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:
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What are ‘collarium’ sunbeds? Here’s why you should stay away
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Reports have recently emerged that solariums, or sunbeds – largely banned in Australia because they increase the risk of skin cancer – are being rebranded as “collarium” sunbeds (“coll” being short for collagen).
Commercial tanning and beauty salons in Queensland, New South Wales and Victoria are marketing collariums, with manufacturers and operators claiming they provide a longer lasting tan and stimulate collagen production, among other purported benefits.
A collarium sunbed emits both UV radiation and a mix of visible wavelength colours to produce a pink or red light. Like an old-school sunbed, the user lies in it for ten to 20 minute sessions to quickly develop a tan.
But as several experts have argued, the providers’ claims about safety and effectiveness don’t stack up.
Why were sunbeds banned?
Commercial sunbeds have been illegal across Australia since 2016 (except for in the Northern Territory) under state-based radiation safety laws. It’s still legal to sell and own a sunbed for private use.
Their dangers were highlighted by young Australians including Clare Oliver who developed melanoma after using sunbeds. Oliver featured in the No Tan Is Worth Dying For campaign and died from her melanoma at age 26 in 2007.
Sunbeds lead to tanning by emitting UV radiation – as much as six times the amount of UV we’re exposed to from the summer sun. When the skin detects enough DNA damage, it boosts the production of melanin, the brown pigment that gives you the tanned look, to try to filter some UV out before it hits the DNA. This is only partially successful, providing the equivalent of two to four SPF.
Essentially, if your body is producing a tan, it has detected a significant amount of DNA damage in your skin.
Research shows people who have used sunbeds at least once have a 41% increased risk of developing melanoma, while ten or more sunbed sessions led to a 100% increased risk.
In 2008, Australian researchers estimated that each year, sunbeds caused 281 cases of melanoma, 2,572 cases of squamous cell carcinoma (another common type of skin cancer), and $3 million in heath-care costs, mostly to Medicare.
How are collarium sunbeds supposed to be different?
Australian sellers of collarium sunbeds imply they are safe, but their machine descriptions note the use of UV radiation, particularly UVA.
UVA is one part of the spectrum of UV radiation. It penetrates deeper into the skin than UVB. While UVB promotes cancer-causing mutations by discharging energy straight into the DNA strand, UVA sets off damage by creating reactive oxygen species, which are unstable compounds that react easily with many types of cell structures and molecules. These damage cell membranes, protein structures and DNA.
Evidence shows all types of sunbeds increase the risk of melanoma, including those that use only UVA.
Some manufacturers and clinics suggest the machine’s light spectrum increases UV compatibility, but it’s not clear what this means. Adding red or pink light to the mix won’t negate the harm from the UV. If you’re getting a tan, you have a significant amount of DNA damage.
Collagen claims
One particularly odd claim about collarium sunbeds is that they stimulate collagen.
Collagen is the main supportive tissue in our skin. It provides elasticity and strength, and a youthful appearance. Collagen is constantly synthesised and broken down, and when the balance between production and recycling is lost, the skin loses strength and develops wrinkles. The collagen bundles become thin and fragmented. This is a natural part of ageing, but is accelerated by UV exposure.
Sun-protected skin (top) has thick bands of pink collagen (arrows) in the dermis, as seen on microscopic examination. Chronically sun-damaged skin (bottom) has much thinner collagen bands.
Katie Lee/UQThe reactive oxygen species generated by UVA light damage existing collagen structures and kick off a molecular chain of events that downgrades collagen-producing enzymes and increases collagen-destroying enzymes. Over time, a build-up of degraded collagen fragments in the skin promotes even more destruction.
While there is growing evidence red light therapy alone could be useful in wound healing and skin rejuvenation, the UV radiation in collarium sunbeds is likely to undo any benefit from the red light.
What about phototherapy?
There are medical treatments that use controlled UV radiation doses to treat chronic inflammatory skin diseases like psoriasis.
The anti-collagen effects of UVA can also be used to treat thickened scars and keloids. Side-effects of UV phototherapy include tanning, itchiness, dryness, cold sore virus reactivation and, notably, premature skin ageing.
These treatments use the minimum exposure necessary to treat the condition, and are usually restricted to the affected body part to minimise risks of future cancer. They are administered under medical supervision and are not recommended for people already at high risk of skin cancer, such as people with atypical moles.
So what happens now?
It looks like many collariums are just sunbeds rebranded with red light. Queensland Health is currently investigating whether these salons are breaching the state’s Radiation Safety Act, and operators could face large fines.
As the 2024 Australians of the Year – melanoma treatment pioneers Georgina Long and Richard Scolyer – highlighted in their acceptance speech, “there is nothing healthy about a tan”, and we need to stop glamorising tanning.
