Cosmetic infidelity: A new way to cheat

By Dr. Anthony Youn, Special to CNN  – updated 6:20 AM EST, Wed November 19, 2014
Surgery can be difficult to hide, especially large operations such as tummy tucks and face-lifts.
Surgery can be difficult to hide, especially large operations such as tummy tucks and face-lifts.

(CNN) — “I have five days to recover from surgery and look good before my husband gets home.”

Marina, a 60-year-old Caucasian woman, sits before me to sign the consent forms for her upcoming operations: a 3-D face-lift, upper and lower eyelid lifts and an endoscopic brow lift.

I see on her information sheet that she hasn’t authorized us to discuss her surgeries with anyone else — not even her husband.

“So you’re not telling him about all these procedures?”

“Not unless I have to. You don’t know him. He wouldn’t understand, and he wouldn’t want me to spend all this money, especially on something he thinks is frivolous. So that’s why I need to look good before he gets back. We’ve got five days, Dr. Youn.”

Cosmetic surgery has become a new form of infidelity — for both men and women. As the number of people having plastic surgery rises, more and more feel the need to hide their procedures from their significant others. In fact, we did a survey of cosmetic patients in my office and found that one-third don’t tell their partners about their treatments.

Hard to believe? While surgery can be difficult to hide, especially large operations with dramatic changes such as tummy tucks and face-lifts, less-invasive procedures such as Botox and filler injections aren’t as hard to conceal.

The first step many patients take is to hide how much they’re spending. According to the American Society for Aesthetic Plastic Surgery, the average cost of Botox is $392, and the average cost of Juvederm is $675 — pretty hefty amounts to cover up.

So how do they do it? Some patients pay with cash. Others split it up and pay half in cash, half in credit. Many of my patients have a certain threshold that they can spend on their credit card before their partner notices the individual charge. This amount usually ranges between $100 and $400. Often the patient will spend up to that amount on a credit card, then pay the rest in cash. Other patients spread small amounts over several credit cards.

Timing the procedure strategically is another way people hide their cosmetic treatments. Many patients, like Marina, have their surgeries done while their spouses are out of town.

They use this alone time to recover, so that when their spouses return, they’re none the wiser. For less-invasive treatments, such as lasers and injections, many patients have the procedures performed on days when their partners have plans after work. This way, they have all night to let the swelling subside. When their spouse sees them the next day, they look normal again.

Some women also take advantage of the fact that their men just aren’t that perceptive. Men are notoriously bad at noticing changes in their spouses. In fact, a 2004 study in the Personality and Social Psychology Bulletin found that women are much better than men at remembering appearances.

I am as bad as any. It can take me days to notice that my wife has changed her hair.

So what happened with Marina?

She underwent all four surgeries, with the hope that she’d look good enough five days later to prevent her husband from noticing the dramatic changes in her face. She stopped by the office to see me several hours before her husband was to return home.

Marina was a hot mess. Her eyes looked like she went 10 rounds with Mike Tyson, her neck was taut as a pair of Spanx, and her lips resembled two Vienna sausages.

“Wow, Marina. You’re still quite puffy and bruised, but give it another week or two and you’ll look fantastic,” I told her. “However, I’m not sure your plan to hide your plastic surgery from your husband is going to work.”

“Dr. Youn,” she deadpanned. “You don’t know my husband.”

He never figured it out.

Patients seek breast augmentation, wrinkle relaxers, surgeons say

Reported by: Jaime Hayden Email:

News 4 looked at what neighbors in northern Nevada are turning to plastic surgery to change. “The typical patient that comes in to see me has been thinking about whatever procedure they’re coming to see me about for years,” said plastic surgeon Dr. Joseph Kiener.

Kiener sees around 15 new patients a week and 80 percent of his surgeries are cosmetic. “People, their motivation is typically that they don’t like something about themselves, and fortunately in my practice most the time it’s the patient that is motivating themselves to come here as opposed to a significant other.”

That is exactly why 60-year-old Janet Baron of Reno said she got a facelift three years ago. “I was taking care of my parents, I had a horrible marriage for 10 years, and I wanted to do something for me.”

