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Designing Women S5 E16 Extra Sugar - Beware of Plastics

Updated: Feb 20

Ah, God bless Bernice and her journey toward self-acceptance. What a thrill to learn we could still be experiencing self-loathing well into our senior years. 

At any rate, Bernice’s foray into plastic surgery feels like reason enough for us to foray into plastic surgery, too. Let’s get some work done! No, not like that! I just meant, let’s talk about plastic surgery! Unless someone else is paying…

OH, and if you’re interested in diving even deeper than we do in this segment, check out these resources:

Come on y’all, let’s get into it! 



Nikki: Hi, Salina.

Salina: Hello.

Nikki: And hi, everybody else.

Nikki: Welcome to this week's extra sugar.

Nikki: God bless Bernice and her journey towards self acceptance.

Nikki: Personally, let me tell you how excited I was to hear that self loathing continues well into your 60s.

Salina: Comforting, isn't it?

Nikki: It is another thing to love about being a woman.

Nikki: But this whole episode about plastic surgery felt to us like reason enough to dig into the whole idea of plastic surgery from ancient roots to today's ethical concerns.

Nikki: I thought we'd poke around a little bit in a segment I'm calling beware of plastics.

Nikki: That's a mean girls reference.

Nikki: Okay, thank you.

Nikki: It's been a long time.

Salina: I'll just catch on.

Nikki: I spent a long time playing with the name of it because I didn't want it to be anything offensive.

Nikki: But also, there was just something there about plastics.

Nikki: I had to go for it.

Salina: Yeah, that's fair.

Nikki: I didn't want to give you an old, boring history lesson, though, because I'm a woman of the people.

Nikki: I structured this segment to be slightly more entertaining than that.

Nikki: Okay, ten things you should know about plastic surgery.

Nikki: Okay, we're going to cover the historical bits along the way.

Salina: Don't worry.

Salina: I wove them in.

Nikki: Feel free to ask questions along the way, Salina.

Salina: Okay.

Nikki: I may or may not have answers, as usual.

Nikki: All right, so, surprising thing you should know about plastic surgery.

Nikki: Number one.

Nikki: Ancient Egyptians invented it.

Salina: It's always egyptian.

Salina: It is every time.

Nikki: They're just the cradle of society.

Nikki: So, plastic surgery dates back 4000 years.

Nikki: The oldest procedures recorded in history are in ancient text called the Edwin Smith Paparis Papyrus.

Nikki: Papyrus.

Salina: Papyrus.

Salina: Papyru.

Nikki: Egyptian pipers.

Nikki: It's named after an american Egyptologist who bought it back in the late 18 hundreds.

Nikki: But the book is thought to date all the way back to 1600 BC.

Salina: Wow.

Nikki: It served as an early trauma surgery textbook.

Nikki: It holds a bunch of detailed case studies of injuries and diagnoses.

Nikki: In the world of plastic surgery, the most notable procedure is something Bernice would have understood.

Nikki: It's kind of a medical procedure for a really rudimentary rhinoplasty.

Nikki: I see you looking at me, Charlene.

Nikki: Rhinoplasty is a nose job.

Salina: Oh, thank you.

Nikki: It was technically a treatment for nasal injuries, but either way, it involved manipulating the nose into the desired position before using wooden splints, swabs, and linen plugs to hold it all in place.

Salina: Oh, interesting.

Nikki: A CNN article I found, which, of course, I'll link to in the show notes, talks about evidence that Egyptians pioneered prosthetics, too.

Nikki: So they gave the example of a mummy that they found in 2000 who appeared to have a prosthetic toe, which they theorized was to help the person walk.

Nikki: So they actually tested the theory by having, like, humans of today put it on and try to walk around to test that.

Nikki: That was really the purpose of the prosthetic.

Nikki: And indeed, it seems like it was.

Salina: Oh, there you go.

Nikki: Not weird.

Salina: And then when they opened up the tomb, there was the first iPhone.

Nikki: Did you see that?

Nikki: Same news article.

Nikki: That didn't happen, Salina.

