But, do San Diegans feel as if they have to live up to this unattainable plastic perfection? Just skim through the San Diego Reader and count the number of ads touting, “Chemical peels”-this and “lipo-dissolve”-that. The attractive models, earth tones and unobtrusive terminology like “enhancement” and “augmentation” are all vying to get people to consider smoothing out their own rough edges.

Even after scary terms like “hematoma,” “skin death” and “facial paralysis” are thrown at patients as possible side effects, confidentiality is key. The most commonly asked question, according to Tammy Ladderbush, a Patient Consultant for Plastic Surgeon Dr. Sadrian of Global Cosmetic Surgery Center, Inc., is “When can I go back to work without anybody knowing I’ve had something done?”

So, who is having something done and how can you tell? According to Ladderbush, Liposuction is one of the most common cosmetic procedures. In fact, it was the top cosmetic procedure performed in 2004. (www.plasticsurgery.org) This is where patients have fat sucked out of them by professionals wielding utensils similar to the ones dentists use for suctioning spit. Ladderbush said lipo is a discrete procedure, difficult to detect. “Patients who are good candidates for lipo are usually within 10-20 lbs. of their ideal body weight, so it’s not going to be much of a change.”

Ladderbush added that more invasive procedures like facelifts, forehead lifts and skin peels have a greater downtime after surgery, leaving patients susceptible to being “found out” if they choose to leave the house.

Following a facelift or forehead lift some patients may sport a “surprised, windblown” look. Incisions around the ears are also a calling card of plastic surgery. “Those are visible for a couple of months,” Ladderbush said.

Two cosmetic procedures that are especially easy to detect are breast augmentations and skin peels. With peels, patients essentially have the top layer of their skin burned off, leaving their face red and raw, while awaiting a new, smoother layer underneath to surface. Imagine trying to sneak out to the store, unnoticed after surgery—not likely.

Patients who have undergone breast implants are easy to spot based on how drastic they’ve decided to go. “When someone has nothing and, you know, all of a sudden has breasts…[you can tell],” Ladderbush said.

In addition, breast implants are easy to detect by the lack of separation between breasts while the person is lying on their back.

As for nose reshaping (rhinoplasty), the second most performed cosmetic procedure in 2004 (www.plasticsurgery.org); it’s difficult to detect if you didn’t know the person prior to surgery. However, some patients, who had healed undesirably, may experience complications like uneven nostrils after surgery, making the procedure obvious.

Maybe it’s because San Diego is full of youthful, body conscious residents with an impressive amount of disposable income, but there is definitely a market here for plastic surgery. These procedures aren’t cheap, either. The typical cost for breast augmentation is around $3,373. Facelifts can set you back $4,822, while rhinoplasty runs about $3,332. (www.plasticsurgery.org) Those amounts don’t include operating room facility or anesthesia expenses, either.

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