Love 'em or hate 'em, reality stars like the Real Housewives have come to dominate popular notions of cosmetic surgery. Taut, inflated, unnatural -- the perception of cosmetic surgery isn't just informed by the way these characters look, but also the personalities of privilege and vanity by which they're motivated.
As a feminist with an unlikely nine years in the aesthetics industry, these stereotypes are of great interest -- and sometimes frustration -- to me. To be sure, the Real Housewives are about as real a representation of the typical plastic surgery patient as they are the typical "house-wife."
So, who is really getting work done and why? A look into some of the facts and trends paints a real picture of cosmetic surgery that is not "as seen on TV."
He's In On It Too
Men are getting plastic surgery. Long associated with breast implants and plumped lips, cosmetic medicine is increasingly unisex. The number of male cosmetic patients has, in fact, skyrocketed by 106 per cent between 2007 and 2012 according to the most recent industry statistics from the American Society for Aesthetic Plastic Surgery.
Whereas breast augmentation reins supreme among the female cohort, the most popular surgical procedures among men include liposuction, rhinosplasty ("nose jobs"), eyelid surgery, treatment for male breasts and otoplasty to correct protruding ears.
This uptick among male patients is not limited to big spenders. Coming to a medspa near you, men are increasingly seeking non-invasive therapies to improve their appearance. According to a report released by the American Society of Plastic Surgeons, men accounted for over 350,000 of the Botox procedures performed in the U.S. in 2012, 126,000 laser hair removal procedures and almost 20 per cent of non-invasive body contouring treatments (Liposonix™, Coolsuclpting™, Exilis™) in 2012.
Men are also among the fastest growing segments of the skin care market. While advertisements talk in terms of "man hide" versus soft and silky, marketing does little to obscure the fact that they are the new beauty consumer.
So what is motivating this shift? Industry analysts have pointed to the need to "stay competitive" in a post-recession labor market as a major driver for men seeking cosmetic medicine. Faced with fewer jobs and a younger, highly educated workforce, men, it is asserted, turn to cosmetic medicine to avoid being left out to pasture (and the other perils of ageism).
But there are other forces at play.
Beauty as Health
Interesting enough, men and women alike, are increasingly viewing the way they look as part of their overall health. More than the pursuit of perfection or, even worse, aesthetic immortality, people are seeking cosmetic medicine as exactly that -- medicine. According to the American Academy of Facial Plastic Surgeons, today's patient views plastic surgery as an extension of personal care and hygiene.
Indeed, research done by AccentHealth, three out of five consumers feel that "looking their best is an important part of how they measure their overall health." That number climbs even higher among respondents who considered themselves to be proactive about their health.
While a new European study announced that researchers found that post-op, plastic surgery patients generally report a boost in self-confidence and enjoyment of life, the contemporary link between health and appearance has less to do with psychology than a culture in which patients feel the right and ability to more completely control their health -- inside and out.
It isn't just the patients, the industry of cosmetic manufacturers and plastic surgery clinics are embracing a verbiage of "health and wellness" and positioning their products and services accordingly. Especially as new technologies make procedures more affordable and accessible, the perception of cosmetic treatments is shifting away from vain extravagance to a standard part of self-care.
The Rise of Customized Cosmetics
In addition to cultural factors, demographics are transforming the face of cosmetic surgery. It may not come as a surprise but a more diverse American population has translated to a higher number of ethnicities seeking cosmetic procedures. Based on information collected from members of the American Society of Aesthetic Plastic Surgeons, ethnic minorities accounted for approximately one fifth of all cosmetic procedures in the U.S. in 2012.
The result, however, has not been a rush to sameness. Rather, professionals are noting a marked increase in their patient's desire to "look like myself" post-procedure, compared with the more transformative ambitions of decades prior.
As Google and WebMD grow a more informed patient base, experts are specifically reporting fewer requests to look like someone else and more requests for particular procedures. Indeed, the AAFPRS reports that requests for celebrity features dropped to 7 per cent among patients seen by AAFPRS members in 2012, while 53 per cent of patients asked about a particular area of concern and almost 30 per cent asked for a treatment by name.
Youth Before Beauty?
The parallel increase in younger patients is a more complicated statistic. While many in the 25-30 bracket are driving the growth of non-invasive, preventative procedures, the growing acceptance of cosmetic surgery has also led to a greater number of kids and adolescents seeking procedures.
Compared to the purely aesthetic goals of the older demographic, these young patients most frequently present with significant asymmetries and even deformities that affect a healthy social life. AAFPRS data estimates that 76 per cent of kids and adolescents seek plastic surgery on visible places like their face (namely ear and nose surgery) to escape being bullied by their peers. Likewise, more than half of breast surgeries among young women are done to correct large size differentials between breasts and other congenital deformities.
