Plastic Surgeries Increase Among Minorities

Cosmetic procedures are on the rise within all minority groups, according to a report from the American Society of Plastic Surgeons. But some question whether the growing number of surgeries reflect an even bigger desire: to look more European, or "white." Two plastic surgeons discuss the trend.

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MICHEL MARTIN, host:

I'm Michel Martin and this is TELL ME MORE from NPR News.

Now we know we're in tough financial times. We just talked about that but people still want to look good. But what is looking good? We're going to take a few minutes to talk about some interesting issues cropping up around beauty and ethnicity. In a moment we'll tell you about a Los Angeles hair stylist who is trying to help white adoptive parents of black and biracial children learn how to deal with their children's hair.

Now you might think this is not such a big deal, but take it from us, it is. We'll talk about why in just a few minutes. But first, we want to talk about plastic surgery among ethnic minorities. According to the 2008 American Society of Plastic Surgeons report, cosmetic procedures are on the rise in all ethnic groups except Caucasians. But with African-Americans, Asian-Americans and Latinos requesting procedures such as nose thinning and eyelid surgery, the question arises, what exactly is a beauty enhancement?

Is that code for looking less ethnic and more Caucasian? Joining us now to talk about all this is plastic surgeon Dr. Anthony Griffin. His work has been featured on the reality program "Extreme Makeover" and he specializes in techniques for minorities. Also joining us is Dr. Christopher N. Chang(ph). He runs a private plastic surgery practice in San Francisco. Thank you both so much for talking with us.

Dr. ANTHONY GRIFFIN (Plastic Surgeon): Thanks for having me.

MARTIN: Thank you both especially for getting up early. So Dr. Griffin, I wanted to ask you first, why do you think the demand for cosmetic procedures is growing among people of color, but not among Caucasians?

Dr. GRIFFIN: Well I think, Michel there is a pent-up demand for procedures and I think it's become much more acceptable now to have procedures done. And I think we're seeing that especially with noninvasive procedures. People don't feel like they're being judged or are being criticized anymore. Particularly the younger group, I noticed - and with a lot of rappers and entertainers, that whole generation feels like it's okay to get whatever you to need get done.

MARTIN: Dr. Chang, what's your take on that?

Dr. CHRISTOPHER CHANG (Plastic Surgeon): Well, I have been in practice for 20 years and we've seen more or less a steady stream of procedures for ethnic minorities. And it's an attempt to give a more desirable look, which is a fairly complex issue.

MARTIN: It is a complex issue. The whole question of the eyelid surgery that some Asians, not just in America, but around the world that women of Asian descent sometimes pursue. Do you do many of those procedures, Dr. Chang?

Dr. CHANG: Yes, I do.

MARTIN: And why do people want them?

Dr. CHANG: Well, again, it's a matter of altering features to obtain either a more Caucasian look or to make the eyes look better without reference to any ethnic features.

MARTIN: Is that - do you mind if I ask, how do you feel about that?

Dr. CHANG: There is no question that our surgery can enhance the results.

MARTIN: But the whole question of de-ethnicizing, a surgical procedure that creates a look that is less ethnic. What do you think about that?

Dr. CHANG: Well we have patients who come in - they have no fold above the eyelid skin edge. We call them in Asian language, double eyelid. And without it, for some people who are in extreme the eyes are slit-like, sleepy, unemotional. So some patients are choosing the surgery to avoid that very negative look, while others choose surgery to further enhance the look of brightness, attractiveness, and then for some people it's a matter of having more of a Caucasian, more desirable look. But I would quickly add that most of our patients is not trying to look Caucasian.

MARTIN: But do you - do your patients - do they identify a more Caucasian look with being more desirable, per se?

Dr. CHANG: Most of them don't look at it that way, although some do. I think in many Asian countries - Japan, Korea, many people want that look.

MARTIN: Dr. Griffin, what about you? Do you have patients who you believe are trying to make themselves look less ethnic? And is that a concern? How do you address that?

Dr. GRIFFIN: No and I don't think - I disagree a bit with Dr. Chang in that most of my patients are not trying to look Caucasian and they state that up front. They just want a little bit more balance. They want to look a little bit more refined. And - because I think one of the biggest things you want to do, if you want to not have an ethnic look, you can just change your hairstyle. And that's probably what people see the most from a distance. So - but people are not - and they emphasize that.

I gave a talk at one of our national meetings here in California and, you know, somebody asked, got up in the back of the stage and said, oh, we all know these patients want to look white. And half the room, you know, kind of had this gaspy look on their face because this particular guy was from a different generation and that is a common misperception, that patients don't want to be white. They don't want sharp angular forms. For example, I do a lot of rhinoplasties and they don't want a sharp angular, Occidental look. They want a refined but yet round and soft and harmonious look. So - and they are very clear about that.

I think a patient like, an entertainer like Michael Jackson has done a lot for my practice in the sense that, you know, patients come in and say, look, I don't want that look. You know, I don't care what you do, just don't give me that look. And Michael had an excellent surgeon. But again, it was just a misperception of what people want. They don't want sharp, angular look. And they really want a soft, you know, rounded, refined look.

