Year of 'Extreme Makeovers'

Today's plastic surgery is quick, with little downtime, and affordable.

From the WebMD Archives

This year, plastic surgery came out of the closet. Extreme Makeovers debuted on prime time TV, and Americans ate it up.

Millions watched as Jeff underwent body-contouring surgery after losing some 150 pounds. Surgeons sculpted him into a new man, carving one foot of droopy flesh from his waistline alone.

Tammy literally glowed after her renovation: eyebrow lift, eye surgery, nose job, countless facial treatments, breast implants, and liposuction. Tooth bleaching, too, was part of her redo -- another trend that exploded this year.

Indeed, it seems the American consciousness has turned a corner. Plastic surgery has lost some of its secrecy. In coffee bars, Pilates classes, and doctors offices across the country, people talked about the "stars" of Extreme Makeovers -- the regular Joes who drew a lucky, all-expenses-paid, head-to-toe makeover.

But there's hope for the rest of us, too. Most plastic surgeons accept plastic.

"Plastic surgery is no longer just for the rich and famous ... it's affordable for anyone who wants to look and feel as good as they can," Rod J. Rohrich, MD, president of the American Society of Plastic Surgeons, tells WebMD.

"We're seeing younger patients, and they want maximum results with minimum recovery -- and with Botox and fillers, with noninvasive techniques, we can do that," says Rohrich, who is also chairman of the department of plastic surgery at University of Texas Southwestern Medical Center in Dallas.

"We're living in the era of age management ... baby boomers don't want to get old, and if they're healthy, they're good candidates for plastic surgery," he says.

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Who's Getting It?

Americans are indeed putting up cash to get trimmed, slimmed, reshaped, and redone. During the past year:

  • Nose reshaping and chemical peels were popular in the under-18 set, though only a small percentage of teens had them.
  • Breast implants and facial microdermabrasion (a "sanding" technique that uses a high-speed rotating wheel to peel away skin) were big in the 19-to-34 age group; they had 24% of the cosmetic surgeries.
  • Liposuction and Botox helped the 35-to-50 age group stave off age; they had 45% of plastic surgeries.

Do-it-together is big: Couples are getting plastic surgeries together, as are moms and daughters, sisters, and friends.

Men are getting plastic surgery to look younger and pump up their careers. Their favorites: nose reshaping, liposuction, eyelid surgery, hair transplants, and ear surgery.

For women, younger and sexier is better: That translates into breast implants, liposuction, nose reshaping, eyelid surgery, and facelifts.

Headline News

This year, two new wrinkle fillers -- Restylane and Hylaform -- inched their way to approval. Whereas Botox relaxes muscles underneath wrinkles, the fillers plump up the area. Both fillers can last two or three times longer than many of the other fillers used now. Restylane got the official FDA nod recently; Hylaform won't be far behind, experts say.

An FDA advisory panel recently gave the nod to silicone breast implants again, stirring up controversy. (The implants were banned in 1992 after claims of serious health risks.) Several public interest groups filed a follow-up letter with the agency, asking the agency not to approve the implants. The FDA has made no final decision as yet.

Not Your Mama's Facelift

A short-scar facelift has gained popularity -- it's the anti-extreme makeover, says Manhattan plastic surgeon Darrick Antell, MD. "We're seeing younger and younger patients who want to look better, not different. They want to look fresher."

This facelift involves shorter incisions than traditional facelifts. "There's no scar behind the ear, so it's really ponytail friendly," says Antell. "There's shorter recovery, fewer complications. You can return to work within 10 to 14 days."

Estimated cost for Manhattanites: upwards of $16,000.

Also, the Schwarzenegger chin is in: "Actually, a strong chin is very attractive on both men and women," Antell tells WebMD. "Sometimes as we get older, we get a little sagging in skin along the jaw line. Rather than having a full facelift, you may be a candidate for a modest implant and liposuction to get rid of the double chin." Most people return to work within five days.

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Body Contouring Is Big

With the rising popularity of weight-loss (bariatric) surgery, people are turning to plastic surgeons to get excess skin removed.

Body contouring "is probably the riskiest surgery of all because of the sheer extent of the surgery," Dennis Hurwitz, MD, a plastic surgeon at the University of Pittsburgh Medical School, tells WebMD. "But as plastic surgeons get more experienced at doing it, the chance of having problems is going down."

He applauds the producers of Extreme Makeovers: "They work with the highest-caliber plastic surgery specialists, and that means the public sees the best of plastic surgery and patient care," says Hurwitz.

Just be prepared for sticker shock, he says. Insurance typically covers surgery when medical issues are involved -- infections, irritations, sores caused by excess skin. But it won't cover the entire procedure. "But people spend $30,000 for a new car, so it doesn't seem unreasonable that they will spend that much on something that will correct your body's problems and improve your life for the rest of your life."

After the surgery, new lives open up for his patients, says Hurwitz. "Women get married after being spinsters for decades. I have men getting jobs they couldn't handle before. It truly is an extreme makeover."

Choose Surgeon Carefully

Before having any type of cosmetic plastic surgery, make sure your expectations are realistic. "Not everyone can look like Julia Roberts, nor should they," says Rohrich.

Be sure you see a board-certified surgeon who is capable of doing all the procedures necessary -- "that's the key," he advises. "Interview them. Make sure you feel comfortable with them." Also, do some homework beforehand about the procedure you want.

In the future, liposuction and facelifts may be done sans surgery. That's right, ultrasonic waves to remove fat and erase aging without surgery will be studied in the next year, says Rohrich.

Let's face it: We've come a long way since your mama's facelift. Even since your big sister had one.

"Some people are a little worried about having a facelift because they remember when it was much more an ordeal than it is today," Antell says. "Today we have much better anesthesia techniques with shorter-acting medications, so we can do these as outpatient procedures. It used to be, if you had your nose done you stayed in the hospital a week; nobody does that anymore."

WebMD Feature

Sources

SOURCES: Rod J. Rohrich, MD, president, American Society of Plastic Surgeons. Darrick Antell, MD, plastic surgeon, New York. Dennis Hurwitz, MD, University of Pittsburgh Medical School. WebMD Medical News: "Silicone Implants Still Worry Panel Chair." WebMD Feature: "Cosmetic Surgery on the Sly." WebMD Medical News: "Latest Plastic Surgery Trends and Stats." News release, American Society of Plastic Surgeons.

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