The Real Deal on Plastic Surgery
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The Real Deal on Plastic Surgery

Get the latest facts on 11 popular procedures.

Plastic Surgery Across America

Extreme Makeover Patient Before
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Extreme Makeover: Before

Are you willing to go to extremes to look younger or more attractive? More than 40 people will get an opportunity to do just that with this season's Extreme Makeover reality TV show, including an entire family who will get a new look (although the show's network, ABC, hastens to mention the children will get hair, makeup, and clothing makeovers only).

Extreme Makeover Patient After
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Extreme Makeover: After

While Extreme Makeover is wildly popular, most Americans would not want to drastically change their appearance, according to a recent survey by the American Society for Aesthetic Plastic Surgery (ASAPS), an association of board-certified plastic surgeons. "What you're seeing in Hollywood are a lot of the distortions of plastic surgery and not always the greatest results," says Rod Rohrich, MD, president of the American Society of Plastic Surgeons and Chairman of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas. "Americans don't want to be transformed into another person. They want to look like a younger or better version of themselves." And how! In 2004, plastic surgeons performed nearly 11.9 million cosmetic procedures (90 percent of them on women), an increase of 44 percent over 2003. Less invasive, nonsurgical procedures are up 51 percent, according to ASAPS.

Why Is Plastic Surgery So Popular?

What's making plastic surgery so popular? "Safety, affordability, and media exposure," says Laurie A. Casas, MD, Communications Commissioner for ASAPS and an Associate Professor of Surgery at Northwestern's Feinberg School of Medicine in Chicago. Also, "Surgeons are always exploring less invasive, less complicated procedures that accomplish the same results," adds Gary S. Berger, MD, a plastic surgeon in private practice in New York City.

For example, fueling the surge are the less costly, nonsurgical procedures, like Botox, Restylane, and other injectable, wrinkle-busting substances. When a doctor injects Botox (a purified form of the bacteria that causes botulism) into lines between the eyebrows, it paralyzes muscles, causing the wrinkles to relax. The results are usually immediate and patients can return to their regular routines right away. "Everyone likes a quick fix," says Rohrich.

The average cost of Botox is about $400 per procedure. Compare that with $2,700 for a brow lift, a surgical procedure that may achieve similar results. In 2004, Americans opted for the shots more than 2.8 million times, up 25 percent from the previous year. "It's a small procedure versus a big operation," says Dr. Casas. "It's not as big a commitment." The downside is that Botox only lasts about three to six months, so repeat visits are typically necessary to maintain the same result.

Who Are the Patients?

The patients lining up for these and other cosmetic procedures are generally between the ages of 35 and 50; together this age group underwent 45 percent of all procedures in 2004. "Baby boomers want the maximum results with minimal or no downtime. They want to look as good as they feel," says Rohrich. In addition, 20 years ago people used to hide the fact that they had had plastic surgery. In 2004, it's no longer "hush-hush." According to a recent ASAPS consumer survey, approximately 82 percent of women said they would not be embarrassed if individuals outside their immediate family and close friends knew they had undergone cosmetic surgery.

If you're planning to invest in plastic surgery, the best ways to achieve satisfying results are to find a highly qualified, board-certified plastic surgeon and to educate yourself about the pros and cons, particularly the potential risks. Today you can literally find a procedure to improve your looks from head to toe.

11 Popular Procedures

Blepharoplasty (Eyelid Surgery) A procedure that can reduce puffy "bags" under the eyes and remove droopy, loose skin hanging down from upper eyelids. The surgery can be performed to add an upper eyelid crease to Asian eyes, but it will not erase evidence of racial heritage.

Botox (Botulinum Toxin Injection) Unlike injectable fillers, which add volume to plump up wrinkles, Botox is injected into a muscle, blocking nerve signals that make the muscle contract. This weakens or paralyzes the muscle, causing the wrinkle to smooth out or disappear.

Brachioplasty (Arm Lift) A surgical procedure that reduces flabby, loose skin in the upper inner arm.

Breast Augmentation (Breast Enlargement) The second most popular cosmetic surgical procedure after liposuction, this procedure enhances the size and shape of breasts. Breast augmentation is also performed to balance a difference in breast size or as a reconstructive procedure following breast surgery.


Breast Reduction (Reduction Mammoplasty) Breast reduction can change the size, weight, firmness, and shape of breasts. Of all body image changes, patients report that breast reduction has in the quickest results.

Chemical Skin Peel Designed to clear up the skin's imperfections -- such as sun damage, uneven pigmentation, fine wrinkles, lesions, and growths -- by peeling away the top layers of skin.

Facelift A facelift is a surgical procedure used to remove wrinkles and sagging of the face caused by age.

Injectable Fillers A doctor injects a substance into wrinkles or creases to add volume or plump them up and make them less noticeable.

Lipoplasty (Liposuction) The removal of fat using suction. First introduced in the United States in the early 1980s, many refinements have been added to make the procedure safer and to provide more precise results with quicker recovery times.

Rhinoplasty (Nose-Reshaping Surgery) A procedure to alter the size, shape, and angle of the nose to enhance its appearance. The procedure may also be performed to correct breathing problems, chronic congestion, and deformity caused by injury, disease, or birth defect.