Makeover shows enrich - and worry - plastic surgeons


April 18, 2004|By Melissa Healy | Melissa Healy,LOS ANGELES TIMES

Like many plastic surgeons, Dr. Randal Haworth has developed a complex relationship with reality TV shows that feature surgical makeovers.

Haworth, who set up shop in Beverly Hills, Calif., in 1995, readily acknowledges that he has benefited from the increased interest in plastic surgery that productions such as ABC's Extreme Makeover and MTV's I Want a Famous Face have sparked.

In 2003, the number of cosmetic procedures performed nationally - from liposuction and tummy tucks to Botox treatments - jumped by 33 percent over the year before, reaching 8.7 million. Those numbers have increased steadily since the American Society of Plastic Surgeons began tracking them in 1992.

But physicians such as Haworth say that in the last year, they have fielded a spate of inquiries from new clients and a few of their established patients that make reference to what they've seen on TV.

"That's a good thing," Haworth says. But, he adds, "it's a double-edged sword."

That's because the expectations of his clients - about what plastic surgery can achieve and its risks and discomfort - have swollen larger than a patient's face after a nose job. Flush with excitement over the seemingly overnight transformations they have seen on TV, prospective clients have flocked to Haworth's office with wild demands and little notion of the pain or risks that so many procedures entail.

The new reality shows and documentaries "in a way are just making plastic surgeons' lives more difficult," adds Haworth. "They instill unrealistic expectations in patients and those patients bring them into their surgeons, who have to spend more time" counseling them on the limits of plastic surgery.

Surgeon for show

Complicated? That's not the half of it for Haworth. Last year, the popularity of the cosmetic-surgery makeover shows landed a new kind of client on his doorstep: TV producers intent on making a show of their own. And that's how Haworth became one of two plastic surgeons helping to transform 17 self-professed "ugly ducklings" for Fox's new entry into the makeover game, The Swan, which premiered April 7.

Now, with the skill of a surgeon, Haworth is threading a fine line between his dual roles. At the same time that he is touting The Swan and busy with new clients brought in by similar shows, he has joined his colleagues in warning that viewers of such shows are developing inflated hopes about what plastic surgery can do for them.

"The new wave of plastic surgery reality television is a serious cause for concern," Dr. Rod Rohrich, president of the Society of Plastic Surgeons, warned in a news release recently. "Some patients on these shows have unrealistic and, frankly, unhealthy expectations about what plastic surgery can do for them."

That said, however, Rohrich acknowledges that plastic surgeons have been buzzing about the shows, even as their offices have hummed with the increased business.

Plastic surgeons say patients undergoing invasive cosmetic procedures must understand that they face all the risks of surgery generally, including infection, complications from anesthesia, pain, swelling and sometimes a loss of sensation around the site of the incision. And because beauty is in the eye of the beholder, plastic surgeons must add disappointment with the results as another risk that patients face. All of these, say surgeons, must be part of the "counseling" they are obligated to give patients.

Rohrich also expressed concern that patients will come to doctors expecting that they could have a large number of surgical procedures done with a single visit to the operating room. While such multiple procedures are not uncommon - 32 percent of patients last year had more than one done in a single session - the "before-and-after" drama of television heightens expectations.

In real life, Rohrich says, "you can only do so much in one operative setting."

Emotional `unveiling'

Extreme Makeover, now in its second season, presents two makeover candidates per episode and takes them through a litany of cosmetic, dental and ophthalmological procedures, as well as sessions with hair and makeup artists and personal trainers.

The show culminates in an emotional "unveiling" of the subjects to their family and friends, and there is much before-and-after comparison.

I Want a Famous Face, in its first season, bills itself as a documentary. It does not pay for the surgical makeovers of its subjects, but follows and documents "the journey" taken by people who want the look - or the breasts or the lips - of a particular celebrity. Some of its documentary coverage is graphic, and its portrayal of surgery's aftermath is occasionally unsparing.

Rohrich cautioned against the desire to look like someone else.

"Everybody is unique," he says, adding that each person's bone structure, musculature and skin tone will prevent them from looking exactly like another person - a point that a reputable and board-certified plastic surgeon would know to underscore.

Rohrich is also deeply critical of The Swan. The show sets out to make over 17 women "inside and out" - psychologically as well as physically - and then conducts a pageant to pick which one will be crowned The Swan.

"I don't think that's real plastic surgery," he says. "We don't have contests. That to me is over the line."

The Los Angeles Times is a Tribune Publishing newspaper.

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