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How Do You Do Your Research Before Deciding on the Procedures?

  • ChaCha21
  • 10 months ago

Hi! Besides this RealSelf site, how do you ladies (and gents) do your research before deciding on which procedures to do? Do you mostly read what the doctors say, or look at the reviews (the bad and the good) from people who have already had surgery? It's seems like there's so much conflicting information, how do you know what to believe? Do you look up statistics? How do you know when to move forward without being concerned that bad results might happen? With liposuction, do you think that being at your most healthy weight for a long time is a must? I know, I've asked a lot of questions here... Any tips you guys use would be appreciated. Thanks.

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Ladies,

For the moment I'm closing this thread to future comments. The intention of this thread, is no longer what it is being used for and is not within the spirit of RealSelf. People will still be able to read past comments, but for the moment, will not be able to post new comments.

Kirsty

Calgarygirl aka .... Look, if you want to have an actual conversation or discussion I am all for it. However again you seem to be persistent in making personal jabs. So, let's see. I had a well regarded physician do the surgery. The name of his business does not mean he is not qualified to do the type of work he does there. He not only has been a practicing physician for over 20 years and who holds a position at a top rated hospital, but also: He holds academic positions at Tufts University of Medicine and Umass Medical School. He is a fellow of the American Society of Laser Medicine and Surgery. I find it odd that you act as if my physician (read: M.D.) is more a red flag than having a Physician's Assistant (who by the way is associated with a Dr. who is being held to a few lawsuits and the subject of many horror stories online; and who because he lied on his license papers was operating under a probationary license; this information is all in the public domain by the way). So that is that. As far as getting old and aging; well I find it odd that I experienced this redistribution one year after the procedure. Hmm...did I age that fast? I know women of similar ethnicity and body type as me (same age) and they do not have the same physical changes. I see your poke at Cha Cha by saying: change your lifestyle, eat less and exercise more. I can only guess that your reaction to that statement (which you misunderstood) comes from a painful place. I get that. But this is a serious issue. People's life, health, and well being are at stake. So you say that lipo isn't the cause of the changes in my body even though you have no idea if this is true or not. I consulted with a plastic surgeon and she confirmed the fat redistribution and she said she worries for her patients because they keep coming back wanting other areas done (because the fat begins to grow there). She also said my abdomen and sides are empty skin. Elastocity she called it. Hmmm...I wonder how that happened? She did not say: well you know when you age you will experience empty skin rolls all in the time span of one year. So understanding what lipo does to the body you have to follow a path. First you see that lipectomy causes metabolic syndrome in rodents. Then you see that metabolic syndrome is associated with cancers and insulin resistance. In fact insulin resistance is correlated with the amount of fat taken. And again, it does cause fat redistribution including an increase in visceral fat (yikes!). Plus fat mobilization in the blood stream. I could go on. But you can *say* these things are not so, however there is more and more evidence that supports these findings. Finally, the bit about the doctor not being good enough? Well it's really more about what happens when fat is removed, what the biology of the body and fat is about. Of course you want a doctor (preferably and M.D.)who is good enough that he won't perforate your bowel while he's in there! I realize you just had the surgery done. I realize you had it done years ago as well (I wonder if.... well never mind). And I realize that people do not want to believe something they can't take back is harmful. And perhaps you won't be harmed. I hope not. It's hard for me to understand though your vitriol. Especially since it is not in the spirit of Real Self guidelines. And I have no idea where you keep getting this 80% number of happy patients. "even a year out".
Calgarygirl74 aka .... The short article I found about the study you mentioned (from MedPageToday) says, "Conney stressed in a press release that it remains unclear whether liposuction, conventional weight loss, or other methods of eliminating body fat would affect human skin cancer risk. ""We don't know what effect fat removal would have in humans," he said. The article said that they fed the mice a high fat diet, and then exposed twice a week to high-energy ultraviolet light for 33 weeks. In contrast, no effect on skin cancer rates was seen in mice fed a low-fat diet and subjected to lipectomy.
It he most important thing is to pick the right specialist. You went to a facial/laser hair removal spa to get your lipo done. Did an experienced doctor even perform this? I've never heard of a plastic surgeon working out of a esthetic spa. Big red flag. I'm sorry you had bad results and believe that your weight gain in other places could be from lipo. Lipo does not cause fat redistribution, however thing that might are getting old, it's called aging! The best thing you can do to fight this is eat less and exercise more! Don't blame the lipo, change you lifestyle. Things tend to slow down as you get up in age! Plenty of studies support the health benefit of removing fat. A controlled study on rats showed removal of abdominal fat significantly reduced cancer rates! Look it up. Plenty of evidence from 80% or more of happy clients post lipo, yes even a year or more post op! Good luck to you!