Baron said she did not like the extra skin under her chin, but it was more than just changing her face. “I feel better, it’s almost like a new me.”

Now, she said strangers often think her 31-year-old son could be her husband. “Okay that’s kind of cool, he’s really upset, he goes that’s gross, but I go, you have to understand that makes me feel good.”

Although Baron said the selfie phenomenon did not affect her decision to go under the knife. Kiener said social media is playing a role for many, including opting for non-surgical procedures. “Things like Botox, the fillers, laser hair removal, as well as other laser and light based treatments.”

Still, Reno plastic surgeon Dr. Phillip Dahan said the number one cosmetic surgery on women’s wish list is breast augmentation. “The majority undergo breast implant surgery, such as augmentation to enhance the size, shape, projection of the breasts, and even to improve two breasts that don’t match, so to improve symmetry.”

Dahan said Botox, fillers, nose jobs and pec implants are popular options for guys, but men still only represent 10-percent of his plastic surgery patients. “Every now and then I have males that are very concerned that they try to exercise and improve the bulk and tone of the chest muscles and they can’t or they want to take it to another level, so it’s a great operation to do it.”

Kiener said he sometimes has to say no, but it is not easy. “You also have to be the patients advocate and say to them, ‘Well, I don’t think this is a good idea for you,” now the problem with that is that they’re so motivated that you know they’re going to go down to street and see somebody else, so where do you draw the line and that is a very difficult thing to do.”

Kiener said over the last two years he has seen the biggest increase in butt surgery. He also said plastic surgery is most popular among women ages 35 to 50, followed by women ages 50 to 65, and then women between ages 20 and 35.

Cosmetic surgery to fix ear “tribal piercings” on the rise

By ALPHONSO VAN MARSH CBS NEWS November 7, 2014, 1:48 PM

HIGH WYCOMBE, England – Liam Palmer says his dream is to serve in the British Army. But the military won’t accept the 21-year old with gaping holes in his earlobes from ear piercings, followed by stretching the skin with plugs.

“I don’t regret it. [Wearing ear plugs] was just a part of who I was,” Palmer says about his younger counter-culture days of gelled hair, skinny jeans and ear plugs – also known as ear gauges or “tribal” ear piercings.

Doctors says once ears like Palmer’s are stretched past half-an-inch in diameter, they won’t shrink back or close up. Cutting away the excess skin is the only way to fix them. So Palmer had cosmetic surgery to reshape his earlobes. Plastic surgeon Adrian Richards says the procedure involves removing the excess stretched ear tissue and using internal and external stitches in the earlobe to recreate a more normal shape.

Surgeons numb the ear for the approximately 40-minute operation, but the patient stays awake. Cosmetic techniques can vary, but doctors say patients end up with a well-hidden scar along the natural contour of the reconstructed earlobe.

Palmer isn’t the only one going under the knife. Richards, who performed Palmer’s operation, says he’s seen a surge in the number of surgeries in the past year due to the negative stigma surrounding what he calls “flash tunnels.”

“We’ve had guys in the Army threatened with discharge if they don’t have their ears repaired,” says Richards, director at Aurora Clinics. He says he sees about ten new patients a month asking about the procedure, ranging from a golf pro to clergy members, school teachers to soldiers.

The U.S Army announced a crackdown on piercings larger than a standard earring on its troops in May. The Army’s website highlights a new regulation banning soldiers from, “willfully mutilating the body… including… ear gauging (enlarging holes in the ear lobes greater than 1.6mm).”

Earlobe reconstruction surgery is more prevalent in the U.K. than in the United States, says Dr. Michael Edwards, president of the American Society for Aesthetic Plastic Surgery. But he says surgeons in cities like Los Angeles and Seattle are carrying out the repair procedure. “Patients realize [ear gauges] are not becoming in terms of job hunting or work – sort of like tattoos,” Edwards says.

Edwards says the surgery can range from $1,500 to $3,000 in the United States. In the U.K., the operation can average a little over $3,000.

