The catchphrase featured on the cover of the “Dr. 90210″ season one DVD reads, “Beverly Hills. Where everyone accepts plastic.” It sums up the idea that plastic surgery in this city is a means to the highly sought-after end to the quest for bodily perfection.

Though this is what Los Angeles is known for, and in part how it markets itself, the realities of plastic surgery challenge those beliefs every day.

“Based on the patient, the nature of their skin and facial structure, the doctor has to be aware of (what can be achieved through surgery),” Dr. Jeffrey Rawnsley said.

Rawnsley, who specializes in rhinoplasty and other facial cosmetic procedures, has been a practicing surgeon for more than 10 years and is a clinical associate professor at the David Geffen School of Medicine.

The kind of work that can be done on a person depends on their genetics.

“It’s is a delicate thing. People have to be counseled about what’s realistic and what’s unrealistic. Some things are achievable, and some are not,” Rawnsley said.

Plastic surgery as a limitless means to achieving movie-star good looks is just one of the misconceptions surrounding the profession, as are the reasons why people have procedures.

“People do it for a variety of reasons, (such as) social anxiety about their nose, about their appearance or if they were teased when they were young,” Rawnsley said. “There is also a strong desire for people to look their best, whether it’s to be competitive in the workplace, to attract a mate, for dating, a good social life or life in general.”

The idea of beauty being necessary for daily life, especially in the workplace, may bring to mind Hollywood’s actors, models and future stars who turn to plastic surgeons for a boost in their careers. People who believe the procedures are unnecessary may be tempted to place blame on the surgeon for convincing them otherwise.

But in the end, Rawnsley said, the decision to have plastic surgery, whether for cosmetic or reconstructive reasons, has to be made by the patient.

“Patients have to decide for themselves,” he said. “It’s not my place to convince them of anything.”

As a plastic surgeon, Rawnsley is aware of the stereotypes surrounding his profession. His experiences with people, however, have been different.

“People are fascinated, really,” he said. “The idea of cutting people and invading their bodies is a fascinating subject for a lot of people.”

This fascination is what inspires the next generation of surgeons. Joseph LaSalle, a third-year sociology and biology student, said he is motivated to become a surgeon by the nature of the work.

“I find it fascinating that you can fix people’s insecurities with the use of a scalpel,” LaSalle said.

These insecurities vary, from facial imperfections to trauma from an accident or combat. LaSalle said he remembers stories of his father working with patients whose facial skin had been badly damaged in combat and how grateful they were after their reconstructive procedures.

“My father was a military doctor. He had to fill all the roles (a doctor fills),” LaSalle said. “He learned how to make new skin and make people look normal again.”

“Dr. 90210″ is not focused on these sort of surgeries because reconstructive surgery does not fit into the image of the beautiful blonde bombshell (seen on the DVD cover as well) Los Angeles is known for.

“All we hear about it is the commercialized side that works just to make people beautiful. We don’t hear about the other side,” LaSalle said.

LaSalle said he wants to specialize in facial reconstruction.

“That’s the first thing you see, and that’s what people are most insecure about,” LaSalle said.

For LaSalle, there is a difference between cosmetic surgery and reconstructive surgery, and that difference lies in who the procedures are aimed at.

“The industry of insecurity is more for models,” LaSalle said.

Whether or not that is actually the case, women in particular have felt a need to alter their physical appearances well before shows devoted to plastic surgery appeared. The need to look a certain way goes beyond the modern culture in Los Angeles and Beverly Hills.

“It’s only in the last 100 years that cosmetic surgery has become so widespread. (But) women wanting to change their looks has been forever,” said Jocelyn Thomas, a graduate student in women’s studies. “Cosmetic surgery as it exists today … has ballooned and become so much more pervasive. But it’s not a new thing.”

Instead of arguing for or against plastic surgery, Thomas said she wants to keep the subject open for debate.

“A woman can be aware of the critical problems of body image and still make the decision (to have plastic surgery). It doesn’t make her a bad woman or misguided. If you make this decision, you’re not excluded from the “˜Rational Woman’s Club,'” she said.

The real question is not the procedure itself, but what the end goal is.

“(We should ask ourselves) how we define what beauty is and what kind of pressure is there … to get to that standard,” Thomas said.

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