True Beauty

The body: make one part bigger, another section smaller. The skin: Inject it. Laser it. Make the individual elements of the body more perfect as defined by either personal standards or societal expectations. Or, defy societal expectations. Stick it with permanent holes, fill with metal. Take a different type of needle, dip it in ink and watch it poke the surface of the skin, altering the pigmentation with an endless array of colors.

Hair: make it shorter, make it longer. Dye it darker, dye it lighter; maybe every strand on the head or maybe go for subtle highlights. Body hair: remove it, one hair at a time with a machine or in waxy strips by a professional.

These alterations go by many names: cosmetic surgery, plastic surgery, body modification, hair cut and color, but the smorgasbord of options for anyone to change the way he or she looks is endless. Like choosing from a menu a la carte, you can find something to change- simply pick a price, an area of the body, and the degree of permanence. It's that easy.

Tulsa flourishes with businesses that meet these ever-changing needs. Hair salons, tattoo and piercing parlors, plastic surgery practices and medical spas are popping up throughout the city and thriving as the clientele grows.

The American Society for Aesthetic Plastic Surgery (ASAPS) reported that 11.7 million cosmetic surgical and non-surgical procedures were performed in the United States in 2007. Tulsans have certainly contributed to this number, with the most popular augmentations being those that start two at a time.

Rhonda Whitlock, the wife of Dr. Bryan Whitlock and a registered nurse and CEO for Whitlock Cosmetic and Reconstructive Surgery, said that nearly 1 in 4 women visiting his practice come for a breast augmentation. This number correlates closely with the national average; the ASAPS reports that breast augmentation is the second most popular surgery, with liposuction coming in first.

Lipo, once a risky procedure, is now safer with the less-invasive "smart lipo." The list of areas that can be treated with smart lipo reads like a 'who's who' of places to suddenly feel self-conscious about: neck, jaw line, arms, breasts, 'bra fat,' abdomen, 'love handles,' 'saddle bags,' inner and outer thighs and knees. Liposuction is still one of the more popular procedures performed in Tulsa, but breast augmentation -- both increasing the breast size and lifting them -- is by far the most popular.

Surgeon Laura Dill from Dr. Roger Mitchell's plastic surgery practice said that one of the top reasons Tulsa women have breast augmentations is, strangely, to be spiteful toward an ex-husband. Another reason for choosing a breast augmentation is to give women the breasts they've always wanted and never had or, for older women, to take their sagging breasts back to their youthful places on the chest.

The number of plastic surgeries fluctuates throughout a given year.

Both Whitlock and Dill asserted that many of the procedures done aren't about giving patients radical new looks, but about re-creating a look they once had. Whitlock said the worst thing a person can hear post surgery is "Who are you?" Rather, patients should hear things like you look "rested," "prettier," "younger," "like you just got off vacation." While plastic surgery aims to make you "a better you," that's not to say that people aren't bringing in photos of celebrities requesting customized faces and bodies.

Down Payment

Plastic surgery and the less radical medical spa treatments (Botox, collagen injections, facials involving lasers, chemical peels, hair removal) are growing in popularity because they are becoming simple, uncomplicated procedures. Patients who approach Dr. Whitlock and Dr. Mitchell have already committed themselves to a procedure by the time they set foot in the door.

With the Internet, patients have done most the bulk of the research; they know the required steps, the risks and the post-op expectations. Most have already examined several pre and post-op photos. By the time they enter the doctor's office, patients simply want to check out the staff and facilities to ensure it's an environment in which they feel safe.

And because all procedures are outpatient and require a recovery time of two weeks or less, plastic surgery is no longer taxing on a patient's personal time. Medical spa treatments are easier to manage due to minimal inconvenience to the patient. The downside is that many medical spa procedures require multiple trips.

Laser hair removal requires three to four sessions before results are complete. Botox and microdermabrasion, depending on the patient's individual physiology, generally need maintenance every three to four months. Procedures typically sought by middle aged customers to repair the signs of aging have seen a surge of women in their 20s having them done as a preventative measure for the future. Taken to stay out from under the knife, it's a risky wager -- 30 plus years of quarterly Botox injections versus one facelift at 50.

As opportunities to finance a cosmetic procedure increase, patient numbers also increase. Cosmetic surgeries are so popular nowadays because they are more affordable. According to the ASAPS, Americans spent a total of $13.2 billion on cosmetic procedures in 2007.

Just as the stigma of plastic surgery is downplayed among the people a patient may know, it is also not frowned upon by financial institutions. With the ability to go online and finance a surgery through a bank with little hassle significantly adds to the "pros" column of having a procedure done. As Whitlock explained, "$4,000 for breast augmentation seems more affordable when reworded as a finance of $99 per month, interest free when paid out over a two-year course."

Injections that require consistent upkeep during the years average around $60 per month. Whitlock said that people now look at these maintenance costs as an investment. Rather than putting money toward a new car every few years or investing further into a home, people invest in their bodies. By breaking down these formerly expensive sums for elective surgery, people approach a breast augmentation or liposuction as something affordable...if they just skip eating out a few times per month or opt for fewer drinks on weekends.