After the surgery, Liam Palmer told CBS News he hopes changing his appearance will pay off. “This is for the Army, [I am] one step closer,” he says. Palmer’s bandages will come off in about a week. Then, he says, it is up to him, to make the cut to make his military dream come true.

Scientists Say They’ve Found the Perfect Breasts

breastsShut the front door: Scientists have finally found the perfect breasts. No, they weren’t hiding in the Amazon or roving solo across the Sahara (although we have no doubt there are women in both the Amazon and the Sahara who have magnificent mammaries); it turns out these perfect breasts were hiding in a plastic surgeon’s office this whole time! Now, before you get all worked up, the American Society of Plastic Surgeons (ASPS) would like you to know that the super-fake looking plastic breasts of yore are not actually what people think are most attractive now.

According to a study published in the Journal of Plastic and Reconstructive Surgery—which involved asking over 1,300 people to look at pictures of naked boobies and rank them by hotness (stop laughing, this is serious research!)—people preferred a more “real” and “normal” look from their silicone, with the ideal breast shape having a 45:55 ratio. People said the best chests have 45 percent of the fullness above the nipple line and 55 percent of the fullness below, in a slightly teardrop shape. Researchers noted this preference remained consistent across gender, racial, and ethnic groups with the 45:55 ratio favored by 87 percent of women in their 30s, 90 percent of men, and 94 percent of plastic surgeons.

We’re certainly not knocking the decision to get breast implants—women have lots of great reasons for enhancements ranging from “it makes me feel more confident” to “what I do with my body is none of your business”—but we are a little confused about calling this new standard “perfect” and even more confused about proclaiming it to be “real.” After all, aren’t all breasts real breasts?

And when it comes to normal breasts, there is a lot of variation. The average American breast size is a 34DDD. But if you’ve been in a locker room lately, you know that normal nippers come in every size from Nearly Flat to Good Golly Miss Molly. There are even more options for breast shape with 19 different identified builds for your bra buddies. Not to mention that both your shape and size can change dramatically over your lifetime as you age, go through puberty, gain or lose weight, have children, fight cancer, or have surgery.

Our breasts go through a lot for us! So we say that whether you have triple-A tatas, size G gazongas, or more moderate mounds, they’re all perfect.

By Charlotte Hilton Andersen Follow @CharlotteGFE
Topics: breastsbody image

Charlatans in South Korea’s booming cosmetic surgery market leave patients shattered

Botched jobs in South Korea’s plastic surgery
Yiming Woo reports.

Kim Bok-soon disliked her nose. She’d heared of a superstitious belief that its shape was a drain on money. She went ahead with plastic surgery despite her family’s objections. She had 15 operations. But when the bandages came off, she knew something was wrong. Only later she found out her doctor was not a plastic surgery specialist. “He ruined my face. This is not a human face. It’s more revolting than monsters or aliens. It is so horrible.”

Another woman, who only gave her surname Park, went to the same doctor. The divorcee wanted to make her breasts bigger in the hope of finding another husband. Instead, after a series of infections, her right breast ended up half the size of the left one. “I regret it too much so I tried to kill myself twice. My mother got me to a hospital. I don’t believe in people any more.”

In South Korea, the world’s largest market for cosmetic surgery, physical perfection is seen as a way to get ahead in marriage and career. Its five billion dollar industry is fuelled by medical tourism. But complaints about botched jobs and unqualified doctors have doubled over the past year. That’s worried the Korean Association of Plastic Surgeons, which wants tighter supervision and stricter advertising rules. “Advertising too much has made people think surgery is a commodity. People now think plastic surgery is like buying stuff somewhere.”
Government data shows 13 out of 1,000 South Koreans have had cosmetic procedures, the highest rate in the world.

