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INSIGHT

Plastic Surgery Becoming More Common

Aired November 5, 2003 - 17:00:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

ROSEMARY CHURCH, CNN HOST: Nipping and tucking. Millions of people turn to plastic surgery each year to enhance the way they look. It's not always a happy ending, with some procedures resulting in heartache and lawsuits. But the pursuit of the perfect face and body continues undeterred.
Hello and welcome to INSIGHT. I'm Rosemary Church, in for Jonathan Mann.

Plastic surgery has almost become part of the landscape of the Western world. Nose jobs, breast enhancement, Botox injections are no longer unusual in the United States, where the cosmetic and plastic surgery industry is now worth an estimated $8 billion a year. People want to look younger for longer. They're encouraged by surveys that indicate beautiful people are more popular and more successful at work. It's a theory that's catching on in places where you might not expect it to.

On INSIGHT today, a penchant for plastic. Lisa Rose Weaver begins our coverage in Beijing.

(BEGIN VIDEOTAPE)

LISA ROSE WEAVER, CNN CORRESPONDENT (voice-over): Life is good for Lucy Hao. She has a part-time job as a freelance writer, an apartment in Beijing, and her 15 minutes of fame has stretched into weeks as journalists document her transformation.

She has become a living billboard for cosmetic procedures in China, going from this pre-surgery look to this four months and 12 operations later. Lucy now has a higher nose and eyes that are larger and rounder. Doctors removed the fold in her eyelid to give her a more European look.

Lucy also had breast implants and liposuction to take fat from here and move it to there, making the 24 year old makeover head to toe.

Many of Lucy's procedures are common enough in China. What's unusual is the promotional nature of what is normally a private matter between doctor and patient.

LUCY HAO, COSMETIC SURGERY PATIENT (through translator): I had an agreement with the hospital. I'll be their spokeswoman after my operations, kind of like being an advertisement. I want more people to know about this hospital also, but they will have done what they need to improve themselves.

WEAVER: Neither the hospital nor Lucy will reveal who paid for the some $50,000 worth of operations, but the Evercare Medical Institution, which serves an affluent minority, wants more people to have work done here rather than go abroad.

UNIDENTIFIED MALE (through translator): Lucy will become a public figure. People will realize that she has become more beautiful because of surgeries performed by Chinese doctors. This will improve the public recognition of Chinese plastic surgeons.

WEAVER: For an elite which travels outside China seeking an alternative aesthetic, the pursuit of perfection includes an element of wanting to look more Western. Beauty and fashion editors notice another pattern for people who make a living on their looks: looking international is bankable.

UNIDENTIFIED FEMALE (through translator): Most of these are actresses and the like. And because their careers depend on international appeal, they are trying to look more European and therefore more fashionable.

WEAVER: But East Asian aesthetics are also finding an expression in surgery. One example, the idea of a gracefully curved jaw line, scheduled to be one of Lucy's last operations. It's a relatively difficult one that can go wrong, as it did for Julia Leo (ph), an aspiring actress.

JULIA LEO, COSMETIC SURGERY PATIENT (through translator): It's difficult to make a face thin. I tried, because I wanted to look good on the screen, but they took too much off my jaw line and my face got too thin. I had to have several operations done. I can't remember them clearly.

WEAVER: Julia has come to the Evercare Clinic to correct the botched surgery which was done somewhere else.

Lucy, meanwhile, says she can understand the impulse to keep on going with cosmetic surgery.

HAO (through translator): Having plastic surgery can be addictive. One might want to do it again and again after the first time. For instance, after seeing good results from changing my eyes and nose, I was confident that the next operation would also turn out really well.

WEAVER: But, Lucy insists, she will know when to stop, and has already decided not to have two procedures her surgeon recommended. She says her quest for physical perfection is not about looking more Western. Instead, her post-surgical self is simply an alternate reflection of a young woman who didn't seem to need any change at all.

(on camera): By one estimate, at least 200,000 people report being disfigured after having cosmetic surgery in China in the past decade. About a year ago, the Ministry of Health passed regulations to help weed out unqualified surgeons.

Even so, potential dangers remain, and they're often overshadowed by rapidly increasing wealth and changing values in a society where changing one's looks is just one more service to be bought for a price.

Lisa Rose Weaver, CNN, Beijing.

