is very accessible pop-science, but the author speaks from a strong professional background in social work, psychology, and psychotherapy, and it shows.
Bottom line: if you’d like to strengthen your relationship skills, this book gives 13 great ways to do that.
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Pinch Of Nom, Everyday Light – by Kay Featherstone and Kate Allinson
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One of the biggest problems with “light”, “lean” or “under this many calories” cookbooks tends to be the portion sizes perhaps had sparrows in mind. Not so, here!
Nor do they go for the other usual trick, which is giving us something that’s clearly not a complete meal. All of these recipes are for complete meals, or else come with a suggestion of a simple accompaniment that will still keep the dish under 400kcal.
The recipes are packed with vegetables and protein, perfect for keeping lean while also making sure you’re full until the next meal.
Best of all, they are indeed rich and tasty meals—there’s only so many times one wants salmon with salad, after all. There are healthy-edition junk food options, too! Sausage and egg muffins, fish and chips, pizza-loaded fries, sloppy dogs, firecracker prawns, and more!
Most of the meals are quite quick and easy to make, and use common ingredients.
Nearly half are vegetarian, and gluten-free options involve only direct simple GF substitutions. Similarly, turning a vegetarian meal into a vegan meal is usually not rocket science! Again, quick and easy substitutions, à la “or the plant-based milk of your choice”.
Recipes are presented in the format: ingredients, method, photo. Super simple (and no “chef’s nostalgic anecdote storytime” introductions that take more than, say, a sentence to tell).
All in all, a fabulous addition to anyone’s home kitchen!
Get your copy of “Pinch of Nom—Everyday Light” from Amazon today!
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How Beneficial Is MCT Oil, Really?
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Often derived from coconuts (though it doesn’t have to be), medium-chain triglycerides (MCTs) are trendy… But does the science back the hype?
First, the principle
MCTs are commonly enjoyed because unlike short- or long-chain fatty acids, they can be quickly broken down and either immediately converted quickly and easily into energy, or turned into ketones in the case of a surplus (in the case of true excess, however, it’ll simply be stored as fat).
Most of that involves the liver, so for anyone who wants a refresher on liver health:
How To Unfatty A Fatty Liver ← notwithstanding the title, this is also important knowledge even if your liver is healthy now—if you’d like it to stay healthy, anyway!
You can also read about the ins and outs of glycogen metabolism and the body’s energy-based metabolic processes in general (including the body’s energy processes that go on in the liver), here:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
If the liver turns the MCTs into ketones, those ketones will then be used for energy if there is insufficient glucose available (as the body will always use glucose from the blood first, if available, before moving to alternative energy sources such as ketones and/or fat reserves.)
Thus, many people look to ketones as a solution for having enough energy to function while on a very low-carb diet such as the ketogenic diet:
Ketogenic Diet: Burning Fat Or Burning Out?
…which as you’ll recall, does work for short-term weight loss, but brings long-term health risks, so should not be undertaken for long periods of time.
So, does MCT Oil help?
With regard to weight loss, the research is weak and mixed:
- Weak, because often the methodology was shoddy, often there are many factors not controlled-for, and often the sample sizes were small (and also, RCTs by their very nature tend to be quite short-term (often 6, 8, or 12 weeks), whereas heavy reliance on ketones from MCTs may fall into the same long-term problems as the ketogenic diet in general).
- Mixed, because the results varied widely (probably because of the aforementioned problems).
Rather than pick at individual studies, let’s look at this review and meta-analysis of 13 studies, with a combined sample size of 749 people (so you can imagine how small the individual RCTs were):
❝Compared with LCTs, MCTs decreased body weight (-0.51 kg [95% CI-0.80 to -0.23 kg]; P<0.001; I(2)=35%); waist circumference (-1.46 cm [95% CI -2.04 to -0.87 cm]; P<0.001; I(2)=0%), hip circumference (-0.79 cm [95% CI -1.27 to -0.30 cm]; P=0.002; I(2)=0%), total body fat (standard mean difference -0.39 [95% CI -0.57 to -0.22]; P<0.001; I(2)=0%), total subcutaneous fat (standard mean difference -0.46 [95% CI -0.64 to -0.27]; P<0.001; I(2)=20%), and visceral fat (standard mean difference -0.55 [95% CI -0.75 to -0.34]; P<0.001; I(2)=0%).