Suffering for their art.. A new exhibition compares depictions of military surgery now and 100 years ago

ENTERING the small room that houses “War, Art & Surgery” at the Hunterian Museum in London, the visitor encounters two images hung one above the other. On top, in sepia tones, is “The Birth of Plastic Surgery” (pictured), painted in 1916 by Henry Tonks; below, strikingly similar though tinted in the blues and greens of the modern operating theatre, is “Hands, hands, hands”, by Julia Midgley, a contemporary artist. Her work has been paired with Tonks’s in this thoughtful show marking the centenary of the start of the first world war. The public might be forgiven for growing a little weary of the anniversary, but here at the Royal College of Surgeons, the subject is approached in an unusual light.

Tonks, who was a surgeon himself as well as a subtle and perceptive artist, was not indulging in hyperbole in his painting’s title. The image depicts the operating theatre of Harold Gillies, the pioneer of facial reconstructive surgery. The two first met at the Cambridge Military Hospital in Aldershot, where Gillies was developing the techniques that laid the foundation for modern surgeons’ ability to rebuild the human face, using as his subjects the young men who had been horribly disfigured in the trenches.

“The Birth of Plastic Surgery” gives way, in this exhibition, to a wall of the remarkable pastel drawings Tonks made of the soldiers’ injuries. (The exhibition catalogue also shows photographs of the wounded and the work performed on them; it, much more than the exhibition, is not for the faint of heart.)

Tonks’s drawings, which have rarely been seen together in this way, are both accurate and humane. The eyes gazing out of shattered faces show confusion, fear—and then, just sometimes, when the surgeon’s work has been completed, hope, as in the images of Robert Davidson, who was serving as a medical orderly when he was wounded in 1916, losing his whole upper lip and left cheek. Gillies’s work enabled Davidson to “speak his native brogue again”, as the surgeon noted.

Opposite Tonks’s images hang those of Ms Midgley, who retired last year as Reader in Documentary Drawing at Liverpool School of Art & Design, and who previously worked as artist in residence at the Royal Liverpool and Broadgreen University Hospitals Trust. For this project, which “doffs its cap to Tonks”, as she says, she spent time not only with wounded servicemen and women at Headley Court in Surrey, where the Defence Medical Rehabilitation Centre is based, but also at Strensall Camp in Yorkshire, observing “Hospex” training—simulations in which amputee actors, equipped with elaborate prosthetics and body paint, help train military medical personnel to evacuate the wounded from Afghanistan and other conflict zones. And it was at the Royal College of Surgeons itself that she observed high-intensity refresher courses for army surgeons. Her work is not as graphic as that of Tonks, not least because facial injury is much rarer in 21st-century warfare. Improvised explosive devices are modern war’s most destructive weapon, so much of Ms Midgley’s work focuses on limb amputation and its after-effects.

Tonks did not think that his work should be exhibited. “They are, I think, rather dreadful subjects for the public view,” he said. But the Hunterian Museum, with a collection that bridges the worlds of art and science by illustrating the history of surgery and people’s fascination with their own anatomy, provides a thought-provoking setting. Ms Midgley’s delicate but forceful work is proof, if such were needed, that the courageous eyes into which Tonks looked so clearly still hold the artist’s gaze 100 years later.

“War, Art & Surgery” is at the Hunterian Museum, in London, until February 14th 2015

A plastic surgeon weighs in on the changing faces of celebs

“Who’s that girl?”

That’s the question many were asking when a woman with Renée Zellweger’s toned body and sleek dress sense — but not her familiar face — posed on the red carpet with the actress’ boyfriend of two years. Turns out it was Zellweger on Doyle Bramhall’s arm — only instead of her trademark deep-set eyes and smirky grin, the 45-year-old actress had wide saucers and an eerily smooth complexion.

Zellweger is the latest example of a disturbing trend: women — and occasionally men — in the public eye who, in the process of “refreshing” or “maintaining” their appearance, go a few millimeters too far and erase or minimize the very features that made them famous in the first place. The result? A generic, fabricated Hollywood look that has sadly become all too common.

“Surgeons are always well-intentioned, but sometimes they’re a little bit too formulaic in the procedures they use,” said Dr. David Hidalgo, a New York-based plastic surgeon. “It’s not so much that it’s overdone, it’s just not individualized. For surgeons, it’s almost [more] important to decide what not to do than what to do. And that comes with experience.”

