Secrets of a Beverly Hills Cosmetic Surgeon

Now that Heidi Montag’s one day, ten-procedure cosmetic surgery marathon has been packaged and delivered in a well-executed P.R. campaign, this event will be the talk of the tabloids and TV talk shows until interest peters out or is replaced by fresh celebrity shenanigans.

Media and other people have called and asked me “What do you think about Heidi Montag having all this surgery?” Maybe they were looking for me to criticize the decision to have all these procedures at once because it is not safe. Well, it is safe provided the proper pre-operative medical evaluation is done and an anesthesiologist is OK with doing the case. Typically, young people – if healthy – are at very low risk for elective surgery.

Or, perhaps there is a question of whether such a young person’s body is so decrepit or aged-appearing that it requires so much “fixing”. “Isn’t she so young to be doing all this?” they ask. Well, she did not look too aged to me in the “before” photos. But, this was not anti-aging cosmetic surgery; this was “optimization” surgery. The lady seeks to monetize her assets.

“Did Heidi really need to have yet another rhinoplasty, installation of larger breasts, chin reduced, neck liposuction, et al?”

My answer: It’s not what I think; it’s really what Heidi thinks about it. And cosmetic surgery, per se, is not about need, as in medical need, it is about “want”. Heidi is the owner of the body and face, and they are hers to do with what she wants. If the doctors think the procedures are safe to perform, it is all systems go.

Such is the essence of the decision-making in cosmetic surgery. It should be done only as an act of self-satisfaction. Not as a reason to help rebound from a divorce, to insure landing a new job or to guarantee better social and marital prospects. Or, because a family-member or friend is “pushing” to have something done, a la parents pulling a teen by the arm into the consult room to have a “nose job”.

But this maximally-publicized Heidi Montag saga, a “staged event”, is a different issue. I see this as a deliberate publicity move; deliberately calculated and meticulously scripted and executed to elevate Heidi’s name-recognition in Hollywood and the rest of the world. A strong attempt to be at the “top of the organic listings on the first page on Google”.

In the recent People Magazine, when asked “Do you finally feel beautiful?” Heidi answered “Yes, I think I look way better and I am way happier.” Well, frankly, that is what it is all about. If all ten procedures have made her happy, fine. Some people make themselves happy by acquiring tangibles, such as automobiles, jewelry, or clothing. For others, ultimate happiness is just hanging out with grandkids and family. It is about personal choices. We may or may not agree with Heidi Montag’s motives because we ourselves might not undertake such a body re-building process. But what counts is that she, an adult, made the decision, accepted the risks, was willing to accept the consequences, and decided to move on with her own program of self-improvement for whatever stated or deep-seated reasons she harbored.

I suspect that this entire episode will prove to be successful, business-wise. The layout in the magazine was very well executed. A fashion photographer took the dazzling “before” picture, and a fashion photographer took another dazzling “after” picture. In both she was well-coiffed, perfectly made up and for her image purpose, scantily clad. She was properly outfitted to portray the image she seeks to distribute to the world. A photographer was even present at the surgery center to record the immediate pre-surgery appearance including the surgeon’s marking pen outline of the day’s work. The right moves were made to illustrate this cosmetic surgery sojourn all along the way. Most patients, including the high-profile brand, consider such a log of the experience no one else’s business. In this case, in Heidi’s grab for fame, she hopes it’s everyone’s business. A huge PR coup.

Please understand that in Hollywood, business is business since “There’s No Business Like Show Business“. Joan Rivers used her first cosmetic surgery to help catapult her career. The tactic was so successful that she just continued having more and more cosmetic surgery, as though each time she would get a new burst of attention and material for her self-deprecating jokes. For Joan, cosmetic surgery was a prop or the gasoline for her marketing engine. Even Phyllis Diller, an outstanding comedian in her own right, as well as an accomplished musician, joked about her cosmetic surgery to benefit her career.

Remember Greta Van Susteren, about whom there was much ado when she had her eyelid surgery? Of course, Greta’s cosmetic surgery just happened to coincide with her moving from CNN to Fox News. Frankly, the surgery didn’t change Greta’s appearance that much. But the procedure sure gave a little extra mileage to the P.R. campaign to help ramp up her ratings. Something else to talk about and P.R. is always cumulative and additive.

In the entertainment world, the numbers are everything: TV ratings, box office ticket sales. For young females seeking to ascend to bigger time stardom, sometimes the right numbers are 36-24-36. And, if it takes the help of cosmetic plastic surgeons to get to those numbers, so be it. When the gal’s accountant write that check to the cosmetic plastic surgeon, it’s just another business expense.

Probably tax deductible, too.

- Robert Kotler, MD, FACS

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