Hi Calgarygirl; I am so glad you brought up this study! That is because it points out how studies can be conducted in ways that seem to support a biased opinion. Dr. Raffi Gurunluoglu (University of Colorado Health Sciences Center, Denver) points out these biases. He calls them: subjective evaluation bias. He remarks that those biases could be "significant". And here is why: "Use of additional outcome parameters to assess fat re-accumulation and redistribution would have strengthened the presented data and provided more evidence on the subject," according to Gurunluoglu. Use of abdominal or limb circumference measurements, subcutaneous skinfold measurements, or possibly even magnetic resonance imaging scans would have added more evidence. The study was a prospective study and used subjects on which the doctor who authored the study performed himself. That also is a bias to consider. And the sample size was pretty small. According to the medwire article: To Gurunluoglu, however, the photographic documentation in these patients was not originally designed to measure changes in shoulder width, mid-humeral width, and upper abdominal width, and this weakens the conclusions regarding fat redistribution. Dr. Gurunluoglu is the Director, Plastic and Reconstructive Surgery, Denver Health, a professor at the University of Colorado, School of Medicine, Department of Surgery. He does reconstructive plastic surgery (like for accidents, cancer, burns etc) and his credentials are: Ph.D, Anatomy, Marmara University Institute of Health Sciences Fellowship, Department of Plastic and Reconstructive Surgery, The Cleveland Clinic Foundation Research and Clinical Fellowship, Department of Plastic and Reconstructive Surgery, Leopold-Franzens University. (His research interests are: Flap physiology, angiogenesis, gene therapy, transplantation of composite allografts, breast reconstruction) So I guess I would not conclude from Swanson's "study" that lipo does not cause fat redistribution. There are many researchers who do not find that is so. I would say that Swanson's study is limited and suffers from biases along with a small sample size. It is good though for us to look at these studies so that we can gain a clear understanding of how studies are conducted and what makes them worthwhile a trustworthy or not. And it's good to read beyond the abstract as well, because many artifacts can be found that reveal these truths.
Lipo does not cause fat redistribution. http://www.ncbi.nlm.nih.gov/pubmed/22842428
I came online with questions about various plastic surgery procedures. I've now seen disturbing photos and read stories of some very bad results. These stories took me by surprise, and outraged me. The surgeons I consulted with seemed too ready to cut up my body in ways that I found outrageous. I apologize to you, calgarygil74. My intentions were not to be rude, but to clarify and ask questions in order to gain understanding; you cut and pasted the questions that I asked you out of context. Sundogcoyote, I learned a lot from you, thank you. Jenni, thanks for offering the studies, although we interpret them so very differently.
There is no misunderstanding here. You did direct the question at me twice as well as make general and negative judgemental comments about people who choose lipo and you assume they have not dieted or exercised enough. So rude and negative! You wrote. 'If you were already eating healthy diet and working out with your trainer 3-4 times a week, are you going to eat less and exercise more to keep the fat off now? I'm just not understanding how this works' It is clear you are anti cosmetic surgery. Therefore I don't understand why you are on Realself.
This is a great study. No research is more important than how women feel after a procedure. How wonderful that they have compiled and published this data. Anyone that would suggest a woman's post op opinion is silly is not the type of negative person I associate with. Misery loves company. Time to get of this negative thread.
And did I read your post right? Are you judging me for having 9 pounds removed? Are you suggesting I'm not a good candidate because you feel I removed too much? What did you mean by that exactly? And do you think you are above the law, the medical community, the regulators? They determine which procedures are allowed by law and who can perform them. I'll trust the professionals over an Internet activist. I'm sorry you had a terrible experience with smart lipo. But you don't represent the thousands of women who have had wonderful experiences. Your research is bogus. I know so many first hand success stories, and I had lipo for saddlebags and a breast augmentation 10 years ago and it was amazing. No fat redistribution, no health issues, no problems. Go ahead and judge that now.
I'm sorry for the misunderstanding, calgarygirl74. My comment about diet and exercise was not directed at you. That's one of the problems with the internet. I asked this question about how to research months ago as a woman seeking information. No one answered for a long time. In that period of time I did a lot of my own research, and my perspective changed. i went to plastic surgeons, and as you said, they seemed intent on cutting, and each one had a different opinion. How would I (or anyone) know what right if each surgeon has a different opinion? There are many dangers to surgery. I just didn't realize the extent before.
