There is no end to Botox applications, it seems. Some plastic surgeons are injecting Botox into the muscles of the chest in an attempt to straighten a woman’s posture and thereby enhance her bustline. In other words, a Botox breast lift.

I’ve never performed this procedure before, but I would bet that the before-and-after photos are not very impressive.

My Beautiful Mommy, a new children’s book released on Mother’s Day, is causing quite a stir.

Written by a plastic surgeon and aimed at 4- to 7-year-old girls, it depicts a young girl watching her mom going through a rhinoplasty and tummy tuck.

Parents can use this book to help explain plastic surgery. However, I believe that if we need to expose our children to plastic surgery, we should do so more responsibly.

For example, instead of telling the tykes, “Mommy is having plastic surgery to be prettier,” try, “Mommy is going to the doctor to treat the loose skin on her tummy to make it like it used to be.”

Recently, Good Morning America and 20/20 broadcast television investigations of Lipodissolve.

The subject of fat reduction without liposuction (or even exercise) continues to be a “hot topic” among the general public, as many plastic surgeons and non-plastic surgeons advertise Lipodissolve, mesotherapy, and other noninvasive fat removal techniques.

With the bankruptcy of Fig ([removed]www.kctv5.com/investigations/15007565/detail.html[/removed]), the largest chain of Lipodissolve clinics in the United States, many patients thankfully became aware of the potential drawbacks of these procedures.

Medicis’ recent $150 million acquisition of Liposonix draws more attention to this subject ([removed]www.irconnect.com/mrx/pages/news_releases.html?d=144728[/removed]). Liposonix has pioneered noninvasive fat reduction using focused ultrasound.

I eagerly await the results of the ASERF study on Lipodissolve, which may shed some light on this somewhat murky procedure.

Someday, less-invasive fat removal will be an effective, safe technique. Hopefully, some of these techniques can help patients who present with minor rippling after liposuction, a problem we have all seen and struggled with.

ABC News has published a list of the 10 cosmetic procedures to avoid:

  1. Mesotherapy and Lipodissolve;
  2. Cosmetic foot surgery;
  3. Permanent filler injections;
  4. Injection for breast augmentation;
  5. Cosmetic leg-lengthening surgery;
  6. Buttock implants;
  7. Permanent makeup;
  8. “Extreme” facial procedures, such as CO2 laser resurfacing;
  9. Augmentation mastopexy (breast lift using implants); and
  10. Any procedure performed by “untrained hands” (I cannot agree more).

Patients have asked me about each of these 10 items, except for cosmetic leg-lengthening surgery, which qualifies as an “urban legend.”

A recent study from Italy, which was published in the April 2 issue of the Journal of Neuroscience, found that rats whose whiskers were injected with botulinum toxin developed minute, measurable amounts of botulinum protein in their CSF.

See also “Let’s Keep Bo Derek Out of This” by Joyce Sunila, in the November 2007 issue of PSP.

This caused a stir among the lay media, especially as this occurred shortly after a January 23, 2008, request by the Public Citizen to the FDA to implement “black box” labels and warnings on Botox and Myobloc.

With more than 4.5 million Botox treatments performed last year alone, I find it surprising that patients who don’t hesitate to get a facelift are absolutely petrified of having Botox injections.

Anthony S. Youn, MD, is a board-certified plastic surgeon and founder of The Hills Plastic Surgery and Laser Centre in Rochester Hills, Mich. He can be reached at (248) 650-1900.