Tag Archives: Heidi Montag


Permalink to Celebrity Plastic Surgery – The Collective Obsession With Youthful Perfection

Celebrity Plastic Surgery – The Collective Obsession With Youthful Perfection

Lisa Rinna Lips

Lisa Rinna Recently Had Her Lip Augmentation Reduced.

Plastic surgery is a part of celebrity culture today. From reality stars like Heidi Montag, Kim Kardashian, Pamela Anderson, and “The Real Housewives of…” to comedians like Joan Rivers and Kathy Griffin, to actors like Lisa Rinna, Nicole Kidman, Meg Ryan, Micky Rourke and of course stage performers like Cher and Kenny Rogers. All of these celebrities and hundreds more like them appear to have had cosmetic work done, and most, save Kim Kardashian and Cher, seem to have gone too far and pushed the limits of what plastic surgery is capable of.

The force behind this Hollywood celebrity trend to use plastic surgery beyond what is rational is a collective obsession with youthful perfection. That is, in American culture, youth is romanticized and physical perfection is idealized. The problem is that we are only young for a brief time in reality. Indeed, this evanescent quality is probably an ingredient of the fuel feeding this obsession. Combine this with the fact that very few, if any of us, are genetically perfect and you end up with a majority of the country somewhat unsatisfied with their appearance. Add to the fire, the pressure celebrities are under to be examples of perfection to those who consume their movies, TV shows, and music videos and you can imagine the desperate feelings these people have to hold on to this image of perfection or lose their celebrity status.

Further complicating the mix is that the personalities who go into that line of work tend to already enjoy some degree of narcissism with their coffee and you have a perfect storm. Nowhere do we see example after example of drastic measures taken by desperate souls to enhance or hold onto any shred of perfect youth that medical science might be able to offer. Likewise, nowhere else do we see so many sad cases of the fuel of this collective obsession with youthful perfection igniting the fire that ends in plastic surgery disasters.

As a plastic surgeon who believes very much that plastic surgery, and other cosmetic procedures such as Botox and facial fillers, can improve a person’s appearance and make them feel more confident, I cringe when I see the next star to step onto the red carpet with lips the size of sausages or faces pulled so tight they look like, as a friend of mine recently described, “a screaming skull.” Likewise, it sickens me to see a breast augmentation disaster such as putting 700cc breast implants in a petite woman of 5 foot 2 inches as was done to Heidi Montag, so she ends up making Barbie look comparatively proportional! These cases are not medical science being used to improve lives, they are a shameful mockery of the fine art of plastic surgery.

The most difficult thing for me to get my head around is the process by which a trained doctor goes through with these surgeries. If he or she is even remotely educated in plastic surgery, or even the pretend plastic surgeons who call themselves, “cosmetic surgeons,” these doctors have to know how awful these results are going to be before they even put the patient to sleep. As a plastic surgeon, my job is to improve on nature while balancing these improvements with aesthetic principles of balance, physical limits, and genetic realities. And a reality of being a plastic surgeon is knowing that some patients will come in with unrealistic expectations. I regularly have to sit down and explain in no uncertain terms, that there is such a thing as “too big” when it comes to breast implant size. It is very common for small framed women who have A-cup breasts to request breast implants that are simply going to make her look very top-heavy, cause stress damage to the skin, and create discomfort to the point that she will need to have them removed. When I explain the physical limits and the reality, most women normally understand and opt for smaller implants. In cases where they are still unconvinced and determined to have the larger implants, I apologize and tell them that as an ethical plastic surgeon, I cannot perform the surgery with the implants requested and we go our separate ways. And yes, occasionally they come back to me to have their “too large” implants removed.

