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Wednesday, November 23, 2005

The Record (Bergen County, NJ)


Flaunting those nips and tucks -- PLASTIC SURGERY HAS BECOME MAINSTREAM


Date: 05-30-2004, Sunday

Section: LIVING

Edtion: All Editions.=.Sunday

For 10 years, 47-year-old Jane M. watched enviously as other women got their tummies tucked by the plastic surgeon whose Paramus office she manages.

But last June, she finally got her own done (with a little lipo while they were in there), and ever since, the envy has been flying the other way.

"Oh my God, I wish I was you," friend after friend has said.

Goodbye shame, hello scalpel. Plastic surgery is morphing into a mainstream beauty tactic. Going under the knife for a tighter face or slimmer stomach is becoming more about good grooming, sort of like waxed eyebrows and manicured nails, and less about gaudy vanity.

"It's so much more acceptable today - not like years ago, when people were afraid to tell people," said Jane's boss, Paramus plastic surgeon John T. Cozzone. "And it's not just for the wealthy. Everyday normal people are doing it."

And they are doing it before our very eyes. The spring prime-time television schedule was bursting with reality shows spotlighting the transformation of average-looking individuals into "beautiful" people. No matter that it may have involved three, four, or 12 surgical procedures. In almost every case, at least as portrayed by the sheer joy at their "reveal," the ends justified the means.

This is all part of the normalization of a cultural phenomenon, said critic Virginia Blum, author of "Flesh Wounds: The Culture of Plastic Surgery." We are mid-stride in the evolution from outrageous to ordinary.

"There is a feeling that if you can transform yourself, you can have a different life. That's really an American story. And then it gets yoked to consumer culture. Buy this and you will feel better. A better body becomes something you buy," said Blum, who herself had a nose job when she was a teenager.

The new packaged , in which a patient opts for a combination of procedures, "is like buying a car with all the perks. There is nothing left wanting," she said.

Before the Seventies, people who had cosmetic surgery were considered pathological, Blum said. In the Eighties, celebrities who got it done were "outed" in tabloids and risked humiliation. Remember - just a couple of years ago - the tempest over the eye job Greta Van Susteren got before moving to Fox News Channel?

Soon, Blum argued, we will come to a time when it will be like getting braces, and people will wonder why someone didn't get to fix their body.

"With Greta Van Susteren it will be like: 'Why didn't she have a whole lower body lift? She only had her eyelids done?' It will move into a place where we criticize people for not having done more," she said.

Sander Gilman, who has written two books about the history and culture of , traces the growing comfort with to the mid-Nineties, when the Discovery Channel first ran shows depicting patients' experiences.

This season, there were four prominent shows; two - ABC's "Extreme Makeover" and Fox's "The Swan" - were reality shows in which candidates were treated to a variety of services, usually including a large number of surgical procedures. The two contestants on "The Swan" then went on to compete for a spot in the show's own beauty pageant, causing a stir among critics.

MTV's "I Want a Famous Face" was a documentary series featuring young Americans who wanted to look more like a certain celebrity and often used implants, lifts, and a host of other surgical techniques to make their dream come true. FX's "Nip/Tuck," a scripted drama, begins its second season June 22. "The Swan II" debuts in November.

Plastic surgeons say the programs have swelled their waiting rooms with new patients at a time when was already on the rise. In 2003, doctors performed more than 8.7 million cosmetic surgeries, up 32 percent over 2002.

"Especially this 'Extreme Makeover' has increased the volume of people who come into the office," Cozzone said. "It has had a positive effect."

Unlike the makeover shows, where the transformation can be dramatic, the vast majority of clients are not looking for wholesale makeovers, said New York plastic surgeon Mauro Romita. Rather they want smaller fixes, for concerns such as a bump in their nose or too many wrinkles, he said.

Still, the American Society of Plastic Surgeons (ASPS) was thrilled with "Extreme Makeover."

"Out of it came many good lessons," said Montclair plastic surgeon Allen Rosen, an ASPS spokesman. "They were taking patients with real cosmetic concerns and seeing that at the end of the day, they were feeling good about themselves."

