Ten thousand applicants tried for a spot on Extreme Makeover's second season.  The popular T.V. show is one in a line of many other reality programs and primetime dramas that take a look at the world of cosmetic surgery.  On Extreme Makeover, participants are away from their families for several weeks, during which time they undergo a number of different cosmetic procedures, and meet with personal trainers and fashion consultants who teach them how to uphold their improved look.  A good portion of the weeks away is spent recovering from surgery and working with makeover specialists.

The show emphasizes the willingness of the participants to stick to a regimented exercise and diet plan.  Also, because the surgeons used for the show are given final veto power over the participants, they have realistic expectations of what will happen after surgery and are willing to do whatever it takes.

Cosmetic Surgery Organizations React

Of course education and understanding expected results are something plastic surgeons have been preaching to their patients for years.  Not surprisingly, shortly after plastic surgery reality T.V. shows like this one, The Swan, and I Want A Famous Face, most cosmetic surgery organizations, including the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) have issued statements urging patients to be reasonable and educated when choosing elective surgery.  As the marketplace expands and advances, and with media attention and television programs that portray either incredible success or surgical disaster, it is no wonder that patient education is seen as a top priority for most cosmetic organizations.

James Wells, former president of the ASPS further emphasized this point; quoted in an April 2004 article for National Geographic as saying "These shows (The Swan and I Want A Famous Face) are in very bad taste.  They really tread on the insecurities of the patient."  Wells offered his early endorsement of Extreme Makeover in 2002 because practicing surgeons were given final permission to veto potential patients, and because he believes it offers a more realistic impression, following patients from consultation through the follow-up.

More about Plastic Surgery

In earlier years, plastic surgery was seen as Hollywood extravagance, and most people marveled at the facial and body changes and unnatural youthful appearance of celebrities like Joan Rivers.  Now this couldn’t be farther from the case.  With financing options now available, plastic surgery has worked its way into new markets including men and the middle class, and most patients are very open about the procedures that they have had done, often having coming out parties to show off their new look.

With around 8.7 million cosmetic procedures performed in 2003, and most patients happy with their results, it is evident that plastic and cosmetic surgery can mean success for prepared patients.  Last year numbers reached an all time high, and with the dramatic increase in procedures like body contouring after bariatric surgery and buttocks implants, operations that reflect the latest cultural shifts, the numbers only promise to grow.

What People Are Getting Done

Participants on Extreme Makeover undergo a wide variety of operations, not necessarily limited to the plastic surgery specialty.  Many people get procedures such as porcelain veneers and teeth whitening to enhance their smile, LASIK eye surgery to correct vision, and hair transplants to combat male pattern baldness.

Of course cosmetic plastic surgery is found in no short order, and its no surprise that many guests choose some of the most popular procedures going.  For the women, procedures like breast augmentation, rhinoplasty (nose job), Botox injections, tummy tuck, and chemical peels, among others, produce the desired youthful and slimming look many of these women are going for.  Of course the men are getting in on the act too with face and body implants such as chin augmentation and male breast implants to make them look more fit.  They are also getting procedures that have been making women look better for years, like eyelid surgery, brow lifts, face lifts andliposuction.

What You Need to Know About Multiple Cosmetic Procedures

On Extreme Makeover patients are getting several procedures done during a single session.  Sessions such as these occurred in rare numbers before the show aired, but now more and more patients are walking into their plastic surgeons with a wish list, wanting three or more procedures at a time.  Another new trend; they know the name of the procedures they want performed.  Before they knew the problem they wanted corrected, they had bags under their eyes and wanted that fixed, now they come in asking for blepharoplasty (eye lid surgery).  

For the most part, surgeons are willing to perform more than one procedure at a given time, but the general consensus is that more than six hours under general anesthesia is too great a risk. In the July/August issue of Aesthetic Surgery Journal, Dr. W. Grant Stevens and two colleagues published the results of a study comparing abdominoplasty surgery performed with no other surgeries with the same procedure in conjunction with one or two others.  The results showed no significant difference in adverse effects.  Many surgeons agree that multiple surgeries are a viable possibility if the patient's health warrants it; after all, safety is the main concern.  Skeptics like Dr. Charles E. Hughes III, who wrote a rebuttal to Stevens' study in the same issue, are fearful that others might not have similar success, as more time on the operating table equals increased risk.  

After Multiple Procedures

The longer a patient is under general anesthesia, the longer the recovery period after.  This is because anesthesia strongly affects the cardiovascular system.  For this reason, there are some surgeons who prefer having to put their patients through surgery only once for a longer duration.  Soreness is generally greater after multiple procedures, and swelling usually lingers longer, therefore the option of more than one procedure during a single session is only an option for those who have adequate time to recover.  On the flip side, some surgeons wish to perform procedures on their patients one at time so that the progress can be gauged after each surgery, and the next can be altered, where necessary, to produce better, more directed results.   

Whichever option you choose, as always, you should do so carefully.  Select board certified physicians, allow for sufficient recovery time, and always follow your doctor's instructions as closely as possible. 

In this cultural climate where the cosmetic surgery boom meets the reality T.V. craze, doctors are enjoying an increase of patients at their front door.  This doesn't always translate to success, however, if the patient's expectations hover over the realm of the possible. Now is the time for patients to be educated, prepared and willing to make the necessary lifestyle changes.