Fuelled in part by a spate of makeover reality-TV shows, plastic surgery of all kinds, from liposuction and brow lifts to Botox and hair transplants, has exploded in popularity in the past decade.
Cosmetic surgery has fanned into mainstream culture, with millions of viewers tuning in to watch ordinary-looking folks get sculpted and buffed like movie stars, to the point where even their relatives barely recognize them.
In the United States last year, surgeons performed around 8.5 million surgical and non-surgical procedures, a 293-per-cent increase from 1997. More than 2.2 million patients smoothed their forehead creases and laugh lines with Botox injections alone.
The concept that physical attractiveness is attainable, and even encouraged, through surgery is a theme that pervades this year's annual meeting of the American Society for Aesthetic Plastic Surgery, which begins today in Vancouver, with more than 2,000 surgeons attending.
The sudden death this week during plastic surgery of Micheline Charest, the co-founder of Cinar Corp., will underscore another issue: safety. But plastic surgeons believe their procedures are safer now than ever.
"Complications and deaths occurring at office-based surgical facilities are rare," says LaSandra Cooper, a media-relations associate with the American Society of Plastic Surgeons. "In a peer-reviewed study that will be published in the May issue of Plastic and Reconstructive Surgery . . . more than 400,000 operative procedures in accredited office-based, outpatient-surgery centres were studied from 2000-2002. Serious complications were infrequent, occurring one in 298 cases or 0.34 per cent, and a death occurred once in 51,459 cases or 0.0019 per cent."
American Society for Aesthetic Plastic Surgery president Dr. Robert Bernard says plastic surgery is at an all-time high because it's safer now and it delivers on its promise to improve a person's looks.
Dr. Bernard, who has practised in an affluent New York suburb for more than 30 years, says the most common response he receives from patients is: "You changed my life."
But critics say there's a downside to the cosmetic-surgery craze. They say the media hype -- especially the televised surgery sagas that end in a dramatic unveiling -- encourage people to undergo radical, permanent changes, all with the suggestion that it will improve their lives and make them happier.
"What these makeover shows have introduced to the mix is this actual cutting and sculpting of the body," says Angela Dancey, a doctoral candidate at Ohio State University. "That's new. We crave the sharp contrast of the before and after that's getting more and more pronounced. Where is this going to end?"
Ms. Dancey, who has studied the makeover phenomenon in film and TV, said programs such as Extreme Makeover and The Swan -- in which a self-described ugly duckling is selected to be transformed into a so-called swan -- go too far. At the moment of the final "reveal," patients and their relatives often appear shocked at the dramatic shift in their appearance.
"There's a moment of misrecognition," Ms. Dancey said. "The moment when they look in the mirror, they say 'That's not me.' "
Even some plastic surgeons are leery of the surge in demand for cosmetic surgery. Dr. Gerald Pitman, a plastic surgeon affiliated with New York University, said too many would-be patients -- and even surgeons -- don't take the procedures seriously enough.
"The three most dangerous words in plastic surgery are: 'It's just liposuction.' " If it's done properly, it's generally safe and "does what it's supposed to," Dr. Pitman said. But it's no substitute for weight loss.
A recent survey of 917 plastic surgeons reported roughly 19 deaths per 100,000 liposuctions. The generally accepted death rate for elective surgery is one in 100,000. The most common cause of death from liposuctions is a blood clot.
Doctors predict plastic surgery will grow in popularity because people will always want to look prettier.
"Don't underestimate the benefits of looking and feeling better," Dr. Bernard said. "These people on television are not faking it."