Just when I thought I had seen every conceivable variation of a plastic surgery reality show, a new twisted version appears. If your entertainment schedule has not allowed you to catch E!’s newest reality television disaster, Bridalplasty, consider yourself fortunate. If you haven’t seen it, it a summary is that it is a bride-against-bride elimination-style show where 12 women compete to have various cosmetic plastic surgery prizes- ostensibly to turn them from ducklings to swans just in time for their weddings. Or, as E!’s tagline cleverly states, it’s the only competition show on television where “the winner gets cut.”
If you are thinking- as I was, You have got to be kidding me, seeing it will only make you feel worse. The household of brides-to-be initially compete in difficult wedding challenges that would test the mental limits of the average grade school child. These ‘prize’ for winning each of the competitive challenges is a surgical procedure intended to help transform the prospective bride closer to physical perfection. Each week one of the contestants gets eliminated while the others receive their dream plastic surgery procedures along the way. Eventually one bride-to-be will receive the wedding of her dreams…and will head down the aisle in a designer dress as a transformed woman ready to surprise her soon-to-be husband.
The concept of a show in which women compete for the grand prize of a plastic surgery makeover in order to be the perfect bride for her wedding day would normally be funny… if it weren’t so sad. At its most basic, the show is a societal commentary on our contemporary fairytale wedding culture where so much effort is spent in both time and money for just a few short hours. Maybe its greatest entertainment value is in seeing how the fully complicit contestants are willing to trade any dignity for some free plastic surgery and a little bit of fame. I suspect the show’s creators are well aware of this self-deprecation but the contestants are clearly completely oblivious to it.
While Bridalplasty may be the pinnacle of self-parody for reality TV, the participation of the plastic surgeon in the show violates some of the most stringent ethics of the American Society of Plastic Surgeons. The most egregious ethical violation is the very premise of the show – all ASPS members are prohibited from giving away free plastic surgery as a prize in any contest. To encourage any prospective patient to undergo surgery because it will be free encourages patients to cast aside any consideration of its risks and expectations. Part of what any ethical, well-trained plastic surgeon should do is to educate the patient about both the benefits and the risks of their procedure(s) of interest. Reaching for a little fame here seems to have affected more than just the brides-to-be.
‘Bridalplasty’ is cringe-worthy TV at its finest, and brings the practice of medicine and surgery to a whole new low point. What’s next, ‘Who wants to win a quadruple bypass’?
Dr. Barry Eppley
There are many reasons why people undergo plastic surgery. The desire for self-improvement is the most compelling but the underlying motivation for such an emotional decision is never quite that simple. In a recent study in a prestigious plastic surgery journal, it was reported that nearly 80 percent of patients surveyed said that part of their decision to have plastic surgery was triggered by television and other media exposures. One television influence prominently noted was that of reality programming. The influence in the last decade of the reality TV concept is undeniable and has focused on everything from cake baking to child rearing..
The early success of ‘Doctor 90210’ and the now defunct ‘Extreme Makeover’ has fueled many copycats and there does not appear to be an end to the public’s desire for this form of reality plastic surgery. Whether the appeal is similar to the transformations seen on ‘Yard Crashers’ and ‘Rock Solid’ or the fascination of watching others subject themselves to an extensive makeover is undoubtedly part of it. I am all for increasing the public’s awareness of the benefits of plastic surgery but the ‘reality’ shown in the little bit of these programs that I have seen doesn’t really reflect the real life experience of the plastic surgery process.
Just like the entertaining but tragically distorted plastic surgery show, ‘Nip/Tuck’, television is all about entertainment and getting you to watch and rarely about truth. Only the highlighted moments of excitement and results is portrayed, leaving out all of what the producers consider dull filler material. This unshown filler, however, is really what plastic surgery is about. Boring accurate information, such as risks and complications and realistic outcomes, are never portrayed. What may happen when the plastic surgery doesn’t turn out so well is rarely if ever shown. In fact, some of these shows focus almost exclusively on the eccentricities of the plastic surgeons or their patients. While Dr. Ray may be entertaining, it is never revealed that he has never taken the effort to be board-certified.