I can feel for these plastic surgeons who have celebrities for patients. I can imagine they hear a lot of desperate stories about needing “that edge” in order to stay relevant in the fast paced world that is Hollywood, where one day you may be the toast of the town and the next you are wondering why you can’t even get an infomercial job. I realize there is tremendous pressure to push the limits because if you don’t someone else will. At the same time, we are doctors first and we have to do what is right by the patient, even if the patient is demanding what is wrong. We know that lips that look like two sausages painted red will look like hell, we know that 700cc implants can not be sustained in a petite woman of 5 foot 2 inches, we know that if you stretch the face back too far you will create a lizard mouth. We know this because it is what we do. Just as an engineer knows what you can and can’t do if you want a bridge to stay standing, a plane to stay in the sky or a computer to crunch ones and zeros and end up with me being able to type this article.

One thing I always stress with my patients is that when all is said and done, a stranger should never be able to look at you and “know” you’ve had plastic surgery. Whether it is breast augmentation, lip augmentation, a tummy tuck or a facelift, all should be subtle enough to look perfectly natural. Sure, if you go from an A-cup to a C-cup overnight, your friends might notice, but to the world, you should just look shapely, balanced and aesthetically pleasing to the eye, not like a freak of nature. Similarly, a facelift should simply take 10 to 15 years off your face, not make you look like a new person. You should look like pictures of yourself from the past. If you look at Joan Rivers now and Joan Rivers from 15 years ago, it is like they are two different people. On the other hand, if you look at Cher now and Cher 15 years ago, she looks the same! That’s plastic surgery done right!

The collective obsession with youthful perfection will probably be a part of the American cultural reality for the foreseeable future. Perhaps, just being a little more aware of it and reminding ourselves and our children to actively work toward being less influenced by it and more happy with our own realities is the answer. Sure, a good plastic surgeon can improve on nature a bit, fix some of the effects of time and make your day-to-day life a little happier because you smile more when you look in the mirror. But youthful perfection is not something we are capable of producing and someone needs to see that Hollywood gets the memo.


Permalink to “The Complicated Life”

“The Complicated Life”

Dr. Frank Ryan

Hollywood Plastic Surgeon, Dr. Frank Ryan

Hollywood plastic surgeon to the stars, Dr. Frank Ryan, died this last week in a single car accident that was apparently the result of texting while driving. A while ago I had commented on some of his surgeries on Heidi Montag. He was a good surgeon involved with a, to put it mildly, unstable patient in Heidi Montag. And I think that even he, in the end, had told her no more, especially with respect to her breast augmentation. He was a board certified plastic surgeon, a UCLA graduate like me and did good work. There are too many surgeons out there who don’t do good work. There are the many pretenders, the  faux plastic surgeons, these are the get-rich-quick surgeons who are entering the profession in droves because there is no reimbursement in conventional medicine. Dr. Ryan was one of the doctors inside plastic surgery doing his best work for his patients.

This is not necessarily a eulogy to Dr. Ryan but more of a commentary on the tragedy of his death. All of our lives are becoming much more complicated. Because of the nature of business today, plastic surgeons are spending a great deal of time on their websites their blogs their Facebook or Twitter and who knows what else will be coming down the road. If the news reports are true, Dr. Ryan’s death was caused by his tweeting while driving on a fairly dangerous road. Once we become addicted to our electronic media they are a constant part of our lives. Multitasking is also something that many of us feel obligated to do because there just isn’t enough time in the day. This combination of factors, keeping up with his twitter, multitasking and being distracted seems to have led to his untimely death. There are several things that we can take away from this tragedy first and most obvious texting while driving kills. There was a ubiquitous sign poster in the 1960s that said speed kills. This was obviously referring to the drug not velocity. Nowadays texting kills. A friend of mine was almost killed recently when he narrowly averted a head-on collision because a girl in the opposite lane was texting while driving 65 miles per hour on a two-lane highway, didn’t have a clue, and then lost control of her car. She hit the side of his car, spun out and ended up in the hospital, lucky to be alive. She said, “I wasn’t texting, I was reading a text,” which, of course, is texting. Don’t text and drive, it’s just that simple.

