- The Washington Times - Monday, April 24, 2006

The American dream often conjures visions of white picket fences, puppies lapping a child’s face and, for some, the wherewithal to afford plastic surgery.

For many minorities, the latter part of the dream is no longer deferred.

A new report by the American Society of Plastic Surgeons, a nonprofit organization based in Arlington Heights, Ill., says the number of ethnic patients going under the knife for cosmetic reasons jumped 65 percent from 2004 to last year.

Those figures dwarf the big picture: The overall number of cosmetic plastic surgery procedures rose 11 percent from 2004, with 7.9 million of those involving white patients.

Among minorities seeking plastic surgery, Hispanics lead the way with more than 921,000 procedures (up 67 percent) completed, followed by blacks, who underwent 769,000 operations (up 67 percent). Asian Americans received 437,000 procedures last year, a 58 percent increase.

The groups requested different procedures in different numbers, but the most commonly requested techniques for all three minorities were treatments with Botox or injectable wrinkle fillers and chemical peels.

Dr. Stephane Corriveau, a Chevy Chase plastic surgeon, says minorities “have been coming in in droves” of late.

“They see all the shows on TV that show all the plastic surgery. They see what’s available out there,” Dr. Corriveau says.

The mass media, as it does with the culture at large, helps shape how minorities see beauty — and themselves.

“The fashions personified by the rock stars or movie stars bring procedures to the forefront,” Dr. Corriveau says, citing actress-singer Jennifer Lopez’s generous derriere as one example. “Buttocks augmentation didn’t exist 10 years ago.”

On the surface, helping minority patients receive top-flight health care is a given for any dedicated doctor. However, plastic surgeons who take on minority patients, Dr. Corriveau and others say, must be aware of the cultural nuances of everybody they treat.

“It’s the job of a physician to choose the right procedure,” Dr. Corriveau says. For example, if a patient’s dark skin makes surgical scars more visible, then that must be taken into consideration when choosing surgery.

Dr. Rafael J. Convit, a plastic surgeon with the Washington Hospital Center in Northwest, says ethnic beauty is a key consideration for his peers.

“It’s so important to maintain the ethnicity of the person. There is beauty within each ethnic group,” Dr. Convit says.

Should an Iranian woman request a rhinoplasty, or nose job, a competent doctor would understand that the balance of proportions in her face would be different than say, for someone of Irish heritage.

Dr. Convit says District-based doctors tend to see more minority patients because of the international makeup of the city, but even by those standards, the numbers of minority patients in his office is jumping.

One reason, he says, is economics.

“There are more solidly middle-class minorities than before. You need disposable income to do this,” he says.

New surgery options also are causing an uptick in post-surgical procedures.

“With the advent of gastric bypass for weight loss, we’re seeing a different patient population, one with a redundancy of excess tissue,” he says.

People who opted for plastic surgery once hid their operations from friends and strangers. Times change, as do the cultural norms.

TV One, a relatively new channel dedicated to black viewers, looked at some of those changes in its original special “Black Don’t Crack.” The program, which will air again at 11 p.m. Friday, explores how many black people view cosmetic surgery with skepticism. The program says that viewpoint is starting to shift, thanks in part to prominent blacks such as actress-singer Queen Latifah who embrace the possibilities of plastic surgery.

Hannah Ruiz, a 31-year-old Lanham resident, says she didn’t hear a whisper of criticism when she decided to undergo a breast augmentation two years ago.

“It’s something I’ve always wanted to do,” Miss Ruiz says, adding that cost never entered the equation for her.

Miss Ruiz did a few basic Web searches to try to find the right doctor before eventually relying on a friend’s referral. Today, she has no regrets about her decision, though she doesn’t know many fellow Latinos who have followed her path.

“It’s not a bad thing as long as you’re comfortable with it. … I have no complaints,” she says.

Keeping cultural identities intact is a tougher job, thanks to the country’s melting-pot makeup.

Dr. Steven Baker, an assistant professor of plastic surgery at Georgetown University Hospital, says ethnic blends make retaining cultural identities harder.

“You need to be the most keen about noticing subtle variations,” Dr. Baker says.

Should a black patient come to him seeking nose reduction surgery, “you wouldn’t want to ‘Caucasian-ize’ the nose. You might soften it,” he says. “We’re going to take you 30 or 40 percent there. They retain some of the ethnicity, but it’s more of a refined look.”

The cross-fertilization of different cultures doesn’t stop with our gene pool.

“The amount of globalization information makes the public aware of different things,” Dr. Baker says of worldwide influences circulated by the media.

Look at brow aesthetics and how the media affects appearance, he says.

“It’s predominantly set by Americans,” he says.

Dr. Baker says the increase in minorities seeking plastic surgery procedures points to a natural progression that goes along with being a nation of immigrants.

“You’re seeing second-generation people, almost like the post-World War II generation in Japan who worked their butts off. They reaped the rewards,” he says.

Those rewards often mean fine-tuning their appearance without ignoring the minorities’ roots.

One of Dr. Baker’s patients, someone from an Irish and Chinese background, explained the balance while discussing a potential eye procedure to reduce puffiness.

“I want my eyes done, but I want to retain that look,” Dr. Baker recalls the man saying.

Who did what:

• Hispanics had 9 percent of the 10.2 million cosmetic plastic surgery procedures in 2005. The most commonly requested surgical cosmetic procedures for Hispanics were nose reshaping, breast augmentation and liposuction.

• Blacks had 8 percent of the total cosmetic plastic surgery procedures in 2005. The most commonly requested surgical procedures for blacks were nose reshaping, breast reduction and liposuction.

• Asians had 4 percent of the total cosmetic plastic surgery procedures in 2005. The most commonly requested surgical procedures for Asians were nose reshaping, eyelid surgery and breast augmentation.

• The most commonly requested minimally invasive cosmetic procedures for all three ethnic groups were treatments with Botox or injectable wrinkle fillers, and chemical peels.

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