The Stepford Syndrome

Is the quest for physical perfection creating a nation of Stepford wives?

From the WebMD Archives

Are we nip-and-tucking ourselves into Stepford-dom? The popularity of plastic surgery reality TV shows, cosmetic surgery, and magazine covers featuring women and men with perfect figures suggest that this may be the case or goal.

As a remake of the classic 1975 thriller The Stepford Wives opens nationally this week, many are speculating that what was once satirical is becoming empirical. And what was once contained to the fictional town of Stepford is now spreading rapidly across the globe.

The original production focused on creating the perfect, dutiful, and subservient robotic wife, but early reports suggest the remake emphasizes cosmetic surgery as a way to create the ideal spouse. In fact, the movie web site offers a feature in which surfers can upload their own pictures for a Stepford makeover. In the remake, Joanna (Nicole Kidman) and her husband (Matthew Broderick) move into the suburban community of Stepford. Joanna notices that the local housewives seem too perfect. After some investigation with her new friend, Bobbie, played by Bette Midler, she finds out that the men of Stepford have been replacing their wives with primped-up robots.

Is There Really a Stepford Syndrome?

Plastic surgery reality TV shows such as Extreme Makeover, The Swan, and I Want a Famous Face, which dramatically alter a person's appearance, may make it seem like there is a Stepford syndrome. Many of the contestants, after undergoing multiple procedures, look similar to other participants or as in I Want a Famous Face, to actor Brad Pitt. In addition, media hype on the myriad of options that exist to create the perfect thigh, nose, or breasts may tempt women into the physical or cosmetic embodiment of Stepford wives.

If there is a Stepford syndrome, it's media-driven, says New York plastic surgeon Lawrence Reed, MD. "The media is creating the impression that everyone has to be beautiful and have a perfect face," he says. "There is a perception generated today that if you are not perfect, you don't exist."

Reed and others say their goal of plastic surgery is not to create the perfect person, "but to level the playing field. We live in a society where fortunately or unfortunately, appearance is coveted," Reed says.

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"When you watch anchor people deliver the news or look at covers of magazines, you don't find unsightly people," he says. In the classic sense, Stepford syndrome "is more about having an attractive, dutiful, and subservient wife," he says. Reed does not have -- nor does he want -- a Stepford wife in the classic sense of the word. He says his wife works hard and he does not need to come home to a hot meal and ironed shirts.

This is "misogynistic and inconsistent with modern times," he says.

"'Stepford' is not an appropriate goal for any type of aesthetic procedure," adds Santa Monica, Calif.-based plastic surgeon Michael F. McGuire, MD, public education chairman of the American Society for Aesthetic Plastic Surgery (ASAPS). "The Stepford concept is [the creation] of controlled, automaton-type individuals and appearance is part of it." Improving appearance can have an indirect effect on how people function, but certainly not as dramatic as in the town of Stepford.

"I don't think women or men in the U.S. are seeking surgery to be ideal in the aesthetic sense," he tells WebMD.

"Most are not really seeking to become different people," he says.

Empirical Evidence Mounts

One fact is indisputable: Cosmetic surgery is on the rise. The number of surgical and nonsurgical cosmetic procedures in the U.S. increased by 20% in 2003; reaching nearly 8.3 million, according to ASAPS statistics. Surgical procedures, notably liposuction, breast augmentation, eyelid surgery, rhinoplasty (nose job), and female breast reduction, increased 12% and the number of nonsurgical procedures, such as Botox, laser hair removal, and collagen injections, climbed 22% from 2002. Since 1997, the overall number of cosmetic procedures jumped 228%.

Who Is Fueling Stepford Syndrome?

The ASAPS reports that women had 87% of cosmetic procedures; comprising 7.2 million procedures and an increase of 16% from 2002.

But who is driving it?

In Stepford, the men rule the roost, turning their wives into pretty, prim, and proper pieces of eye candy -- but in reality, women seem to be driving the quest for physical perfection.

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"The truth is husbands almost never come with their wives, and they all tell their wives not to do it and that they don't need it," Reed explains. "It is very rare that men drive women to undergo cosmetic surgery."

And this is the way it should be. "When you come in to do your face, eyes, breast, or behind, the only person it should be for is you -- not your husband or your boyfriend," Reed says.

"About 95% husbands say, 'You are my wife, I love you, and don't mind that your neck is flabby or whatever [the perceived imperfection is],'" he says. In fact, Reed says, men get very nervous at the thought of their wives going under the knife. For these reasons, many women choose to undergo surgery when their husbands are out of town. But once the husband sees his newly rejuvenated wife, "they are so happy and often joke that their wife will now leave them for a younger man."

McGuire adds that "in many of these reality TV shows, patients are told what they need and that is not how a consultation goes -- surgeons don't suggest surgery to patients, McGuire says. People on these shows "are being moved to some type of ideal appearance, but it is largely driven by the plastic surgeon."

Botox Behaving Badly?

Botox injections continued to rank first among all cosmetic procedures combined, increasing 37% from 2002, according to ASAPS statistics. As a result, media reports suggest that some Hollywood directors are complaining that actors older than 35 can't look angry anymore because the Botox has paralyzed this ability. In a sense, there is a Stepford factor at play since they all have the same expression now.

This is why, "with my celebrity clientele, I caution about using Botox if expression is important," McGuire says. For example, comedians don't want to minimize facial expression.

Realistic Expectations Still Exist

"In terms of my practice, I do not see the quest for perfection," says plastic surgeon Laurie A. Casas, MD, an associate professor of surgery at Northwestern University's Feinberg School of Medicine in Chicago and the ASAPS communications chairwoman. "I see the quest for normal. I see realistic expectations and the desire for subtle change."

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People who Casas sees in her practice often want their breasts or belly back if they lost them due to pregnancy or rhinoplasty if their nose is too large for the face. "I don't get people coming in saying, 'Make me beautiful,'" she says.

"If someone comes in and says, 'I want to look like Barbie,' I would say maybe we could explore why you want this because plastic surgery doesn't change who you are -- just how you feel about yourself," she says.

Perfection is "not stamped on by an external force," McGuire says. Everyone comes in looking for perfection in terms of no scars and absolute symmetry, but aesthetic perfection differs, he says. The perfect African-American nose is different then the perfect Scandinavian nose.

If someone comes in and says I want so-and-so's nose, it can be a basis for discussion, McGuire tells WebMD. "But wanting to look like actress Julia Roberts is not a healthy inquiry or a realistic expectation."

One way to avoid any Stepford syndrome pitfalls is to choose a surgeon who is certified by the American Board of Plastic Surgery (ABPS) and a member of ASAPS. To find one near you, visit the ASAPS web site at www.surgery.org.

WebMD Feature

Sources

SOURCES: Lawrence Reed, MD, New York. Laurie A. Casas, MD, associate professor of surgery, Northwestern University's Feinberg School of Medicine, Chicago; ASAPS communications chairwoman.

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