By Gabriel Dance
October 23, 2003

The canvas has been cleaned and clearly lined with a red marker. The artist begins a delicate task that requires exacting control coupled with intense concentration. There is no starting over. The canvas splits along a line following the artist's tool. Red begins to spread over the artwork, but the artist wipes it off- he is a sculptor, not a painter. Several hours later the sculptor steps back. He's pleased with his work and believes that his subject will also approve. His work is symmetrical, has clean lines, good form and the right firmness. It is the perfect breast.

Body Shaping Boom

Plastic surgery's history dates back far before breast implants and liposuction. It is an industry that was initially driven to help reconstruct physical abnormalities as well as those wounded in war. The United State's first prominent plastic surgeon was Dr. John Peter Mettauer who performed the pioneer cleft palate operation in 1827, according to plasticsurgery.org. With the great wars of the 20th century, doctors were encountering more destructive facial and head injuries than ever before. However, as plastic surgeons gained experience working with the impaired they realized the possibilities for those without injury or abnormality who were simply interested in looking better. Herein lies the difference between reconstructive plastic surgery and cosmetic, or aesthetic, surgery, both of which are commonly referred to simply as plastic surgery.

Breast augmentation, which is commonly referred to as breast implants, is just one of the many different types of cosmetic surgery, and among the increasingly popular trend of cosmetic surgery, breast augmentation is one of the most prominent.

"The most common cosmetic surgery in Fort Collins is breast augmentation," said Jeffrey Chapman, a cosmetic surgeon at the Northern Colorado Plastic PC.

Recently Sharon Osbourne, wife to rock legend Ozzy Osbourne and pop mom from "The Osbournes" MTV reality show, declared plastic surgery "just like going to get your teeth cleaned." Osbourne has admitted to having operations, including a face lift, tummy tuck, liposuction and breast augmentation.

But today cosmetic surgery goes far beyond just superstars, millionaires and models. Some of the most common procedures include tummy tucks, cosmetic eyelid surgery, breast reduction, liposuction and nose reshaping. But those are just the surgical procedures. Nonsurgical procedures, many using lasers and injections, are far more popular and include Botox injections, which is the process of deadening nerves to create smoother skin, chemical peels, collagen injections and laser hair removal.

While not quite as common as going to the dentist, cosmetic surgery is definitely becoming more popular. According to the American Society for Aesthetic Plastic Surgery there were nearly 6.9 million cosmetic surgical and non-surgical procedures performed in 2002, a 228 percent increase from 1997. Females compromised 88 percent of the procedures while males accounted for 12 percent. The top surgical procedure for both males and females was liposuction, with nose reshaping coming in second for males and breast augmentation holding the number two spot for females.

Media Shaping Us

Along with the boom in cosmetic surgery there has been a surge of newspaper stories, television shows and magazine articles focusing on the topic.

In the Oct. 6 issue of "Time" magazine the implications associated with ethnicity and cosmetic surgery were addressed. Although cosmetic surgery was originally thought of as an upper-class procedure typically performed on Caucasians, that perception is quickly changing. The number of nonwhite Americans opting for cosmetic surgery has quadrupled since 1997, according to www.time.com. The magazine article focused on an African-American woman who wanted to change the shape of her nose without making it "look white," an unusual request in light of the fact that in cosmetic surgery the ideal nose generally has stereotypically "white" characteristics.

One of the most popular new television shows, FX's "Nip/Tuck," also dealt with this issue in a recent episode where a white man had his eyes cosmetically altered to appear Chinese in order to satisfy his fianc?e's mother. The demand within the field of cosmetic surgery to change physically ethnic characteristics is steadily becoming more common place.

Another article in the Aug. 21 issue of "People" magazine recently featured famous personalities who had undergone cosmetic surgery such as the aforementioned Sharon Osbourne, Roseanne Barr, Melanie Griffith, Queen Latifah and Pamela Anderson.

"It was like opening Pandora's Box," Osbourne said in the magazine.

"Ozzy said anyone who gets one tattoo wants another one. I think plastic surgery is like tattoos. If you're happy with the results, then you push the button again and again."

She does counter that though with some advice to younger people.

"You have to be you and know who you are," she said. "It takes years to do that. When you hear these girls who get graduation gifts of nose jobs, it's like, hey, wait a little to see who you are."

A June article by Reuters posted on MSNBC.com discussed another recent trend in cosmetic surgery- men are becoming more common customers. The article stated that contrary to the previous year when men's use of Botox, laser resurfacing, collagen injections and skin smoothing decreased, they had all risen in 2002. During last year, men's use of Botox jumped 88 percent and fat injections were up 497 percent. Chapman has also observed this within his own private practice.

"The number of males having cosmetic surgery in FortCollins is on the rise," he said. "Rhinoplasty (nose reshaping) is the most common male procedure that I perform."

ABC's and check out "Extreme Makeover" takes the idea of cosmetic surgery to a whole new level. Using the skills of what ABC calls an "Extreme Team" comprised of plastic surgeons, eye surgeons and cosmetic dentists, the show features two people per episode who undergo various procedures in their quest to become beautiful. An example of just how extreme the show is Liane from Upton, Wyo. Liane had nose reshaping, fat injections in the face, lower eye lift, face and neck lift, pre-hairline brow lift, erbium laser of the mouth, breast augmentation, liposuction of the thighs and teeth whitening.

Shaping our Values

At the forefront of the controversy surrounding cosmetic surgery is questions about patients motives.

"The best surgeon in the world can't help you if your motivation is wrong or if your expectations are unrealistic," according to The Institute for Cosmetic Surgery. "You should be doing it for yourself."

Approaching cosmetic surgery "won't turn you into a movie star and it won't turn an unhappy life into a happy one," says the Institute's web page.

Sharon Osbourne has a different outlook.

"For me, if something bothers you about your appearance, just get it changed," she said. "If you're lucky enough to be in a position to afford it, if it makes you feel better about yourself, go for it. You're not hurting anyone."

The age at which the surgery is performed is another debate that continues to become more controversial with the ease and popularity of cosmetic surgery. In 2001 a doctor in Britain rejected a parent's request to give their daughter breast implants for her 16th birthday saying that the daughter's body and breasts in particular hadn't developed to the point where alteration was a viable option. This sparked a large media interest in Britain with American cosmetic surgery at the forefront. However nose jobs and breast implants are not uncommon amongst teens. Many parents and doctors feel as if cosmetic surgery could be what makes the difference in the child's life.

"There are no hard and fast guidelines (for teen cosmetic surgery), you really have to make an evaluation," said Gerald Colman, a plastic surgeon with the Plastic Surgery Group in Albany. "If something is interfering with a child's life and development, you can do miracles. You just see lives changed by this."

All over the world cosmetic surgery is taking large steps in different directions. A trend with Asian women is to have their eyelids cosmetically altered and even their legs lengthened in order to more fit the western view of beauty. Ethnically-sensitive plastic surgeons are trying to open the field to all races in order to allow them to experience cosmetic surgery, while still holding onto their individual characteristics. With a rising number of cosmetic procedures being performed within America comes an ever-increasing awareness of the issues involved in such a decision, however across the board cosmetic surgery is becoming more acceptable.