Nine Cosmetic Treatments to Rethink

'Non-surgical' doesn't always mean safe. Why these nine procedures and drugs could leave you disappointed—or worse.

Nine Cosmetic Treatments to Rethink

Botox breast lift

By Maggie Koerth-Baker for MSN Health & Fitness

Why do it: In spring 2008, high-profile New York dermatologist Patricia Wexler, M.D., began touting a new way to use Botox. Wexler claimed in interviews that by injecting the drug into the pectoralis minor chest muscle to temporarily paralyze it, she could make back muscles called rhomboids pick up the slack, so to speak. She said this forces the patient to stand up straighter, which in turn essentially gives the breasts a surgery-free "lift."
The problems: "It's nonsense. Worse, it's dangerous nonsense," says Michael McGuire, M.D., president-elect of the American Society of Plastic Surgeons. He and Patrick McMenamin, M.D., president of the American Academy of Cosmetic Surgery, agree that Wexler's procedure wouldn't work. And both doctors say injecting anything into the pectoralis minor is dangerous. Hidden beneath larger muscles and very thin, the pectoralis minor sits on top of the rib cage. On false move, and the needle could puncture a lung. McGuire and McMenamin also worry about whether paralyzing the pectoralis minor would make breathing more difficult, and whether the amount of Botox needed could reach dangerous levels.

Nine Cosmetic Treatments to Rethink

"Doctor fish" manicures and pedicures

Why do them: "Doctor fish," also known as garra rufa, love to eat dead human skin cells, which they suck off of the body, revealing fresh skin underneath. The fish have made a splash in Europe and Asia, where they're used for pedicures and to treat the symptoms of psoriasis, and are now becoming trendy stateside.
The problems: Living creatures are hard to sanitize. At least three states—Washington, New Hampshire and Texas—have issued regulations against doctor fish, saying there's no way to guarantee the fish are clean. Martin Grassberger, M.D., who's researched garra rufa at the Medical University of Vienna, says there's another concern. Some spas use a different species of fish called the chinchin, which feeds more aggressively than garra rufa. Chinchin can draw blood and spread disease, particularly in communal pools where blood-borne illnesses like hepatitis B can be passed by fish or through water to open wounds. If you try a fish spa, Grassberger says, make sure you get a private, sanitized basin of water and that the spa uses only garra rufa fish.

Nine Cosmetic Treatments to Rethink

Waxing

Why do it: Waxing yanks unwanted body hair out by the roots. It's faster than tweezing and lasts longer than shaving.
The problem: First off, burns from hot wax can be severe and are more common than you might think, according to the medical journal Burns. Waxing also leaves your body vulnerable to infection. In fact, the FDA advises people with weakened immune systems to avoid waxing entirely. Anyone using wrinkle creams or acne treatments that contain retinol should also rethink waxing. Retinol can make skin so sensitive that there's a risk of it peeling off along with the hair. But the biggest worry is topical skin-numbing cream, often used to make waxing and laser hair removal less painful. The FDA says drugs in the cream can end up in your blood. Use too much of it, or a cream that contains too high a concentration of the numbing ingredients, and the results can be life-threatening or even fatal. It's best to avoid numbing cream altogether, but if you do use it, the FDA says to choose a cream they've approved as safe, to use as little of the cream with the lowest amount of active ingredient as you can. The FDA also recommends leaving the skin uncovered (don't cover the treated area with plastic wrap or other dressing), and says to pick the correct cream with your doctor's help—not that of your hair stylist or spa technician.

Nine Cosmetic Treatments to Rethink

Eyelash-thickening drops

Why use them: Newly approved by the FDA, the drug Latisse promises thicker eyelashes. Latisse is actually a lower-dose version of Lumigan, a drug that's been used to treat glaucoma since 2001. Longer, thicker lashes were a surprising side-effect for those patients.
The problem: Itching and redness may hamper your ability to make the most of those newly lush lashes. In addition, Latisse may darken the skin on your eyelids or turn irises brown—permanently—not good news for anyone who really values their baby-blues. And, like with many drugs, Latisse may not be a good choice for pregnant or nursing women. The National Institutes of Health reports the active ingredient in Latisse is associated with low birth weights and miscarriage in studies on mice and rats. While this doesn't necessarily mean Latisse is dangerous for human fetuses, there haven't been any good studies so far. Fact is, we just don't know right now whether Latisse is safe for pregnant women or not.

