Reality Cuts

ABC has cancelled "Extreme Makeover," but it's already found new life in an unexpectedly serious outlet, the academic journal Plastic and Reconstructive Surgery. The journal's July issue reports the first known data on how reality television affects plastic-surgery patients—and they're sobering.

Four out of five people seeking cosmetic surgery in the study said they'd been "directly influenced" by shows including "Extreme Makeover," E!'s "Dr. 90210," MTV's "I Want a Famous Face" and Bravo's "Miami Slice." More than half of the patients said they watched at least one such program regularly, and most admitted that the shows had played a significant role in their decision to go under the knife.

Are these shows just harmless entertainment—the sort of thing that people who are open to cosmetic procedures would seek out anyway? Or are they bad medicine?

First, some perspective: if these makeover shows are pushing people into the operating room, it's not in huge numbers. Doctors performed about 1.8 million cosmetic surgical procedures last year, according to the American Society of Plastic Surgeons. That's up only about 2 percent from 2005. Other statistics from trade groups like the American Society of Aesthetic Plastic Surgeons (ASAPS) even show a decrease in surgical procedures. Meanwhile, there were about 9 million less-invasive nonsurgical procedures, like Botox injections and laser hair removal, in 2006. That's an 8 percent increase over the previous year.

But while this kind of programming may not be increasing the number of cosmetic surgeries overall, it does seem to be a factor among those who are opting for procedures like liposuction, breast augmentation and nose reshaping—which are among the most popular surgeries. According to the study, 79 percent of the 42 patients examined said that "television/media influenced their decision to pursue a cosmetic-surgery procedure." Only 12 percent of patients seeking plastic surgery said they'd never seen a reality show about it.

Makeover programs may be only a small part of a bigger change in attitudes toward cosmetic procedures, both surgical and nonsurgical. More people are open to the medicalization of beauty. "The [cosmetic-procedures] trend existed before the reality shows did," says Dr. Robert Singer, a plastic surgeon in La Jolla, Calif., and a past president of ASAPS. "The shows were just one more thing adding to it."