While TV, especially reality television, may be shaping the image plastic surgery has on the general population, the reality is that it is becoming a more common practice across demographics. It will be interesting to see how the face of plastic surgery continues to evolve in the future.
In May, Bynes took to Twitter to reveal: "Intouch used a photo from years ago on their cover and I hate it! The reason I've asked all magazines and blogs to stop using old photos of me is I don't look like that anymore! I had a nose job to remove skin that was like a webbing in between my eyes. I wasn't going to tell anyone, but I look so much prettier in my new photos that I don't want old photos used anymore! I'm so sick of magazines and blogs using old photos! I'm so sick of magazines and blogs using old photos! When will they stop? I will never look like that again! Having surgery was the most amazing thing for my confidence!"
18-year-old Stodden went under the knife recently to change her natural C breast to DD's. Her <a href="http://www.huffingtonpost.com/2013/06/23/courtney-stodden-breast-augmentation-video_n_3486954.html" target="_blank">surgery was filmed and posted on the Internet </a>for all the world to see.
She had plastic <a href="http://www.huffingtonpost.com/2012/11/25/kris-jenner-breast-implants-boob-job_n_2187940.html" target="_blank">surgery before Kim Kardashian's wedding and also had her second breast augmentation</a> on Season 7 of "Keeping Up With The Kardashians."
The former Olympian <a href="http://www.accesshollywood.com/bruce-jenner-and-family-on-his-plastic-surgery_article_20573" target="_blank">opened up to "Access Hollywood" in 2009</a> about the nose job and partial face-lift he had in 1984. "‘Because you’re Bruce Jenner, Olympic champ [people said], ‘Oh my gosh, you shouldn’t be doing things like that.’ The media kind of went nuts on that stuff,” he said. Jenner later underwent further surgery to correct the previous procedures. “I had it done and not even my close friends knew I had it done,” he revealed. “I mean that’s how good of a job they [did].”
Abrams was not shy about admitting <a href="http://www.huffingtonpost.com/2013/06/21/farrah-abraham-topless_n_3479821.html" target="_blank">her recent "adjustments."</a> She had a breast augmentation and "loves her new body," according to her Twitter.
The "Teen Mom" star <a href="http://radaronline.com/photos/janelle-evans-busty-self-portraits/photo/360884/" target="_blank">underwent a breast augmentation back in June. </a> And lucky for her, her boyfriend thinks he's <a href="http://popsoundoff.com/teen-mom-jenelle-evans-boyfriend-disses-her-pre-surgery-bod/" target="_blank">"lucky that she doesn't look like that anymore,"</a> in reference to her pre-surgery body.
Alexis Bellino told the <a href="http://www.ocregister.com/articles/housewife-343427-job-nose.html" target="_blank">Orange County Register</a> she had a nose job.
She <a href="http://www.huffingtonpost.com/2013/05/29/brandi-glanville-liquid-nose-job_n_3354279.html" target="_blank">revealed on Twitter</a> that she had a breast augmentation.
She has admitted to have breast augmentation surgery, but any work on her face has gone unconfirmed.
When she was 22, she got surgery to go from a B-cup to a C-cup. "It was so dumb... I just got the idea in my head one day, and that was that. There was no talking me out of it," said Kardashian in an interview with Us Weekly. (Getty photo)
In her memoir, "Kathy Griffin: My Life On The D-List," the comedian writes about her very many plastic surgeries, including a nose job, brow lift, Botox injections, dental veneers, chemical hair straightening, chemical peels and liposuction. (Getty photo)
Parton has admitted to breast implants, liposuction, under-eye work, fillers, Botox and removing “the pelican pouch” under her chin. In 2012, she told InTouch, "Anybody that’s got the nerve, desire and the money to have surgery, should find a good doctor and just do it."
The actress admits to getting a breast-lift in 1991 after the birth of her second child and having collagen injections to her lips. In 1999 Griffith was quoted in Britain's Mirror saying, "I have been thinking about plastic surgery, but I'm not saying where. Turning 40 is difficult. I often think, 'If only someone could put a zip down the back of me and tighten everything up!'"
The "Everybody Loves Raymond" star and mother of four kids, told People why she underwent a breast lift and tummy tuck: "Vanity. I mean it. Vanity. I had four C-sections and my stomach looked like the map of the world. My breasts were hanging down to here from breastfeeding those babies, and my nipples were like platters. I wanted to fit into the gowns that I finally got to wear."
