Trendy Isn't the Same as Necessary
Cosmetic procedures go through trends the same way sneakers do. Social media speeds the cycle up, and a treatment can go from obscure to everywhere in one summer before landing in revision clinics a few years later. Some of these trends carry real risks, and others don't deliver results that last. A handful have drawn formal warnings from the FDA or the CDC. Here's 20 things plastic surgeons say no one actually needs.
1. Botox in Your Early 20s
Preventive Botox, which got FDA approval for frown lines back in 2002, gets marketed as a way to stop wrinkles before they start. Each round lasts about three to four months, so starting at 22 means decades of appointments for lines that may never have formed. Daily sunscreen and a decent retinol handle a lot of that prevention for a fraction of the cost.
2. Buccal Fat Removal
Taking out the fat pads that give the lower cheeks their fullness became a celebrity-driven trend in 2022. Faces lose volume naturally with age, and removing that fat in your 20s can leave a hollow, gaunt look by your 40s. There's no putting it back.
3. Overfilled Lips
Hyaluronic acid filler in the lips usually lasts somewhere between six months and a year. A little can add shape, but past a certain point the lip line blurs and the mouth starts to look like it belongs to a different face. An enzyme called hyaluronidase can dissolve most of it, which is the rare happy ending on this list.
4. Filler Everywhere at Once
Adding filler to the cheeks and jaw in quick succession, then going back for more, is how people end up with what injectors call pillow face. Each area might look fine on its own. Together, the face turns puffy and oddly smooth, especially mid-smile.
5. Thread Lifts
Thread lifts use dissolvable sutures under the skin to pull features upward, including the fox eye look that took off around 2020. The lift usually fades within months as the threads dissolve. Infection and visible puckering are two of the more common complaints, and some patients can feel the threads for weeks.
6. Dimpleplasty
Dimples come from a small quirk in a cheek muscle, and surgeons can create one with an internal stitch in about 30 minutes under local anesthesia. The result is usually permanent, since the stitch leaves scar tissue that holds the dimple in place. Some patients get a dimple that shows even when their face is at rest.
7. Brazilian Butt Lifts
In 2017, a task force from the Aesthetic Surgery Education and Research Foundation estimated that about 1 in 3,000 BBLs ended in death. Most of those deaths came from fat injected into the gluteal muscle, where it could slip into large veins and travel to the lungs. Updated guidelines call for injecting fat only above the muscle, and the procedure is safer than it was, though it still carries more risk than most cosmetic surgeries.
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8. Butt and Breast Injections
The FDA has not approved any injectable filler for enlarging the buttocks or breasts, no matter what a salon's Instagram says. It has also warned against injectable silicone for body shaping, which can migrate and cause serious infections. Those injections still turn up in unlicensed settings, often at prices that seem too good to be real, and a patient may not learn what was injected until something goes wrong.
9. Liposuction for Weight Loss
The American Society of Plastic Surgeons describes liposuction as a tool for reshaping stubborn areas. Its ideal candidates are within about 30% of their target weight and have firm, elastic skin. Gain weight afterward and it tends to settle somewhere new.
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10. A Tummy Tuck Before Your Last Baby
Another pregnancy can stretch out the muscles and skin a tummy tuck just tightened. The ASPS recommends waiting until you're done having kids.
11. Fat Freezing on Big Areas
Cryolipolysis, sold under brand names like CoolSculpting, works best on small, pinchable bulges. In rare cases, the treated fat grows larger and firmer instead of shrinking, a side effect called paradoxical adipose hyperplasia. Fixing it usually takes liposuction, the very surgery the patient was trying to avoid.
12. Kybella Below the Neck
Kybella is a synthetic version of deoxycholic acid, a bile acid your body uses to break down fat. The FDA approved it in 2015 for one area, the fat under the chin. Some clinics use it off-label on bra rolls or arms, where the swelling can last for days and bigger areas need many more rounds, each billed separately.
13. Cellulite Shots
Qwo, the first injectable for cellulite, won FDA approval in 2020. Its maker discontinued it in 2023 after complaints about bruising and uneven results. Creams and body wraps haven't done much better, since cellulite comes from fibrous bands beneath the skin pulling it down.
14. Vaginal Rejuvenation Lasers
In 2018, the FDA warned that energy-based devices marketed for vaginal rejuvenation hadn't been approved for those uses. The agency had received reports of burns and scarring. Clinics had been promoting the treatments for dryness and for changes after childbirth.
15. Vampire Facials at Spas
A vampire facial uses a patient's own blood plasma during microneedling. In 2024, the CDC reported HIV infections linked to an unlicensed spa in New Mexico, the first documented cases tied to a cosmetic injection. Reused needles and poor sterilization were at the root of it.
16. Iris Implants
Silicone implants placed over the iris to change eye color were originally developed for people with eye injuries and birth defects. Clinics overseas started selling them for cosmetic reasons, and the American Academy of Ophthalmology has warned they can lead to glaucoma and vision loss. Tinted contact lenses do the same job and come out at night.
17. Cosmetic Leg Lengthening
Surgeons break the thigh bones and slowly pull them apart with internal rods, adding up to a few inches over several months, using a technique borrowed from the treatment of limb deformities. Patients spend weeks learning to walk again with a walker and physical therapy. The bill can run well into six figures, and insurance won't cover it.
18. Rib Removal
Taking out lower ribs to shrink the waist gets talked about online far more than it gets performed. The floating ribs help protect organs like the kidneys, and removing them for looks trades real protection for an inch or two off the waist.
19. Bargain Surgery Abroad
Cheap packages that pair liposuction with a beach hotel can look like a deal. The CDC investigated a 2023 outbreak of fungal meningitis among Americans who had cosmetic procedures under epidural anesthesia at clinics in Matamoros, Mexico. Flying home soon after surgery also raises the risk of blood clots.
20. Barbie Botox
Injecting the trapezius muscles to make the neck look longer became a TikTok trend in 2024. The same shots have legitimate uses for chronic shoulder tension and certain muscle spasms. Done purely for looks, the effect fades after a few months and can leave the shoulders feeling weaker.