The other thing that this incident does is it gives us pause for reflection about how complicated our lives have become. Are we spending more time with our computers, laptops and iPhone’s then we are with the people we love. Are we tweeting, facebooking and texting more than talking and sitting with these people? The pace of life seems to accelerate every year just a little bit. Like the lobster in the stew pot, we don’t even know we are being boiled until it’s too late. This may be a good time to reevaluate all our relationships with our machines, how dangerous they are at times and how much of our lives they consume. Life is short and you never know when your number is going to come up, take time while you still have a chance to enjoy it. The second to last of Frank Ryan’s tweets was, “After 25 years of driving by, I finally hiked to the top of the giant sand dune on the pch west of Malibu. Much harder than it looks!  Whew!”

Frank Ryan's Border Collie

Dr. Frank Ryan's last tweet: "Border collie jill surveying the view from atop the sand dune."

Then he posted a picture of his dog at the top of the sand dune while driving away. It is a sad irony that it would be the high-tech sharing of a moment he stole away from his hectic schedule to enjoy actually living, that would end his life.


Permalink to Megan Fox Plastic Surgery Mysteries

Megan Fox Plastic Surgery Mysteries

Megan Fox Plastic Surgery Controversy

This time it’s Megan Fox - another, “does she or doesn’t she? Has she or hasn’t she?”  Unlike Heidi Montag’s obvious cosmetic surgeries, Megan Fox has a more refined look.  Megan Fox is a beautiful young woman by anyone’s standards – you don’t have to be a Transformers fan to enjoy that!  But, has she had some “refining”?  The beauty of good plastic surgery is that it is subtle, and it often begs the question, “Did she or didn’t she?”

As a plastic surgeon here in Sacramento, I get questions all the time as to whether I think this starlet or that celebrity has had cosmetic work done. One thing I often say is that pretty much everyone in that line of work has or will have something done to improve their appearance. Because Megan Fox has been in the news a lot lately, combined with the fact that she is one of the most beautiful starlets in Hollywood, I get asked about her a lot! If you look at pictures of Megan Fox on the Internet, you can come to several conclusions fairly quickly.  In my medical opinion, I believe I can spot a few procedures she’s undergone.  The important thing is that if she has undergone these procedures, they were performed very well so kudos to her doctor!

1. Megan Fox most definitely has had breast augmentation with breast implants. That’s fairly obvious even to a non-plastic surgeon, but her enhancement matches the rest of her figure, and it is not over the top literally like Heidi Montag’s breast augmentation.  It enhances her body without distracting from her other features.

2. She has also probably had two rhinoplasties.  The first rhinoplasty looks to be slightly unsuccessful.  There is an inverted V look on her upper nose in several photos that were taken after the bump was removed from her nose. This inverted V comes from the bones not coming together after being fractured. This was corrected the second time around, and further refinement appears to have been done on her nose, especially the tip.

3. Megan Fox likely has regular  Botox injections in her forehead. Even young people have some expression lines, but her forehead is incredibly clear without even a hint of a line. By using Botox at her age, she will avoid lines appearing in the future. She also seems to have had some shaping with advanced Botox techniques to raise a lateral and give her an exotic Angelina Jolie -type look.

4. Megan Fox also appears to have had a very good lip augmentation. Unlike many lip augmentations, Megan Fox’s lips are not over-the-top.  Her lips are definitely fuller, but it still looks relatively natural.

5. There has also been some suggestion of cheek implants, but unless they are very small, she just appears to have gotten older and a little more defined with some weight loss.

So what does this all mean?  It means that plastic surgery has something for everybody: for a middle-aged woman who wants to take in her neck a bit, or a young woman who wants a flatter stomach after having babies… or an aspiring superstar just shy of perfection. Were the changes reasonable?  I think she managed to fine tune her already attractive features and she did so without going way overboard like Heidi Montag. Is she more beautiful?  You can judge for yourself. But generally speaking a straight nose, fuller lips, a curved brow, and fuller breasts are often considered to be more attractive by our culture’s current standards of feminine beauty.


