Julie Albright

Have you ever had a patient walk in who wants to have a nose job, breast job, or some type of surgery, and you know just by looking at her she really doesn’t need it? What makes a perfectly beautiful woman risk her appearance, health, and—potentially—her life? A recent study says the media—that’s right: television, movies, and magazines—is the largest contributor to your business.

Julie Albright is a professor at the University of Southern California who has developed notable research1 and even a documentary2 about the impact of media and reality makeover television shows on women’s body image and anxiety. Young, impressionable girls don’t always realize that what they see on television isn’t necessarily real. Is this a problem for you or just good business?

Albright looked at the media’s impact on actual plastic surgery patients—their expectations, satisfactions, and the connection “between watching such reality makeover/plastic surgery shows and what their expectations are for their own transformations,” she says. “We are already seeing the impact on college students that haven’t gotten the plastic surgery yet but have gone to the next step.”

The study was published in the spring of 2009 Configuration, a journal of literature science and technology out of John Hopkins University. “It was predated 2007,” Albright adds.

“It is a quantitative study. We studied 662 undergraduate college students in Buffalo, New York, and Los Angeles,” she notes. “We looked at these two areas to see if there were regional differences. It actually turned out to be a ‘class’ issue between the two.”

According to Albright, when she measured social class she looked at occupational status, education, income, or some combination of the above. “It turns out that LA has a much higher parental income, of over $100,000 or above.

“Fifty percent in LA have incomes that high, but only 22% in Buffalo. Another indication of class is mother’s educational attainment. In LA, the mothers most often had a bachelor’s degree while in Buffalo they had only graduated high school. Typically, Buffalo is more of a factory town. The people are blue-collar factory workers.”

Los Angeles has a higher percentage of professionals, as well as more highly educated parents, she adds.

Albright focused on the women depicted in recent plastic surgery makeover reality television shows, such as Extreme Makeover, The Swan, and Dr. 90210. “The literature has not really looked at the impact of viewing these reality makeover shows on one’s own body image, anxiety, and things of that nature,” Albright says.

“That’s what I wanted to see. Is there an impact on body anxiety for the viewers of these shows? We have seen by looking at media that particularly teens and young women take as role models the images they see on TV or film. In fashion magazines, for example, images of thinness are portrayed by the beauty standard of the long-legged, big-bosomed, blonde female.”

Recent research in this field has not looked at what effects these increasingly popular shows might have on body anxiety and related psychological issues, Albright says. “Although these makeover shows have more viewers than the Miss USA contest,” she adds.

Albright asked the question, “Are makeover shows increasing or exacerbating beauty anxiety among young women?”


“Buffalo watches more of these shows than the [viewers] in LA,” she explains. The Buffalo respondents showed “higher levels of anxiety regarding different parts of [their bodies]—their waist, thighs, hips, butts, and breasts. The women in Buffalo did show a higher level of anxiety than those in LA.”

How does this information apply to plastic surgeons? Physicians should know that people in Buffalo evaluate themselves more negatively than those in Los Angeles, Albright says.

“Look at the general outcome of this anxiety. People in both Buffalo and LA, to a level, were worried or embarrassed about their features. They want to avoid work, as well as social situations with friends, relatives, and acquaintances. Some even avoid close physical contact with others, sexual activity, and things like that,” she says.

This “curvaceous beauty anxiety,” as Albright describes it, invades other areas of the respondents’ lives, “with friends and social situations,” Albright notes. As a result, they were seeing themselves either as a bad person or inexpert at life.

Is the solution to dealing with this anxiety to have plastic surgery?

“That is one thing the doctors may want to ask more about. How distressing is the disliked body part to the patient? Is it impacting other areas of their lives, like their social interactions, or their abilities to perform their work? For example, the Buffalo people, as a result of their appearance, question their own abilities,” Albright says.


The makeover reality shows have common elements, according to Albright. They are set in high-class environments, such as Beverly Hills and Miami Beach, and embrace the accompanying lifestyles. The subtext in these shows is like a “Cinderella” story.

“As women age, we are going to be seeing more women try and maintain their youth and beauty to try and hold onto their husbands. They think if they have these surgeries and are beautiful, they can get the prince and they think they will feel good.”

If getting plastic surgery was merely about feeling good, then women wouldn’t necessarily carry around high levels of anxiety over it, Albright says.

Research suggests that women getting breast augmentations and other surgeries are, perhaps, Albright notes, more often also in the psychologist’s office dealing with things like body image and anxiety disorders.

However, the research in incomplete, she says. “It has been documented that there is correlation between people who have had breast augmentations and suicide.

“I did a show called Made Over in America [in which] we followed this girl that had multiple surgeries,” she says. “I thought, wouldn’t it be ironic if you go through all these surgeries and nothing happens? Your body goes through all these physical changes, but your life doesn’t transform in some fundamental way to make you happier. It may be that there are psychological issues alongside the body-image issues that need to be dealt with. Surgery alone may not be the magic bullet for those types of issues.”

Ultimately, she continues, some patients may tap into a neurosis that feeds itself in the first place and ultimately does not satisfy the problem.

“It can’t ultimately satisfy because of the aging process,” she adds. “Women will always see that next flaw, and advertising always points it out to them. These plastic surgery shows diminish the pain and downtime associated with surgery.

See also “The Shape of Things to Come” by Wendy Lewis in the January 2008 issue of PSP.


Some doctors are also going beyond their training and experience. Media indicates you can have multiple procedures and just come out looking beautiful. They don’t show the downside: the downtime. They don’t show the deaths, the disfigurements.

“By using the word ‘cosmetic,’ the procedure is made to sound no more dangerous than putting on lipstick. That is not exactly the truth of the matter. The shows are minimizing the physical impact of what could happen when you have several procedures at one time. The professionals need to think about that, too.”

The surgeons, however, should overstate the potential downside or be extra cautious to protect self and patient, according to Albright.

“It behooves the profession to regulate itself because so much is at stake,” she adds.

Shannon Triplett Leade is a contributing writer for PSP. She can be reached at [email protected].


  1. Albright J. Impossible bodies: TV viewing habits, body image, and plastic surgery attitudes among college students in Los Angeles and Buffalo, New York. Configurations; Project MUSE. 15;2:103-123.
  2. “Made Over in America: A Film Preview and Discussion of Beauty Culture and Plastic Surgery.” Wegenstein/Rhodes Productions, 2007.