Nikki: Fun fact number two, and I'm a little nervous.

Nikki: I recounted these facts several times.

Nikki: I'm mildly concerned.

Nikki: I don't actually have ten, but just go with me.

Nikki: Fun fact number two has to do with why we call it plastic surgery.

Nikki: The term plastic surgery comes from the greek word plasticose, which means to shape or mold something.

Nikki: The term was first used in the 18 hundreds to describe the process in which doctors or surgeons reshaped or molded body tissue.

Salina: Okay.

Nikki: Along those same lines, the plastic surgery of yesteryear had much more to do with medical necessity than the cosmetic plastic surgery we talked about this week in designing women, or that you might just be thinking about.

Nikki: In fact, thing number three that you should know about plastic surgery is that the first massive wave of plastic surgery enhancements, or, like, advancements, actually occurred because lots of soldiers after World War I or during World War I needed a lot of reconstruction.

Salina: That makes sense.

Salina: It's also very sad.

Nikki: My God, it's very sad.

Nikki: The war and their related injuries, combined with the fact that scientists had now discovered and perfected the idea of blood transfusions, meant that they could try things they hadn't been able to do before.

Nikki: So they were trying facial reconstructions so injured soldiers could breathe and eat properly.

Salina: Yeah, I'm just imagining all this very rudimentary versions of this.

Nikki: So the CNN article that I mentioned above quoted the author of a book, Andrew Bamgee, or Bamji, about the history of plastic surgery.

Nikki: And he talked about how influential the war was in progressing the techniques of plastic surgery.

Nikki: So I thought this part was really interesting, kind of.

Nikki: I think you were talking more about rudimentary procedures, but this is sort of like the process was kind of interesting.

Nikki: So he's talking about Queen Mary's hospital in London, and he said that lots of patients were concentrated there.

Nikki: It was sort of like a hub for rehabilitation and these types of surgeries.

Nikki: So he said, quote, you've got literally dozens of surgeons working there, and they can bounce ideas off of each other.

Nikki: We have photographs of two operations happening in the same operating theater at once, which from a cross infection point of view nowadays would be completely forbidden.

Nikki: But you have this incredible exchange of ideas and the development of reconstructive techniques.

Nikki: So literally while they're operating on the people, they're talking like, did you try this?

Nikki: Have you considered this?

Nikki: What if we do this also just.

Salina: This idea of an operation.

Nikki: Theater.

Nikki: Theater.

Nikki: Theatre.

Nikki: So how did we go from facial reconstructions, like, simply to help battered soldiers live again, to weekend Botox parties?

Nikki: Well, after the wars ended and the reconstructed soldiers all returned to their new normal lives.

Nikki: That's a terrible way to say that.

Nikki: I'm sorry.

Nikki: After the wars ended and the soldiers returned home, plastic surgeons started looking for new ways to keep their specialty moving forward.

Nikki: So this is fun fact number four.

Nikki: In the 1950s, we saw a new breast augmentation option.

Nikki: Finally, there was no saline or silicone yet.

Nikki: Can you think of what they used in these early days?

Salina: Jello.

Nikki: Good guess.

Nikki: Yeah.

Salina: I mean, I have no idea.

Salina: Beanbags.

Nikki: What about a sponge?

Salina: Oh, that seems terribly unsanitary.

Nikki: Okay.

Nikki: And also they harden up eventually.

Nikki: So the first silicone implants would actually be about a decade away.

Nikki: By the 1960s, silicone implants were much more common.

Nikki: The sponges didn't work, needless to say.

Nikki: Fun fact number five is that today's plastic surgery option, Dujour botox, came along shortly after breast implants.

Nikki: But like usual, it was for an entirely different reason.

Nikki: It was actually developed in the 70s as a treatment for crossed eyes.

Salina: Oh.

Nikki: I guess at some point, though, someone realized it also tackled pesky facial lines.

Salina: It's always so interesting what something was developed for versus what we know it for today for sure.

Nikki: And I think plastic surgery is one of those medical specialties where I feel like I saw a lot of that because you're just trying things out, just trying stuff out and see what it works.