However, if you’re desperate for the tanned look, there is a safer and easy way to get one – out of a bottle or by visiting a salon for a spray tan.
Katie Lee, PhD Candidate, Dermatology Research Centre, The University of Queensland and Anne Cust, Professor of Cancer Epidemiology, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Protein Immune Support Salad
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How to get enough protein from a salad, without adding meat? Cashews and chickpeas have you more than covered! Along with the leafy greens and an impressive array of minor ingredients full of healthy phytochemicals, this one’s good for your muscles, bones, skin, immune health, and more.
You will need
- 1½ cups raw cashews (if allergic, omit; the chickpeas and coconut will still carry the dish for protein and healthy fats)
- 2 cans (2x 14oz) chickpeas, drained
- 1½ lbs baby spinach leaves
- 2 large onions, finely chopped
- 3 oz goji berries
- ½ bulb garlic, finely chopped
- 2 tbsp dessicated coconut
- 1 tbsp dried cumin
- 1 tbsp nutritional yeast
- 2 tsp chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp MSG, or 1 tsp low-sodium salt
- Extra virgin olive oil, for cooking
Method
(we suggest you read everything at least once before doing anything)
1) Heat a little oil in a pan; add the onions and cook for about 3 minutes.
2) Add the garlic and cook for a further 2 minutes.
3) Add the spinach, and cook until it wilts.
4) Add the remaining ingredients except the coconut, and cook for another three minutes.
5) Heat another pan (dry); add the coconut and toast for 1–2 minutes, until lightly golden. Add it to the main pan.
6) Serve hot as a main, or an attention-grabbing side:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Cashew Nuts vs Coconut – Which is Healthier?
- What Matters Most For Your Heart?
- Beyond Supplements: The Real Immune-Boosters!
- Goji Berries: Which Benefits Do They Really Have?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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The Fiber Effect – by Nichole Dandrea-Russert
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The author, a registered dietician-nutritionist (RDN), brings to this work her decades of professional experience specializing in heart disease, diabetes, sports nutrition, and women’s health—and it shows.
The main premise is, of course “eat more fiber”, but she also talks us through what happens if we don’t, and how very many people (including 95% of Americans) suffer the consequences of a fiber-deficient diet, usually without even knowing that that’s the reason.
This book details the many different kinds of fiber (which is one of the reasons for consuming a wide variety of plants, not just one or two star-performers), what they do, what we need to prioritize for what, and more.
The recipes, of which there are 40 (enough to furnish us with a 14-day meal plan, which she does) are plant-based and varied.
The style is energetic and friendly, with plenty of (well-referenced) scientific information, but little-to-no jargon.
Bottom line: if you’d like to improve your fiber intake, then this book can help you supercharge that!
Click here to check out The Fiber Effect, and feel the difference!
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Top 10 Unhealthy Foods: How Many Do You Eat?
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The items on this list won’t come as a shocking surprise to you, but it can be a good opportunity to do a quick tally and see how many of these have snuck into your diet:
The things that take away health instead of adding it
Without further ado, they are…
- Alcohol: not only is it high in empty calories, but also it’s bad for pretty much everything, especially increasing the risks of liver disease, high blood pressure, and stroke.
- Processed snacks: low in nutrition; contain unhealthy fats, refined sugars, and artificial additives that often aren’t great.
- Potato chips: get their own category for being especially high in fat, sodium, and empty calories; contribute to heart disease and weight gain.
- Processed cheese: some kinds of cheese are gut-healthy in moderation, but this isn’t. Instead, it’s just loaded with saturated fats, sodium, and sugars, and is pretty much heart disease in a slice.
- Donuts: deep-fried, sugary, and made with refined flour; cause blood sugar spikes and crashes, and what’s bad for your blood sugars is bad for almost everything else.
- French fries & similar deep-fried foods: high in saturated fats and sodium; contribute to obesity and heart issues, are not great for blood sugars either.
- White bread: made with refined flour; cause blood sugar spikes and metabolic woes.
- Sodas: high in sugar or artificial sweeteners; can easily lead to weight gain, diabetes, and tooth decay.
- Processed meats: high in calories and salt; strongly associated with heart disease and cancer.
- Hot dogs & fast food burgers: get their own category for being the absolute worst of the above-mentioned processed meats.
This writer scored: no / rarely / no / no / no / rarely / rarely / rarely / no / no
How about you?
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You might also like to read:
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Gut-Healthy Spaghetti Chermoula
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Chermoula is a Maghreb relish/marinade (it’s used for both purposes); it’s a little like chimichurri but with distinctly N. African flavors. The gut-healthiness starts there (it’s easy to forget that olives—unless fresh—are a fermented food full of probiotic Lactobacillus sp. and thus great for the gut even beyond their fiber content), and continues in the feta, the vegetables, and the wholewheat nature of the pasta. The dish can be enjoyed at any time, but it’s perfect for warm summer evenings—perhaps dining outside, if you’ve place for that.