In an exclusive statement sent to People magazine, Zellweger dismissed suggestions she’d had work done as “silly” and attributed her highly alert appearance to being in love and enjoying a healthier lifestyle. “I’m glad folks think I look different!” she wrote. “I’m living a different, happy, more fulfilling life, and I’m thrilled that perhaps it shows.”

There is an art to looking “well-rested,” and top surgeons proceed with caution. Dr. Timothy Marten, a San Francisco-based plastic surgeon, notes that “certain areas of the face — in particular the eyes and lips — are known as loci of identity.” In other words, mess too heavily with these parts, and you just might wind up unrecognizable.

According to Marten, traditional eyelid surgery involves removing tissue that “can change the look of the eyes.” With lips, “there’s a tendency with famous faces to overfill the upper lip, and it looks unnatural” — when it should be the other way around.

Here’s a look at Zellweger and other stars remarkably transformed over the years.

Renée Zellweger

Renée Zellweger in 2011 and 2014.Photo: From left: Mike Coppola/Getty Images, Jon Kopaloff/FilmMagic

“She’s a beautiful and talented woman who may or may not have had a facelift,” says Dr. Timothy Marten. “She had a very full upper and lower eyelid and part of the reason she looks different is her eyelids no longer have that full, girlish look we all loved about her. It’s also possible something was done to her lips.” Her face has perhaps lost some of its softness, he noted. “She may have either lost weight or had facial liposuction or radio frequency or ultrasound,” he says, referring to skin-shrinking techniques that can result in the loss of facial fat.

Tatum O’Neal

Tatum O’Neal in 2009 and 2014.Photo: From left: Duffy-Marie Arnoult/, Gregg DeGuire/WireImage

The youngest person ever to win a competitive Academy Award is now 50 and likely fighting the hands of time with injections, not surgery. “It’s all about fat transfer or filler,” says New York-based Dr. David Rosenberg, adding that the substances dissolve so the pillowy effect will wear off.

Kenny Rogers

Kenny Rogers in 2000 and 2014.Photo: Right: Rick Diamond/Getty Images

The singer-songwriter and actor is a wide-eyed and bushy-tailed 76. “It looks like he had his eyes done and possibly a brow lift,” says Dr. David Hidalgo. “It has totally changed his appearance. It doesn’t look like he’s had a facelift because of his neck.” Does he look better? “It’s safe to say that he looks cleaner but he looks different.”

Olivia Newton-John

Olivia Newton-John in 2005 and 2014.Photo: From left: Eric Neitzel/, Bim/Broadimage

We’re hopelessly devoted to the “Grease” star and singer, even if she’s done the lift and fill. “To have a neck like that in your sixties, you’ve had a facelift,” noted Dr. David Rosenberg, adding that she’s probably had some filler or fat transfer and put on a few pounds. “She’s looking beautiful. She looks better than when she was 30 years old.”

Winona Ryder

Winona Ryder in 2005 and 2014.Photo: From left: Steve Granitz/, Bruce Glikas/FilmMagic

Her first major role was as a goth teen in “Beetlejuice,” and while she could no longer pass as a high school student, grad school would not be a stretch. Dr. Rosenberg does not believe the gorgeous 42-year-old actress has had a facelift or her eyes done. “She looks thinner and it doesn’t look surgical. It looks like she has maybe some fillers in her cheeks. You can see the pads under her eyes.”

British woman dies during cosmetic surgery in Thailand

The Guardian, Friday 24 October 2014 12.43 BST


A British woman has died during cosmetic surgery at a clinic in Thailand, authorities in the country have said.

The 24-year-old was said to have been undergoing a procedure by an allegedly uncertified surgeon in Bangkok before her death.

She repoPolice close the street after a British woman was found dead at a beauty clinic in Bangkok, Thailandrtedly died during a corrective procedure after undergoing surgery at the same clinic in the Thai capital weeks earlier.

Boonruang Triruangworawat, an official at the Health Service Support department, said attempts had been made to revive the woman, who stopped breathing after being given an anaesthetic last night.

