Confessions of an <i>Extreme Makeover</i> Plastic Surgeon

In 2003,traveled to NYC from LA and I was one of the plastic surgeons who participated in that episode. I would like to share the experience with you.
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The television show Extreme Makeover was a hit and a pioneer in reality TV that premiered in 2002 and featured individuals who were transformed over a six-week period through diet, exercise and plastic surgery. Changes in hairstyle, makeup and clothing completed the process. The show followed these individuals throughout a six week process, documenting each step, from the initial consultation with the "Makeover Experts" to the final "Reveal," when the participants returned home to their friends and family for a party to show off their makeover.

In 2003 the show traveled to NYC from LA and I was one of the plastic surgeons who participated in that episode and I would like to share the experience with you.

First off: Why did they choose me? I mean I was flattered and all, but I was not one of the famous plastic surgeons in NYC who rubbed elbows with the elite of society and performed their surgery. I did not have a publicist and was never featured in the beauty magazines. All the other surgeons selected were from LA and known for their work on movie stars. When I pressed the producer, he told me that I was chosen because I am Board Certified, passed the background check and had no "skeletons" in my closet. That, he explained, was vital because the show was being aired on ABC network, which is owned by Disney, who is very concerned about maintaining a clean image. Wonderful, Micky Mouse liked my work!

My next thought: Is this a good idea? What if something went wrong? I could see the headlines: "Plastic Surgeon Botches Operation in Prime Time!" After controlling my hyperventilation and calming down, I reasoned that I was confident in my ability and certain that my conservative approach and meticulous preparation towards surgery would serve me well in front of the cameras. Also, in the event of catastrophe, I could always move to Tijuana and open a clinic there!

My thought process continued. What if the opposite occurred? What if I was a big hit and became famous? Patients would be banging down my door, begging for my services, changing my life forever. I might become the Dr. Oz of plastic surgery! Wait a minute...I didn't have Dr. Oz's boyish good looks, wit or charming personality! I would be a disappointing T.V. failure because I have the face only a mother could love!

I had my concerns when I was first approached by the show's creator, Howard Schultz. Who were the participants? Would I have complete autonomy in the patient selection process and more importantly, the surgical procedures to be performed by me? I did not agree with several of the "mega-operations" performed in previous shows in which the patients were on the OR table in excess of 8 to 10 hours. Mr. Schultz assured me that I could select the patients and choose the procedures as I saw fit. He explained that I would review videos submitted by aspiring participants, choose 5 possible candidates who would be flown into NYC for consultations by me, which would be filmed, and 2 would be chosen for the show. After reviewing scores of submitted tapes, I chose 9 candidates, just to be sure. That required filming each consultation in my office over a two day period.

What he failed to explain was that the consultations would be attended by the show's associate producers who tried to influence me in the selection process to choose candidates with the most dramatic storyline or most dynamic transformation possibility. I had to temper their enthusiasms for the dramatic with the reality of patient and procedure selection; things like patient health, anatomy, desires and expectations. I had to choose patients that required a reasonable surgical plan that I deemed safe and realistic.

Unfortunately, some participants had to be excluded for health issues and others because I felt that the procedures that they requested or needed to accomplish their goals were too lengthy to accomplish at one sitting required by the show. The truth is that many "makeovers" require two or three stages or operations to safely accomplish the set desires. To their credit, the producers granted me final say and I chose my 2 candidates.

Now the fun began. The first patient, Samantha, a survivor from the Columbine High School shootings, was slated for a facelift, brow lift, fat transfer to eyelids, laser resurfacing and lip augmentation. She also required dental work. She was a wonderful candidate because she had gorgeous facial bone structure and very realistic expectations. The second candidate, Denise, was slated for rhinoplasty, mini-brow lift, breast augmentation and chemical peel of her face. She too was a fine candidate.

On to the operating room. Samantha went first. I must admit that initially, I was a bit nervous. There was one stationary camera filming the entire operation and a second hand held camera to be used intermittently for a different angle. Once we started, and I became immersed in the surgery, I felt more comfortable and everything proceeded according to plan. The producer asked me to explain what I was doing at certain points and I discussed the key maneuvers of the operation. Denise had her surgery the following day without incident. They tried to film the patients while in the recovery room, but my very protective nurse forbid contact to allow the patients to wake up from anesthesia safely and with dignity.

The following weeks were the hardest for me. During the post-operative period, every single contact with each of the patients had to be filmed, which lengthened each encounter and that became tiresome because we all were very aware that we were on camera. The sessions felt staged and artificial. During that time the other makeover specialists did their thing during the following weeks. The surgery always went first to allow post-operative swelling to decrease in time for the unveiling. This was also frustrating because in reality, complete resolution of swelling takes longer, 3 to 6 months.

What life lessons did I take away from the experience? I have always tried to dispel the notion that cosmetic surgery is trivial, and that it should be taken seriously, as complications can occur. I am not sure that my participation, even with a very conservative approach towards surgery, adequately accomplished that goal. Also, cosmetic surgery should not be viewed as the only alternative to a "life makeover", because true beauty starts on the inside and emanates outward. I have learned my lesson and now I preach that to my patients.

In the end, everything turned out reasonably well, and both ladies were pleased with their makeovers, and their "Reveal" parties were a success. My practice reverted back to normal and I must say that I was glad to return from "Reality TV." I was grateful to participate in the show, but realized that Hollywood was not for me. When you have a face that only a mother could love, it is better to put that face behind a surgical mask, instead of in front of the camera!

To learn more about my concepts regarding beauty and cosmetic surgery please go to the book's website,,, or friend me on Facebook.

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