MARTIN: If you're just joining us this is TELL ME MORE from NPR News. I'm Michel Martin and we're talking about plastic surgery among people of color with Dr. Anthony Griffin and Dr. Christopher N. Chang. They're both prominent plastic surgeons. And they're talking about the fact that the number of procedures being done among people of color has increased in recent years.

And Dr. Chang, you've been in practice for two decades now. Have you noticed a change in your patients over time? Dr. Griffin was saying that the younger generation is perhaps a little less judgmental about some of these issues than perhaps earlier generations were among ethnic minorities. Have you noticed a change in what your patients want over time, what their motivations are for seeking this surgery over time?

Dr. CHANG: Well, I don't think I see a major change. I think what they're trying to do is to achieve a look that within the ethnicity is more desirable. I would have reinforced what Dr. Griffin said. Most of my patients do not want to alter the ethnic features. And so for the upper eyelids, for example, you can do them two ways or different ways to create different distances between the lid edge and the crease and you can either preserve the fat or remove the fat to create some fuller more typical Asian look or a more hollow Caucasian look. And the patient - most patients tend to avoid the exaggerated stylized look.

MARTIN: And like - why are they getting this surgery? Is it that they feel that they're being negatively perceived in the marketplace for example or it just makes them feel better? Why do they want it?

Dr. GRIFFIN: I think a big part of all these procedures are both self image and how they are looked by others. And for some people they're looking for refinement. For others the clear departure from what most of us would think of as being beautiful is large.

MARTIN: And Dr. Griffin what about you, about this whole question of, you know, the esthetics of - the whole black is beautiful movement among African-Americans. It's sort of a very profound political, social phenomenon. Have you noticed over time - I mean you haven't been in practice as long as Dr. Chang. But have you noticed over time the way people talk about what they want and how they want to look? What is that they say that they want?

Dr. GRIFFIN: Well, I've been in practice now - I'll 15 years coming in July and - excuse me - but, you know, I do think again people, if you look at the standard of beauty now, if you look at the covers of the magazines, there are much more people of color than there were years ago. The features that were common among African-American peoples is now what a lot of Caucasians want. They want bigger lips, bigger butts and so, in fact, I have never put in collagen or any injectable into the lips of a black person. So I think over the years we're - that ethnicity has been beat down for all for all sorts of social reasons now is becoming more and more desirable. So - and we see that reflected in our popular culture, like I said, magazines.

I mean, if you look on the covers of every major magazines, including Vogue and things, there are people of color on those magazines now, whereas…

MARTIN: Why were you attracted - I'm sorry, why were you attracted to this area of practice, by the way? And I also wondered if any of your relatives or friends ever gave you the business about it. They think oh, you know…

Dr. GRIFFIN: Well, yeah, as a matter of fact, they did. I knew I was going to be a doctor when I was probably five or six. All my brothers, I have four younger brothers, they all have asthma. And so I - we were always in and out of the doctor's office and the emergency room. So I always figured I was going to be a doctor.

I thought I was going to be a pediatrician until I saw an article in Ebony magazine that featured five African-American plastic surgeons, and the title of the article was "Operating Room Artists." And I always had interest in art, I still oil paint today. And I just thought oh, my God. You can be a doctor and an artist at the same time?

And I immediately knew that I was going to do. And, of course, I got ridiculed and belittled and said, you know, black people don't get plastic surgery. We don't know who you're going to operate on. And, of course, now, you know, years later, you know, I get interviewed, and people say, well, you must have been really encouraged. And I didn't. I had to find my own mentors and almost keep it secret that that's what I wanted to do. But, of course, I'm glad I did it.

MARTIN: All right. Dr. Chang, what about you?

Dr. CHANG: Well, I have to make a confession. Ever since I was a child, I was looking at beautiful faces. So that was at the age of six or seven, and I think that has some impact throughout a long journey through being a science major, medical student, going through general surgery and then switching to plastic surgery.

So for me, all along, there are ideals, there are goals that are deep down inside, unconscious, maybe, and what I chose to allow me to translate those desire into something that people want.

MARTIN: And has your concept of what is beautiful, has that changed over time?

Dr. CHANG: I don't think so. I think each ethnic group has its own beauty. You look around, and you'll see a beautiful Chinese woman or a beautiful Caucasian woman. There are different features, and so again, we are not trying to change from one cultural standard to another, but we're trying to enhance the features within that ethnic standards.

MARTIN: Dr. Christopher Chang runs a private plastic surgery practice in San Francisco. He's also a voluntary clinical faculty member at the University of California in San Francisco. He joined us by phone from his home in San Francisco.

We were also joined by Dr. Anthony Griffin. He's a plastic surgeon in Los Angeles. You might have seen him on the reality show "Extreme Makeover." He joined us from our studios at NPR West in Culver City. Doctors Griffin and Chang, thank you both so much for speaking with us.

Dr. GRIFFIN: Thanks for having me.

Dr. CHANG: Thank you.

MARTIN: Remember, at TELL ME MORE, the conversation never ends. Now we'd like to hear from you. Do you think that plastic surgery among people of color is just about enhancing what's already there or de-emphasizing ethnic features? Let us know. Please call our comment line at 202-842-3522. That's 202-842-3522. Or you can go to our Web site at the TELL ME MORE page at npr.org and blog it out.

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