No differences were seen in blood lipid levels.
Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected.❞
So, if we’re going to take those numbers at face value, that means a net weight loss, over the course of the trial period, was…
*drumroll*
0.51kg (that’s about 1 lb).
To put that into perspective, if you did nothing else but pee 1 cup of urine before getting weighed, you’d register as having lost 0.25kg (or about ½ lb) by virtue of the bathroom trip alone.
Here’s the paper:
What about cholesterol and heart health?
With regard to cholesterol, MCT oil is touted as improving blood lipids, which means lowering LDL and increasing HDL (within a safe range, anyway).
You’ll remember that the above review concluded “No differences were seen in blood lipid levels”.
It may again be a case of individual studies cancelling each other out. For example…
This study found that it improved lipids in 40 young women as part of a calorie-controlled interventional diet:
This study found that it worsened lipids in 17 young men, worse even than taking an equivalent amount of sunflower oil:
In short, it’s a gamble.
It may be good for insulin sensitivity, though
This one seems to be specific to people with type 2 diabetes. The paper heading says it all, but we include the link in case you want to know the details (the short version is, it improved insulin sensitivity in diabetic subjects only (not others), and didn’t affect anything else that was measured:
The sample size was small (20 people total, of whom 10 had diabetes), and the next study was with 40 people, this time moderately overweight and all with type 2 diabetes:
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Supergreen Superfood Salad Slaw
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
When it comes to “eating the rainbow”, in principle green should be the easiest color to get in, unless we live in a serious food desert (or serious food poverty). In practice, however, a lot of meals could do with a dash more green. This “supergreen superfood salad slaw” is remarkably versatile, and can be enjoyed as a very worthy accompaniment to almost any main.
You will need
For the bits:
- ½ small green cabbage, finely diced
- 7 oz tenderstem broccoli, finely chopped
- 2 stalks celery, finely chopped (if allergic, simply omit)
- ½ cucumber, diced into small cubes
- 2 oz kale, finely shredded
- 4 green (spring) onions, thinly sliced
For the dressing:
- 1 cup cashews (if allergic, substitute 1 cup roasted chickpeas)
- ½ cup extra virgin olive oil
- 2 oz baby spinach
- 1 oz basil leaves
- 1 oz chives
- ¼ bulb garlic
- 2 tbsp nutritional yeast
- 1 tbsp chia seeds
- Juice of two limes
Method
(we suggest you read everything at least once before doing anything)
1) Combine the ingredients from the “bits” category in a bowl large enough to accommodate them comfortably
2) Blend the ingredients from the “dressing” category in a blender until very smooth (the crux here is you do not want any stringy bits of spinach remaining)
3) Pour the dressing onto the bits, and mix well to combine. Refrigerate, ideally covered, until ready to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Spinach vs Kale – Which is Healthier?
- Brain Food? The Eyes Have It!
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What Different Kinds of Hair Loss/Thinning Say About Your Health
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Dr. Siobhan Deshauer shows us different kinds of hair loss, what causes them, and what can be done about them:
Many different causes
Here’s how to tell them apart:
- Alopecia areata is an autoimmune condition where the immune system mistakenly attacks hair follicles, causing hair loss that can occur at any age and affects about 1 in 50 people. It often presents as smooth patches of hair loss and can be treated with steroid injections. Severe cases may require high-dose prednisone, which can restore hair growth over time.
- Discoid lupus is an autoimmune disease that affects the skin, leading to inflammation, scarring, and permanent hair loss. Unlike alopecia areata, it causes visible damage to the scalp and hair follicles. This type of lupus typically does not involve internal organs, unlike systemic lupus.
- Telogen effluvium occurs when a major systemic shock, such as an infection, surgery, or significant stress, triggers many hair follicles to enter the resting phase simultaneously, resulting in delayed hair shedding. The condition is diagnosed with a “hair pull test” and is typically temporary, as the resting phase is followed by normal hair growth phases.
- Allergic reactions to products, such as hair dye containing PPD, can cause hair loss due to scalp irritation and inflammation. An allergic response may trigger hair follicles to enter a resting phase, leading to hair loss by the same mechanism as telogen effluvium. Treatment with steroids can calm the reaction, and hair usually regrows after recovery.
