Chapter 1
Cosmetic Plastic SurgeryâThe Basics
Thinking about having a cosmetic surgery procedure done? Not sure whether you want to let friends and relatives know you are considering having that nose reshaped, the bags under your eyes removed, or that tummy tuck to remove the bulge thatâs been there since your last child was born? Not sure about what is involved in the procedure, where to find information, or what doctor to perform the procedure? Afraid even to ask about cosmetic surgery because you donât know enough yet to ask intelligent questions?
Well, this book is for you. A wealth of information is available via the Internet, and, it can be accessed anonymously. As cosmetic surgery becomes more mainstream, the Internet is rapidly gaining popularity as the first resource to turn to for information. You can gather all sorts of background information about cosmetic surgery procedures, identify potential doctors to perform the procedures, and even chat online with others who have had cosmetic surgery, all from the comfort of your own home. The problem is, in fact, that there is too much information about cosmetic surgery on the Internet, and not all of it is accurate. This book is intended to guide you to quality sources of information about cosmetic surgery, but only you and a qualified physician can eventually make the decision as to whether or not you should undergo a cosmetic surgery procedure.
WHAT IS PLASTIC SURGERY?
Plastic surgery is the medical specialty involved with changing a personâs appearance via surgery. Although people tend to think of plastic surgery in terms of its cosmetic use, in reality, according to the American Society of Plastic Surgeons, the majority of surgeries are reconstructive in nature. Cosmetic surgery is generally defined as surgery done for the purpose of improving appearance, i.e., it is plastic surgery for aesthetic purposes, while reconstructive surgery is done to correct or repair a defect, for example to correct a birth defect or repair an injury. The same procedure may be used either cosmetically or for reconstruction, and frequently the purpose of the surgery determines whether it is covered by health insurance. Most cosmetic procedures are not covered by insurance, although itâs always good to check with your health insurance company.
Readers should keep in mind, however, that a procedure may be used either for cosmetic or reconstructive purposes, so this book will also be valuable for readers who need reconstructive surgery.
COSMETIC SURGERY IS A HOT TREND
Despite its cost, the days when cosmetic plastic surgery was limited to movie stars or the very rich and famous are long gone. Cosmetic surgery has boomed over the past decade or two, and several factors have contributed to this amazing increase in popularity. In recent years, people have become more open about having cosmetic surgeryâit has become the âinâ thing to do. Perhaps itâs the aging baby-boomer set that doesnât want to admit it is aging; or, perhaps itâs the increasing number of movie stars admittingâactually, being very open about the factâthat they have had cosmetic plastic surgery. The topic of cosmetic plastic surgery is much more out in the open than ever before. People that might not have considered cosmetic surgery several years ago are increasingly deciding to âgo under the knife.â
Cosmetic Surgery and Celebrities
The Internet is loaded with sites that discuss cosmetic surgery procedures of celebrities. Several sites list the stars, what procedure was done, and before and after pictures.1,2 Included are, to name only a few, Pamela Anderson, Drew Barrymore, Cher, Heather Locklear, Madonna, Demi Moore, Anna Nicole Smith, Sharon Stone, and Raquel Welch. The search engine Yahoo! even has a âCelebrity Plastic Surgeryâ category among its directories.3
In fact, several sources go so far as to say that virtually everyone in Hollywood has had cosmetic surgery of some form or another. Although some are still reluctant to admit that theyâve had surgery, the fact is that in Tinseltown, looks are everything, and since age eventually takes its toll, cosmetic surgery, from laser peels through liposuction, ultimately wins out.4
In recent years, however, as more TV and movie stars have begun talking about their cosmetic procedures, âordinary,â everyday people are opening up about their experiences. Almost all of the daytime talk shows have explored the topic, it is constantly mentioned on syndicated TV shows such as Entertainment Tonight (ET) and Extra, and itâs been discussed on many primetime news shows and on ABCâs Good Morning America.5 In spring 2003, ABC TV introduced Extreme Makeover into its nighttime lineup of shows after the success of a pilot program in late 2002. This show takes ordinary people and offers them a free cosmetic surgery makeover; application forms for people wanting to participate in this program can be found on <http://www.abcnews.com>. Other networks are also offering shows about cosmetic surgery, including FXâs Nip/Tuck, a drama based on the life of a single, eligible plastic surgeon; FOX networkâs The Swan, where women undergo cosmetic surgery and then compete in a beauty contest; and MTVâs I Want a Famous Face, where patients undergo cosmetic surgery to look like a celebrity. Although these TV shows have popularized cosmetic surgery, many of the professional medical associations are concerned that they are unrealistic and do not disclose enough about the risks of surgery. Programs such as 60 Minutes and 20/20 have aired âexposĂ©sâ about the risks of cosmetic surgery and the need to carefully select your surgeon.
Baby-Boomer Generation
As the generation of baby boomers has aged, health and physical fitness have become priorities. Women (and men) want to look and feel good about themselves. Cosmetic surgery is one way to keep a youthful appearance, whether itâs used to erase those wrinkles and lines that appear with age, or to reshape oneâs body when exercise alone wonât do the job.
Recent reports from the Centers for Disease Control indicate that obesity in America has become a major health concern. Interestingly, the increase in gastric bypass surgery (stomach stapling), a treatment for morbid obesity, has helped promote cosmetic surgical procedures. The major weight loss from stomach stapling can result in the need for cosmetic surgery to tighten up the body and remove excess skin.
More and more younger adults, even teens, are choosing to have plastic surgery as a means of correcting what they view as âdefects.â The prevailing attitude is, âif you donât like it, fix it.â In the heavy-duty world of corporate America, appearance is everything. The confidence gained as a result of cosmetic surgery might make the difference between being hired or not, between getting that promotion or not.
