Beyond “Nip/Tuck”


Dispelling Plastic Surgery and Cosmetic Procedure Myths

Plastic surgery. The term conjures visions of frozen foreheads, distorted celebrities and glossy TV dramas. But what is it really? Is it the quick and painless beauty of a television makeover? Is it a weight control solution? Is it self-care or extreme vanity? The answers might surprise you.


MYTH: I’ll be in and out and on my feet in no time.
REALITY: “It is important to understand at the beginning of the process that [plastic surgery] does not occur overnight,” says Donna Hochberger, BSN in Olmsted Medical Center’s plastic surgery department. “You cannot expect your results in a week. The results on makeover TV shows probably took three months, if not longer, to achieve. This is real surgery—pain, recovery, blood and stitches—and the body must go through the healing process.”

Most common plastic surgeries take one to four hours to perform, involve swelling and bruising for weeks with final results six months to a year after the operation. Liposuction—the most common plastic surgery in the US—takes two to four hours to perform (depending on the amount of work done) and 6-12 months for final results. A face lift, circumferential body lift and nose alteration also take two to six hours on the surgical table and a year of waiting for results.

MYTH: Plastic surgery is filled with vain, shallow women.
REALITY: Of the hundreds of patients Dr. Steven Jacobson sees every year as a plastic surgeon at Mayo Clinic only 15% are purely aesthetic (OMC reports about a 50/50 split). The remaining 85% of Dr. Jacobson’s patients seek various forms of reconstructive surgery including breast reconstruction for congenital defects, asymmetry and cancer treatment; facial reconstruction to repair damage from accidents or aging (such as an eye lid lift necessitated by sagging skin obstructing the patient’s vision); and body reconstruction like the tummy tuck performed on a fit, active patient whose abdomen had been so distorted and distended by pregnancy she looked perpetually six months pregnant long after giving birth.

For Dr. Jacobson, all of the above are reconstructive plastic surgery (even if insurance companies disagree) because they all restore dignity: “Augmentation is the same whether it’s for reconstruction or aesthetic purposes. All surgery is reconstructive—just a matter of what we are reconstructing—image or body parts. This is not a celebrity having her fifth surgery; this is about people who look in the mirror and struggle with what they see because it’s not how they feel and say, ‘I want to look how I feel.’”

MYTH: Liposuction is for people too lazy to lose weight by exercising and dieting.
REALITY: Designed to remove localized fat that is resistant to diet and exercise, liposuction is not a weight-loss method.

“Liposuction is not a diet solution. It is not for weight loss and does not remove significant fat. Eight pounds is on the border [limit] of what we will do,” explains Donna Hochberger, BSN in Olmsted Medical Center’s plastic surgery department.

It can be an incentive for getting in shape, though, since candidates need to be at their ideal weight and maintain it for six months before the procedure.

MYTH: Anyone can have anything done, as many times as they want to.
REALITY: “Patients with the highest satisfactory rate are ones who are already confident and maybe just want one thing done,” says Jennifer Sanneman, owner of Essence Skin Clinic in downtown Rochester. “When I sit down with a new patient, I ask, ‘If there is one thing that you could change about your appearance today, what would it be? What is one thing I can do for you today?’ If they can get it down to just one or two, then that is a healthy attitude. If the list is too long to narrow down, that can be a red flag that they are experiencing other problems, and I cannot help them.”

OMC’s plastic surgery department takes a similar view in counseling patients: “We steer the patient back to what is bothering them and we will talk about if we can make a difference,” says Hochberger. “But there shouldn’t be any expectation that we can make you look like Jennifer Aniston. It comes down to meeting the person where they are at and finding out more about them so we can come up with a plan of care and seeing if we fit.”

MYTH: Spas and salons offering non-surgical, minor cosmetic procedures don’t need to use doctors.
REALITY: There are a range of cosmetic services offered at spas and salons in Rochester, and many are performed by or under the direction of a doctor. Specifically, Botox must be done under a medical director’s or doctor’s care, as should all injections, laser resurfacing, and significant dermabrasion or deep chemical peels. Essence Skin Clinic, Ansara and Hair Studio 52 Salon + Day Spa keep a doctor on staff for these purposes.

“If it is a medical procedure, look for a medical professional who is properly certified to do the procedure,” advises Dr. Victoria Hagstrom, a doctor with 20 years’ experience as a family physician who now owns ANew Aesthetic Medical Center (in Minneapolis) and performs services at Hair Studio 52 Salon + Day Spa. “Listen to your own intuition when it comes to someone providing a service that can change your health or your skin and make sure the person has the credentials to perform the service and that you know their background.”


