Editor's note: Dr. Anthony Youn is a plastic surgeon in metro Detroit. He is the author of "In Stitches," a humorous memoir about growing up Asian-American and becoming a doctor.
(CNN) -- Horns. Forked tongues. Elf ears. Whiskers.
No, these aren't features from the latest fantasy film. Today, thousands of people are getting their bodies modified in all sorts of bizarre and unusual ways. Tattoos are just the tip of the iceberg for people interested in body modification, referred to as "body mutilation" by detractors.
People called "body modification artists" perform these unconventional surgical procedures, typically on young clients. These treatments range from the simple, such as implanting metal bolts on a person's neck, to the extreme, such as creating ridges under a person's skin in order to make him look like a human lizard.
Hard to believe? The website Body Modification Ezine has more than 3 million photos of people who've undergone these various types of body modification.
And it's not just in the United States. Other industrialized countries are seeing the body modification trend expand with new, and increasingly bizarre, treatments. In Japan, young people are plumping up their forehead by injecting large amounts of saline, then pressing their thumb into the middle to create an indentation. This leaves a temporary doughnut-like appearance, dubbed the "Bagel Head."
Extreme body modification procedures are almost never performed by actual physicians. These treatments are more often associated with tattoo parlors than medical offices. In fact, I've never heard of a single plastic surgeon who's admitted to performing extreme body modification. And because actual doctors aren't involved, the patients don't benefit from modern anesthetics.
Yes, people have this done without real anesthesia.
Want to fork your tongue? Take a swig of whiskey, apply some ice, and try to stay still while the body modification artist slices it in half. Seriously.
Although I've never been asked to fix or treat a split tongue, there is one body modification trend I've been asked very commonly to repair: gauge earrings. These are circular earrings that function to gradually dilate an ear piercing, often to massive size. People with gauge earrings may believe their earlobes look stylish when the earrings are in place, but they look like limp noodles when the jewelry is removed.
Most of my patients who've undergone repair of their stretched earlobes have had it done to improve their job prospects -- what works for an interview at a tattoo parlor may not be appropriate when applying for a managerial position.
Apart from its effect on professional prospects, can extreme body modification be a sign of underlying psychiatric issues?
One of the most famous body modification subjects, Dennis Avner, spent years making himself look like a cat. He went so far as to have whiskers implanted into his cheeks and his teeth filed into fangs. About a year ago, he died of an apparent suicide. Some have speculated that Avner may have suffered from body dysmorphic disorder, a psychiatric condition involving a person's self-image. It has a very high rate of suicidal ideation.
As a board-certified plastic surgeon, I'm well aware that the patients in my medical field have a much higher rate of BDD than the general population. Plastic surgery is basically a more socially acceptable form of body modification.
However, there is a big difference between plastic surgery and extreme body modification. Board-certified plastic surgeons are required to undergo at least nine years of schooling and training, pass a slew of rigorous exams and perform their procedures in a safe, accredited medical center.
So if you're considering extreme body modification, think about it very seriously. Surgical procedures should be performed in a sterile medical environment under the hands of an experienced surgeon. Things can go wrong even under the best of circumstances.
Also consider that what you want today may not be want you want in the future. Fashion changes. While it may be cool to have Frankenstein's bolts in your neck now, in 10 years they may just make you look like a monster.
The opinions expressed in this commentary are solely those of Dr. Anthony Youn.