Police said the doctor who carried out the operations, named as Sompob Sansiri, was later arrested. The clinic has been shut for 60 days while investigations are carried out.

A spokesman for the Foreign Office said: “We were informed of the death of a British national in Thailand on 23 October. We stand ready to provide consular assistance.”

Consultant plastic surgeon Michael Cadier, president of the British Association of Aesthetic Plastic Surgeons, said: “Details are still emerging, but it’s important that the public remember the serious risks involved in any surgery, which are increased by travel abroad.

“This tragic case highlights how, if lured by the prospect of what is essentially ‘cheap surgery’, patients can be left vulnerable.

“Standards for healthcare may vary, and patients frequently undergo ‘consultations’ with company representatives who have no medical background, and are therefore not being given the appropriate knowledge in order to give informed consent.

“In some cases, patients are even being treated by a person without proper surgical credentials – if any at all – which breaches all the fundamental guidelines for safe practice in cosmetic surgery in the UK.”

Brazil surpasses U.S. in number of plastic surgeries

Janet Timal, 47 (right), stands with her niece Thairine, 21. Janet has had a tummy tuck and breast augmentation and helped her niece pay for liposuction. "The ideal is to be able to put something on, to sit down and not have your belly jumping out. Here in Brazil it gets hot, and the less clothes, the better," says Janet.

Jimmy Chalk for NPR

October 07, 201412:11 PM ET
Lourdes Garcia-Navarro Janet Timal, 47 (right), stands with her niece Thairine, 21. Janet has had a tummy tuck and breast augmentation and helped her niece pay for liposuction. “The ideal is to be able to put something on, to sit down and not have your belly jumping out. Here in Brazil it gets hot, and the less clothes, the better,” says Janet.

Janet and Jaqueline Timal are 40-something-year-old sisters, and they have what they call a plastic surgery fund. “I’m always saving money. When I see I’ve gathered up enough money for another surgery I do it,” Jaqueline says. She has had breast implants put in and also a tummy tuck. She’s visiting the plastic surgeon’s office again to do a famed Brazilian butt lift, which is the same as a breast lift, but on your backside. Janet has had a tummy tuck; she’s now doing her breasts, too. Between them, they will have had five surgeries.

Janet and Jaqueline aren’t rich — far from it. One works at a retirement home; the other owns a small shop. They both say this isn’t about bankrupting themselves for beauty but rather the opposite — Jaqueline says she sees the procedures as an investment. “I think we invest in beauty because this is very important for women here. You can get a better job because here they want a good appearance, a better marriage because men care about the way you look,” she says.

Brazil has just surpassed the U.S. as the place with the most cosmetic surgeries performed in the world, even though it has fewer people and collectively less disposable income than the U.S. Last year, according to the International Society of Aesthetic Plastic Surgery, 1.5 million cosmetic surgeries were carried out in Brazil — 13 percent of all the elective plastic surgeries done all over the world.

One reason is that Brazil simply has more plastic surgeons per capita than the U.S. There’s a health care crisis in Brazil that has led the country to import doctors from Cuba to work in rural and poor areas. Yet there’s a surfeit of plastic surgeons.

The other reason is women’s increasing financial power. In the past 10 years, Brazil has grown economically, and salaries and disposable income have gone up. Women like the Timal sisters have overwhelmingly chosen to use that money on their appearance.

While in the U.S., people may hide that they have had plastic surgery like it’s something shameful, in Brazil they flaunt it. The attitude is that having work done shows you care about yourself — and it’s a status symbol.

But even though people have more money and greater access to credit, many of the poor wouldn’t be able to afford to pay for all of their cosmetic procedures unless they got a helping hand.

The Ivo Pitanguy Institute in Rio de Janeiro is named after the famous Brazilian plastic surgeon who is renowned for saying, “The poor have the right to be beautiful too.”

Here the ethos is beauty shouldn’t just be a privilege of those who can afford it.

The institute’s lobby is packed as attendants call out the names of women — and a few men — who are waiting to be evaluated for cosmetic surgeries. This is a charity and teaching hospital, and the surgeries given are either free of charge or heavily subsidized.

