It used to be a shibboleth of women's magazines that the responsible woman seeking plastic surgery ought to know what to expect. She should expect minor improvements to her appearance. She should not expect nose jobs, liposuction, Botox, or breast implants to change her life.
Now is the time to forget all that. Expect the world. ABC has introduced Extreme Makeover (Wednesdays, 10 p.m. ET) , the weekly documentary on which two homely people are sawed and sanded into two beautiful people—and thus granted deliverance from the travails of existence. At the end of each episode, Extreme Makeover revisits patients from previous shows. Their lives are amazing. Consider these testimonials: "His self-esteem alone has risen from 10 percent to, like, 100 percent." "Before she was a follower, now she's a leader." And finally, for a man whose eyelids no longer droop, "The prospects for the future are just unlimited."
Extreme Makeover marks a serious departure from reality dating shows like The Bachelor because it's a show about ugly people. Moreover, it's a show about ugly, suffering people. As Extreme Makeover opens, plastic-surgery candidates describe lives of torment, during which beaches seemed off-limits and career advancement impossible. On Wednesday night's show, Evelyn's daughter Ashley had taken it upon herself to write to the network requesting that her mother be surgically overhauled. Evelyn looked a little fat around the waist. "She's had a really rough time of it," Ashley wrote. When Evelyn learned that she was slated for liposuction, a breast augmentation, and extensive dental work—all on network television—she wept with joy.
Sharon, the other candidate, worried that she wasn't as pretty as her twin sister, Karen. Indeed, her nose was long; her chin receded. She wanted a nose job and a synthetic chin implant. Sharon also wanted someone to restore her navel, which had been distorted in a hernia operation. She, too, bawled when ABC chose her for major surgery. "Everybody has something that they want," Karen said, supportively. "And this is what she wants."
Does it go without saying that Evelyn and Sharon were already good-looking? Evelyn, whose features were regular and lovely, appeared to be a decently proportioned size 12. Sharon, who was extremely delicate, had a cool face for indie film, a minor exaggeration of Hope Davis'. But watching Extreme Makeover, you quickly regard the "before" appearances as serious medical problems. In Act 2, the surgeons enter, and the show's expert fix-it spirit kicks into high gear.
The characters on Extreme Makeover never look happier than when, in the doctor's office, they get to choose their new features and form. A nifty nose, the thinking goes, then brighter eyes, slimmer thighs, and—what the hell—bigger breasts. It may be hardest to see small breasts as a medical problem, even a psychological burden, so the show allows a little levity to enter as the women select their new cup sizes. After all the dicey face-cutting, breast-inflation comes to seem like surgical dessert. "I truly do want more volume, yes," said Evelyn. Big B/small C? Or no—big C/small D. Yum.
Under the knife they go, sometimes with fleeting thoughts of What the hell am I doing? as the anesthesiologists recite the risks, and the surgeon somberly forecasts bruising, swelling, and pain one more time. Sharon, on Wednesday, seemed genuinely afraid. "The pain itself is really on my mind," she said. She called her angel-faced sister and accepted wobbly reassurance. Around this time, Sharon's surgeon, Dr. Yuan, told the camera, "We're going to start with the rhinoplasty because it requires good hand control. You do largest surgeries after that. Your hands can shake, so I like to start with the nose first."
At this point in the show, the two stars always become irrefutably hideous—almost revolting. Their faces are sliced up and broken down; we typically get a glimpse of how much a nose has to be dismantled in order to be trimmed. Tissue around the eye—the skin that, while conscious, one automatically protects—is slit wide open, pushed up, and sewn into place with black stitches. There is, perhaps, no more violent show on television.
Evelyn, who had not been shy describing her defects ("I've got all this nasty, hanging skin and then no boobs; they're gone—there's nothing left, flat, pancake titties—gone with the wind"), and who had lost 10 pounds in preparation for her liposuction, succumbed to fat removal and got studded with "between 500 and 1,000 stitches," in Dr. Yuan's estimation. (Different surgeons, each one tanned and debonair, appear each time on Extreme Makeover, though the show often uses the same dentist.)
Soon Evelyn and Sharon, both looking near-dead, are laid in hotel beds for an opulent, TV-sponsored recovery. This is a low point of the show. Their faces now show none of the eccentricity, animation, shame, and tragedy that made them compelling pre-op. Neither do they look like the radiant if rather stiffly cut-out "afters" they'll soon be. In the hotel rooms, they appear only perplexed and deeply pained—troubled, schizy creatures who have chosen to have their flesh ruptured and their bones splintered.