In California, once famed as the place to get cosmetically freshened up in America, Los Angeles and Hollywood no longer even represent the epicenter of nips and tucks. That honor now belongs to the San Francisco Bay Area. Yes, Silicon Valley, home to geeks, Google and Intel Inside™, is now the plastic surgery capital of America.

Perhaps it’s not so surprising that as the Baby Boomers age, members of the generation that once said “Never trust anyone over 30” are not going into their golden years without a fight.

According to the American Society for Aesthetic Plastic Surgery, more than 10.2 million cosmetic procedures took place last year (the latest date for which such figures are available). While that number represents a decrease of 12.3 percent because of the economic recession, nevertheless Americans are choosing to go under the knife in record numbers. Just a little over a decade ago, in 1997, only two million such procedures were conducted.

San Francisco-based plastic surgeon Dr. Karen Horton own experience shows that more people are choosing plastic surgery to look better and feel better about their appearance. While 60 percent of her female patients are getting reconstructive plastic surgery after a mastectomy or other breast cancer-related procedures that have left ugly scars, 40 percent of her patients are seeking cosmetic work.

In this sense, plastic surgery has become simply the next step beyond working out and Botox.

“Most people getting facial plastic surgery don’t want to look different, just refreshed,” Dr. Horton said. “The greatest compliment I received was from a patient who said even her mother couldn’t tell she’d had surgery.”

However, Dr. Horton cautions that plastic surgery is not a replacement for working out and eating right. She warns her patients that surgery is an extremely invasive procedure and that they must be in top physical shape, on a stable diet with a stable weight, and have a supportive partner, friends or family ready to help with their recovery before they embark on a cosmetic procedure — whether it be a facelift, body contouring, breast augmentation, eyelid lift or any of the many other surgeries now available.

One particularly popular procedure is commonly known as the Mommy Makeover, a specialty of Dr. Horton’s; the goal, she said “is to restore the woman’s body to its pre-childbearing shape, or sometimes to even better shape.”

Mommy Makeovers usually involve breast augmentation and/or reduction, liposuction and a tummy tuck (abdominoplasty) to create a flat stomach. However, this is no easy fix to give mommy a Baywatch body. A tummy tuck requires the surgeon to cut into muscle, sometimes pulling muscles of the abdominal wall together, and multiple procedures can take 6 to 8 hours to perform while the patient is under general anesthesia.

The recovery time for scars to heal and the woman to regain her full physical strength can be up to a year.

Dr. Horton says the ideal candidate is a woman in her mid- to late=30s, is already in good physical shape, has a supportive partner and is not planning to have any more children —although the surgery in and of itself does not preclude childbearing.

Because Mommy Makeovers are so popular nationally, a plastic surgeon in Florida, Dr. Michael Salzhauer, has written a children’s picture book called My Beautiful Mommy explaining why Mother has come home from the hospital bruised and bandaged, because, the doctor said, “The kids have questions.” His book aims to answer them with pictures and simple sentences that children aged four to seven can understand.

However, it’s not just women who get plastic surgery. Nationally, men account for 8 percent of procedures. Although Dr. Horton’s clinic specializes in treating women, she still conducts 5 to 10 percent of her procedures on men.

“The number one reason is business,” Dr. Horton said of her male clients. “Starting in their 40s and 50s, men feel the need to compete with their younger business competitors. They want to look as good and energetic on the outside as they feel on the inside. They don’t want to look tired.”

Procedures popular with men include liposuction of the flanks and/or chin area; removal of lumps, bumps or moles; blepharoplasty (eyelid lifts); facelifts; and nonsurgical procedures such as Botox or laser resurfacing of the skin.

In Silicon Valley’s highly competitive environment, having youth is having the edge. Men under the age of 30 represented the biggest innovators in the first dot-com boom of the 1990s. Jerry Yang and David Filo, Yahoo’s co-founders, created the search engine when they were still students at Stanford University. Today’s web 2.0 leaders are similarly very young; the founders of Facebook, for example, were four Harvard undergraduates.

Even though older software engineers and executives may know their computer science and code like the back of their hands, they feel that they need to look young to compete. And in terms of which startups venture capitalists want to fund, 20-somethings have a distinct advantage.

Hence, Silicon Valley’s rush to jump on the plastic surgery bandwagon.

“You only have one chance to give a first impression,” Dr. Horton said. “In business, looks matter. Looks can make or break a deal.”

While all this emphasis on appearance may seem superficial, the effect on society has been profound. The most difficult fields of medical science for students to get into are not cardiology, neurosurgery or oncology — all fields that require great skill as well as knowledge of cutting-edge research in order to save lives. Instead, the majority of medical students with the highest scores and best grades and most prestigious internships are now competing to be accepted into dermatology and plastic surgery programs, according to The New York Times.

While the acceptance rate for internal medicine residency programs is 98 percent, for dermatology and plastic surgery it is a mere 61 percent.

The reasons may be obvious. While the average American medical student going to a top school is saddled with a minimum US$330,000 debt upon graduation, it’s simply more cost effective to go into the more lucrative fields of medicine.

As one Massachusetts dermatologist, Dr. Eric C. Parlette, told the Times, “It is an unfortunate circumstance that you can spend an hour with a patient treating them for diabetes and hypertension and make $100, or you can do Botox and make $2,000 in the same time.”

Most popular plastic surgery procedures in US:
1. Breast augmentation
2. Lipoplasty (liposuction)
3. Eyelid surgery
4. Rhinoplasty (nose surgery)
5. Abdominoplasty (“tummy tuck”)
Source: American Society for Aesthetic Plastic Surgery


Plastic surgery procedures

abdominoplasty (“tummy tuck”)
blepharoplasty (upper and/or lower eyelids are treated)
brachioplasty (removal of fat and extra skin from upper arm)
breast augmentation (silicone or saline implants)
breast reduction
brow lift
chin implant
face lift
gynecomastia (“breast” reduction in men)
lipoplasty (liposuction)
mastopexy (breast lift)
microsurgery (cutting-edge technique that refers to reconnecting blood vessels under a microscope)
rhinoplasty (surgery on the nose cartilage)
thigh lift