You can control for some of the risks associated with plastic surgery—you’ll be safer if you see an experienced provider, for one—but if you choose something inherently dangerous, it’ll always be a bit of a gamble. The riskiest procedures tend to be the trendiest ones. We don’t mean popular, like Brazilian butt lifts and breast augmentations, but truly trendy. Think ski-jump Barbie noses and waist-whittling rib removals that defy nature.
While we’re all free to modify our appearances as we please, there’s no need to deprioritize health and safety in the name of cosmetic results. In fact, most of today’s most dangerous plastic surgery procedures have safer alternatives that will both satisfy you aesthetically and put your friends, family, and primary physician at ease. With the help of the experts, we break down five risky procedures and their lower-risk counterparts.
1. Eyelash transplants
For those who struggle with a medical condition, such as alopecia or trichotillomania, or may simply want lusher, longer lashes, there’s permanent eyelash transplantation. It works just like traditional hair transplantation; donor hairs are harvested from the scalp and placed into the lash line. “The hairs take readily and grow like head hair does, requiring regular trimming,” explains New York City board-certified plastic surgeon Dr. Gerald Imber.
The precise placement of lash transplants is critical, and not just to achieving a natural-looking outcome. Surprisingly, pubic hair (yes, really) can be used for grafting. “Some doctors promote the use of pubic hair transplants because of the curly nature of the hair, which I think is a bit of a stretch,” says Dr. Imber. Using this type of hair also increases the risk of poor results. “While eyelash transplants are a bad idea in general, they’re even worse if pubic hairs are used for the grafts,” says Dr. Diane Hilal-Campo, a board-certified ophthalmologist in Oakland, New Jersey, who explains that the angle of the hair directly affects your ocular health and safety. “These hairs are typically much coarser and grow far more irregularly than eyelash hairs or even hair from the scalp.”
Transplanted hair—regardless of the donor site used—can grow into the eye, which puts your eyes in danger of irritation and abrasion that could result in infection and lasting vision issues. The irregularity of pubic hair “significantly increases the risk of growth into the eye and, consequently, potential corneal abrasion,” adds Dr. Hilal-Campo. Remember, your eyelashes aren’t just an accessory—first and foremost, they’re a shield to protect your eyes from dust, dirt, and other debris. Beyond the damage they can cause to your eyes, haphazard transplanted lashes won’t be able to protect your eyes as well as natural ones.
You’ll also want to consider how this procedure affects the moisture levels in your eye. Tiny glands behind the lash line, known as meibomian glands, produce an oil that prevents your tears from evaporating too rapidly. The surgery could disrupt the overall architecture of your eye, including the glands themselves, causing chronic dry eye symptoms. The same can be caused by the length of your lashes. “When lashes are unnaturally long—whether that’s due to lash growth serums, lash extensions, or lash transplants—they create a wind tunnel effect, actually pulling more air into the eye with every blink,” says Dr. Hilal-Campo. “This causes tears to dry too rapidly, causing dry eye symptoms that are very irritating—including a gritty and scratchy sensation, itchiness, redness, and watering.” This can also end up affecting your vision.
Instead of eyelash transplants, you can go for something topical. “You can enhance your eyelashes with Latisse, which has its own side effects but is generally safe,” says Dr. Imber. Those side effects can include hyperpigmentation of the eyelid and iris (which can cause blue eyes to darken) and permanent fat atrophy under the eye. For that reason, Dr. Hilal-Campo suggests natural treatments—ideally, those made with castor oil, like her own twenty/twenty beauty Get Growing Lash & Brow Serum. “Compounds in castor oil known as ricinoleic acid bind to lash growth receptors, like the ingredients in artificial lash serums do, but without those side effects,” she says. “You can also use false lashes on occasion—just don’t sacrifice the health of your eyes for the beauty of your eyelashes!”
2. Silicone injections
Silicone injections have long been used to add volume in all parts of the body. Today, it’s typically used in very small amounts—but the medical product used, Silikon 1000, isn’t approved for cosmetic use, and there are plenty of people booking highly dangerous silicone injections with unlicensed providers using non-medical-grade materials. (Case in point: Cardi B’s basement butt injections, performed by a woman who ended up killing someone with the same treatment.) The FDA explicitly warns against the use of silicone for cosmetic enhancement.