Permalink to Heidi Montag Lessons

Heidi Montag Lessons

Heidi Montag Breast Augmentation

Heidi Montag's Breasts Are Too Big!

Some stories just won’t go away. The Heidi Montag saga seemed like just another fifteen minutes of fame for a desperate starlet. And it makes for a great story: D-list celebrity trying to get an edge with an extreme makeover that will catapult her to stardom… or not.

But now, after the initial stories cataloging her surgeries mini brow lift, nose revision, facial and buttock fat grafts, breast implant revision, ear pinning, neck liposuction, the stories continue. She’s in pain. She’s happy. She’s not happy. She wants bigger implants. She’s going outside the U.S. for implants she can’t buy in the U.S., and the stories just continue on and on, probably fed by her publicist.

Since Heidi Montag and her drama are not going away anytime soon, what can we all learn from this modern-day tale of transformation that will help us in our thinking about plastic surgery?

If you are considering plastic surgery, it is important to be realistic about what you are considering and why.  Number one, if you don’t want to set yourself up for disappointment the only reason you should have plastic surgery is for yourself.  No one should be considering plastic surgery because someone else is telling you to.  Plastic surgery should not be undertaken to get or keep a husband or boyfriend, nor to get a specific job. The procedure, and your new image, should be its own reward. It should give you a positive self-image and give you more confidence. To expect secondary gain is setting yourself up for disappointment. The exception to this rule may be a situation where someone is looking prematurely old and seeks facial surgery for better competitiveness in the job market. Heidi Montag is not prematurely old.

Less is more–rule one: I don’t know exactly how long Heidi’s ten procedures took, but I try to limit my procedures to less than six hours. The medical standard for safe elective surgery is less than six hours. This means that after six hours the risk of medical complications rises. It is also more difficult to recover when you can’t get in a comfortable position because of the pain resulting from your multiple procedures. Performing fewer procedures in two operations makes for two shorter, safer operations with quicker recovery time, as opposed to one long one with a much longer and more uncomfortable recovery.

Less is more–rule two: As you age you should only have the minimum amount of work done to correct the problems. There is no such thing as prophylactic facelifts, although some people claim to do them. I’m okay with the chin and nose changes. But the brow lift and fat grafts actually made her look older boring here and harsher. Nothing can replace the freshness of youth and once it’s gone it’s gone.

Less is more—rule three: And important thing to remember about breast augmentation is that breasts can be too big! The only kind of movie Heidi Montag’s new breasts will get her into is the kind with three X’s, rather than snagging Meghan Fox’s roll in Transformers 3! I’ve put in large implants, even the maximum size, 800cc, but these are cases where the woman could handle them because of her height and the size of her chest. If Heidi wants to go bigger than her current 700cc implants, in order to really see a difference she would need to go to 1000cc which is way too much for anyone, much less a thin woman who is 5’2.

The downside of really big implants: Bigger scars to put them in for silicone implants. Putting in 1000cc  saline implants would be a nightmare. They would come down to her knees in no time.

What goes up must come down. Implants that large would have minimal muscle support. There is no breast lift that would lift them up for any significant length of time. She will have to downsize in order to have a successful breast lift.

Implants that big would make her skin tissues paper thin over time. Wrinkles and ripples would be visible.

Implants that large would actually pull down on her shoulders and neck. They would likely cause severe back pain. Most women who naturally have breasts that size eventually come in for breast reduction.

Just because a surgery can be done, doesn’t necessarily mean it should be done. She’s not yet in the ranks of plastic surgery monsters but if she keeps this up, there is little doubt she will be listed on one of many scary plastic surgery Websites.  Good plastic surgery is designed to makes people look like themselves and doesn’t make you look like a different species. Is she on her way? Only time will tell.

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