This accessibility to face and body change must be doing wonders for future generations. This past April, a new children's book, "My Beautiful Mommy," put television commentators up in arms. The book teaches children about what to expect when Mommy goes in for a minor cosmetic procedure. Plastic surgery is certainly not the cause of children as young as eight years old disliking the way they look. Plastic surgery is also not the only reason why many girls ask for breast augmentation as a high school graduation present. People will forever have self-esteem issues about their appearance, but does a licensed professional admitting that they can make someone look better resolve that self-consciousness or increase it?

Plastic surgery could be perceived as the silver lining, the salvation for someone who truly is unhappy with his or her appearance or as the dark grey cloud that hangs overhead telling a person that they don't look good enough yet.

A story from the "News of the Weird" section (found in the back of this paper) a month ago told about a 48-year-old South Korean woman addicted to being "under the knife." Obsessed for more than 20 years, Hang Miroku moved from South Korea to Japan for better access to surgery and said she had convinced herself that each procedure in her odyssey only made her more beautiful than the last. Upon her return to South Korea, one doctor gave her a syringe and silicon; when the silicon ran out, she resorted to injecting cooking oil into her face.

Nationally, plastic surgery for men increased 17 percent from 2006 to 2007; Dr. Whitlock's ratio of men to women reflected the national average. Whitlock noted that, of his clients, men represent 10 percent of the plastic surgery and 25 percent of the medical spa practice. Likewise, men account for nine percent of plastic surgery procedures in the U.S., reports the ASAPS. Tulsa men receiving medical spa treatments choose Botox, waxing, laser facial treatments, electronic hair removal and injections.

For plastic surgery, Tulsa men want liposuction, primarily on the "beer belly" and on their breasts. It has been suggested by medical professionals that increased acceptance among men taking to cosmetic procedures is a newly created bonding experience; men and women come in together to change their appearance; the couple essentially de-ages together.

Both Whitlock and Dill said that plastic surgery loses the stigma it once had as a hush-hush topic. Men and women freely admit to the work they've had done, almost bragging, telling family and friends of their latest procedure.

The Daily Grind

Nothing is more day-to-day for women than the application of makeup. Like any other pesky beauty regimen, this too can be made easier by a professional. Those who want visible abs without the daily crunches go for lipo; those who want rimmed eyes without the application of eyeliner go for permanent makeup.

Also known as cosmetic tattooing, this practice gives the appearance of continual eyeliner, lip color, eyebrow shape, hair imitation, beauty marks and lash enhancement. Ranging in price from $500 to $800, the procedures are as permanent as any tattoo but may fade in time, therefore requiring retouching. What's interesting is why a person might opt for one of these procedures.

The Society of Permanent Cosmetic Professionals said that these procedures are for everyone. They note the health-related reasons, how the procedures are "beneficial to people who can't wear other cosmetics due to allergies and skin sensitivities...also the vision impaired who have difficulty applying their cosmetics, and others with motor impairments such as arthritis, Parkinson's disease, multiple sclerosis, stroke survivors, and those with unsteady hands who cannot apply their own makeup" but also a sector of people "who want to look their best for activities such as swimming, hiking, biking, tennis, aerobics, and those who don't want to worry about 'sweating off' or reapplying cosmetics." Apparently, the people still participating in aerobics are also the people that need a full face of make makeup to exercise.

Take it Further

Permanent makeup has always been legal in Oklahoma, but it wasn't until 2006 that Oklahoma became the last state in the nation to legalize tattooing. Since its legalization, the body art form has moved from underground practices in artists' homes to many legitimate businesses throughout Tulsa. Tattoos aren't judged as harshly as they used to be. The Harris Poll found in February of this year that 16 percent of Americans have tattoos. Overall, that statistic seems low, but when the numbers are broken down into age groups the figures make sense: 32 percent of Americans ages 25 to 29 have tattoos and 25 percent of people ages 30 to 39.

Interesting still is that, almost entirely across the board, the numbers for people with tattoos have decreased since the last time the Harris Poll conducted the same survey. Whether based on region of the United States, age group, gender, race, political affiliation, or sexuality all percentages decreased roughly two percent, excluding, oddly enough, the 65 and older crowd which increased two percent.

Is tattooing a trend that has run its course? Or, is it just an unfortunate stigma that exists, especially for those who have ink in the workforce? While local businesses with an eclectic clientele -- area coffee houses, salons, restaurants, or any business with a younger, hip crowd -- accept pierced and tattooed professionals, many workplaces aren't as accepting of visible tattoos. It's because of this stigma that area tattoo parlors like Just Another Hole try to dissuade their visitors from permanent ink that could hinder their careers.

Co-owner Jon Solpis works with customers to provide them with the tattoo they want as accurately as possible. His artists give patrons the tattoo they want, so long as it looks good and they abide by Just Another Hole's regulations against artwork expressing bigotry, racist symbolism or images affiliated with gangs.