“They’re illegal, and for good reason,” says Dr. Imber. The injections are permanent, and even the best of outcomes tend not to last: “Injected silicone for defects and wrinkles must be perfectly placed and often migrates anyway,” he explains. Adds Dr. Andrew Cohen, a board-certified plastic surgeon in Encino, California, “Silicone can get infected or cause a hard ball of tissue called a granuloma that needs to be surgically removed.” And in most cases, silicone can’t be removed easily, as once it’s injected, it can travel freely throughout the body. If you’re hoping to excise existing silicone injections, it may take many attempts (which could be largely unsuccessful) that result in scarring or disfigurement.
Beyond the cosmetic casualties, silicone injections can cause blockage of blood vessels, resulting in tissue necrosis. That embolism can also travel through the body, leading to stroke and even death.
Instead of silicone, try hyaluronic acid fillers, which tend to stay put and last only for up to two years—and can be dissolved with an injection of an enzyme called hyaluronidase if the placement is dissatisfactory or in any way dangerous. You could also opt for Dr. Imber’s preferred alternative, fat grafts. “Fat grafts are you—they are natural,” he says, noting that this procedure offers a high probability of a permanent outcome.
3. “Barbie nose” rhinoplasty
Largely performed in Europe and countries like Turkey and Lebanon, a Barbie nose procedure is exactly what it sounds like—a rhinoplasty that creates a petite button nose with a low bridge and dramatically upturned, ski-jump-like tip. Reputable providers won’t even consider performing it, and Dr. Imber is one such surgeon. “The Barbie nose is simply aesthetically unacceptable,” he says. “The nose must be appropriate with the face.” Dr. Cohen is in agreement. “I don’t do these ‘named’ nose procedures,” he says. “I don’t believe in aggressive, unnatural surgeries that will distort the face or body.”
Beyond the aesthetic oddity of a Barbie nose outcome, providers refuse to create them because of the likelihood of major complications, including nasal obstruction (which reduces a patient’s ability to breathe) and a weakened nasal structure, which can cause the whole thing to collapse. Worse, because the surgery necessitates the removal of so much soft tissue and cartilage, there’s often not enough left to use for reconstruction.
Instead of finding a surgeon who will create a one-size-fits-all nose modeled on a doll that’s more than 60 years old, find one who will create a bespoke nose—one perfectly tailored to your face. ”I just do what will look nice and natural for each patient,” says Dr. Cohen, as would any skilled and trustworthy rhinoplasty surgeon.
4. Rib removal
For those who have never considered or even heard of this procedure, it might sound alarming—don’t we need our ribs? But as it happens, our lowest ribs aren’t essential. “They serve no respiratory or protective function,” says Dr. Imber. In some cases, patients request removal because their lowest ribs are so prominent that they create a stark protuberance from the body, says Dr. Cohen, who has removed ribs in these instances. Though Dr. Imber shares that using rib removal surgery to accentuate the waist can be safe in highly trained hands, “the result obtained is not worth the trouble,” he says. “The risks associated with rib removal include perforating the chest lining under the rib and causing a pneumothorax, or collapsed lung.” Other risks include tissue damage and infection.
Instead of removing these bones, which puts you at risk of organ damage, try something less invasive. Both providers suggest liposculpture as a safer and effective alternative to create a narrower waist. You can also try muscle stimulating procedures, like Venus BlissMax, Emsculpt Neo, or TruSculpt Flex
5. Calf reduction
For the most part, the calf is composed of muscle, which can cause a bulky appearance in some. Because there’s typically so little fat to work with, removing some of the muscle is the most effective way to reduce the size of a calf—but it isn’t recommended. “Surgical reduction of the calf muscle, while possible, is difficult to calibrate and often leaves an irregular surface,” warns Dr. Imber.
If slimming down the muscle is your goal, “destroying the nerves that supply the calf muscles can cause the muscles to atrophy and reduce in size,” he says. That makes Botox injections and other neurotoxins an option—limiting nerve function is how they work—but to maintain your results, you’ll face recurring treatment costs. Considering that neurotoxin treatments tend to last for about three months, you can expect a hefty expense.
Alternatively, if you’re hoping to remove some unwanted fat in the area (usually around the ankle), you can go with the gold standard of surgical fat removal, liposuction. “I perform calf reductions by doing careful limited liposculpture,” says Dr. Cohen. “This is a safe procedure, if done by an experienced board-certified plastic surgeon.”
