Popular television shows such as Extreme Makeover, The Swan, and I Want a Famous Face, where participants/patients undergo drastic, life-altering cosmetic surgery on camera, are no doubt the guilty pleasures of the year -- if not the decade.
On The Swan, plain-Jane contestants go through a cosmetic boot camp and ultimately compete in a beauty pageant. On I Want a Famous Face, starstruck patients go under the knife to look like, say, actor Brad Pitt or another mega-star.
And on Extreme Makeover, compelling contestants undergo multiple surgeries and fashion makeovers that turn them from the dumpy to the divine and from the mousy to the magnificent. What's so bad about that? The answer depends largely on who you ask.
While their spins are decidedly different, many plastic surgeons say these types of shows have several alarming things in common -- namely, they trivialize plastic surgery; minimizing its very real risks and set unrealistic expectations for viewers. Others, however, say that these shows can be positive and empowering to viewers.
Risks, Options Largely Ignored
"These shows trivialize cosmetic plastic surgery, and that does such a disservice for the patients," says Laurie A. Casas, MD, an associate professor of surgery at Northwestern University Medical School in Chicago and the communications chairwoman of American Society for Aesthetic Plastic Surgery (ASAPS).
"There is no discussion of options, no discussion of risks and benefits, no sense of the length of surgery or the postoperative course," she says. "That is all glossed over."
As a result, "the public walks away with the impression that cosmetic surgery is no big deal," she tells WebMD. "If it were reality television, it would explain that as consumers, there are options in physicians, locations for surgery, procedures, and the timing of procedures."
Moreover, "reality TV leaves you with unrealistic expectations," Casas says. "There is no way you walk away with realistic impression of what any of this means or costs."
Peter B. Fodor, MD, a Los Angeles-based plastic surgeon and ASAPS president, agrees. "Patients expect a transformation, and that is not realistic, and that is the biggest shortcoming of these shows."
When it is a contest environment like on FOX's The Swan, he says, "there is a tendency to do more longer procedures, and any time a surgery lasts longer than six hours, the risks of complications increase dramatically," he says.
"I can understand how these shows are entertaining to a segment of the population, and claims have been made that plastic surgery has become more popular as a result, but historically increases in cosmetic plastic surgery are more economy-related," he says.
Randall Flanery, PhD, associate professor of community and family medicine at St. Louis University in Missouri, says, "The more we learn about [these shows], the more staged and manipulated they look, but the visual image is very compelling, so we are willing to believe that it's true. I am sure the surgeries are real, but they occur in such contrived situations."