Well this is again how people get angry when something like this is questions. And that's fine, I respect your opinion/thoughts etc. I wasn't actually judging you about 9 lbs. I was just surprised because from what I have read on doctor's advertising is that lipo is for 'stubborn pockets of fat'. And it is 'not a weight loss procedure'. I do hate to think you took what I said as a judgment. My research is not bogus however. It's just scientific. I think science is important. How do you know I am not a research scientist by the way? I am not conducting research but I do a LOT of research. That is pretty much where I am coming from. I wouldn't use my own personal experience as evidence of anything. It just sparked my interest. 80-90% of women who got lipo are not happy with it. I'm not sure how you can say that, because there is no relevant study that shows that. Even on this site the 'worth it' rating is around 75%. Liposuction was a horrible procedure when it first came around. Lots of blood loss etc and so doctors didn't want to do it. I am not being rude; I am actually making an effort to be detached and respectful; I am sorry you feel differently (and really, ,I am sorry you thought that I was judging you). I think there are metabolic disorders that make it so people cannot lose weight. So not judging that way either; I hate to exercise. I wish lipo worked. I think if a person is very overweight, perhaps they are happy with the results of losing some of the fat. But there are men who just had breast fat removed who have had problems. I am not ChaCha. I guess I can't prove that to you. But I understood her point from a different thread where people were saying that they gained weight after lipo and also physicians/researchers who said that the body mass is less and so less food is needed. So that means a person has to eat less than before because his/her body is smaller. I think that's what she meant. The re-distribution issue is not a theory. It's been proven. Doctor's know about it. As far as laws go, well that is something that is changing; regulations are being put on this industry which has really been a free-for-all. I mean, a gynecologist can take a seminar on lipo, buy a machine and do the procedure. Personally, I think people should be protected from that. I think doctors think they are above the law actually. Think about the consent forms that protect them, not the patient. Think about the patients who are asked to sign them while under sedation. As far as commenting on this thread..it was started by ChaCha and you commented here. So, you know, it's not that anyone is singling you out or needs your permission to comment to you on this thread. I just think that you are taking an honest back and forth discussion personally (that could be my fault for asking you that question, which I apologized for, I just didn't understand if that's what you meant). And again, I am not against cosmetic procedures. I love botox, I had other procedures done which I am happy with. I don't equate fat removal with those things. Fat is an organ. It's different. I have not judged anyone. Not you, or anyone on any other thread. (you can look at my comments). I just don't see how presenting facts is conflated with being judgmental. If you are happy and had no fat re-distribution I am happy FOR you. But I won't be bullied by you either. I never called you "rude" or "judgmental", nor did I accuse you of having multiple accounts here, I did not call you "one sided". I don't use "jargon". I didn't provoke you (e.g."go ahead and judge that now") I have been "supportive" of others here. Because of the pain and suffering of myself and others, I have studied this a lot. Because of my position I have access to almost every medical and science journal; so I utilize that to help me understand this procedure better. There are people on this site who talk people INTO a procedure based on their own 1 month post op experience. Do you think that is ethical? I don't know.. I understand it, but I don't see the difference then between that and telling someone to research the procedure before she commits to it. Again, not rude, not disrespectful, not judging, but really just caring for people.
You are not a doctor, a research scientist, and I did not solicit you or chacha's advice on how negative lipo is. We all have the Internet, thanks. We're all informed and just as smart as you. Your statistics and information are one sided and wrong. Lipo doesnt have a great history? really? So 80-90% of hapoy women are wrong? How rude of you to suggest that. For chacha21 ( probably your other userid) to suggest people don't try everything like diet and exercise is so judgemental and wrong. How dare you judge people that way? How dare you assume you know anything about people and their personal struggles and stories? For her to repeatedly push and ask people if they will eat less and exercise more after lipo is rude! Your fat redistribution theory is bogus. There are many success stories to prove you wrong. If you are against plastic surgery, cosmetic enhancements etc...then this is not the website for you. This community of support, trust, and sharing, not negative unproven jargon and judgemental behaviour. I saw your post trying to talk a girl out of plastic surgery. That is not appropriate. Shame on you!
Hi calgarygirl 74. Asking questions before having surgery is a really good thing in my opinion. I agree that some surgeons are spreading themselves thin by performing too many so many different procedures rather than choosing a select few to master! Thank you for pointing that out. By reading other stories it looks like that's a point -that many people with access to the same internet - have not considered. Asking questions and engaging in conversation is how I learn. Because questions that others on this site have asked, and their conversations which I read, I am able to find some information I might not have found on my own. In your google searches, did you come across the clinical studies? I find them helpful.