WHAT ARE THE NUMBERS?
How many people have cosmetic surgery each year? What are the most frequent procedures, and do women have certain procedures more frequently than men? Is age a consideration in cosmetic surgery? How much does it cost? These are all questions that come to mind when one is considering cosmetic surgery. After all, it is comforting to know that others have had the same cosmetic procedure that you are considering. Having some realistic expectation of both costs and results will help you to make your decision.
Answers to all of these questions, and more, can be found on the Internet. Perhaps the best source of statistics on cosmetic surgery is available on the Web site of the American Society of Plastic Surgeons (ASPS) <http://www.plasticsurgery.org> (note: this is the form that will be used in this book for locations on the Internet; you will learn more about Internet addressesâURLsâin the next chapter). Statistics are available on this site by year (currently, 1992, 1996, and 1996 to 2003); by type of procedure; and by age, sex, and ethnicity. Also given are national average physician fees for cosmetic procedures (itâs interesting to compare 1992 versus 2003 average fees). These numbers are for procedures reported by âASPS member plastic surgeons certified by The American Board of Plastic Surgery.â6
The ASPS site includes many quick facts about cosmetic and reconstructive surgical and nonsurgical procedures. Press releases on the ASPS site for 2003 indicate that over 8.7 million cosmetic surgery procedures were performed in 2003, up 32 percent from over 6.5 million procedures in 2002. The top five surgical procedures were nose reshaping, liposuction, breast enlargement, eyelid surgery, and facelifts.
Looking only at cosmetic surgery procedures for women, itâs interesting to note that the top five female cosmetic procedures in 2003, according to the ASPS, were liposuction (287,930), breast enlargement (254,140), nose reshaping (226,780), eyelid surgery (200,324), and facelifts (115,908). Overall, women accounted for 1,469,265 cosmetic surgeries, or 82 percent of the total cosmetic surgical patients.
The largest jump in demand, according to the ASPS, was for minimally invasive plastic surgery, which jumped 41 percent in 2003 to over approximately 7 million procedures (from over 4.8 million in 2002). The biggest âwinnerâ here was Botox, with nearly 2.9 million procedures. Distant second and third, for both men and women, was chemical peeling and microdermabrasion. Women accounted for 87 percent of the procedures.
Another site that has excellent statistics for cosmetic surgery is the American Society for Aesthetic Plastic Surgery (ASAPS) <http://www.surgery.org>. Their statistics also reflect procedures performed by members of the association. According to the ASAPS, the top five cosmetic surgeries for women in 2003 were liposuction (322,975), breast enlargement (280,301), eyelid surgery (216,829), breast reduction (147,173), and nose reshaping (119,047). Women accounted for 87 percent of more than 8.2 million procedures performed.
Many other sites on the Internet include statistics for cosmetic surgery, both in the United States and worldwide. However, the statistics available from the ASPS and ASAPS will be listed for each procedure (where available) because of the structured reporting procedures for each group of physicians. Note that these statistics are updated each year by the ASPS and ASAPS, usually in March for the previous year.
If you are considering cosmetic surgery, you are definitely encouraged to log onto the ASPS site <http://www.plasticsurgery.org> and the ASAPS site <http://www.surgery.org> and check out the numbersâwhoâs having what procedure done. Itâs reassuring to know that many, many other people have had the procedure(s) that you are considering.
HOW MUCH DOES IT COST?
One other really interesting piece of information provided by both the ASPS and ASAPS is the cost for cosmetic procedures. What is listed at each of these sites is the U.S. national average surgeon/physician fee. You should note that anesthesia, facilities (operating room, outpatient surgicenter), and other expenses are not included, and that variables such as geographic location are not included. In 2002, over $7 billion were spent on physician fees for cosmetic surgery according to the ASPS. For 2003, the ASAPS reports over $9.3 billion spent.
WHY READ THIS BOOK?
Every woman wants to feel good about herself. It is a proven fact that a positive self-concept is linked to how you look and feel. How you look can be enhanced by cosmetic surgery. The decision to have cosmetic plastic surgery is a big step. It involves a physical change that will alter not only how you will look at yourself, but also how others will look at you. There are risks with surgery. In addition, the surgical costs are normally not covered by health insurance.
As you begin to evaluate whether or not you might want to undergo cosmetic surgery, you should gather as much information as possible so that you can make an informed decision. Although many people have had cosmetic surgery, you might not know anyone who can tell you of their experience; or, even if you know someone who has had a cosmetic procedure, you might not feel comfortable asking him or her about it. Locally, you will find that many plastic surgeons hold clinics to explain procedures. These informational meetings are usually a way of advertising and promoting procedures at their clinics. Even before attending such a meeting, knowing what is involved in a cosmetic procedure will help you to evaluate and ask good questions.
This is where the Internet comes in to play. Besides the information that your doctor will give to you, the Internet is perhaps your best source for information about cosmetic procedures. However, the Internet can be overwhelming in itself because of the quantity of informationâthere is so much available that it can be confusing, not all of it is accurate, and some can be actually misleading. This book will help you to identify Internet resources you can trust. The following chapters will cover basic Internet searching, finding a doctor, and how to locate information about specific cosmetic surgical and nonsurgical (minimally invasive) procedures. Youâll learn about evaluating information from a Web site, selecting a âcredentialedâ physician, and locating information about specific procedures.
Ultimately, the choice of whether or not to have cosmetic surgery is yours, and yours alone. Input from family and friends and your doctor will all influence your decision, but the better informed you are about the surgical procedure, along with risks and complications, the be...