Nikki: Fun fact number six is that there would still be several decades after that, after those first breast augmentations and the first uses of botox for cosmetic plastic surgery to outpace reconstructive surgery.

Nikki: So by the 90s, that's exactly what happened.

Nikki: By 2005, the number of cosmetic surgeries was double that of reconstructive surgeries, according to the American Society of Plastic Surgery.

Nikki: So there was definitely a blow up of cosmetic surgery around the time this episode aired into like the 2000s.

Salina: Sure.

Nikki: Fun fact number seven is kind of related to that.

Nikki: In 2002, the show Extreme Makeover aired a really graphic segment of a breast augmentation procedure, which you kind of would think would turn people off right.

Nikki: That face you're making turns you off.

Salina: I don't know, because there's, like, Dr.

Salina: Zit, and I think people like to.

Nikki: See that when I get to.

Salina: Not that those two are the same, but you know what I'm saying?

Salina: They just like to see the grotesque.

Nikki: Yeah.

Nikki: Let me tell you, I'm not spending a lot of time on social media these days.

Nikki: And it's because of this realization I would spend so long poking around on TikTok that I would get to the doctor's it videos and I would watch, like, 20 minutes of them and then realize I've seen all the Internet has to offer.

Nikki: I'm done.

Nikki: I've seen enough for today.

Nikki: I can't stop watching them.

Nikki: Really.

Nikki: I cannot stop watching them.

Nikki: I cringe, I cover my face, and then I still watch them.

Nikki: There are some that are too much for me.

Nikki: I think this extreme makeover show would have been too much for me.

Nikki: However, 250,000 women got breast augmentations that year.

Nikki: That was 147% increase from five years prior.

Nikki: So kind of like that normalization of cosmetic surgery in mainstream media, it kind of made it, like, a more realistic option for people.

Salina: It also has put me in the mind of that show, the swan that came out.

Nikki: I haven't thought about that in a really long time.

Nikki: I think that was three.

Salina: And they just, like, did a hairline to toe makeover.

Nikki: I might have come across that in doing my research for this.

Nikki: That definitely was part of that wave of normalization of plastic surgery.

Nikki: So thing you should know, number eight, is that in 2021, the plastic surgery industry experienced the zoom boom, or a wave of people looking for plastic surgery post Covid because they just spent an entire year looking at themselves on zoom.

Nikki: And the cameras are not flattering.

Nikki: What do you mean?

Salina: I love it.

Nikki: It's so horrible.

Salina: Good for your psychology to sit there and look at your face for so long.

Nikki: I've made mine as tiny as possible.

Nikki: Sometimes I'll just minimize the window altogether so I don't have to even look at myself.

Nikki: I can only see the person who's talking.

Nikki: But then I start to get paranoid.

Salina: Still this big on the other person's screen, right?

Salina: It doesn't help a highway sign.

Nikki: So a UCLA health article that I found said, quote, according to a 2020 survey published in facial plastic surgery and Aesthetic magazine.

Nikki: I'm sorry.

Nikki: And aesthetic medicine, 40% of respondents who had never tried cosmetic procedures before have been inspired to pursue them based on how they look on video conferencing platforms.

Nikki: Most expressed interest in nonsurgical options, including neurotoxins like Botox and injectable fillers today.

Nikki: And I feel like it goes so fast.

Nikki: What do you call that?

Salina: Spirals.

Nikki: Yeah, it spirals really quickly.

Nikki: Like you start with just let's take care of these lines right here.

Nikki: And then all of a sudden you've got a facelift.

Salina: So challenging.

Salina: And we've circled this issue before and it's like, I never want to yuck anybody's yum.

Salina: Everybody should just do what they want to do.

Salina: But it does seem to get out of control if you're not cautious and you would hope that maybe the providers would help kind of like throw up the caution tape and stuff just to make sure that you're taking it like one thing at a time and you're not getting into deep waters before you're ready to swim and all of this stuff.

Salina: But they're making money.

Salina: So it's going to be a little, not maybe almost subjective audience and that's too bad.