Great read! (And yes Latisse works!). This site Realself has really created a trusting community for thousands of people to share their experiences, ask questions, and as this study shows, for doctors to identify areas of improvement in patient results and satisfaction. Most doctors and practitioners have their patients best interests at heart, and they are building a career with families to support just like all of us. It is in their best interest to do the best they can for us. Unfortunately there are exceptions to every rule, and I think some surgeons could be spreading themselves thin by performing so many different procedures rather than choosing a select few to master. As for the safety of the procedures themselves, they have been approved by the regulators and we all have access to the same Internet and can make our own decisions. This community of trust and sharing is not the place for judgements, negative opinions, and fear mongering.
Hi everyone! I thought you all might find it interesting to know that, while we are researching procedures and plastic surgery practitioners, plastic surgery researchers are researching US! Social media has become much more prominent in recent years, and RealSelf.com has popped up in the literature as being an additional way for doctors to better understand patients' level of post-op satisfaction. Kinda neat! Self-reported "worth it" rating of aesthetic surgery in social media. Domanski MC, Cavale N. Source Department of Surgery, Washington Adventist Hospital, 7600 Carroll Avenue, Takoma Park, MD, 20912, USA. mcdomanski@gmail.com Abstract BACKGROUND: A wide variety of surveys have been used to validate the satisfaction of patients who underwent aesthetic surgery. However, such studies are often limited by patient number and number of surgeons. Social media now allows patients, on a large scale, to discuss and rate their satisfaction with procedures. The views of aesthetic procedures patients expressed in social media provide unique insight into patient satisfaction. METHODS: The "worth it" percentage, average cost, and number of respondents were recorded on October 16, 2011, for all topics evaluated on the aesthetic procedure social media site www.realself.com . Procedures were divided into categories: surgical, liposuction, nonsurgical, and dental. For each group, procedures with the most respondents were chosen and ordered by "worth it" score. A literature search was performed for the most commonly rated surgical procedures and the satisfaction rates were compared. RESULTS: A total of 16,949 evaluations of 159 aesthetic surgery topics were recorded. A correlation between cost of the procedure and percentage of respondents indicating that the procedure was "worth it" was not found. The highest-rated surgical procedure was abdominoplasty, with 93 % of the 1,589 self-selected respondents expressing that abdominoplasty was "worth it." The average self-reported cost was $8,400. The highest-rated nonsurgical product was Latisse, with 85 % of 231 respondents reporting it was "worth it" for an average cost of $200. The satisfaction scores in the literature for commonly rated surgical procedures ranged from 62 to 97.6 %. No statistically significant correlations between literature satisfaction scores and realself.com "worth it" scores were found. CONCLUSIONS: Abdominoplasty had the highest "worth it" rating among aesthetic surgical procedures. Aesthetic surgeons should be wary that satisfaction scores reported in the literature might not correlate with commonly achieved results. Social media has opened a new door into how procedures are evaluated and perceived. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266
Hi Jenni. My understanding is that MC Domanski who authored this report was an ear, nose, and throat specialist when he wrote it. The report says, "Aesthetic surgeons should be wary that satisfaction scores reported in the literature might not correlate with commonly achieved results." I am closing my account here. I don't have time for this anymore. I wouldn't get liposuction with the information I have now.
I'm sorry to see you go ChaCha; I have appreciated your input and research and questions. Very important!
Jenni~ How can this possibly be evidence based research? I mean yeah, it's evidenced that the comments and ratings exist. But they are not statistically provable at all. How could they be? It's sort of a dumb study if you ask me. For example, I don't think I can change my "worth it" rating that I made soon after the lipo to "not worth it" after a year later I found I had much larger breasts, arms, thighs etc (yet weighed the same). And if I did change it, what does this do to the data? Also what about fake posts? And by that I mean people who are paid to make fake reviews (for example one woman posted that she had lipo, breast augmentation, and one other procedure all in a one or two month period...) One important ability to have is being able to assess what a study is actually saying and if it's flawed or not. Just because it is published does not mean it is a good study (believe me I have read plenty). Studying social media...I mean people blather on that all day long. One can go to something like Angie's list or Yelp and hopefully find a good service provider. However that is a totally different type of review process whereas it is not asking whether the procedure is worth it or not; but whether the provider was. RealSelf conflates the two and therein lies a problem. The problem has to do with credibility, biases etc. And so I think that study is pretty much worthless. Sorry...please take this in the tone of a healthy debate.

