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Fighting Plastic Surgery Addiction

With cosmetic medicine, it's critical to know when to stop.

There is no Betty Ford Center for cosmetic surgery junkies, but perhaps there should be. Every year the red carpets for the Oscars, Emmys and Grammys reveal a fresh crop of celebrities who keep nipping and tucking until they’re virtually unrecognizable. And the obsession affects mere mortals too: According to the American Society of Plastic Surgeons, the number of cosmetic procedures has jumped 77 percent in the last decade. This ongoing cultural obsession with appearances and youth has spawned a growing number of plastic surgery addicts.

“Sometimes I feel like a mental-health professional,” says Robert Weiss, M.D., a dermatologist in Hunt Valley, Maryland. “People get fixated on things they see in a magnifying mirror that nobody else notices. I tell most patients, ‘Let’s do the absolute minimum.’ Then there are those who feel that getting work done is the only way to stop aging. You don’t want to confuse maintenance with being age-obsessed. If you’re 55, you can’t possibly look like you’re 25—but you can keep people guessing.”

“It’s our job as physicians not to do a procedure just because someone wants it,” says New York–based Amy Wechsler, M.D., one of only two doctors in the country who are board-certified in both dermatology and psychiatry. “Managing patient expectations is very important. We don’t want people to think they’re going to have a Cinderella effect, that their entire look is going to change, that they’ll get the man or get the job. This is never the reality.” The motivation may be the same as in Hollywood. “Sometimes it’s ageism in the workplace,” says Dr. Wechsler. “A patient will come in and say, ‘I didn’t really think I’d be doing this yet, but my company is hiring all these twentysomethings.’ Some people express concern that having cosmetic procedures could be a slippery slope, but I assure them I won’t let that happen. If the work is done well, the less you need.”

What Are You Doing For Lunch?

Going for a quick self-improvement session of Botox or a laser treatment, often referred to as the “lunchtime procedure,” can be tempting. “But beware,” says Felmont Eaves, M.D., a plastic surgeon in Charlotte, North Carolina. “There’s so much greed without accountability from doctors who prey upon our desire for less scarring, less anesthesia, less downtime.”

New York plastic surgeon Gerald Imber, M.D., pioneered the short-scar facelift, which uses a small incision in the sideburns to lift the muscles under the skin. “The word ‘noninvasive’ gives patients a false sense of security,” he says. “Take Sculptra, touted as a noninvasive filler—people have reported uncontrollable growth of collagen nodules.”

Boston dermatologist Jeffrey Dover, M.D., agrees: “People get hurt by nondoctors in some states who are allowed to perform such procedures. This isn’t like a bad renovation; you can't just call in a new carpenter.”