The hospital offers all the usual fare: breast implants, breast lifts, Botox, nose jobs, face lifts and, of course, the ever-popular butt implant.
This is where the Timal sisters are having their surgeries. The price for Jaqueline’s butt lift? It’s 3,800 reals, about $1,600. At a private hospital it could run over three times that.

Francesco Mazzarone, who now heads the institute, explains why it’s important to provide cosmetic surgeries to the disadvantaged. “This is about equality, which is the philosophy Pitanguy created. Equal rights to everyone. The patients come here to get back something they lost in time. We give to them the right to dream,” he says. “What we do here is altruism.”

And the women NPR spoke with are grateful, but they also acknowledge that there is a lot of pressure in Brazil to conform to a physical ideal.

Jaqueline Timal says her 21-year-old daughter has already had liposuction. “I told her she should wait, but to be very beautiful, we push ourselves — and also society pushes us. I think she is too young for that, but as it was her great desire, I supported [her] so she can be happy,” she says.

Some in Brazil, though, balk at the idea that happiness can be achieved at the end of a scalpel.

Being a feminist is a lonely business in Brazil, says Karen Polaz, a blogger and women’s rights activist. She says despite the fact that Brazil has a female president, it’s still a very sexist country. She says beauty as a right sounds good in principle; what that means in practice is that a very narrow view of what is beautiful is being pushed onto people here. “Before accepting the idea that everyone has the right to be beautiful, we have to understand the image of beauty that is being sold, because this is an industry, an extremely lucrative industry. They transform women into consumers,” she says.

And in Brazil, that transformation has a racial component.

Brazil imported more slaves, some 4 million, than any other country. Today, it is a primarily a mixed-race country, but you wouldn’t know that by looking on TV and in magazines here, which rarely feature people of color. “ If you look at the traditional body type of a Brazilian, you would see a woman with dark skin, curly hair, small breasts and a larger bottom, a body that is very different from the body marketed as desirable. – says Marcelo Silva Ramos, an anthropologist and social scientist.

He says what is sold as beautiful here is someone like Brazilian model Gisele Bundchen: a woman who is tall, thin, blond with straight hair, bigger breasts and fewer curves. That has meant people who don’t look the right way — and by this he means “the white way” — are often excluded, he says.

“In our culture, the view is women who look acceptable get money, social mobility, power,” he says.

Take for example the popular Miss Bumbum contest, which annually crowns Brazil’s best backside. All of the contestants this year are lighter skinned.

Claudia Alende, the 22-year-old front-runner of this year’s competition, looks like American actress Megan Fox, right down to the blue contact lenses she wears over her natural brown eyes. She says she is competing for a simple reason.”The contest is famous around the world, and I want to be recognized around the world and become famous, too,” she says, laughing. She says the contest is a way for her to become a TV presenter or an actress. The rules of the contest allow for plastic surgery anywhere but on the backside. She openly admits she’s had work done. “It was [because] everyone was doing [it] so I did [it],” she says.

Previous Miss Bumbum contestants have indeed gone on to arguably bigger and better things. One became a TV presenter; others have become actors and professional dancers on TV. But they are among the few.

Maria da Gloria de Sousa is 46 but looks 30. Maria da Gloria de Sousa, 46, has had six surgeries at the Pitanguy Institute. She’s unemployed but has had six surgeries at the Pitanguy Institute and speaks about her procedures with characteristic Brazilian humor and openness.”First off, I do this for me. These kind of things you need to do for yourself. And second, there’s nothing better than getting a compliment, right? That you’re good, that you’re sexy, it’s really good. I like it.”

"Plastic surgery starts to become an addiction. You're born perfect, but then you have children and you know what having children does. Then suddenly comes the rebirth: plastic surgery. You can be beautiful, even more beautiful than you were before." — Maria da Gloria de Sousa, 46.

Jimmy Chalk for NPR

“Plastic surgery starts to become an addiction. You’re born perfect, but then you have children and you know what having children does. Then suddenly comes the rebirth: plastic surgery. You can be beautiful, even more beautiful than you were before.” — Maria da Gloria de Sousa, 46.