Breast Augmentation vs. Lift: Augmentation increases breast size; a lift improves position.

Lift (face, arm, buttock or inner thigh): A lift tightens and repositions tissue and skin and removes excess fat and skin in one or more regions.

Circumferential Body Lift: This major surgery makes incisions around the entire circumference of the body to remove excess fat and skin at the waist, abdomen and hips.

Eyelid Rejuvenation (blepharoplasty): Repairs droopy eyelids by removing excess skin, muscle and fat. It is only considered reconstructive if an ophthalmologist confirms that the sagging skin is impairing vision.

Facial Contour Alterations (not a facelift): A variety of procedures that include chin augmentation, reduction or implants; cheek or cheekbone implants or augmentation.

Rhinoplasty (aka nose alteration): This procedure can shorten or lengthen the nose, straighten the bridge, reshape or define the tip or narrow the nostrils and can repair birth defects, injuries and breathing problems.

Tummy Tuck (aka abdominal reduction or abdominoplasty): This major surgery takes three hours to complete and involves incisions to remove most of the skin and fat between the bellybutton and pubic hair line, as well as stitching together connective tissues over the abdominal muscles to tighten them.

Sources: Department of Plastic Surgery at Olmsted Medical Center and Mayo Clinic websites found at and


Chemical Peels: Chemicals applied to the face that remove varying layers of skin—depending on the peel’s strength—to treat fine wrinkles, minor skin discoloration and scars.

Botox Injections and Facial Fillers: Hypodermic needle injections made in facial skin to reduce wrinkles. Botulinum toxin injections (i.e., Botox®, Dysport®, Myobloc® and Xeomin®) temporarily relax the facial muscles that underlie and cause wrinkles. Fillers fill in wrinkles (and lips) with various substances including collagen; hyaluronic acid (brand names: Juvederm®, Perlane® and HylaForm®); synthetic microspheres (Radiesse®) or fat collected and refined from other parts of the body.

Dermabrasion: Procedure utilizing a rapidly spinning disk which “sands” the outer layers of skin to remove acne scarring, wrinkles, scar tissue, tattoos and lesions. Laser Resurfacing: Intense laser heat destroys the skin’s outer layer (epidermis) while heating the underlying layer (dermis) to remove aged or damaged skin. New skin forms which is smoother and tighter.

Thermigen: Radio frequency used to tighten the skin by inserting a cannula (thin, hollow tube) under the skin and heating it from the inside.

Laser Hair Removal: An intense, pulsating beam of light removes unwanted hair anywhere on the body except the eyelid and surrounding area.

Sources: Essence Skin Clinic and website for Mayo Clinic Department of Plastic Surgery,


MYTH: Only men suffer pattern baldness.
REALITY: 30/40% of all people, including women, have genetic hair loss. Female pattern baldness, a genetic condition, generally causes an overall thinning of hair rather than a receding hairline. Hair loss can also occur because of certain medications, hormonal fluctuations (i.e. pregnancy, birth control pills or menopause) or a medical condition.


Medication: Dihydrotestosterone (DHT) is a chemical produced by the body which is the major genetic cause of hair loss in women and men. Medications like prescription finasteride (Propecia) block DHT to help regrow hair. Minoxidil (Rogaine®) stimulates follicles by applying topically.

Surgery: Surgically removing and transplanting part of the scalp (and its hair follicles) from one part of the head to another.

NeoGraft: Hair transplantation device which removes hair follicles from the back of the head (without removing parts of the scalp) and transplants them to thinning areas, reputed to involve less pain and downtime than traditional surgical or grafting options.

Hair Stimulating Laser Treatments: Utilizes lasers to increase blood flow to the scalp to stimulate hair follicles. These treatments can be done at home with a hand-held unit or with a more powerful machine at a clinic like Reiland’s Hair Clinic, Inc. (Rochester) and ANew Asthetic Medical Center (some services offered at Hair Studio + Day Spa in Rochester, others in Minnetonka). Requires repeat visits (2-3 times per week for a year).

Prosthetics: Unlike commercial wigs or toupees that are often machine made of synthetic hair, custom-made hair enhancements and replacements are soft, light-weight prosthetics made with human hair that are designed to be worn all the time, even while sleeping. Reiland’s Hair Clinic specializes in analyzing and fitting hair enhancements to fit all stages of hair loss.

Topical Solutions: From Nioxin® to Aveda’s Invati System™, there are many non-prescription topical solutions designed to help stimulate hair growth, control hair breakage or increase fullness.

Sources: Reiland’s Hair Clinic, Inc. and Dr. Victoria Hagstrom at ANew Aesthetic Medical Center.