Plastic Surgery for Fighters

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

Not sure what I think about this trend of plastic surgery for fighters discussed in this New York Times article -- Cut-Prone Fighters Turn to Surgery to Limit Bleeding by R.M. Schneiderman (Published: July 10, 2009).  

In 16 years as a professional boxer and mixed martial arts fighter, Marcus Davis has received stitches above his eyes 77 times. The cuts have affected him: doctors have stopped fights, and his battered face, he says, has influenced judges’ decisions.

So last summer, Davis, 35, contacted a plastic surgeon in Las Vegas. He wanted to make his skin less prone to cutting.

The surgeon, Dr. Frank Stile, burred down the bones around Davis’s eye sockets. He also removed scar tissue around his eyes and replaced it with collagen made from the skin of cadavers.

Now, at least in theory, when Davis takes a blow to the face, he will be less likely to bleed.

Medical researchers have not analyzed the procedure, and until they do, the American Society of Plastic Surgeons will not comment on its efficacy. But Davis and several others swear by it.

I can understand why the ASPS won’t comment.  I have no problem revising scars for anyone who is realistic with what can be accomplished.  Prominent brows are smoothed down (not in my practice, as I mostly do body work) for cosmetic reasons -- orbital rim contouring or brow shave. 

It is neither of those that gave me pause when I read the article on plastic surgery for fighters.  It is the question of real or implied promise of the surgery decreasing the risk of “bleeding” or “cutting” that gives me trouble.  Possibly it does. 

Surgery always carries risk.  In this population, maybe less than the chosen occupation of boxing or martial arts fighting, but still it carries risks.  There is the risk of infection (skin and sinuses), bleeding, and scarring.   Would I tell the young man that his risk of “cutting” would be 50% less or 15% less or 65% less?  Wouldn’t he need that information in making the decision to proceed with the surgery if his reason was not for cosmetic purposes but the goal of less “cutting”?

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The degree of supraorbital bossing usually falls within three groups.  X-rays or head CT scan is needed preop to determine the bone thickness over the frontal sinuses.

• Group 1 are those with minimal to moderate anterior projection of the supraorbital rims and thick skull bone over the frontal sinus and/or absence of the frontal sinus.  These deformities can be corrected by bone reduction alone utilizing a surgical burr.
• Group 2 are those with minimal to moderate anterior projection of the supraorbital rims but with relatively thin bone over the frontal sinuses of normal size. Correction requires completing as much contouring of the bones as possible without entering the sinus.
• Group 3 are those with severe anterior projection of the supraorbital rims is so excessive that adequate bone reduction contouring is impossible without entering the frontal sinus.   These require obliteration and filling of the sinuses in order to reduce the contour enough.