(END VIDEOTAPE)

CHURCH: And we're going to take a break now. When we come back, a booming business, the world leaders in cosmetic surgery.

Stay with us.

(COMMERCIAL BREAK)

CHURCH: In the 1990's, the Miss Brazil pageant changed its rules to allow plastic surgery, hair extensions and colored contact lenses. Still, Miss Brazil 2001 caused a sensation when it became clear just how much she'd had done. Juliana Borges was reported to have had more than 20 cosmetic procedures to alter her appearance. They included correction of the ears, collagen injections, breast implants and liposuction around the tummy area.

Welcome back.

Brazil is second only to the United States for the number of cosmetic procedures done each year. Last year, though, an estimated 6 million procedures were performed in the United States. That's down from 7.5 million the year before. Some people attribute that drop to the bad economy. Others say that more Americans are traveling overseas for experimental or controversial procedures that are not yet approved for use in the United States.

Elizabeth Cohen takes a look.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): How far would you go to find the fountain of youth? Would you leave the country? Would you try a drug that the U.S. government still considers experimental?

Anya Dorfman (ph) did.

(on camera): Tell me about what you're about to do in Jamaica.

ANYA DORFMAN, COSMETIC SURGERY PATIENT: I'm going to have Botox and lifting of my lines, facial lines.

COHEN: Anya (ph), I don't see any lines. Where are they?

DORFMAN: They are there. They are there. They are there. There are lines.

COHEN (voice-over): Anya (ph), a hair colorist, is 38.

DORFMAN: My clients, when they come, they always say, "I don't understand. Yesterday I didn't have the roots and this morning I woke up and they are there."

And one day, it happened to me. I looked in the mirror, and I said, "Yesterday, I didn't have the lines, and now they are there."

COHEN: So what do New Yorkers do when they wake up one morning and find lines? They head to the Big Apple's own fountain of young, Park Avenue, home to countless plastic surgeons, including Dr. Paul Lorenc.

He recommended two temporary fixes: Botox, a muscle relaxer, and the latest wrinkle filler, Restylane. Some call it a facelift in a syringe. But there's a catch. Restylane is still under study in the United States and is not on the market, although it is pending before the Food and Drug Administration.

So he told Anya (ph), if you want Restylane, you have to leave the United States. And the cost for both Restylane and Botox, about $2,000, travel expenses not included.

DR. Z. PAUL LORENC, PLASTIC SURGEON: I have patients flying in on their private jets to be injected with Restylane in Jamaica from the states. They love it.

COHEN: And that's exactly what Anya (ph) did in her battle against aging.

LORENC: Frown please. That's it, that's it, that's it. Just try to relax your face.

COHEN (on camera):: How are you feeling, Anya (ph)?

DORFMAN: Very good.

COHEN (voice-over): In about half-an-hour, Anya (ph) is done with her injections.

DORFMAN: Wow. Do you see the difference? It's amazing.

COHEN: The injections won't take their full effect for about a week.

Elizabeth Cohen, CNN, Montego Bay, Jamaica.

(END VIDEOTAPE)

CHURCH: Well, one person who spent quite some time working with doctors in other parts of the world is Ronald Goldstein. He's a cosmetic dentist, who joins us now from Miami, in Florida.

Doctor, thank you very much for being here.

DR. RONALD GOLDSTEIN, COSMETIC DENTIST: My pleasure.

CHURCH: I do want to take us back to the developing world, and this incredible popularity of cosmetic surgery. There had been a reluctance some time back to alter one's appearance. Why are we seeing this sudden popularity?

GOLDSTEIN: I think that the Internet has made a huge difference, plus satellite television, because people are getting it all over the world, and they're seeing what media figures look like, and they're becoming more and more interested. So that's a major reason.

And the third is because of the programming that shows the benefit of looking your best, you get more out of life.

CHURCH: What's the proof of that?

GOLDSTEIN: Well, there have been over 2,000 studies in the United States that shows that you get more money if you look better. You do better in school. You're judged better. There have been so many studies that have -- live studies on television, other studies, that are beyond a shadow of a doubt.

CHURCH: And this eye-widening operation seems to be probably the most popular procedure across Asia. Why are Asians turning their back on their own natural eye shape? Is it just the pursuit of the Western look?

GOLDSTEIN: I think they've seen the movie stars that have been the most popular.

