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Extreme Plastic Surgery: How Much Is Too Much?

Are your expectations reasonable, or are you starting to obsess?
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By Tammy Worth
WebMD Feature
Reviewed by Laura J. Martin, MD

It may start with one body part. A woman goes in for a tummy tuck after having kids. The surgery is relatively painless and successful, so she figures, why not try another? Maybe a breast lift or a nose job. And what about those little lines that have started appearing around her eyes when she laughs and forehead when she frowns... well, those can be taken care of, too, she tells herself.

Cosmetic surgery is no longer just for the rich and famous. It has gradually seeped into the mainstream.

The number of cosmetic procedures performed in the U.S.  has soared in the past decade, from 940,000 in 1997 to more than 1.6 million in 2010, according to the American Society of Aesthetic Plastic Surgery.

“Now it’s not framed as this kind of freakish thing only celebrities do," says Natalie Wilson, PhD, a professor in the women's studies program, literature and writing at California State University San Marcos. "It’s acceptable, expected, and you can get it on your lunch break.”

For some people, it goes too far. And it's not just the Hollywood crowd that's altering their bodies -- sometimes in extreme ways -- to reach their idea of perfection.

How Much Is Too Much?

According to the American Society for Plastic Surgeons, business from “repeat” patients grew by 13% from 2009 to 2010.

It's relatively typical for people to come in and have two to three surgeries performed at once (like the so-called “mommy makeover,” consisting of a tummy tuck and breast lift), says Phil Haeck, MD, president of the American Society of Plastic Surgeons.

Though he says it’s not the norm, he says he has heard of surgeons spending 10 or more hours performing numerous elective surgeries at once.

Wilson, too, has heard many stories of someone going in for one procedure and leaving the office thinking they need four. She says practices such as “up selling,” offering credit plans and reducing prices for multiple procedures, are not uncommon.

“I have talked with people who go in for a nose job or tummy tuck and then start getting marked up” by the surgeons, Wilson says. “Not all surgeons do that, and some turn people away, but that is how they make their money -- by doing surgery.”

David Reath, MD, a plastic surgeon in Knoxville, Tenn., says he doesn’t see a lot of people wanting extreme surgery, but it does happen. And it’s not always easy to recognize when there might be an issue.

“Sometimes you start working with someone who is reasonable and the more you work with them, you begin to realize you will have to extricate yourself,” he says.

Part of the reason it is difficult to know how much is too much is because it varies from person to person, Reath says.

Some patients may be fine getting three procedures. For others, one may be too many. Knowing if there is a problem starts with figuring out why the patient wants the surgery.

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