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TV's 'makeover' shows: Maybe there is Such a thing as bad press

National report — Television reality shows that focus on cosmetic surgeons and their patients have some physicians questioning the time-honored public-relations adage, "There's no such thing as bad press."


Dr. Goldberg
Shows such as ABC's "Extreme Makeover," MTV's "I Want a Famous Face," Fox's "The Swan," E! TV's "Dr. 90210" and Discovery Health Channel's "Plastic Surgery: Before & After" have generated major public awareness of plastic and cosmetic surgery. It has been reported that in the year or so following the November 2002 debut of "Extreme Makeover" the number of plastic/cosmetic surgery procedures in the United States increased by nearly one-third — and while that jump shouldn't be credited totally to one TV show, there's no question that "Extreme Makeover" and the wave of similar shows that followed have had an extremely significant impact.

"There is no question these shows generate increased interest in not only the procedures being presented, but in all sorts of cosmetic procedures," says David J. Goldberg, M.D., director of Skin Laser & Surgery Specialists of New York and New Jersey and director of Mohs Surgery and Laser Research at New York's Mt. Sinai School of Medicine. "My evidence is anecdotal, but the response is the same in all locations — patients are fascinated by what they see on these shows."

Reality shows not reality

Dr. Alster
According to Dr. Goldberg and others, however, too many viewers considering cosmetic procedures may be fascinated to the point that they make a decision based on what they see on these reality shows, rather than on reality.

"On the whole, I think the shows have had a negative impact on cosmetic surgery, despite the increased demand," says Tina Alster, M.D., director of the Washington Institute of Dermatologic Laser Surgery, Washington. "The shows tend to minimize the fact that these surgeries are medical procedures with inherent risks — and they often omit the risks of performing multiple concomitant surgeries and conveniently gloss over the prolonged postoperative recovery required."

Keeping perspective


Dr. Zachary
Though acknowledging that these shows, by and large, feature reputable physicians who have years of experience, Christopher Zachary, M.D., says they must be viewed in the proper perspective.

"Public education of any sort about cosmetic or plastic surgery is beneficial, but problems can occur with a little bit of knowledge," says Dr. Zachary, professor and chair of the department of dermatology at the University of California-Irvine School of Medicine. "Viewers get the impression that these procedures can totally change their lives, and while there are procedures that can be very beneficial personally and psychologically, the procedures done on these shows often are unrealistic and overly aggressive."

Dr. Goldberg, who, in addition to his med-school academic position, serves as adjunct professor of Law at New York's Fordham Law School adds: "They are at risk of either creating unrealistic expectations or more importantly, from my legal perspective, underplaying the risks of these procedures. Overall, however, I think the shows are a plus for the profession."

Dr. Alster isn't quite as enthusiastic.

"I have been approached to do one of these shows and I've turned down the opportunity," she says. "One of the reasons I turned it down is that I think the shows reduce the reputations of physicians who participate in them."


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