 “I’m almost an android! I had done my breasts three times. I didn’t stop there. I did a tummy tuck and then a lipo, and, lastly, I did my bottom,” she says. She says she has spent the equivalent of the cost of three cars on her operations. “I’m much happier, there is no doubt about it. My bottom will never sag, my breasts will never sag. They will always be there, hard. It is very good to look at the mirror and feel fine,” she says.
When I ask her if it was all worth it, she tells me she has a 21-year-old lover. “Things have gotten a lot better,” she quips. She waves goodbye and, smiling, sashays down the beach — and nothing jiggles.

Plastic surgery helps patients complete transformation after weight loss

Sue Thoms | By Sue Thoms | sthoms1@mlive.comThe Grand Rapids Press on September 29, 2014 at 7:00 AM, updated September 29, 2014 at 11:07

GRAND RAPIDS, MI – When Dr. Ryan Mitchell was in his plastic surgery residency, he developed an interest in a growing area of practice – body contouring for patients who have sustained a major weight loss.

The surgery to remove the excess skin left behind is becoming more in demand, as obesity rates rise and bariatric surgery becomes more common, he said.

Mitchell, who recently joined the Bengtson Center in Grand Rapids, pursued a fellowship to specialize in the treatment.

“It became my passion,” he said.

His draw to the specialty is the chance to address quality-of-life and physical needs of the patient. Many of the patients he has met, although they have lost in the range of 100 pounds and are much healthier, experience a bit of “buyer’s remorse,” he said.

Bengtson before and after.jpgBefore after photos show a patient of Dr. Bradley Bengtson after body contouring surgery. Dr. Ryan Mitchell, a surgery specializing in body contouring after major weight loss, recently joined Bengtson’s practice.

Even with diet and exercise, they can’t lose the excess, sagging skin.

“People have said I look worse now than I did before. One patient said when she was larger, she was just the largest person on the beach. Now when she goes to the beach, she feels she gets looks and attention because she doesn’t fit into either mold,” he said.

Body contouring procedures often target the belly, arms, legs and buttocks area.

The problems caused by excess skin are not all cosmetic. There also are functional problems, particularly with the skin around the belly. That area is prone to rashes and infection. And for some patients, the excess skin on the thigh prevents them from wearing slacks.

While health insurance sometimes covers removal of the overhanging skin on the abdomen, patients usually must pay out of pocket for contouring procedures on other parts of the body.

Mitchell said the cost of surgery varies depending on a number of factors. But as a general range, the cost to patients can run from $14,000-$16,000 for abdominal surgery and $6,000-8,000 for arms, including surgical and hospital fees.

A dual U.S-Canadian citizen, Mitchell received his medical degree in plastic surgery from the University of Manitoba. He did his fellowship in body contouring and reconstructive surgery at the University of Pittsburgh Medical Center.

To undergo body contouring surgery, patients must meet certain criteria, Mitchell said.

“They have to be weight stable for about 12 months,” he said. “In some of them, their weight tends to fluctuate. Once they have reached their plateau, that’s when they are optimized for surgery.”

Because some post-bariatric patients are at risk of malnourishment, patients must be on a high-protein diet to improve wound healing, he added.

He cautions patients that there will be scars. He can often hide abdominal scars in the area that would be covered by undergarments or bathing suits, but scars can’t be hidden on upper and lower extremities.

“Almost every surgeon has the ability to do what I do,” Mitchell said. “The question is whether they are passionate in order to do it or comfortable to do so. What I specialize in are the larger cases.”

He cites research showing that plastic surgery can help a patient maintain weight loss. A study in the October 2013 journal Plastic and Reconstructive Surgery found those who underwent body contouring regained an average of 11 pounds, compared with 50 pounds for those who did not undergo surgery.

The plastic surgery may be “the final hurdle to get somebody to the place they’ve always wanted to be,” Mitchel said. “To me, that’s the rewarding part – to be able to be involved in someone’s life and to be able to make that final difference.”

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