The strangest (and most controversial) beautifying procedures patients want, from the experts

By Alpana Mohta, MD, DNB, FEADV, FIADVL, IFAAD | Fact-checked by Barbara Bekiesz
Published February 10, 2025

Key Takeaways

Industry Buzz

  • “There is an acronym described by the five attributes often seen in such patients seeking unrealistic types of surgery… Those are typical warning signs to stay away from, because any type of cosmetic surgery will only fuel [them] and often ends poorly for both doctor and patient.” — Paul Rosenberg, MD

  • "It's really important to assess the patient's psychological health, making sure they don't have conditions such as body dysmorphic disorder, which can impair their judgment.” — Aaron Gilson, DO

Find more of your peers' perspectives and insights below.

Although traditional procedures like liposuction and breast augmentation remain prevalent, there’s a growing demand for extreme, unconventional surgeries.

Related: A dermatologist predicts 2025’s biggest trends in anti-aging and beauty

Dr. Tony Youn, a Michigan-based board-certified plastic surgeon, shared one of his wildest requests on a Reddit AMA: “I've had a lot of people ask me for wings. Like, turn them into the X-Men character The Angel. And they believe it's possible. The next craziest thing someone asked for was to look like Kim Kardashian.” 

While angel wings may remain a fantasy, some actual elective surgeries are nonetheless unquestionably extreme. Here’s a look at the most controversial procedures currently making headlines.

Rib removal for a slimmer waist

Partial rib resection, or rib removal, is performed to create a dramatic hourglass figure by excising the floating ribs (11th and 12th). Surgeons access these bones through incisions on the back or sides, carefully dissecting intercostal muscles, ligaments, and neurovascular bundles.

Despite the aesthetic appeal, the procedure is highly invasive with risks of intercostal neuralgia, pneumothorax, and potential damage to the thoracic cavity. Earlier this month, influencer Emily James spent $17,000 on this surgery, even planning to turn her removed ribs into a crown. Post-surgery, she described a painful recovery but defended her decision as a personal right.[]

Leg-lengthening surgery

Originally developed to correct limb-length discrepancies, leg-lengthening surgery (aka distraction osteogenesis) is now a cosmetic procedure for height enhancement. The procedure involves breaking the femur or tibia and inserting a metal implant that slowly extends the bone. This stimulates new bone growth to fill the gap.

While patients can gain 2–3 inches in height, they must endure months of intense recovery, and complications such as bone infections, uneven growth, and chronic pain can ensue.

Nevertheless, the demand for this procedure has surged in the US, with femur lengthening growing by 10.2% annually and tibia surgeries by 4.9%.[]

Unconventional injectables

Injectables like Botox and fillers are also finding unconventional applications. For example, "Pokertox" helps poker players suppress facial expressions to avoid giving away emotional "tells." 

Related: ‘Baby Botox’ may worsen wrinkles

Meanwhile, foot fillers are used to cushion the plantar fat pads, providing relief from discomfort from wearing high heels. While this application is niche, the procedure is relatively low-risk when performed by a skilled injector.

Scrotum lifts

Scrotum reduction, or scrotoplasty, is a surgical procedure designed to address scrotal enlargement, low-hanging scrotum, and penoscrotal web.

Apart from physical discomfort and skin chafing, a subset of patients also seek the scrotum lift due to dissatisfaction with appearance.[]

Animal-inspired surgeries

In the most extreme cases, individuals undergo procedures to look like specific animals. A notable example is Chiara Dell’Abate, who has had over 20 surgeries to resemble a cat—including facial surgeries, ear modifications, and subdermal implants for a more feline appearance.[]

However, most experts are often wary of performing such extreme procedures. “I tend to be fairly conservative and am less likely to perform procedures outside of the aesthetic norm,” Aaron Gilson, DO, a board-certified plastic surgeon from Oregon, tells MDLinx

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“When a patient asks for extreme surgeries, I start with considering a psychological assessment. It's really important to assess the patient's psychological health, making sure they don't have conditions such as body dysmorphic disorder, which can impair their judgment,” Dr. Gilson says. “The goal is to maintain a collaborative, transparent, and respectful discussion [...] while making sure they are informed of the risks.”

Plastic surgeon Paul Rosenberg, MD, outlines warning signs for MDLinx: “There is an acronym described by the five attributes often seen in such patients seeking unrealistic types of surgery. It is SIMON: Single Immature Male Obsessive Narcissist. Those are typical warning signs to stay away from, because any type of cosmetic surgery will only fuel their mental disease and often ends poorly for both doctor and patient.”

Related: A dermatologist predicts 2025’s biggest trends in anti-aging and beauty
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