A nip here and a tuck there can make a world of a difference – or it can be a disaster. Plastic surgeon (and RHOC husband) Terry Dubrow, MD, knows this all too well. He and partner Paul Nassif, MD, are returning to their E! show Botched where they attempt to correct extreme plastic surgeries gone wrong.
Dubrow says the most often botched procedures are the most common ones; breast implants, liposuction and tummy tucks. “Doctors who take a weekend course and call themselves cosmetic surgeons are doing breast augmentation surgery,” says the reality star. But the reconstructions aren’t limited to chests, tummies or removing fat. “In season 3 of Botched, which we’re filming right now, we’re calling the ‘season of the butt’ because it’s a ton of patients who have had really bad buttock problems.” Butts may be big (pun intended), but so is the desire to look like idolized celebrities. Dubrow isn’t digging either trend.
Yahoo Beauty: What trends are you seeing lately in plastic surgery?
Terry Dubrow: I’ve seen some good trends and some not-so-good trends. The good trends are towards more natural plastic surgery. No one really wants the big lip injections anymore. We’re seeing much smaller breast implants. No one really wants to be a D [cup] anymore. It’s more of a mid-C; lots of small Cs. People still really want big butts.
Regarding their behinds, do people say they want to look like Kim Kardashian?
It’s the Kardashian effect. The big butts are very ‘in’. I see a lot of young girls want to do the Kylie Jenner thing; for a while she was getting lip injections. They wanted lips just like hers.
What do you think about the trend of trying to look like celebrities?
I always say, “We can’t make you look like celebrities.” If we could, I would look like Brad Pitt. It’s not possible. I don’t like it at all. It’s not realistic. “Celebrities change their looks all the time, so which version are you trying to look like?”
Do you ever worry or evaluate the psychological state of the patients who come in?
It’s a consideration with every patient. In our plastic surgery training, you learn how to evaluate patients’ candidacy for plastic surgery – both physically and psychologically. We have a series of questions we ask.
What questions are key?
I always ask, “What makes you want to do this now? Why right now?” That tells you a lot about what motivates a patient.
What are answers that indicate a red flag?
If they say a recent breakup or they’re newly single. If they want to look better and look more marketable, then that’s fine. If they’re trying to fix depression or anxiety, or they think this is the one thing that is missing in their life and will fix their life; that’s a disaster. When you talk to them, you can tell within a very short period of time if something’s off about them. If they make you feel uncomfortable regarding the reasons they’re considering having it done, or describing what their goals are; that’s a red flag.
Are there any other types of people you won’t operate on?
If a patient comes in with an underlying anger, and you feel like they’re mad, I never work on those people. The target of their anger is going to be their results – whether it’s good or not.
What is a trend you find alarming or concerning, and why?
The butt thing is really concerning, because they want to go big. They’re pushing the envelope of what the buttocks will take. When you put a ton of fat in the buttocks, some of it’s going to dissolve. Some of it’s going to die. You can get into fat necrosis and scarring. The buttocks is really, really hard to fix.
What does a derriere enhancing procedure entail?
The most common way, now, of doing buttocks augmentations is fat transfer.
What does the prep involve?
Normally, the prep for plastic surgery is to be healthy; don’t take any aspirin or jeopardize the post-op. When it comes to fat transfer, it’s usually the skinny patients who want bigger butts. We tell them to gain 20 pounds so there’s some fat to use. The prep is getting chubbier.
How about the recovery?
The post-op is important, because you can’t be on your butt for a week. You don’t want to kill the fat by putting pressure on it. You have to lie on your side, sleep on your stomach, and can’t sit for long periods of time.
What is the worst procedure you’ve had to fix, and how did you do it?
Last season, there was a woman who had implants that destroyed her breasts. She was turned down by 14 doctors. She couldn’t get a job because her breasts were so big. That was the riskiest. This season, we have a person who has concrete injected in her face, and she is severely cosmetically disabled. You have to get the masses in the face localized so you’re not doing damage to the nerves or blood vessels around it. We use steroids.
Where do you see plastic surgery heading?
The trend is toward less invasive procedures, lasers or energy transmissions you can deliver to the skin – doing a face tightening procedure without having to cut and pull. Also, injections. Botox really changed the world. We’re trying to figure out ways to rejuvenate the skin, both topically and injections without cutting.