First we've seen fashion. I think if you look at cultures, you see that fashion -- people get dressed up and they look so good and then you look in the mirror and say, "What's left? What's wrong?"

And they may see an eye that stands out or it may be their smile, the jaw, or some part of their face. So that's where they may be attracted to go next.

CHURCH: If that continues, that eye-widening operation continues, for say a generation, could you see this possibly having an impact on the genetic influence of the eye shape?

GOLDSTEIN: I think very possibly so. The same way that many people don't have their third molars today, because we've extracted so many third molars.

Over a period of centuries, certainly it could make a difference. But you've got billions of people in China and certainly not billions of people are going to have it done. We're talking about a relatively small group that are having it done now, but it's going to be increasingly so in years to come.

CHURCH: And you have spent a considerable amount of time in China. There are -- the demand in fact for cosmetic surgery far outstretches those licensed surgeons there. What sort of consequences did you see from that?

GOLDSTEIN: This frightens me terribly, because I lectured to plastic surgeons, cosmetic dentists, beauty experts, dermatologists, in all five academies there, in both Southern China and Northern China, and what concerns me is there have been over 200,000 lawsuits in the past decade in a civilization that's not litigious.

And one reason is because they're going to people that are not qualified, and two, they're going about it the wrong way. They're doing the nose without considering that the smile is where you start first. The bones of the face, where you have to start. Then you go to nose or eyes, because it changes the proportions of the face.

It took us 10 years to assemble dual-degree specialists in Team Atlanta, our practice, in order so we could look at the face with plastic surgeons who proportion.

Well, that's what I tried to teach in China, and that's going to take a long time to develop, in a country that doesn't have enough plastic surgeons to begin with.

CHURCH: Now, of course, you're talking about botched jobs by those surgeons, or they may not indeed be surgeons. They're not licensed, at least. But what about those surgeons who are licenses? What sort of standards and procedures do they have?

GOLDSTEIN: I saw some very high quality of plastic surgery, cosmetic dentistry, but it's being done in hospitals. And I saw also that the economy of China shocked me, because it's just exploding, and I see so many Chinese shopping with -- being able to buy fashions that we wouldn't even think of here, the prices.

So with this in mind, the next step is going to be asking for more and more plastic surgery, cosmetic dentistry, dermatology. Where will they go to get it? I think that these people will want private practice, and that's something that doesn't exist too much in China today.

So I think they're going through an aesthetic revolution. They're seeing the birth of the one starting today.

CHURCH: So you could possibly see China as a center for cosmetic surgery, like the United States, like Brazil?

GOLDSTEIN: I think you're going to see an explosion there that -- it's going to take a while before it catches up wit Brazil, Argentina and the United States, but you're going to see it, because there is the demand.

We see people in our practice from all over the world, and the reason they come is because of botched surgery or incorrect things that were done, or because they can't get it in (AUDIO GAP).

CHURCH: And just very quickly, do you see any dangers in (AUDIO GAP)

GOLDSTEIN: (AUDIO GAP) concentrate on one part of their body to the point where it's just (AUDIO GAP).

(COMMERCIAL BREAK)

CHURCH: (AUDIO GAP)

Wendy, do you foresee a time when (AUDIO GAP) some form of procedure just to keep up?

WENDY LEWIS, COSMETIC SURGERY CONSULTANT: I think we're getting their quite quickly, because I know in my own consulting business, I see clients in their 20's now, worrying about maintenance and preventative things, and they're interested in having (AUDIO GAP) as they get older. So we're seeing it now. It's a cultural phenomenon I think worldwide.

CHURCH: Usually people think of facelifts and nose jobs. We just saw that on the "Extreme Makeover" program. But there's a lot more now. We're talking about toe extensions, toe shortening, all sorts of things. Tell us a few of the procedures that you know about.

LEWIS: I think you should look at it this way. Cosmetic surgery has gone from the realm of just changing the fact to changing the face to changing the face, the breasts, the bodies, and now we're looking at sort of the extreme aspects of it.

So there is no body part anymore that cannot be changed. Hair restorations have become a huge hit. Men are very interested in having procedures done. We're seeing a lot of more invasive body surgeries. After bariatric surgery, or surgery for obesity, when there's a lot of skin fold rolling extra, then the surgery would be much more extensive: a body lift, a tummy tuck and an extended scar.