FYI, you can change your ratings any time. Just click the "Edit" link next to the section you want to update.

You changed your Worth It Rating to "Not Worth It" on your review last month: http://www.realself.com/review/massachusetts-smart-lipo-wow

Oh that's right! Well needless to say I had forgotten about that, and also, it doesn't really change my point, since most people probably don't bother; there's no way to know.
Of course the study had flaws...the researchers clearly indicate that the results are level III evidence. This means that the results represented "reports that are not based on scientific analysis of clinical outcomes. Examples include case series, case reports, expert opinion, and conclusions extrapolated indirectly from scientific studies". Everyone knows that social media isn't 100% reliable because people can post whatever they want, true or not. But not everyone lies online. The researchers are looking at social media as a potential way to evaluate data from a large numbers of people (which usually tends to dampen the effect of "fibbers"). In any case, I included the abstract simply because I thought people might get a kick out of the fact that RealSelf was mentioned. And don't be sorry...you're entitled to your opinion, and healthy debate is always welcomed!
I get what you are saying. But I worry about these things because people don't understand how studies are constructed and they think it is 'truth'. When it's clearly not. I don't think everyone lies online. However, I do think people are more likely to say "yay! this was great!" than they are to say the opposite. And even less likely to change a real-self rating (even though as Sharon pointed out, I did! But my summer has been horribly intense so I forgot that I did it.). I would have to look at that study to see what they controlled for in order to deal with confounders. I mean, it would be terribly hard to control for those things, regardless of sample size. Even the sample size presents a problem (fake reviews, reviews that are no longer relevant, changed feelings, death of original poster, etc. etc.) I do realize that marketers use the internet to glean data. But I think this is a unique type of issue that is not the same as say, what kind of beer do 25 year old men like to drink. You know? Anyway...peace out!
I also, am sorry to see you go, ChaCha21...I think you offer a valuable perspective on this site. Good luck to you.
I agree with you that no one can expect to get "scientific results" from a social media site...for all of the reasons you mentioned. However, I think the main point of the study is that plastic surgeons might be able to get useful "non-scientific" information from sites like RealSelf. They note that "social media has opened a new door into how procedures are evaluated and perceived". It gives doctors an "window" into patients' subjective experiences that they wouldn't otherwise have. Trends in social media postings might highlight areas of misconception about procedures and suggest ways to better educate patients about plastic surgery. It might also give doctors a better understanding about what is and is not important to patients.