Salina: Not to say.

Salina: I'm sure there are lots of plastic surgeons out there that really care and they're not trying to take advantage of you.

Salina: But gosh, how do you know until.

Nikki: You'Re just yelp until you're poor Bernice with your nose reconstruction.

Salina: Right?

Nikki: Yeah.

Nikki: I think the surgeon is super important and I personally do not do or have not done, I should say Botox or fillers or anything like that.

Nikki: What I will say, though, is just given our age and where we are in life, I know a lot of people who have and it really comes down to having the person that you trust do it and having a really blunt conversation.

Nikki: I don't want to look plastic.

Salina: Well, I mean, and if we're to take people at face value, and obviously I haven't fact checked the statement, but you're really supposed to start the Botox.

Nikki: Stuff young, which is so crazy because who has the money?

Salina: Yeah.

Nikki: Anyway, plastic surgery seems limited to reconstructive or cosmetic types.

Nikki: But fun fact number nine is that there used to be a subspecialty of plastic surgery, sort of like a weird cousin to cosmetic plastic surgery called prison plastic surgery.

Salina: Wait, hold on.

Salina: Prison?

Nikki: Prison?

Nikki: Like jail?

Salina: Okay.

Nikki: Have you heard of.

Nikki: I guess you haven't heard of this.

Salina: No, because I was like prism.

Nikki: So this was a plastic surgery offered to and performed on prisoners as a means of social rehabilitation.

Nikki: The idea was that it would reduce the rate of recidivism to do some of the things I'm going to talk about in a second.

Nikki: So this type of surgery included nose job, scar removal and tattoo removal.

Salina: I was thinking tattoos.

Nikki: And it was normally provided as part of a larger package of care, like work training and psychological services.

Nikki: So the idea, again, was that by making prisoners look, quote, more normal, they'd fit into mainstream society better when they left prison.

Nikki: So these programs.

Nikki: Yeah, they began in the early 20th century.

Nikki: They were actually commonplace until the early 90s.

Nikki: They took place across the US in 42 ish states, the UK, Canada and Mexico.

Nikki: And since I'm talking about them in the past tense, I think that would imply to you that they've ended.

Nikki: Well, they ended because the ethics were, shall we say, questionable.

Nikki: While one examination of some of the mid 20th century prison programs did suggest that plastic surgeries reduced recidivism, in some cases they actually dropped it from 76% to 33%.

Nikki: Scholar Jessica Mitford wondered if prisoners were really in a position to consent to these procedures.

Nikki: So she wrote in kind and unusual punishment that a doctor told her that inmates had become, quote, our companions in medical science.

Nikki: This has been a rewarding experience, both for the physician and the subjects.

Nikki: But a lot of people have noted that in a prison dynamic, there's just too much undue influence for the prisoners to consent fairly.

Nikki: So you offer them this thing, they can't really say no, necessarily, but they might not really want to do it either.

Nikki: So the whole argument was like, this is unfair consent.

Nikki: It's not completely fair.

Nikki: So they stopped the programs.

Nikki: So that leads us to the final thing you should know of this segment, which is sort of like 15 things you should know all in one.

Salina: You counted it.

Nikki: Was it ten?

Salina: Yeah.

Salina: As long as we didn't skip any numbers, somebody will tell us.

Nikki: Basically, it's that plastic surgery is an ethical minefield.

Nikki: So, like we just mentioned, informed consent is a huge issue in all fields of medicine, but also in plastic surgery, there's, like, a ton of other issues to consider.

Nikki: To me, the ones that stick out the most relate to body image and mental health and cultural and societal pressures.

Nikki: I feel like these are just super relevant to us and the things we've talked about on the show.

Nikki: So I kind of wanted to talk about both of those briefly.

Nikki: So we have both sides of the coin.

Nikki: First important caveat, I think it's well established.

Nikki: You just said it a few minutes ago.

Nikki: You do, you kind of gals like no judgment.

Nikki: It's all about you.

Nikki: You do what feels comfortable to you.