The crowd is as varied as the designs, ranging from those getting their first tattoo to those returning to complete a full sleeve. Although the average age of the tattooed Tulsan is around 18, even a 78-year-old felt the need to modify his body.

While tattoos and piercings allow people to customize their bodies much like plastic surgery, the two practices differ in many ways. Some people use tattoos and piercings as a way to stand out, something that good plastic surgery should never do. Tattooing is a means of self-expression, people using their bodies as a canvas to display what they are about, from their interest in popular culture to a display of their personal faith.

Tattoos can also be a way to deal with personal achievements or tragedies. These tattoos may take the form of homage to a deceased loved one, from their name and birth/death dates to the person's image rendered on the body, as well as symbolic imagery to evoke memory. Tattoos can also represent moments in time, from a person getting a lover's name tattooed, those who with wedding bands tattooed on their finger to those celebrating their 18th birthday or the finalization of a divorce.

Others may get inked as a mantra, receiving a symbol or phrase eternally etched on their bodies. Sometimes people forget to do their homework, so the Chinese symbol that was supposed to mean "love" instead means "sandwich."

Whatever direction a person might take, like plastic surgery, it can become an addiction. Once people who experience tattooing or plastic surgery have that surge of exhilaration, repeating the process requires little encouragement.

What may also require little encouragement is the decision to remove a tattoo. The statistics vary. Some surveys suggest only 17 percent of Americans regret their tattoos, but other studies say that nearly 50 percent of Americans regret at least one tattoo. Regret and removal are two different things however, as not all regrettable tattoos will eventually be erased. Removal reasons vary, with American Society of Dermological surgery listing "social, cultural, or physical" circumstances for most tattoo removals. There are even cases where an allergic reaction can develop years after the tattoo was performed.

While removal reasons may vary, the removal itself is completed through only a few options: laser surgery, dermabrasion or surgical excision. These procedures require more time, money, pain and permanence than the tattoo itself. Scars can develop; treatments need to be performed between six and ten times and the cost of removal averages around a couple thousand dollars.

New 'Do

Removing your hair, or at least part of it, is a different story. A person's hair is like tattoos or even dressing -- another way to show a piece of the inner self. Unlike tattooing or plastic surgery that has a no-turning-back-now effect, a haircut, its color, and style offer the chance to change one's appearance without the "Oh shit!" factor.

Drastically change your hair, and you can easily change it back.

This wasn't always the case. Previously, a cut gone wrong could only mend with the passage of time. Many salons offer extensions. For women who want length or thickness and for who can spare one to four hours, extensions are the latest hair service.

Depending on how much time and money a person wants to invest, or how realistic the craftsmanship looks, one can opt for glued-in tracks or have small strands of real human hair fused to the hair shaft. The latter option, which lasts eight to nine months, is ideal for people who want results now that will last until much later. The options to change their look are still possible; coloring and any form of styling can be performed on the real fake hair.

Most people want something basic. Unlike a tattoo that can be placed in a discreet location or plastic surgery that is meant to make patients look merely "rested," and therefore unnoticeable, hair is a more prominent feature. This produces an element of conservatism in the approach to hair care, but that's not to say that all men and women need a basic cut in blonde, brunette, red, or black. Amy "June" Sanders, owner of June's Garage, has an edgier clientele. Among the doctors and other professionals who frequent her salon, there are also requests for blue Mohawks and bright red hair.

Luckily, a blue Mohawk is not permanent. Changing hair is more accessible than plastic surgery or medical spa procedures, but not necessarily cheaper. Visiting an upscale salon means spending at least $100 a visit. When some haircuts and color necessitate maintenance every six to eight weeks, it definitely adds up. In fact, YWCA recently released "Beauty at Any Cost", a report that stated women in the United States spend $7 billion a year on cosmetics and beauty products. This translates to roughly $100 per month per person.

Lookin' Good

As the economy continues to waver and people need their money to spend on groceries, gas, and not having their home foreclosed, it will be interesting to see if the popularity of aesthetic alternations continues. But it's possible that people may need to make them no matter what the personal or financial cost. Whether it's landing a job or landing a man, studies show that looks aren't just a factor, but the factor.

Many people want to pinpoint what exactly has brought on this surge in changing the bodies and faces of Americans- from women chatting at lunch to "specialists" on 24-hour news programs, and even scientific studies. Is it because of what Hollywood projects to the public, or is it the experiences people have in day-to-day life? Whether the pressure comes from keeping up with the Jones' or keeping up with the Angelina Jolies, people throw money at their perceived imperfections. There's really no telling what these people desire, as there is no definition of a perfect specimen for comparison. Acceptance within? The love of another? The sense of control? The reasons for modifying one's appearance are as varied as the procedures themselves. What can or should society do? Maybe the only thing Americans ever seem to do: seek out a professional and schedule an appointment.