If you gave aliens the past two decades’ worth of plastic surgery TV shows to watch, their takeaway might be that women aren’t allowed to practice medicine in America. This would be a logical conclusion, given that it’s taken us 18 years since the premiere of Extreme Makeover to come out with a female-led show centered around cosmetic surgery. Why?
It certainly wasn’t for lack of cultural interest. In 2002, Extreme Makeover—a first-of-its-kind reality show on which “ugly” people were surgically altered into conventionally attractive people—made Dr. Garth Fisher a rock star in the field. Nip/Tuck, Ryan Murphy’s characteristically depraved drama about two male plastic surgeons performing a lot of boob jobs and having a lot of sex, came out in 2003 and aired for six seasons. A year later, in 2004, we got both The Swan (a downright sadistic beauty pageant, featuring Drs. Terry Dubrow and Randal Haworth) and Dr. 90210 (a Who’s Who of the top dogs in plastics—Drs. Gary Motykie, Robert Rey, Raj Kanodia, Gary Alter, Jason Diamond, David Matlock, Robert Kotler, Steven Svehlak, Daniel Yamini—plus Dr. Linda Li, who was recruited only after her anesthesiologist husband pointed out the complete lack of women to producers). Then, in 2014, Drs. Terry Dubrow and Paul Nassif brought us Botched.
For as long as there has been a narrative around plastic surgery on television, that narrative has been told exclusively from the point of view of male doctors—and that’s made for some highly problematic programming. But things are finally shifting in 2020, thanks to two groundbreaking new shows. In July, Netflix released Skin Decision: Before and After, a docuseries that follows plastic surgeon Dr. Sheila Nazarian and registered nurse Jamie Sherrill, aka Nurse Jamie, as they fix patients’ injuries and scars left behind from domestic violence, car accidents, pregnancy, and other traumas.
“We’re showing the huge psychological impact that beauty procedures have and blurring the line between reconstruction and cosmetic,” says Dr. Nazarian. There’s a sensitivity and emotional intelligence running throughout Skin Decision that we haven’t seen in plastic surgery shows before it. For example, there are no doctor-patient clashes over just how big an implant will fit. “I don’t have to look like Barbie—I just want to look normal,” says one woman who is hoping to remove her excess skin after major weight loss. Dr. Nazarian credits the Me Too movement with helping to make way for a show like theirs: “It was just time for women to take over women’s beauty. Plastic surgery was always men telling women what they should look like, and women are over it.”
After all, women account for 92% of all cosmetic surgery procedures, but only 15% of plastic surgeons are women—a discrepancy the all-female Dr. 90210 reboot, which premieres Sept. 28 on E!, leads with. Drs. Cat Begovic, Kelly Killeen, Michelle Lee, and Suzanne Quardt make up the new ensemble, and they aren’t afraid to confront the sexism in their field head-on. Dr. Begovic says, “It was evident that there was a need to show plastic surgery in a different light and that TV also needed female-positive and female-empowering programming.” She’s been developing the show for the past five years—“back when less than 10% of all board-certified plastic surgeons were women”—and says that finding enough female doctors willing to be vulnerable enough to let viewers into not only their operating rooms but their homes and personal lives as well “was the most challenging part.”
On Dr. 90210, three out of the four surgeons have children, and it was important to them to show the realities of being working mothers. “Everyone knows that women are saddled with the majority of the child-rearing responsibilities—and it’s hard, because men [in medicine] look down on you when you take time off to take care of children. I think people are interested in what that’s like for us,” says Dr. Killeen.
Growing up with a mother who was also a surgeon, Dr. Killeen says she knew it was a possible career for her but didn’t realize just how high the cards were stacked against her until she went to medical school. “You were expected to be better than the men just to be treated equally. You were excluded from activities. Male attendings would have poker nights, and guess who was never invited? The male locker room was where everybody got together and discussed their cases, and guess who couldn’t be in there? If you talked back and fought for something that you believe needed to be done for a patient, you were difficult and bitchy. You were labeled something negative.” Her hope is that talking about the realities of being a woman in medicine on TV will benefit all women, “because this happens in every field.”
In the show’s trailer, a patient laments, “Male doctors always assume I want bigger boobs.” “I just want to punch those doctors,” responds Dr. Killeen. It’s a refreshing moment for viewers, but the women of Dr. 90210 insist they’re not trying to create a gender conflict—they just want to highlight the differences. “Men are wonderful doctors and they make great surgeons, but they don’t understand what you go through as a woman who’s had a baby,” says Dr. Killeen. “You watch every molecule of your body change.”
“Female plastic surgeons bring a woman’s perspective to their patients and their surgeries. My patients often tell me that I ‘get it’ when it comes to what they want and that I listen more intently, perhaps, than some male counterparts,” says Dr. Quardt. “I’ve heard some other male surgeons tell [women] they need a certain volume and style of breast implant, and ‘that’s it’—I never tell them what they ‘need.’”
What will happen to beauty standards once women are in control remains to be seen. Change may take another two decades. But it’s hard not to feel hopeful that the field of plastics could soon be seen as empowering, not superficial. As Dr. Killeen puts it, “My hope for pop culture is that the focus of plastic surgery takes a hard turn away from creating bodies that don’t exist in nature. Hopefully we’ll pay respect to the body we started with.”