At What Cost Beauty?

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In one of the Florida cases under investigation, a combination of surgeries may have proved fatal. James McCormick had decided to go to the Florida Center for Cosmetic Surgery in Fort Lauderdale to nip and tuck his crow's feet. His doctor recommended a brow job as well and offered to throw in a chin implant at a discount. McCormick agreed to all the procedures and was at the facility less than four hours. By the next day, he was dead. Citing patient confidentiality, Dr. Jeffrey Hamm, medical director of the facility, declined to discuss the case.

Bernard reports that he has received more requests for combination surgeries since the premiere of Extreme Makeover, a phenomenally popular reality show on ABC in which subjects undergo as many as six surgeries at a time to remove any perceived flaws on their bodies. He says the show has generated good p.r. for the field, but he is worried that it raises unrealistic expectations. "People don't realize that subjects on the show are preselected," he says. "They're in excellent health, screened by psychologists and analyzed by the best plastic surgeons in the country to ensure that their transformation has the potential to look like a home run." Bernard points out that the subjects also work with dermatologists, cosmetic dentists and hair stylists.

Sometimes a patient can appear to do everything right but still end up paying the ultimate price. For her chin tuck, a procedure generally characterized as routine, Goldsmith chose the best board-certified plastic surgeon royalties could buy and had the operation at a respected hospital but still had a bad reaction to anesthesia. Her death was not necessarily related to plastic surgery; it might very well have happened during an emergency appendectomy. It did, however, cause a momentary flutter in the plastic-surgery community. Doctors across Florida, California and New York said they received a few concerned calls from patients that week. But virtually no surgeons reported any cancellations. And the phones kept ringing for new appointments.