Nikki: I think I have opinions and I have thoughts, but I don't live your life.

Nikki: So ultimately, it does not matter what I think.

Nikki: That said, I do think there's value in considering all the angles of plastic surgery and making sure you're really doing it for you and not for what society thinks is best for you.

Nikki: So in my own personal experience, and after all the research, how do you.

Salina: Even tease that out?

Nikki: It's really challenging.

Nikki: I think it's a lot of self reflection.

Nikki: It's a lot of self reflection.

Salina: Sorry, that was just popped into my head.

Salina: Like, you don't really know.

Nikki: You don't know.

Nikki: You don't know.

Nikki: Plastic surgery falls in a murky gray area.

Nikki: Ethically, for me, it simultaneously bleeds into the realms of body image, mental health, societal pressures.

Nikki: And then, to your point, I think it's really hard to find the clear lines of personal autonomy and then the influence of external pressures.

Nikki: So, to your point, how do you tease that out?

Nikki: I think in modern times, a lot of people struggle with unrealistic physical expectations, and then they use plastic surgery as a method for attaining their aesthetic ideals, only to realize they may still fall short.

Nikki: And it's because it was unrealistic to start with.

Nikki: So, like taking the example of Bernice, maybe she looked in the mirror every day and just really hated her nose, so she considered plastic surgery on the face of it.

Nikki: My reaction is, first of like, if you're my friend, I'm like, you're perfect.

Nikki: You're exactly the way you're meant to be.

Nikki: Like, you are the person that was meant to be on this earth right now.

Nikki: Don't mess with it.

Nikki: But also, if it bothers you that much, I don't want you to live with that every day and look at yourself in the mirror and hate yourself.

Nikki: If you have the means and the mode to fix it.

Nikki: You know what I mean?

Nikki: Go fix it.

Nikki: That said, my bigger question would be, where did that hatred of your nose come from?

Nikki: And I think that's worth exploring.

Nikki: I think if you're struggling with something related to your physical experience or your physical appearance, don't ever make the mistake of thinking it's a you thing.

Nikki: There are probably, and have always been for most of your life, these forces outside of your control that have built a narrative that it's just really hard for you to unhear.

Nikki: Now, is it reason enough, then that you should get surgery to fix it?

Nikki: Maybe.

Nikki: But just think about it.

Nikki: Think about whether you really hate your nose or if someone's told you your whole life you should hate your nose.

Nikki: So when I think of nose jobs, it's hard for me not to think of the so called jewish nose.

Nikki: This is something that has come in and out of the media over the years, especially, like, Bradley Cooper was in a movie where they gave him a quote, unquote jewish nose, which was just like a whole.

Nikki: Yeah, but I ended up googling it because I felt like this was so relevant to the storyline we're talking about, and it's so relevant to this societal perspective as well.

Nikki: So I found a Jewish Chronicle article that told the story of the complicated history around, actually, rhinoplasty and the jewish community.

Nikki: So the article was written in 2023, and it noted that more orthodox women were pursuing rhinoplasty before they begin dating, and that surgery is often enthusiastically supported by their families.

Nikki: So this was sort of just like making themselves a more attractive partner for their future husband.

Nikki: But the article noted that historically, Jews have gone to great lengths to disguise their, quote, jewish nose as a means of assimilation.

Nikki: So the article said, quote, not necessarily an aesthetic choice, but often a safety mechanism to protect oneself in a hostile environment.

Nikki: So at some point, that complication was further mixed when experts and medical providers began telling them there was something wrong with their noses.

Nikki: So as early as 1850, a scottish anthropologist described the jewish nose as, quote, a large, massive, club shaped, hooked nose, three or four times larger than suits the face.

Salina: Okay.

Nikki: He concluded, quote, the jewish face can never be and never is perfectly beautiful.

Nikki: By the early 19 hundreds, surgeons were arguing that fixing, quote, racial characteristics in patients can improve patient well being.

Nikki: But a 2001 paper published in the medical journal JAMA.