There are many more big procedures like that on the market, and the flip side is that more people are interested in the noninvasive procedures, like botulinum toxin and Restylane and fillers and lasers and peels as well.

CHURCH: Is this all about an increased self-indulgence, or access to higher incomes so that people can indulge themselves? What's behind it?

LEWIS: I think that's part of it, and I also think it's -- much as Dr. Goldstein said, it's very much driven by our obsession with celebrity.

If, you know, you're in your 20's and your role models are every aspect of physical perfection -- just look at Victoria's Secret ads on U.S. television. It's hard to compete. So the average person back home thinks, "Gee, I want to get a piece of that too."

It's also much more available to the average person today. It used to be only for the rich and famous, and that's just not true anymore. It's more affordable. Recovery times are much shorter, so you can get back to your lives and business that much faster.

CHURCH: Now Dr. Goldstein also mentioned this obsession some people have, where they concentrate on one part of their face, and we have seen that with some celebrities. What stories can you tell us about people who really just don't know when to stop?

LEWIS: Unfortunately, this is all too common and every plastic surgeon, cosmetic dentist or dermatologist sees this all the time.

I know I see it in my own consultancy practice. I very often have to talk people out of having things done. It's an obsession with a very small, minor, maybe a flaw that is invisible to the rest of the world. And you have to take it in perspective. The world looks at you as the whole package. They don't necessarily zero in on one tiny little flaw that to you gets magnified every time you look in your bathroom mirror.

Unfortunately, this is on the rise, and not only among older women, it's very big among younger women. Even some men as well.

CHURCH: Wendy, I do want to talk for a moment about Botox, because people really talk about Botox like Tupperware parties. People are going to Botox parties, but there are problems. I've read about one woman in particular where there was seepage into the muscle and she basically couldn't close her eye for the four month period that that Botox stays actually in the system. So what are some of the side effects? How dangerous are some of these procedures?

LEWIS: Having had Botox myself for now four years and I have no intention of stopping, I think the dangers are very minimal, as do most doctors.

However, I think the danger lies in the Botox parties that often mix alcohol and a social setting and a very happy-go-lucky atmosphere. This is a medical procedure and should be done in a clinical environment using sterile technique with appropriate lighting.

I know the doctor I go to, who is a board certified plastic surgeon, to do my Botox, it may take him a half-an-hour to get it just right, and he doesn't have 10 other women drinking away and talking about their boyfriends in the background.

This is a medical procedure and I think that that has minimized it in the public's eye.

CHURCH: But why do some of these procedures go so terribly wrong? Is it just about finding a qualified surgeon, or even qualified surgeons, do they make mistakes?

LEWIS: Qualified surgeons make mistakes, but a lot less likely than if you go to someone who is not very experienced and not well trained, and I think the real answer to your question, Rosemary, is greed. There is demand out there, and doctors are getting killed by managed care, and certainly this is as true in other countries as it is in the United States, like Canada and the United Kingdom, where it's much more difficult.

These procedures are available out there and in a lot of cases, maybe not the surgical procedures, but GPs are doing these things, radiologists, every other medical specialty, not only plastic surgeons and dermatologists.

In my view, that's where the danger lies. You have to chose your practitioner wisely.

CHURCH: Just how absurd is this getting, though? I mean, we look at stats here, quickly. The average Miss America 40 years ago was a size 10, she's now a size 2. Her weight has decreased by 25 pounds. These expectations, are they just getting ridiculous?

LEWIS: I believe they are. I think that the group that's most susceptible to that are young women and young men as well, that are much more vulnerable. You know, by the time you get to your 40's, you have a better sense of who you are and, you know, I'm never going to have model's legs. I accepted that fact.

But in your 20's, you still get mad that you can't, and you get angry at your gene pool for some reason because you can't fix everything. But these procedures are out there, and I see young women now coming in at 18 and 20 wanting breasts implants and liposuction, Botox being done in the late 20's. it's much earlier, and I think a lot of it is driven by the role models that we see I the media every day.

CHURCH: All right. Wendy Lewis, thank you so much for talking with us here on INSIGHT.

LEWIS: My pleasure.

CHURCH: And that's it for this edition of INSIGHT. I'm Rosemary Church. The news continues.

END

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