Not all plastic surgery programs on TV, however, are badly done. There are some that are especially informative and insightful. This is the case with the Discovery Channel’s “Plastic Surgery: Before and After.” It is clear in this type of programming that their intent was educational, not a festive diversion to keep your eyes glued. Rather its intent is to teach, educate, and give us a greater explanation of what cosmetic surgery is all about. That is meaningful time spent about a serious TV subject.
In reality, most patients are not primarily driven to get plastic surgery because of these reality TV programs. They do it because they have physical imperfections that are bothersome to them. These TV programs are an extension of the often distorted Hollywood world where the pursuit of physical perfection and the fighting of father time is taken to sometimes ridiculous levels. They promote unhealthy desires such as teenage girls possessed about enlarging their breasts or changing their nose in the hope that this make them famous or get them noticed. Most people may be able to see through the façade of these shows and see them for the trivial entertainment that they are. But impressionable teenagers and insecure adults may not be so discerning. Just like the recently passed Health Care Reform bill, the devil is in the details. The real reality of plastic surgery is in that boring stuff that is hardly worth watching…but is really worth knowing.
Dr. Barry Eppley
The trail of plastic surgery devotees in Hollywood is growing faster than sequels to the movie Saw. From aging musicians and film makers to young actresses on the rise, Tinseltown is awash with everyone getting nips and tucks. While an occasional tweak or two may be the norm, some ‘ stars’ are becoming more mannequin than human in their quest to turn back the hands of time.
Most recently, Heidi Montag of ‘The Hills’ fame, underwent a second round of extensive plastic surgery procedures. The 23-year-old reality TV star, who had a rhinoplasty and breast augmentation in 2007, confessed to having ten plastic surgery procedures in one day according to People magazine. By her own admission, she admits to being addicted to plastic surgery. In her quest to be “the best of me”, she had liposuction on her neck, waist, hips, and thighs, a buttocks augmentation, revision of a prior breast augmentation, an ear pinning, a “mini” brow lift, chin reduction, Botox in her forehead as well as fat injections in her cheeks and around her mouth.
Ms. Montag represents the ‘extreme’ plastic surgery patient. Low self-esteem, combined with easy access and large amounts of disposable income and an insatiable need for attention, can create this perfect storm with the end result what we now see on the cover of People magazine.
Heidi Montag’s situation is definitely the exception. But real addiction can and does occur outside of reality TV and mainly affects those that suffer from Body Dysmorphic Disorder. (BDD) In this condition, there is a never-ending unhappiness with changes that keeps the person affected with it coming back for more. Most repeat plastic surgery patients, however, are not ill and are motivated by what I call ‘accomplishment feedback’, a normal psychological response that creates a desire for further benefits after a previous positive experience. Every retail business thrives to create that outcome. That is a far cry from a BDD illness or a ‘plastic surgery addiction’. The sheer reality of economics prevents most people from ever crossing the line into either of these behaviors.
Ms. Montag’s plastic surgeon has also been the target of criticism. When should plastic surgeons tell patients no? How much is ‘enough’? While many people are appalled by what Heidi Montag did and felt she did more than she should have been ‘allowed’, the answer is not so straightforward. Should McDonald’s be selling those 80 grams of fat in a burger and fries meal to anyone overweight or should home mortgages or debt consolidation services be tendered to people whose finances knowingly don’t support them?
Elective plastic surgery is medicine mixed with a good dose of business and marketing. While the safety of the patient is the number one limiting factor to the number of procedures that should be performed at a given time, it’s impossible to remove the component of ‘personal responsibility’ from the equation. Defining what is reasonable for someone to want is akin to you telling me what I should like. While beauty may be in the eye of the beholder…what is needed to get there is most certainly in the mind of the beholden.
Dr. Barry Eppley