Nikki: In that article, surgeon Beth Preminger essentially argues that by lending credibility to cosmetic and aesthetic prejudice, doctors actually helped perpetuate stereotypes, prejudice, and, in essence, racism.

Nikki: It's crazy, right?

Salina: I was wondering when this was going to get around to racism.

Salina: It had to get there eventually.

Salina: I knew it would happen.

Salina: Yeah.

Salina: It's so sad.

Nikki: It's really sad.

Nikki: So the article then goes on to tell what I think is a really well known cautionary tale of Jennifer Gray, who was baby from dirty dancing.

Nikki: She decided really early in her career to address her jewish nose.

Nikki: She thought it would help improve the ods of being cast in more movies.

Nikki: What she learned, though, was that it took away some of her identity, some of what made her unique.

Nikki: So she became invisible to casting staff later.

Nikki: And she believes her career suffered because of it.

Nikki: So, of course, in Jennifer's instance, the cosmetic surgery may or may not have been the boon to her self esteem that she was hoping for.

Nikki: Maybe it was.

Nikki: It's just that her self esteem boost wasn't enough to outweigh the reality that her new look didn't seem to have positive influence on her career.

Nikki: Either way, she's been pretty verbal in seeming to have regret for the surgery.

Nikki: So then I started wondering, is that the case for everyone or even most people, or even some?

Nikki: And the answer is yes and no.

Nikki: I found a really recent 2022 article about self esteem post cosmetic surgery.

Nikki: They concluded, quote, this study's findings indicate that cosmetic surgery improved self esteem and body image, which may be of interest to health policymakers and professionals.

Nikki: And I found that conclusion validated in a few other places.

Nikki: So there is something to it, but there's a flip of it.

Nikki: There are some patients who experience negative feelings after cosmetic surgery.

Nikki: Some are really acute, like a brief depressive period post surgery.

Nikki: It's probably because they're frustrated with their recuperation or because the medication is uncomfortable for them, something really short and brief just to get them through the rehab period.

Nikki: But there are a lot of other negative feelings that people report that are a lot longer lasting.

Nikki: So some patients experience what they call like, an early honeymoon period with their procedures results.

Nikki: They're in love.

Nikki: They're so happy.

Nikki: But then as time goes on, they realize, like, they didn't get the promotion they were looking for, they didn't get the casting roles they thought they'd get.

Nikki: They never did get that husband or wife, whatever it is.

Nikki: Then they start to get depressed because they think the surgery didn't work.

Nikki: And then it seems there's a not insubstantial number of people who are kind of disappointed with the results because they're just still them.

Nikki: Like, they didn't end up Kim Kardashian or Beyonce or whoever they were trying to be.

Nikki: They're still just them with a new nose.

Nikki: You look like you're having all the thoughts.

Salina: Yeah.

Salina: I mean, it's like you hear that people talk about this with success.

Salina: They thought if they just got to this point in their career or they just made this much money or whatever, and then they get there and they still feel the same.

Salina: And it's because, in my opinion, you have to figure out how to be okay with your essential self.

Salina: All that other stuff, whether it's looks or money, or accolades, degrees, cars, houses, all that stuff is just very earthly and it's very temporary.

Salina: I don't have the answer for how to get happy.

Salina: I'm open to suggestions, but I know that all of these little temporary fixes, or even more permanent fixes, they're just window dressing.

Nikki: Yeah.

Nikki: And I think that's kind of the point.

Nikki: That I wanted to make with all this is really understanding your why is the critical part like plastic surgery is whatever you do, you again.

Nikki: But just make sure you know why you're going into it because it is permanent unless you have the resources to go back and fix it like Bernice did in this episode.

Nikki: But you really need to know why you're doing it.

Nikki: And then of course, have realistic expectations going in.

Salina: And she had resources because someone else came in and helped her.

Salina: The truth is, she did not have the resource.

Nikki: Right.

Salina: And that seems like a really terrible position to be in.

Nikki: For sure you'd be stuck, right?

Salina: Yeah.

Nikki: So it's just important to see both sides of the coin is my whole point.

Nikki: Before we leave the topic of plastic surgery, I wanted to mention one more thing.