You will need
- 9oz wholewheat spaghetti (plus low-sodium salt for its water)
- 10oz broccoli, cut into small florets
- 3oz cilantro (unless you have the soap gene)
- 3oz parsley (whether or not you included the cilantro)
- 3oz green olives, pitted, rinsed
- 1 lemon, pickled, rinsed
- 1 bulb garlic
- 3 tbsp pistachios, shelled
- 2 tbsp mixed seeds
- 1 tsp cumin
- 1 tsp chili flakes
- ½ cup extra virgin olive oil
- For the garnish: 3oz feta (or plant-based equivalent), crumbled, 3oz sun-dried tomatoes, diced, 1 tsp cracked black pepper
Note: why are we rinsing the things? It’s because while picked foods are great for the gut, the sodium can add up, so there’s no need to bring extra brine with them too. By doing it this way, there’ll be just the right amount for flavor, without overdoing it.
Method
(we suggest you read everything at least once before doing anything)
1) Cook the spaghetti as you normally would, but when it’s a minute or two from being done, add the broccoli in with it. When it’s done, drain and rinse thoroughly to get rid of excess starch and salt, and also because cooling it even temporarily (as in this case) lowers its glycemic index.
2) Put the rest of the ingredients into a food processor (except the olive oil and the garnish), and blitz thoroughly until no large coarse bits remain. When that’s done, add the olive oil, and pulse it a few times to combine. We didn’t add the olive oil previously, because blending it so thoroughly in that state would have aerated it in a way we don’t want.
3) Put ⅔ of the chermoula you just made into the pan you used for cooking the spaghetti, and set it over a medium heat. When it starts bubbling, return the spaghetti and broccoli to the pan, mixing gently but thoroughly. If the pasta threatens to stick, you can add a little more chermoula, but go easy on it. Any leftover chermoula that you didn’t use today, can be kept in the fridge and used later as a pesto.
4) Serve! Add the garnish as you do.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Less Obvious Probiotics Benefits
- Making Friends With Your Gut (You Can Thank Us Later)
- What Matters Most For Your Heart? ← spoiler: this is why, while we do watch the sodium, we care more about the fiber
- All about Olive Oil: Is “Extra Virgin” Worth It?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
Don’t Forget…
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Walnut, Apricot, & Sage Nut Roast
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It’s important to have at least one good nut roast recipe in your repertoire. It’s something that’s very good for making a good dish out of odds and ends that are in your house, and done well, it’s not only filling and nutritious, but a tasty treat too. Done badly, everyone knows the results can be unfortunate… Making this the perfect way to show off your skills!
You will need
- 1 cup walnuts
- ½ cup almonds
- ¼ cup whole mixed seeds (chia, pumpkin, & poppy are great)
- ¼ cup ground flax (also called flax meal)
- 1 medium onion, finely chopped
- 1 large carrot, grated
- 4 oz dried apricots, chopped
- 3 oz mushrooms, chopped
- 1 oz dried goji berries
- ½ bulb garlic, crushed
- 2 tbsp fresh sage, chopped
- 1 tbsp nutritional yeast
- 2 tsp dried rosemary
- 2 tsp dried thyme
- 2 tsp black pepper, coarse ground
- 1 tsp yeast extract (even if you don’t like it; trust us; it will work) dissolved in ¼ cup hot water
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃, and line a 2 lb loaf tin with baking paper.
2) Heat some oil in a skillet over a moderate heat, and fry the onion for a few minutes until translucent. Add the garlic, carrot, and mushrooms, cooking for another 5 minutes, stirring well. Set aside to cool a little once done.
3) Process the nuts in a food processor, pulsing until they are well-chopped but not so much that they turn into flour.
4) Combine the nuts, vegetables, and all the other ingredients in a big bowl, and mix thoroughly. If it doesn’t have enough structural integrity to be thick and sticky and somewhat standing up by itself if you shape it, add more ground flax. If it is too dry, add a little water but be sparing.
5) Spoon the mixture into the loaf tin, press down well (or else it will break upon removal), cover with foil and bake for 30 minutes. Remove the foil, and bake for a further 15 minutes, until firm and golden. When done, allow it to rest in the tin for a further 15 minutes, before turning it out.
6) Serve, as part of a roast dinner (roast potatoes, vegetables, gravy, etc).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Chia Seeds vs Pumpkin Seeds – Which is Healthier?
- Apricots vs Peaches – Which is Healthier?
- Goji Berries: Which Benefits Do They Really Have?
- Ergothioneine: “The Longevity Vitamin” (That’s Not A Vitamin)
Take care!
Don’t Forget…
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