A new picture book about plastic surgery aims to explain why mom
is getting a flatter tummy and a 'prettier' nose.
When she was pregnant with her son Junior, who turns nine this
month, Gabriela Acosta ballooned from 115 pounds to 196. Acosta
lost the weight but wound up with stretched, saggy skin. Even her
son noticed it. He told her that her stomach looked "pruney," the
result, he thought, of staying in the shower too long. So the
29-year-old stay-at-home mom scheduled a consultation with Dr.
Michael Salzhauer, a board-certified plastic surgeon in Bal
Harbour, Fla.
Acosta told Salzhauer that she wasn't sure how to talk to her
son about the procedures she was considering. That's when he showed
her the manuscript for his children's picture book, "My Beautiful
Mommy" (Big Tent Books), out this Mother's Day. It features a perky
mother explaining to her child why she's having cosmetic surgery (a
nose job and tummy tuck). Naturally, it has a happy ending: mommy
winds up "even more" beautiful than before, and her daughter is
thrilled.
The reassuring tale helped win Acosta over—she scheduled breast
augmentation and a tummy tuck. Since February, when she had the
surgery, she and Junior have read the book a half dozen times, and
she says it helped him feel excited rather than scared. "I didn't
want him to think [the surgery] was because I was hurting. It was
to make me feel good," she says.
That message seems to have gotten through. Instead of being
uncomfortable about the surgery, Acosta says her son actually spoke
up about it at a big party. "Did you see her new belly button? It's
so pretty!" he said of his mom. "I think he was proud," she
says.
What's the market for a children's picture book about moms
getting cosmetic surgery? No one specifically tracks the number of
tummy-tuck-and-breast-implant combos (or "mommy makeovers," as
they're called), but according to the latest numbers from the
American Society of Plastic Surgeons, breast augmentation was the
most popular cosmetic surgery procedure last year, with 348,000
performed (up 6 percent over 2006). Of those, about one-third were
for women over 40 who often opt for implants to restore lost volume
in their breasts due to aging or pregnancy weight gain. There were
148,000 tummy tucks—up 1 percent from the previous year.
Salzhauer got the idea for a book after noticing that women were
coming into his office with their kids in tow. He says that
mysterious doctor's visits can be frightening for children.
"Parents generally tend to go into this denial thing. They just try
to ignore the kids' questions completely." But, he adds, children
"fill in the blanks in their imagination" and then feel worse when
they see "mommy with bandages," he says. "With the tummy tucks,
[the mothers] can't lift anything. They're in bed. The kids have
questions."
"My Beautiful Mommy" is aimed at kids ages four to seven and
features a plastic surgeon named Dr. Michael (a musclebound
superhero type) and a girl whose mother gets a tummy tuck, a nose
job and breast implants. Before her surgery the mom explains that
she is getting a smaller tummy: "You see, as I got older, my body
stretched and I couldn't fit into my clothes anymore. Dr. Michael
is going to help fix that and make me feel better." Mom comes home
looking like a slightly bruised Barbie doll with demure bandages on
her nose and around her waist.
The text doesn't mention the breast augmentation, but the
illustrations intentionally show Mom's breasts to be fuller and
higher. "I tried to skirt that issue in the text itself," says
Salzhauer. "The tummy lends itself to an easy explanation to the
children: extra skin and can't fit into your clothes. The breasts
might be a stretch for a six-year-old."
The book doesn't explain exactly why the mother is redoing her
nose post-pregnancy. Nonetheless, Mom reassures her little girl
that the new nose won't just look "different, my
dear—prettier!"
It remains to be seen how many plastic surgeons will recommend
the book to patients. Richard D'Amico, president of the American
Society of Plastic Surgeons, who gives the book a B grade, says he
would "make them aware that it's out there and leave it up to the
patient's discretion." He says the illustration (specifically the
breasts) look somewhat "overdone," since most moms are just looking
for restoration.
Child psychiatrist Elizabeth Berger, author of "Raising Kids
With Character," likes the idea of a book for kids. "If the mother
is determined to pursue cosmetic surgery, I think it's terribly
important to discuss it with the child," Berger says. But she says
the book is incomplete. She wishes that the mom had just said
something like, "This is silly, but I really want it anyway," she
says. "That is more honest and more helpful to the child."
Berger doesn't want to come across as anti-cosmetic surgery, but
she notes that it can be difficult for small kids to understand.
"The younger the child, the more mysterious and potentially hurtful
the mother's absence, or mother being out of commission, or mother
looking like she's been beaten up, will be," she says. Small
children are "concrete" and "sensible" and think "you go to a
doctor because you're hurt or sick," she says. After considering
how their children might react, she says that "some mothers may
realize that the total burden of the child's anxiety might be a
side effect of the procedure they hadn't quite thought through and
that might inspire them to postpone it until the child is
older."
Despite the marketing nickname "mommy makeover,"
which can sound like a trip to a day spa, these are serious
surgeries with potential complications that can require additional
procedures—and disruption for kids. With breast augmentation, for
example, the initial operation is not likely to be the last.
Implants may last 10 or more years, but they do not last a
lifetime,
according to the FDA. About a quarter of all implant patients
have to have another operation within five years due to problems
like leaking, breast asymmetry and encapsulation of the
implants.
Then there are the body image issues raised by cosmetic
surgery—especially for daughters. Berger worries that kids will
think their own body parts must need "fixing" too. The surgery on a
nose, for example, may "convey to the child that the child's nose,
which always seemed OK, might be perceived by Mommy or by somebody
as unacceptable," she says.
The book doesn't go into any medical detail. "They should do
more about what the surgery is," says my own eight-year-old
daughter. "Kids," she says, will want to know more about "what
they're going to do to you." But on the other hand, if they knew
more about the procedures they might not want their mothers to go
through with them. As my daughter points out, "a five-year-old is
going to be horrified that their mom is getting water balloons put
in her breasts."
Salzhauer knows that not everyone will like his book. "There's a
good percentage of your readers who are dead set against plastic
surgery, who see it as a sign of the decadence of Western
civilization," he says. "But when done by a properly trained
board-certified plastic surgeon, it really does help make lives
better." Salzhauer may someday get a chance to test that theory—and
his book—at home. His wife hasn't had any work done yet but is
pregnant with her fifth child.