Who loves reality television?

Reality TV has exploded from its humble beginnings as simple game shows into one of the biggest genres of entertainment on television today. Reality TV shows run the gamut from classy and educational to trashy and fun.

Starting in the early 2000s, reality television took a turn into the world of plastic surgery with the advent of an ABC show called Extreme Makeover. Although it is true that shows like this have helped break down certain myths and misconceptions about plastic surgery in the mainstream, many believe that they have caused severe damage to our industry and to the reputation of plastic surgery on the whole.

Back in 2003, one of our sister societies, the American Society of Plastic Surgeons (ASPS) were consultants on one of the first reality plastic surgery shows, Extreme Makeover. They pushed for high ethical standards, emphasizing informed consent and educating the patients about every procedure to be done. The result was seen as a solid reality show about the results of plastic surgery. Yes, it was all glamorized, but that’s TV.

The perceived problems started when Extreme Makeover became a huge hit. Other networks started to race to put out a variety of similar shows about plastic surgery, many without the same high ethical standards that ASPS helped put into place on Extreme Makeover. Viewers saw consent and patient consultations de-emphasized for cheap drama and spectacle.

Although almost all of the actual plastic surgery you see in reality television is real, the circumstances that surround that surgery can be very, very different from the reality of working with an ISAPS plastic surgeon. ISAPS plastic surgeons educate their patients about procedures, recommending restraint when necessary and telling them about the potential drawbacks and side effects. Television producers, on the other hand, may edit this entire education process out – and in some cases may even be pushing their patients/contestants into going more “extreme” for the cameras.

One of the possible dangers of plastic surgery in reality television is that it can create unrealistic expectations in patients who watch these shows. At the end of the episode, during the “reveal”, contestants/patients are shown to have flawless results. Of course, these results are usually helped along the way by professional makeup artists, hairdressers, professional lighting, digital post-production, and other kinds of television “magic”. This can create an incredible aesthetic, but the plastic surgery is only a single part of it. In TV land, there are generally no complications when it comes to plastic surgery, just perfect results. The risks of plastic surgery are often minimized and the “ready for TV” results are emphasized over actual “reality”.

And not all reality television portrays plastic surgery in a positive light. One recent reality show about plastic surgery is Botched, highlighting cosmetic surgery procedures gone wrong. Shows like these definitely highlight the potential downsides and complications of cosmetic surgery, but show them for entertainment value. This is why the selection of your plastic surgeon is the single most important decision you can make. ISAPS plastic surgeons have undergone extensive training and board certification to be admitted as members. It’s also important you understand the difference between a cosmetic surgeon and an ISAPS plastic surgeon.

We want to emphasize that we aren’t saying that plastic surgery procedures and the results can’t be a form of entertainment. In today’s internet age, the popularity of plastic surgery on reality shows has spun off into Snapchat and other streaming video platforms.

So, yes, plastic surgery reality shows do feature actual surgical procedures, but there is more to the story than just that. Final results are often enhanced by professional television makeup artists and post-production, which can create unrealistic expectations of plastic surgery in the public. In other words, reality television featuring plastic surgery is about as “real” as any reality show: not at all.