In his 18 years as a plastic surgeon in Beverly Hills, David Alessi, M.D., has gotten a lot of strange requests: the woman who wanted a forehead implant, the one who asked for "ankle lipo" and the patient who requested he break and reshape her jaw for a bigger smile. "Nothing much shocks me anymore," he says. But even he was taken aback by a 25-year-old who recently came in for a consultation. "When I asked what she was here to see me about, she said, 'I want to have my belly button removed.' Completely removed," says Dr. Alessi.
As unusual as that may sound, more and more young women are monkeying around with their body parts. They're shortening their toes, padding their butts with implants and downsizing their labia (yes, labia) to make them more "attractive." These are the new extreme — or, as some docs have dubbed them, "fashion" surgeries. And while they aren't nearly as common as, say, breast implants or nose jobs, they're getting more popular. According to the most recent figures from the American Society of Plastic Surgeons (ASPS), 1,030 "vaginal rejuvenations" were done in 2006 — a 30 percent increase from just the year before. The number of butt implants rose 18 percent in that same time frame.
Surprisingly, many takers are not plastic surgery junkies ("Darling, I've done my boobs and my thighs and now I positively must do something about my labia!"). "Most of the patients requesting extreme procedures are actually first-timers, women who came of age in our makeover culture and simply think everything's possible," says Dr. Alessi, founder of the Alessi Institute for Facial Plastic Surgery and Alessi Skincare in Los Angeles. "Many of my young patients think about getting plastic surgery the way they'd think about getting their hair done."
Some women do have good reason to seek nips and tucks; in certain cases, seriously elongated labia, for example, can make even a brisk walk uncomfortable — let alone sex. And if there's an aesthetic issue that's crushing a woman's confidence, surgery can be a legitimate option. Still, the ubiquity of plastic surgery in general has raised the beauty bar to an impossible standard, says Ann Kearney-Cooke, Ph.D., a Cincinnati-based psychologist and co-author of "Change Your Mind, Change Your Body." "Looking 'normal' is no longer the norm. Now there's pressure to be perfect from head to toe — literally! — and women feel the smallest perceived imperfection needs to be fixed."
So who's doing these procedures? While some unethical doctors want to make a buck off women's distorted body image, plenty of respectable M.D.s are slicing and dicing away. "From a surgical standpoint there's not much difference technically in putting implants in the butt than in the breasts, and liposuction is generally the same whether done on the thighs or shoulders," notes Brian M. Kinney, M.D., a clinical assistant professor of plastic surgery at the University of Southern California in Los Angeles.
"There's a mind-set among doctors," adds Dr. Alessi, "that someone's going to do the surgery, so it might as well be me." Dr. Kinney notes that he's had to fix many botched procedures because a woman went to a less qualified or reputable doctor. "In certain cases," he says, "I'd rather she get it right the first time, whether that means reshaping her nose or labia." There's even an experienced surgeon in L.A. who specializes in "vaginal rejuvenation," a man one colleague jokingly refers to as "the labia king of America."
That said, most doctors do draw the line somewhere. Dr. Alessi, for example, refused to obliterate that 25-year-old's belly button. "I often tell patients, as gently as I can, that they need to see a psychiatrist first, not a surgeon," he says. That's a good thing, since plastic surgery is surgery. "Women don't really consider it to be a serious procedure that leaves scars. But it can cause complications and does require healing time," says Dr. Alessi. Take a look at the extreme surgeries that are gaining popularity among women these days — even though many doctors don't think anyone needs them.
The extreme surgery: butt implants
The dirty details: "It's the whole Brazilian-model look: smaller breasts and curvier behinds," says Dr. Kinney. To do this procedure, a doctor slices the butt cheeks (can we just say: Ow!) and inserts silicone implants. Recovery takes weeks. The other option: a Brazilian Butt Lift. It involves extracting fat from the abs, hips or thighs and transplanting it into the butt. Cost: $6,000 to $13,000 for implants; $7,500 to $15,000 for a lift.
Why you may not want to go there: Shooting pain or numbness (from nerve damage) is not uncommon. Ruptures can occur since people do tend to sit down. And things can get ugly: Lorena, 37, an at-home mom in Florida, had fat injections and a permanent filler put into her rear. "I felt self-conscious about my butt being flat," she says. A year post-op, she developed lumps and open sores that turned into a serious infection. "I had to have a large chunk of my right butt cheek removed," she says. "I would tell any woman considering the procedure: Don't do it! It's not worth the risks."
Better than surgery: Get that butt to the gym. "The surgical results aren't going to be much more dramatic than what you'd achieve through regular exercise," says Dr. Alessi. "Toning moves like squats can go a long way toward reshaping your backside." Looking for more roundness? Frederick's of Hollywood Booty Pads ($36, fredericks.com) slip into your regular skivvies and produce the effect without making you feel like you're sitting on river rocks.
