This article was originally published in Maclean's Magazine on April 26, 2004
TV Makes Cosmetic Surgery Seem Easy
IT WAS ARGUABLY Carnie Wilson, better known as Beach Boy Brian Wilson's daughter - and perhaps best known as "the plump one" from the early '90s musical trio Wilson Phillips - who sparked our strange fascination with extreme makeovers as entertainment. In August 1999, in a pioneering venture, Wilson allowed her gastric bypass surgery to be broadcast live on the Internet. A quarter of a million voyeurs logged on to watch as doctors stapled her stomach down to the size of a fig. Several months later, Wilson re-emerged on the cover of People magazine looking glamorous and entirely reformed - literally, as the cover line read, "half her size!"
The latest pack of reality TV makeover shows - ABC's Extreme Makeover, Fox's The Swan and MTV's I Want a Famous Face - produce the same fantastical, ratings-grabbing results, although they've managed to whittle the entire process down to tidy, one-hour segments. Typical episodes consist of tears, unnaturally handsome doctors, a five-minute healing montage, a new hairdo and frenetic squeals of joy. These shows make cosmetic surgery look so straightforward, so oddly life-affirming, you almost wonder why more people don't have a go at it.
Then reality - the kind that happens off-camera - rears its head. Last week, Micheline Charest, co-founder of scandal-ridden Montreal animation house Cinar Corp., suffered cardiac arrest during six hours of surgery under general anaesthetic for a face- and breast lift, dying the next day. Hers was the second such high-profile death in recent months. In January, novelist Olivia Goldsmith, author of The First Wives Club, died after undergoing a routine chin tuck.
We're suddenly reminded that a new nose isn't quite the same as a new hat - that, despite the recent appetite for radical transformations on TV, these are still major surgical procedures carrying the same risks they always have. In March, the American Society of Plastic Surgeons put out a press release calling this new wave of reality TV shows "a serious cause for concern" and cautioning the viewing public "to have realistic expectations about cosmetic plastic surgery." Dr. Robert Stubbs, a Toronto cosmetic plastic surgeon perhaps best known for penis enlargements, says now he often has to "deprogram" patients. "They think what they see on TV is real. What they don't understand is, it's edited."
What's lost on the cutting-room floor are the risks - a list a mile long - including all those that accompany general anaesthesia, as well as blood clots and infection. Not to mention the healing process, which can be physically and emotionally arduous, and can last upwards of a year. "I didn't train for 13 years to be a beautician," says Stubbs. "Everything I do is major surgery."
At their core, extreme-makeover shows are entertainment, but their effect is to normalize plastic surgery. As with most major attitudinal shifts, this acceptance has been a subtle evolution. According to Robert Thompson, director of the Center for the Study of Popular Television at Syracuse University, the mass popularity of gateway procedures like Botox injections (a recurring motif on Sex and the City) and other "drive-in cosmetic techniques" suggests we've moved away from the idea of plastic surgery as the ultimate act of vanity, making it palatable "to a body of people who otherwise wouldn't have considered it."
Thus cosmetic surgery continues to boom in North America. Canadian statistics aren't available, but the American Society for Aesthetic Plastic Surgery reported that in 2003, there were more than 1.8 million surgical cosmetic procedures in the U.S. - an 87-per-cent increase over 1997.
Until now the makeover, that quintessentially North American theme, has manifested itself in TV shows that deliver a new wardrobe, hairstyle or family room. The body's a whole new frontier. ("I'm fine with reality TV shows," says Thompson, "until they require antibiotics.") The stigma of cosmetic surgery is fading, but so is any real sense of risk. "These shows give the patient a little bit of information," says Stubbs, "but in medicine, a little knowledge is dangerous." A little stigma, on the other hand, might not be so unhealthy after all.
Maclean's April 26, 2004