NY Times


If Beauties Multiply, They’ll Be Plain to See

By Alex Kuczynski

THE American fascination with self-improvement, inside and out, has been documented in many variations. But the ardor for physical and aesthetic enhancement was best captured this year by “Extreme Makeover,” an ABC reality program. In it, middleclass Americans – a police officer, a waitress, a local radio D.J. – were transformed by plastic surgery, sometimes several procedures at a time, from plain Janes and Johns into coiffed, glossed movie-star lookalikes.

Along with the approval of BOTOX® for wrinkle reduction in 2002, the popular neurotoxin that has conquered wrinkles, the show drew attention to the increasingly popular notion that plastic surgery is not just for the vain or the wealthy.

If cosmetic plastic surgery is available to the average consumer – thanks in part to lending agencies that specialize in financing cosmetic procedures – and no longer bears the stigma of vanity, the question arises: Are we on our way to becoming a nation of the surgically enhanced? If looking beautiful becomes as easy as buying a car or a dress, will beauty – or an imitation of it – become so commonplace as to be meaningless?

The American Society of Aesthetic Plastic Surgery reports that the overall number of cosmetic procedures has increased 228 percent since 1997. The numbers are likely to rise as the population ages, prices drop, younger patients seek out surgery, technology and genetic engineering generate new techniques, and more doctors from various fields offer cosmetic surgical procedures.

Surgical procedures will inevitably become less expensive, said Dr. Lloyd M. Krieger, a plastic surgeon who also has an M.B.A. from the University of Chicago, in part because procedures that 10 years ago took place in a hospital operating room and required expensive overnight stays now take place in a doctor’s office.

And, like any consumer product, as it becomes more popular, the laws of economics dictate that the price will come down. “Usually that does not apply to health care, which is bound up with insurance issues, but in the case of cosmetic surgery, people are using their own money so the typical health-insurance restrictions don’t apply,” Dr. Krieger said. Consumers approach cosmetic surgery as a retail decision, “as if they were buying a cruise, a vacation, a car.”

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