In September 2003 Roseanne Barr spoke to People about her tummy tuck, nose job, breast reduction and face-lift saying: "I want to get butt implants and a waist. But it's been, like, 10 years since I had anything and I'm kind of scared of it. I'm old and I don't know if I"ll wake up from the anesthetic."
Kelly told a friend, "When all else fails, I get Botox injected right here, right into my forehead, as much as possible." She also <a href="http://www.elle.com/pop-culture/celebrities/kelly-ripa-interview">admitted to getting Botox in her armpits</a> to Elle Magazine.
Adrianne Curry talked to KROQ radio station about her breast augmentation in 2007. The model revealed that after a miscarriage, one of her breasts grew larger than the other, causing a two inch difference in her breast size. Curry underwent surgery to even them out, as it were.
On his radio show in 2006, Howard Stern admitted to having gotten a nose job and chin lipo.
The "Bachelor" star made no secret about <a href="http://perezhilton.com/2011-07-20-bachelorette-vienna-girardi-gets-a-nose-job">her new nose.</a>
Once on "Oprah" Clooney admitted to having an eye lift ... though the actor claimed later to Esquire magazine that he was just joking.
<a href="http://www.harpersbazaar.com/magazine/cover/gwyneth-paltrow-interview-0513#slide-1" target="_blank">Gwyneth told Harper's Bazaar in 2013</a>, "I won't do Botox again, because I looked crazy. I looked like Joan Rivers!"
"I wish I'd never had my breasts done the last time," she told New Magazine. "They've put these bloody great bags in that are too f***ing round--it's like a water bed on your chest." (Getty photo)
"When I was 19, a doctor put in bigger implants than what I asked for. I was in such a hurry to get them that I didn't research my doctor," Richards told Us Weekly. "I just thought because they're a plastic surgeon, they must be good. You have to be your advocate for your own body and ask 100 questions." Later Richards wrote: "At 19 when I first got my breasts done, I wish that I was confident enough with my body to not have had surgery. That is something that I really want to encourage in my daughters, to embrace their healthy body and have confidence. I actually feel more confident in my skin now than in my 20's. Being confident is one of the sexiest qualities a woman can exude." (Getty photo)
"Me and my friends found a doctor in Arizona that cost about $1,500 to get our boobs done--because they didn't use anesthesia and I didn't know it," McCarthy told WENN. In a later interview with Us Weekly, the former playmate said she was "too young" when she got her implants at 19. (Getty photo)
In an interview with British Vogue, Victoria was asked about the absence of her "torpedo bazookas," to which the former Spice Girl reportedly replied, "gone". (Getty photo)
In an interview with Now Magazine, Kimberly states her famous father was supportive of his daughter when she had the implants put in at 18, and even more supportive when she decided to get rid of them. She recalls, "He's very supportive of whatever I do. He was just like, 'If you don't feel comfortable, if you don't feel safe, just get them removed.'" (Getty photo)
"When I had implants, I felt uncomfortable," the former porn star told Us Weekly. "I would be shy at the beach. I know it sounds funny, but I'd wear high-necked clothes, unless I was at an adult-film convention. So I thought, 'why don't I be who I am and get my real ones back?'"
"I was a 34B, but the right one was always bigger than the left," she told Us Weekly. "He gave me Cs, and I didn't want them. At all." (Getty photo)
Anderson has had multiple breast augmentations.
“I’ve had a little plastic surgery. I’ve had a little lipo. I’ve had a little Botox. And you know what? None of it works. None of it,” <a href="http://www.more.com/news/womens-issues/jamie-lee-curtis-true-thighs?page=2" target="_blank">Curtis revealed to More magazine in 2002.</a> "Ten years ago, before anybody did that, I had fat taken from underneath my eyes because I was on a movie and I was puffy. And I remember the cameraman saying, ‘I can’t shoot her now.’ I remember being mortified. And yet, you know what? Nobody tells you if you take fat from your body in one place, it comes back in another place," she added.
When rumors circulated that Simpson had rhinoplasty in 2006, <a href="http://www.people.com/people/article/0,,1193063,00.html" target="_blank">her initial response</a> was "Everybody's already saying it, so I just don't talk about it." Her dad then acknowledged the surgery, <a href="http://www.foxnews.com/story/0,2933,297925,00.html" target="_blank">telling Fox News</a>, "Girls have their own ideas. Anyway, there was a real problem with her breathing and that was cured." Ashlee later confirmed it to Us Weekly, <a href="http://www.today.com/id/23620386#.UYliMOBhWA0" target="_blank">telling the magazine</a>, “I was never really unhappy with how I looked, (and) I don’t think I am more beautiful than I was (before). I just see the same old goofy girl I see every day.”