Nikki: So obviously I did not dive into the concept of medical tourism or international plastic surgery today.

Nikki: It's like related, but out there it's just like another layer on the big old Vidalia onion plastic surgery.

Nikki: But I'm only going to bring it up briefly here because as I was writing this piece, there was a really big story circulating in the press that I feel like it would just be silly for me to talk all about plastic surgery and not acknowledge that the latest in plastic surgery is this idea of medical tourism or like, international plastic surgery.

Nikki: So anecdotally, over the years, I've heard lots of stories of people who travel to other countries to get plastic surgery because it's a lot cheaper because us healthcare is generally broken.

Nikki: Not the point of this story.

Salina: I'm just going to get that plug in there in case anybody wants to know.

Salina: It absolutely sucks and we're all screwed.

Salina: But also, yay, America.

Nikki: So stories like that usually come with some sort of warning about ensuring the safety of the place you're going to, the environments where you'll have the surgery.

Nikki: But like I said, right now there's a lot of media coverage around the nearly 100 deaths of Americans after plastic surgery in the Dominican Republic.

Nikki: I felt like I needed to at least acknowledge that.

Nikki: More specifically, it was 90 deaths of Americans from 2009 to 2022.

Nikki: More than half of those 90 deaths occurred after 2018.

Nikki: Each of the cases involved the brazilian b*** lift, or a procedure where fat from the patient is taken from somewhere else in their body and then injected into their buttocks.

Nikki: That's a lot.

Salina: It is.

Nikki: I know that's high.

Nikki: All but one of the patients were women, and the average age was 40.

Nikki: Most of the deaths happened because of blockages in the bloodstream, either blood clots or fat buildup.

Nikki: And in most cases, other procedures were done at the same time, which is a risk factor.

Nikki: When it comes to plastic surgery.

Nikki: The general rule is like, don't pile on procedures.

Nikki: It just puts you at more risk.

Salina: Anytime you start opening up the body and swirling stuff around.

Salina: I don't care what it's for, the body doesn't like that.

Nikki: And so I think people see it as, while you've already got me open, do all these other things, but it is almost like overload for your body.

Nikki: It's just too many things at once.

Salina: So scary.

Nikki: So a high proportion of the patients had other risk factors for embolism or blood clots, essentially, which included obesity.

Nikki: So they found all this out because the US embassy and the Dominican Republic asked CDC to do an investigation in collaboration with the Dominican Ministry of Health.

Nikki: The main source material that I used for this bit noted that negative outcomes are not limited to overseas surgeries.

Nikki: Not even a little bit.

Nikki: A separate report, sort of published at the same time found that 15 cases in nine states occurred of an antibiotic resistant bacterial infection post cosmetic surgery.

Nikki: And all of those surgeries were done at the same medical center in Florida.

Nikki: So just, I don't know if you.

Nikki: Surgery, surgery.

Nikki: Safe.

Salina: Florida.

Nikki: Oh, Florida.

Nikki: So let's bring this thing on home.

Nikki: Salina.

Salina: We covered the Dominican Republic before I went to Florida.

Nikki: Since ancient times, humankind has seen plastic surgery morph from a necessity into a choice.

Nikki: From the ancient egyptian who needed a prosthetic toe just to walk to the World War II soldiers looking for a second chance at life postwar to the modern man looking to tighten up excess skin after weight loss.

Nikki: So, I don't know, he can wear clothes more comfortably.

Nikki: Plastic surgery has been an interesting crossroads between the scientific world and the cosmetic one.

Nikki: For some, a means to explore our collective pursuit of selfimprovement.

Nikki: For others, a means to an end, a chance at a happier life.

Nikki: Either way, the field is ever evolving, life changing for some, downright infuriating for others, and just curious for even others.

Nikki: So that's the end of this week's extra sugar.

Nikki: You know where to find us.

Nikki: We're on TikTok and Facebook.

Nikki: You can email us at, catch us wherever you listen to podcasts and find us on social media at sweet tea and tv.

Nikki: And that is this week's extra sugar.


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