Ethnic plastic surgery grows popular as attitudes change

When Sonia Batista got a nose job two months ago, it wasn't because she wanted to look white, she said.

"I just wanted to improve my appearance," said Batista, a Puerto Rican who lives in Elmwood Park, N.J., and thought her nose was disproportionately wide and flat.

More Americans of all ethnicities are going under the knife these days, but for minorities, the rise is especially sharp.

From 2000 to 2005, there was a 65 percent increase in so-called ethnic plastic surgery, according to the American Society of Plastic Surgeons. For the overall population, the increase was 38 percent.

Once the secret of rich white women — who didn't advertise their nips and tucks — cosmetic surgery has filtered down to the masses, experts say.

It's now easier to afford, with many surgeons offering financing plans on procedures ranging from $2,000 for a nose job to nearly $10,000 for a face lift. And thanks to shows like "Extreme Makeover" and "The Swan," on which unhappy patients of all ethnicities are physically — and emotionally — transformed, it has more publicity than ever before.

"People are more willing to talk about it and are more accepting of other people's experience with plastic surgery," said David Sarwer, a psychology professor at the University of Pennsylvania's Center for Human Appearance.

For minorities, cosmetic surgery is no longer viewed as a sign of self-hatred or a rejection of racial identity, he said.

"Traditionally, the motives were to erase ethnic characteristics," Sarwer said. "It's not like it was 30 or 40 years ago, when Italian and Jewish patients sought surgery as a means of assimilating. While some of that may still be going on, our current standards of beauty are far less Caucasian and Eurocentric than they used to be."

"A beauty culture"

But how much have standards changed?

Not much, said Janie Ward, head of the Africana Studies Department at Simmons College in Boston.

"The beauty ideal has been white for a very long time. I think it's a little bit naive to say it [ethnic plastic surgery] is about personal esthetics and choice. That negates 400 years of history," Ward said.

"African-American women in particular have a complicated relationship with their bodies and sense of beauty," she said. "A lot of it has to do with a culture that says your nose is too wide, your hips are too wide, your hair's not right. The image that's in women's heads when they walk into a surgeon's office, when they think of 'proportionate' — that's very much shaped by the images they've been consuming in the media."

But others say minorities seek cosmetic surgery for the same reason as whites: In a country obsessed with appearance, it's just one more way to look better.

"We live in a beauty culture. We've always been bombarded with images of perfect people. Now, we have these procedures that give people a quick, easy way to attain these beauty standards," said Julie Albright, a sociology professor at the University of Southern California, who is working on a documentary titled "Madeover in America."

Not only has technology changed, but so have the surgeons themselves. Compared to past decades, many are likely to be minorities.

"More people who are performing these procedures actually come from those ethnic backgrounds, and we're sensitive to those perceptions," said Julius Few, a Chicago plastic surgeon who is black.

Anthony Griffin, an African-American surgeon who stars in "Extreme Makeover," believes his presence on the show has had an impact.

"I was the first one to do ethnic patients on the show, and the audience saw that people looked normal. They didn't look like Michael Jackson," Griffin said. "In fact, a couple of the patients pointed out on air that they wanted to maintain their 'flavor.' "

Procedure breakdowns

Nose reshaping is the most common form of cosmetic surgery among African Americans, Asians and Hispanics. For the overall population, it ranks second, after liposuction, according to the American Society of Plastic Surgeons.

Among Hispanics, who constituted 9 percent of plastic surgery patients last year (8 percent were black; 4 percent were Asian), the second most popular procedure was breast augmentation, followed by liposuction.

For blacks, breast reduction was the second most common procedure, followed by liposuction. The second choice for Asians was eyelid surgery, with breast augmentation coming in third.

John Chu of Union City, N.J., had his eyelids done last year, but not because he wanted his eyes to look rounder, he says.

"It was mostly to look younger," said Chu, 38. "They were sagging a little bit. I didn't like the way I looked. I looked older than I was."

Others say the beauty ideal of their ethnic group influenced their decision.

Vera Millan, who is Puerto Rican, had her breasts augmented in part because she comes from a culture that prizes voluptuous women, she said. From the waist down, Millan had the right look, but her top didn't match her bottom.

"In Latin communities, curves are really important. I just wanted to be in proportion," said Millan, a patient of plastic surgeon Steve Fallek of Englewood, N.J. "I wasn't able to fit correctly into nice tops, dresses or bikinis. The top would be so empty. I would cry sometimes. I was very upset."

In May, Millan, a 29-year-old New Milford, N.J., resident, went from an A-cup to a C-cup.

"My new breasts are gorgeous. They are natural-looking and perfect for my size and height. Now I can wear these shirts I want to wear," she said.

While Millan doesn't mind telling others about her surgery, another of Fallek's patients, a black woman whose family is from Jamaica, keeps silent about her recent liposuction. She worries that others would think she's vain and unable to accept herself.

"I guess its a culture thing," said the woman, who is 31 and didn't want her name printed in the paper. "They feel that you are who you are and you should stay that way."

Thanks to cosmetic surgery, however, she didn't have to stay that way. She got rid of the tummy bulge that persisted despite dieting and exercise.

According to Sarwer, 80 percent to 90 percent of plastic surgery patients claimed in studies to be satisfied with the results of their surgeries. But patients who hope their lives will change dramatically are often disappointed, he said.

And that's true of every ethnicity.

"There's a difference between thinking, 'Rhinoplasty will make me feel better about my nose and less self-conscious' and 'Having my nose done will save a failing marriage,' " Sarwer said.