And it just happened to have altered a lot of people's minds about , including that of one of the show's executive producers, Lou Gorfain. Before viewing an episode, he considered "a vanity thing" and the concept for the program "very exploitive."

"I thought, 'What has reality TV come to: carving up people for the amusement of millions?'-" he said.

But when he saw the impact of the surgeries, his impressions shifted.

"These were people whose lives were deeply, deeply affected by their appearances. The changes they made were more than cosmetic. They made a holistic impression," he said.

MTV's "I Want a Famous Face" was more disturbing, perhaps because it documented an extreme segment of our society. MTV did not pay for the surgeries, it simply followed people who were willing to pay a high price, in both pain and money, for their new look.

Kate Winslet said she wept after watching a show in which a fan underwent extensive surgery to look more like her. In another episode, a blonde wanted the bust of Pamela Anderson so she could be a Playboy Playmate. A third spotlighted two brothers' efforts to resemble Brad Pitt.

Rosen said a proper surgeon's job is not to make others look like someone else, but to enhance and "bring into balance" the individual. However, the idea for the show came after following around young patients, most of whom brought in photos of celebrities, said co-creator and producer Marshall Eisen.

"We're documenting what's really happening out there. Part of what's shocking to some people who see this is finding out how prevalent it is out there," he said. Rosen argues that when patients bring in a photo to his office, which they do frequently, he uses it to help identify what they desire in a feature - sculpted and balanced or chiseled and strong - as opposed to trying to replicate someone else's nose on another individual's face.

But Eisen was not surprised to find so many people who wanted to look more like a celebrity. We live in a culture with an established beauty ideal, so it's a natural outgrowth, he said.

Nely Galán, creator of "The Swan," loves the idea that will soon be considered as normal to Americans as apple pie, as it is in much of the Latin world.

"To say you have is a status symbol. Beauty is very important to us," said the Cuban-American, who hails from Teaneck.

American women feel bad about themselves because they can't measure up to a celebrity beauty that exists largely as a result of the most of the stars are getting done, she said. As Galán sees it, the problem is not that people are getting the work done, but that no one is admitting it.

Perhaps, she said, if the media were more honest with their images of women, people would feel less need to achieve the same level of unattainable perfection.

"I hope that within the next five years, it will be very cool for actresses to admit what they've gotten done instead of all trying to hide it and make people feel bad and think that they are somehow genetically better," she said.

Studies three years after cosmetic surgeries show that patients remain satisfied, Gilman said.

"How many people, after three years, are still satisfied with their cars?" he asked.

Blum, however, is less certain.

"I'm not anti-. But I think it is not making people as happy as it promises to," she said.

Less invasive procedures and more outpatient work are making the procedures easier to obtain, another factor contributing to the increasingly blasé attitude toward the surgery.

Romita has an operating room in his Fifth Avenue office, where he can perform a short-scar face-lift, rhinoplasty, and breast augmentation, among other procedures. The shorter surgeries, which require less anesthesia, are more appealing to people who don't want to stay in a hospital and don't want to be out of commission for long.

"Now it's like taking a gallbladder out," Romita said. "Safer, faster healing, and the results are better."

Traditional costs have held steady for the past five years, but now the outpatient procedures are cutting them significantly. Anesthesia is 20 percent cheaper, and the facility costs are about 60 percent less. Where a hospital face-lift may cost between $4,600 and $5,000, a similar procedure in Romita's office might be $3,000, he said. The same is true for eyelids and noses.

Still, there are many people like Jane M., the doctor's office manager, and an Oradell real estate broker interviewed for this story, who are very happy with the outcome of their surgery but remain reluctant to be quoted by full name.

"I'm absolutely thrilled. It feels good," said the 52-year-old real estate agent, who got her eyes done and plans to get a face-lift in a few years.

"I don't think I would say too much to too many people," she said. "There's bound to be a story, some horror story, and that's not what you need to hear."



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