Nine Cosmetic Treatments to Rethink

UV-activated teeth whitening

Why get it: Who doesn't want a mouth full of gleaming, pearly whites? Most whitening methods rely on hydrogen peroxide solutions, but some companies claim the hydrogen peroxide works better and faster when combined with UV lamps.
The problem: New research shows UV lamps don't boost the bleaching process, and even worse, can be dangerous. In February 2009, research published in the online version of the Journal of Prosthodontics showed no difference between teeth whitened with a combination of hydrogen peroxide and light or heat lamps, and those whitened with the solution alone. A January 2009 study in the British journal Photochemical & Photobiological Sciences went further. Not only does light-activation not work, the article reported, but it also exposes users to startlingly high levels of cancer-causing UV radiation. One lamp the team tested gave a dose four times as high as what you'd get from sunbathing for a full afternoon in midsummer.

Nine Cosmetic Treatments to Rethink

Permanent makeup

Why get it: Eyeliner, lip and brow color tattooed onto your skin can be a permanent solution for women who want the look of makeup all the time.
The problem: Colored tattoo ink isn't necessarily designed with the human body in mind. In fact, the FDA hasn't approved any tattoo inks, and many of the colored inks used for permanent makeup are the same as those used in the automotive and printing industries. The FDA has received numerous reports of allergic reactions in women who received makeup tattoos. These tattoos are also notoriously difficult to remove, even with newer technologies. If you decide later that you'd prefer a different color or no makeup at all, you could easily face multiple painful laser treatments and no guarantee of completely removing the pigment.

Nine Cosmetic Treatments to Rethink

Chemical peels

Why get one: Chemical peels, usually creams or serums containing mild fruit acid, can remove dead skin cells and help clear up acne, according to the Mayo Clinic. Peels can also encourage the growth of new, younger-looking skin cells.
The problem: Most chemical peels have relatively mild side effects, including a risk of oddly colored, patchy skin in women who are taking birth control pills; redness, scaling and blisters for those with sensitive skin; and the possibility of triggering previously dormant cold sores. The real danger comes from at-home peels purchased online, which have been known to cause painful, scarring burns. The problem is in the concentration. Most effective over-the-counter alpha-hydroxy acid creams contain about 8 percent concentration of alpha-hydroxy acids, according to the University of Maryland Medical Center. But you can buy AHA cream online, without a prescription, in concentrations as high as 60 percent. That strength shouldn't ever be used outside a doctor's office and can be dangerous, particularly if you're used to the 8 percent cream and didn't realize you were buying something so strong.

Nine Cosmetic Treatments to Rethink

Brava breast enhancement

Why have it: Introduced in 1999, Brava is a breast enhancement system that claims to help make breasts an entire cup size larger without surgery. The appeal pretty much speaks for itself.
The problem: According to clinical trials, Brava works, but the process is time consuming and rife with side effects. And the results will never be as dramatic as surgical implants. Brava is a set of plastic domes hooked up to a small vacuum pump. The domes are placed over the breasts, with the suction turned on, for 10 hours every day over for at least 10 weeks. If you miss a day, you have to add an extra one; some women report getting rashes and blisters from the long process. The good news is that women who use Brava do, on average, gain a cup size. But it won't work as well on women with extremely small breasts, or for those who have a low body-mass index. Some women have also been disappointed with the final results because temporary swelling can initially make it appear that Brava is working better than it really is. Ingrid Schlenz, M.D., a Medical University of Vienna researcher who has studied Brava, cautions that women who try the system need to be aware that final results don't match the initial ones.

Nine Cosmetic Treatments to Rethink

Thermage

Why use it: Approved by the FDA in 2002, Thermage uses heat generated by radio waves to give patients tighter, more taught skin; it's often promoted as a "non-surgical facelift." Oprah first championed the procedure, which is also known as ThermaCool, in 2003.
The problem: The episodes of "The Oprah Winfrey Show" that touted the treatment aren't forthcoming about its potential side effects or effectiveness, according to a New York Times article from 2006. And Thermage doesn't really function as a face-lift substitute. While it can reduce the appearance of fine wrinkles and acne scars, it's not likely to tighten jowls—patients who go in expecting a miracle probably will be disappointed. And while side effects are rare, doctors say they often get glossed over in breathless media reports. Thermage treatments can burn the skin, particularly if a doctor uses a higher setting in pursuit of grander results. The machine can also "melt" the fat under your skin, leaving you with scars, dents and grooves on your face. Neither complication is very common, but both happen often enough that doctors say potential patients need to be more aware of the risks.