The peg legs and hand hooks of pirate amputees have long been replaced by highly functional prosthetic limbs. No doubt that during the lifetimes of many people alive today, mankind will be able to construct an entire new leg out of a person's own tissues. Even more exciting would be to selectively turn on the DNA to regrow an entire new leg, just like a frog can do. All cosmetic surgery patients and surgeons are excited about the possibilities of using a patient's own tissues to build up parts of their body, either to augment breasts, rejuvenate and tighten skin, or to replace the natural hollowing that occurs in the face with aging. But realize that those considerations should be secondary to the need to make a whole new breast for a woman that has lost it to cancer or a nose for someone who lost it to trauma. Likewise, fixing spinal cord tissue in paraplegics, replacing brain cells in Parkinson's, and replacing pancreatic tissue in diabetics are the highest priorities for "tissue engineers." It is said that the person who figures this out will probably be richer than Bill Gates! Everyone expects to see major advances in these areas in the coming years. No doubt, this is the future of plastic surgery. But it is not yet the present. For example, at the time of this writing, there are clinical trials involving small numbers of patients overseas using stem cells for breast augmentation. But this is very early and very preliminary; we need to know whether these stem cells can make new breast tissue without making that tissue susceptible to form cancers! This is a very serious issue. I make a big point of this, because there is a natural tendency of patients and some doctors to emphasize the positives of stem cell augmentation without also discussing the many sobering realities that must be dealt with.