Cosmetic surgery’s bright, shiny new face

Alex Johnson Reporter • Profile

Time was — this was not so long ago — that cosmetic surgery was a little scandalous. If you had something nipped or tucked or lifted or vacuumed, you were just a wee bit too vain. Boy, Jessica looks great, doesn’t she? Well (sniff), she’s had work done.

Things have changed:

“I started at 25. I had a breast augmentation at 25.”

Marianne Guarena, who lives in Las Vegas, is editor-in-chief of Enhancement Media, which operates several Web sites devoted to cosmetic surgery. The marquee site, Yes They’re Fake!, draws more than a million unique visitors a month, she said.

She is 33, but she must still get carded every time she goes into a bar. This is because in the last eight years, Guarena has undergone more than 20 major and minor cosmetic procedures, all chronicled on her Web site.

On one day alone — May 5, 2004 — she had a breast implant exchange; liposuction to her flanks, hips, thighs and abdomen; a modified brow lift; lip augmentation; and a graft of fat into her cheeks.

If there used to be a stigma, it has long since been erased for people of means of Guarena’s generation.

“Before, it was, like, hush-hush, and no one really talked about it, but then the media started getting in on it and we have all these makeover shows,” she said.

“It’s become a household word, to the point it’s not embarrassing  to say that you’ve had it,” she added. “The more people speak about it, the more they, too, want something done.”

More in-your-face than ever
For many years, medical professionals have pointed to the increasing sexualization of American culture, selling the idea that Young + Slim = Beautiful. What’s new is the advent of reality TV makeover programs, which pound home the message that Young and Slim can be bought.

“Over the past five years, I have seen a community standard shift,” said Dr. Andrew Jacono, a facial plastic and reconstructive surgeon at the New York Center for Facial Plastic and Laser Surgery. “It is not whether cosmetic surgery is acceptable. It’s a question of what procedures they are going to do and when.”

Cosmetic surgery     What to watch for Harvard Medical School Professor Brooke R. Seckel, author of “Save Your Face,” says patients should look for these “red flags” when they consult a plastic surgeon: Your surgeon should be kind, respectful and concerned about you as a patient. If he or she is not, leave. Also leave if: — The surgeon is a “cold person.” — The surgeon gets uncomfortable, defensive or angry when you ask about his or her experience or board certification. — The surgeon acts more like a salesperson than a doctor. — The surgeon or staff make you feel stupid for asking a question. — The surgeon offers you a “cut-rate” deal. What is he or she leaving out? — The office staff acts more like fashion models or starlets than health care providers. They provide essential support during your recovery ... make sure they are professionals. — The surgeon does cosmetic surgery only occasionally. — The surgeon is just starting his or her practice. Expertise in cosmetic surgery takes years of experience. SOURCE: “Save Your Face” by Brooke R. Seckel, MD

“Obviously, from my standpoint, [things have] changed dramatically, especially with all of these reality shows,” said Dr. Blane T. Shatkin, a cosmetic surgeon in Weston, Fla., and chief of staff at Memorial Hospital in nearby Miramar. “I mean, the reality shows have just gone crazy with plastic surgery.”

There are other influences, to be sure. Advances in technology have made cosmetic surgery safer and have cut recovery time, while they also have brought down the cost enough so elective surgery is within reach of much of the middle class. And, as with pretty much every other social trend, you can blame the baby boomers.

“I think it’s an outgrowth of Freudian psychology,” said Dr. Brooke R. Seckel, an assistant professor of surgery at Harvard Medical School and founder of the Lahey Center for Cosmetic and Laser Surgery in Lexington, Mass. “The boomers, so to speak, are more centered, more self-focused and less concerned about others’ opinions.”

And now “they’re having children,” said Shatkin, who said he had worked on a lot of young women following in the footsteps of their mothers. “They’re much more educated [because] their mom has had implants and they know all that’s involved with them.”

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