Mar 2007

Should Doctors Perform Plastic Surgery on Reality TV? Commentary 1

Robert Rey, MD, MPP
Virtual Mentor. 2007;9(1):229-230. doi: 10.1001/virtualmentor.2007.9.3.oped1-0703.


The success of the reality television show Extreme Makeover spawned several offspring programs in which actual patients undergo plastic surgery procedures performed by real surgeons. Virtual Mentor asked for opinions about physicians' participation in such television programming from those in the field.

Commentary 1

I often get asked if having a television show changes the nature of my plastic surgery medical practice. What follows is my answer to that question.

Between cell phones with cameras, blogs, instant information via the World Wide Web and the very open nature of the world we live in, the barriers between the public and private spheres have broken down, and you should consider every patient interaction and medical decision you make a public decision. Whether you wish to be or not, you are a role model.

You may not live your life and practice medicine with a television camera looking over your shoulder like I do, but in this day and age you should act like you do. In other words, I don't change a thing when the cameras aren't rolling.

I'm terribly proud of the spotlight Dr. 90210 has shone on the profession. Not surprisingly, most people think that plastic surgery is all about glamour. And, while I am fulfilled when I make people look better and feel better about themselves, I insist that this be a balanced show that reveals the true nature of what we do.

Dr. 90210 shows not only the before and after but also the in-between. Potential patients and the public need to know that pain, bruising, swelling and other consequences occur between the operating room and the end result. I know that televising the sometimes graphic reality is the right thing for me and the patients. The truth is the profession's best ally; well-educated, well-informed patients have the most realistic expectations.

My patient rejection rate is nearly 80 percent, and I want current and prospective patients alike to know that plastic surgery is not for everyone. It's not like getting a haircut or a new pair of shoes. It's a life-changing, serious medical procedure that requires time, money and commitment. Together my patients and I weigh the risks and benefits, and seeing this process on television helps prospective patients understand this delicate balancing act.

Because of the Internet, a great deal of information on cosmetic surgery is available for public consumption. Much of it is excellent, but there is also an abundance of misinformation out there, and Dr. 90210 helps address some of the myths and misconceptions of our work. For example, not all doctors have access to the latest techniques, equipment and medical research. We do, and we try to showcase the present state and the future possibilities of cosmetic surgery on the show.

It's no secret that in the early part of this decade, immediately after September 11, 2001, the number of plastic surgery procedures was on the decline. Yet I am told and research bears out the fact that televised shows, like Dr. 90210, have attracted more patients than ever and that the profession's work load has significantly surpassed pre-9/11 levels.

It's interesting that a great many of my fellow physicians who have criticized my show admit to never having watched it. I would urge you to see what it's about. Sure, we do work on movie stars and other celebrities, but we also work on nurses, teachers and truck drivers and show that plastic surgery is an option for the middle class, not just millionaires. Audiences also learn that plastic surgery is about correction and reconstruction and not only rhinoplasties and breast augmentations. These messages reach millions of potential patients—not just potential patients for me but for the entire profession.

Dr. 90210 is also an excellent vehicle for highlighting the pro-bono work that so many of my colleagues and I do. Last year I worked with rehabilitated gang members and removed their affiliation tattoos so they could be more employable; I went to Mexico and operated on children with cleft palates to give them a smile, self-esteem and help with their speech and quality of life. Next season I will be heading to Israel to help victims of terrorist bombings regain something of their former appearance and function through reconstructive surgery.

It is easy to think you're just a cosmetic surgeon, but you're much more. Patients look to you for answers, hope and solutions. The actual surgery is crucial, but it is only one part of what members of our profession do. The sooner we all realize that the light is shining on us as physicians and that we have responsibilities to the public and the profession, the better, stronger and more respected we will all be.


Virtual Mentor. 2007;9(1):229-230.



The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.