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How Much Is Too Much?

Over-bleaching, over-tweezing, over-Botoxing.... The craze in upkeep has women so hooked, doctors and industry pros are now turning them away.

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Dr. Patricia Wexler, a prominent Manhattan dermatologist, says that some women who land in her waiting room are victims of the rubber-mask effect. "Their skin has no texture whatsoever; it's been peeled and lasered so much that it's lineless and has no pores. They ask for filling to augment a nose that's been reduced four times; they ask to fill cheeks that are already too big."

Dr. Harold Lancer, a Beverly Hills dermatologist, explains the problem with today's antiaging gluttons: "Too much laser work, and you appear a little marbleized. Too many chemical peels, and you look chronically inflamed. And then you have the overfilled look, like a puffer fish."

Yep, we're well acquainted with it (see Lara Flynn Boyle). "Most of these patients aren't aware that they look artificial," says Dr. Foad Nahai, president of the ASAPS. "The majority of cosmetically addicted people have forgotten what they used to look like," adds Lancer. "They're caught up in the method of excessive maintenance, plus they're surrounded by others who think the same way."

The pressures facing celebrities in today's youth-obsessed culture are enormous. While airbrushing technologies have made it possible for stars to show up at photo shoots 10 pounds overweight and still look perfectly toned on magazine covers, the looming specter of universal high-definition TV demands an almost unprecedented level of head-to-toe perfection. Porn star Jesse Jane has already cited this technology as the reason she had her breast implants rejiggered — but don't expect the same candor from mainstream stars!

Doctors say they are aware of the problem and are taking steps to address it, which is in itself significant. Overindulgence in aesthetic treatments has been a problem since plastic surgery was invented some 200 years ago (initially to treat war wounds, by the way — not droopy jowls), but the effort to sensitize plastic surgeons on the topic has only begun in earnest in the past 10 years. The ASAPS, says Nahai, now regularly invites psychiatrists to speak at its seminars. One thing doctors are taught to look out for is body dysmorphic disorder (BDD), a psychiatric condition affecting a small percentage of overenthusiastic antiaging patients. BDD sufferers are chronically unhappy with one or more perceived physical flaws and often continue to be unsatisfied despite repeated surgeries. The Los Angeles Body Dysmorphic Disorder Clinic (you knew there had to be one) estimates that 1 to 2 percent of the population has BDD, though of course not every sufferer undergoes plastic surgery. "If someone in their mid- to late 20s or early 30s has already had six or seven cosmetic operations, that's a red flag," says Nahai. Doctors say they try to determine a patient's motivation for seeking surgery or enhancement, and screen particularly for recent upheavals like divorce, which may indicate a patient is seeking treatment to handle a problem larger than crow's-feet. Such patients are often referred delicately to a psychiatrist. "BDD is not treated with surgery; it's treated with psychotherapy and antidepressants," says Sander Gilman, Ph.D., director of Emory University's Program in Psychoanalysis.

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