If television was, for a moment there, getting too highbrow for you—with Louie confronting Nietzschean crises and Orange is the New Black continuing its meta-commentary on the prison-industrial complex—worry not: You now have the husbands of the Real Housewives franchise.
Paul Nassif and Terry Dubrow, world-renowned cosmetic surgeons and spouses of Adrienne Maloof (now ex; Beverly Hills) and Heather Dubrow (still together; Orange County), star in a new reality show that has them correcting the plastic surgery disasters of too-vain, if not just unlucky, clients. Botched, which premiered last month on E! and airs Sunday nights, is the latest in a series of body-image exploitation shows, but tries to distinguish itself by showing some of the shadier practices of the cosmetic surgery industry.
In many ways, Botched continues the tradition of older plastic surgery shows like Extreme Makeover and The Swan, which debuted in 2004 and promised the show’s winner—determined by beauty pageant-like tasks—a chance to score the cosmetic procedure of a lifetime. But Botched does something arguably more sinister than simply exploit insecurities using the classic ugly-duckling trope: It feeds off society's dark tendency to root for other people’s failures—in this case, the gruesome failures of patients desperate for new bodies.
In the first episodes, famed supermodel-turned-reality star Janice Dickinson comes in to replace her 30-year-old breast implants, which had become so worn out that they started forming wave-like ripples on her chest. Dubrow and Nassif gave her fresh implants, but only after scolding her for not getting them swapped out with newer ones sooner.
“These implants being from the ‘70s,” scoffs Dubrow. “Who knows, we may take them out, put ‘em on there, and there might be streaks of cocaine left.”
Then, in the second episode, a Chinese woman named Cheryl comes to see Dubrow and Nassif after a failed “eye westernization” operation left her hardly able to blink—a quandary made worse by her enormous cheeks, which she filled herself with illegally obtained silicone.
“Uh, I bought some black market, you know, fillers from China—they were really cheap. So I just stuck it in there, and, you know,” Cheryl tells the surgeons as she mimes a syringe in her cheek.
“You practiced medicine on yourself?” yells a dumbfounded Dubrow.
These sort of blame games and accusations towards victims of botched work are common from the plastic-surgery establishment, says Victoria Pitts-Taylor, a sociologist at Wesleyan University and specialist in body image and feminist studies. And they expose a larger question of who gets held accountable when a surgeon’s over-eagerness for profit results in a surgery disaster, or when patients, so distraught over their body image, find poorly regulated fillers to fix themselves up or demand the impossible and the risky from their own doctors.
“Who is blamed in the narrative for the situation that they're in?” Pitts-Taylor asked when I spoke with her. "I think we're all being a little bit too willing to accept these narratives of blame of individual patients for being too crazy, or being too careless, and there's certainly not enough critique of the industry as a whole."
The industry’s alleged ethical issues and the high risks surrounding cosmetic surgery—even the kind conducted by board-certified physicians like Botched’s Dubrow and Nassif—are well-reported and illustrated by a number of famous cases.
For example: Kanye West’s mother, Donda, died in 2007 after receiving a radical breast reduction and tummy tuck. She had reportedly consulted with a number of surgeons who’d refused to perform the operations due to her pre-existing—and potentially fatal—cardiac condition. But then Donda West found Dr. Jan Adams, a Beverly Hills surgeon and regular guest on The Oprah Winfrey Show, who performed both operations. West died the next day.
While her death no doubt resulted in part from the seriousness and risk level of her operation, a sizable portion of the total number of plastic surgery deaths happen from something as small as a needle. Minimally invasive cosmetic procedures—such as fillers or injections—have increased in popularity by more than 140 percent in the past decade, according to the American Society of Plastic Surgeons, and because of their pervasiveness and varying sets of regulations, fillers are also some of the easiest to sell on the black market.