Are reality TV makeovers positive or negative for the business of plastic surgery?
In January 2003, ABC-TV began a new trend in reality television programming when it began airing a show titled “Extreme Makeover.” This program is a “reality-based” extravaganza in which up to three participants per week are followed through what the producers call a “makeover.”
Participants are selected from a pool of volunteers and then sent to Los Angeles to undergo a six-week transformation. The “extreme makeovers” that they receive include not only a wide range of cosmetic surgery procedures and extensive dental work, but also hairstyle, make-up and clothing sessions done by professionals. Furthermore, they meet with a nutritionist and a personal trainer.
By all accounts, the results are dramatic and the participants appear to be thrilled with the final results. On the heels of this show’s success, such programs as Fox’s “The Swan,” a post-plastic surgery beauty pageant, and MTV’s “I Want a Famous Face,” a celebrity look-alike contest, have followed suit. Television has exploded onto a new frontier.
Harmless Versus Harmful
Many believe that these programs are harmless. However, I beg to differ. The impact of these shows on the general public runs much deeper. For example, the average age of an individual who watches MTV’s “I Want A Famous Face” is only 21—legal by government standards, but maybe not mature enough to grasp the enormity of the decision to have cosmetic surgery. Do we really want to fill young minds with the idea that larger breasts, straighter teeth, and blonder hair will eliminate all of their problems and insecurities? We are working with a very impressionable age bracket and must do so with great care.
Furthermore, this program endorses young people who are trying to look like famous celebrities, not just improving their own likeness. Are we comfortable with telling these young people that their own image is not good enough? The frightening part—the surgeons who bow to their requests to look like Brad Pitt or Jennifer Lopez— with no note of caution. Isn’t it our responsibility to care for our patients’ psychological as well as physical states? One cannot become another person simply through surgery. And the number of very young folks who are receiving cosmetic surgery is rising rapidly. This is potentially dangerous.
Realistic Expectations for Patients
As not only the president of the American Academy of Cosmetic Surgery, but also a cosmetic surgeon for more than 30 years, I believe that these types of “reality” programs do more than just raise red flags in my mind. It would be easy to argue that they “are good for business” or “raise the public’s conscience about cosmetic surgery.” There is much more at risk. By communicating such surgical procedures through a vehicle like television, the viewer is told that every surgery is easy, flawless, and hazard-free. We know better. Surgery involves blood, pain, bruises, and the occasional complication; and these realities are never portrayed on television. Moreover, the lengthy healing process is never properly documented. And these programs are called “reality TV?”
I would be naïve to believe that all of these programs have not affected my practice or my affiliated organizations. I have been told that after such a program as “Extreme Makeover” airs, the number of hits that the American Academy of Cosmetic Surgery’s Web site receives rises substantially. People start talking, they get interested, and they want to know more. Many of my colleagues have chosen to embrace these types of television shows. They wrap advertising around the show’s commercial breaks, they try to engage local television stations into producing their own “extreme makeovers,” and they even try to become surgeons on the show. These are all valuable ideas that are worth exploring, but I must offer them my words of caution. One hour of media and public relations exposure may not be worth the price that is being paid by our specialties.
A Big Responsibility
I understand, especially with many of the young surgeons I speak with on a regular basis, that the pressure to complete medical school and the subsequent training is enormous. Your expenses from such a lofty education are high, and your need to establish your practice is critical. However, as a more seasoned surgeon, I want to remind you that making the commitment to train as a surgeon is a long road. As surgeons, we all have a responsibility not only to our patients, but our potential patients as well. For the majority of my career, I have followed two mantras: “There are no minor surgeries, only minor surgeons,” and the American College of Surgeons’ “Do no harm.” I do not believe that programs such as “Extreme Makeover” offer enough positive results to outweigh the potential negative outcomes. Nothing is minor when is comes to caring for our patients.
As medical professionals, we have a responsibility to elevate our specialty to new levels by encouraging the public to make educated choices, to ask the proper questions, and to feel empowered by their decisions. Today, cosmetic surgery is more prevalent than ever, which only makes our job tougher. We must not only educate our patients, but help them traverse the many myths and misinformation.
Therefore, I can only offer my extreme caution to every surgeon out there. We have difficult waters to navigate on a daily basis. These types of television programs may open the public’s mind, but are we comfortable with the message that is entering their consciousness?