<a href="http://www.people.com/people/archive/article/0,,20342923,00.html" target="_blank">According to People</a>, the "Hills" star followed up her 2007 nose job and breast augmentation with a 10-hour series of procedures in 2010 that included a mini brow lift, nose-job revision, chin reduction, neck liposuction, buttock augmentation, among others. "For the past three years I've thought about what to have done," <a href="http://www.people.com/people/archive/article/0,,20342923,00.html" target="_blank">she told People</a>. "I am absolutely beyond obsessed." She added, "I was made fun of when I was younger, and so I had insecurities, especially after I moved to L.A. People said I had a 'Jay Leno chin'; they'd circle it on blogs and say nasty things. It bothered me. And when I watched myself on The Hills, my ears would be sticking out like Dumbo! I just wanted to feel more confident and look in the mirror and be like, 'Whoa! That's me!' I was an ugly duckling before."
The "High School Musical" star <a href="http://www.people.com/people/archive/article/0,,20174328,00.html" target="_blank">opened up about her nose job to People in 2008</a>, and the inevitable tabloid criticism that followed, telling the magazine that "people were saying I was 'unveiling my look,' but I was still recovering! That's not what I look like right now." She added, "I think I still look like me."
"I've had my breasts done. But my breast operations were a nightmare. They were really botched in every way. If anything, they were worse after than before," the "Turn Back Time" singer <a href="http://www.people.com/people/archive/article/0,,20111940,00.html" target="_blank">told People in 1992.</a>
In 2011, <a href="http://www.huffingtonpost.com/2011/08/02/dianna-agron-tells-david-letterman-she-had-her-nose-fixed_n_916488.html" target="_blank">the "Glee" star told David Letterman</a> that she'd had her nose done, after breaking it twice. Of the second fracture, she explained, "I couldn't get it fixed because we were in the middle of doing this concert tour and we were filming. We had a day off and I met up with some of my friends and we were dancing. And again, there was another collision of sorts -- I must be turning too quickly, people don't see me coming or something -- but it's fixed now!"
In 2006, <a href="http://www.people.com/people/article/0,,1183537,00.html" target="_blank">the singer-songwriter told People, </a>"Last year I had so many lines coming in at the side of my eyes up here. So I went in and got my eyes done, and I’m not happy about it. (The surgeon) is going to go in and fix that for me. They’re too tight around the eyelids for me. It drives me crazy. "
In a 2010 interview with Entertainment Weekly, Rivers discussed her notorious penchant for plastic surgery, <a href="http://popwatch.ew.com/2010/06/18/joan-rivers-talks-about-plastic-surgery-hecklers-and-her-new-documentary-joan-rivers-a-piece-of-work/" target="_blank">telling the magazine, </a>"Babies respond to pretty faces. So stop telling everyone it’s okay not to be pretty! If you can fix it, fix it! If it makes you happier. I love to look in the mirror and say, 'For 77, you look good.' That’s all. I don’t care what anyone says. Not bad for 77." In a 2012 interview with Anderson Cooper, <a href="http://www.nydailynews.com/life-style/fashion/joan-rivers-haven-739-plastic-surgeries-e-comedian-joked-new-weekend-article-1.1018711" target="_blank">the "Fashion Police" host joked</a>, "Every weekend I just go in and I do something new. I get a tenth one free. It's a little like coffee, you just keep going."
<a href="http://www.washingtonpost.com/wp-srv/style/tv/features/jennifergrey.htm" target="_blank">In a 1999 Washington Post interview</a>, the "Dirty Dancing" star explained the decision to poke fun at her <a href="http://www.usmagazine.com/celebrity-style/news/jennifer-grey-looks-the-same-she-did-in-1987-2010309" target="_blank">botched nose job</a> while playing a version of herself on the short-lived sitcom "It's Like, You Know ...." "I decided to make fun of this, to make my fiasco become my reality," she explained. "After all, it's not cancer, and it's absurd that just a nose job could wreak such havoc."
"I admit to having a nose job, but that's all.... I lost my baby fat, and people said I had work done," <a href="http://www.people.com/people/archive/article/0,,20140945,00.html" target="_blank">Spelling said in 2000, according to People. </a>
In 2007, Love acknowledged a nose job on her website, writing that she had her "old nose" back. "I hated that nosejobby nose, it was like a little beak," <a href="http://www.people.com/people/article/0,,20016348,00.html" target="_blank">she wrote, according to People. </a>"[It] looks like the one god gave me so im happy not to have crazy lips and a crazy teensy unnatural little nose."
Take a look at some celebrity plastic surgery junkies, such as Heidi Montag, Kris Jenner, JWoww, Tara Reid and Courtney Love.
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