- Syphilis, a sexually transmitted infection, can present with varied symptoms, including hair loss in a distinct moth-eaten pattern. Hair loss due to syphilis is reversible and curable with penicillin treatment, with hair regrowth typically occurring a few months after treatment.
- Biotin deficiency is rare due to its production by gut bacteria and presence in foods such as nuts, seeds, and beans such as soybeans. Deficiency can result from excessive consumption of raw egg whites, which block absorption. Severe deficiency causes hair loss and skin issues but can be treated effectively with biotin supplements.
- Iron deficiency anemia can cause hair thinning along with symptoms like fatigue and breathlessness. It often results from inadequate dietary intake, but can also occur after heavy menstrual bleeding. Treatment with iron supplements, or blood transfusions in severe cases, can restore both hair and energy levels, leading to significant improvements.
- Trichotillomania is a psychological condition marked by an uncontrollable urge to pull out one’s hair, often associated with anxiety or depression. Hair patches may show different stages of regrowth. While it can be challenging to manage, the condition can be treated with appropriate psychological and medical support.
- Traction alopecia results from hairstyles that exert prolonged tension on the hair, causing it to thin or fall out. This type of hair loss can be prevented by reducing the strain on the hair. Loosening hairstyles and giving the scalp a break can help hair regrow over time.
- Hypothyroidism causes symptoms like fatigue, dry skin, and hair thinning due to insufficient thyroid hormone production—however, it can be managed with diet, and if necessary, thyroid medications.
- Zinc deficiency may also cause hair loss and a characteristic rash. Treatment with zinc supplements can significantly improve hair growth and other symptoms.
- Medications, such as chemotherapy drugs, Accutane, and anti-seizure medications like valproic acid, are known to cause hair loss as a side effect. This type of hair loss is often reversible once the medication is stopped.
- Male pattern hair loss, or androgenic alopecia, is influenced by testosterone and genetic risk factors—which, contrary to popular belief, can come from either or both sides of the family. Early onset, especially before age 40, is linked to an increased risk of heart disease. However, effective treatments are available, and early intervention is beneficial.
- Female pattern hair loss is basically the same thing as male pattern hair loss (indeed, it is literally still androgenic alopecia), just a) almost always much less severe and b) with a gender-appropriate name. It affects up to 40% of women by age 50 and is characterized by thinning hair at the top of the head. It’s related to hormonal imbalances involving testosterone, such as those seen in PCOS and menopause, amongst other less common causes. Early treatment can be effective, and research is ongoing to develop more targeted therapies.
Dr. Siobhan Deshauer advises, if you’re experiencing hair loss, to monitor other symptoms too if applicable, take photos for tracking, and consult a doctor early for diagnosis and potential treatment.
For more on all of this plus visual illustrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Big Think’s #1 Antidote To Aging
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Why This Video Is Important
A lot of what we talk about here at 10almonds is focused on healthy aging. We want you – our lovely readers – to not only live for a long time, but also be healthy enough to enjoy that “long time”.
We’ve talked about anything from Dr. Greger’s eight anti-aging interventions, to the specific benefits of resveratrol or metformin in combatting aging, to even reducing stress-induced aging.
So, why is this video important? It goes beyond just talking about what we know about living longer, but also focuses on how we should live longer; there’s a big difference between living a long life but never leaving your house vs. living a long life beyond your front door.
The Takeaways
The core message that Big Think wants to convey is that our lifestyle is our best bet in slowing the aging process. Our bodies are adaptive systems, responding positively to healthy lifestyle choices. They focus on exercise: regular physical activity increases healthspan, consequently extending lifespan.
A key takeaway is the difference between physical activity and exercise. While any movement counts as physical activity, exercise is a deliberate, health-focused activity. It benefits the brain by releasing growth factors that strengthen critical areas like the hippocampus and prefrontal cortex.
The video encourages embracing physical activity in any form available to you, from gardening to walking. The goal isn’t to hit a specific number of steps but to stay active in a way that suits your lifestyle.
Science may not solve death. Yet. But focusing on maintaining a healthy, functioning state for as long as possible is the real victory in the battle against aging. And, at the moment, exercise seems to be our best bet:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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