Unfortunately, there is huge profit to be made in antiaging today, and since even pediatricians and OB/GYNs clamor to oversee medi-spas, patients with BDD can almost always find someone willing to grant them their wishes.
But BDD being rare, the frozen expressions and voluminous lips crowding the Chateau Marmont owe mostly to a more pedestrian impulse. You start and — based on a confluence of factors, emotional and environmental — you just can't stop. Doctors say people with addictive personalities are more prone to overuse, but that it can happen to any of us — provided we're rich enough. (Botox, at an average of $417 a pop, and laser resurfacing, which can run upwards of $2000, are fevers many of us can't afford to catch.) The very fact that many of today's cosmetic treatments are repetitive may make them more addictive.
While it is tempting to think Americans invented plastic surgery gluttony — after all, when we find something we like, whether a hamburger or a handbag, we supersize it — this isn't entirely true. Gilman points out that South Korea has the greatest number of aesthetic surgeons per capita in the world, and Brazil has the greatest number of procedures per capita. It's a burgeoning worldwide obsession he attributes to the rise of a global "health culture" in the past 10 years — fueled by our desire to look younger and more attractive, and thus be more accepted.
Luckily, most trends in this country eventually produce their own backlash (see awfulplasticsurgery.com, an addictive phenomenon in its own right). And these days, most women don't see Janice Dickinson, with her waxlike complexion, as a beauty ideal they wish to emulate. With In Touch accusing Ashlee Simpson of "Botox at 23!" could it be we will become savvier, more skeptical consumers of antiaging treatments thanks to the same tabloid weeklies that sold us on them in the first place?
"Every time Michael Jackson comes on TV, my phone stops ringing," says Dayan. "When celebrities go a little overboard, that actually hurts us. People don't want to look like that."