16 Behind-the-Scenes Secrets of Plastic Surgeons

IStock
IStock

Our culture is pretty obsessed with what it sees in the mirror: Cosmetic procedures have risen an astounding 115 percent since 2000, with nearly 16 million procedures performed in 2015 alone. Breast augmentation, buttocks lifts, and minimally-invasive “injectables” have all conspired to literally change the shape of the male and female form.

For insight into the highly skilled hands that make these transformations possible, mental_floss spoke with several accomplished plastic surgeons about the living sculptures they create.

1. THEY SEE BEAUTY AS A MATHEMATICAL EQUATION.

Early in his career, Donald Kress, M.D., a plastic surgeon in Baltimore, Maryland, would find himself puzzled when encountering facial features he found unappealing. “I couldn’t figure out what it was,” he says, “until I’d match the face with the Golden Ratio.” The Golden Ratio, or Golden Mean, is a formula first articulated by Greek mathematician Euclid and later used to theorize that the most pleasing appearances in art and nature are created at a ratio of 1.618:1. In the 1970s, surgeon Stephen Marquardt, M.D., began to study commonly appreciated beauties like Marilyn Monroe and Sophia Loren and found the ratio applied to many seemingly universal standards of attractiveness.

Visualizing the formula using a “mask” designed by Marquardt in 1992 (above, middle) can reveal where a face is asymmetrical, though experienced surgeons can make a similar evaluation intuitively. “It comes up when you’re younger and don’t have a good eye for things,” Kress says. “After a few thousand patients, you can see it in your head.”

2. THEY HOST “BROTOX” PARTIES.

OnabotulinumtoxinA—commonly referred to by the brand name Botox—has been used for decades to paralyze muscles at a local injection site, which can prevent the contractions that cause wrinkles and frown lines. Some practices have taken to hosting the increasing number of male patients coming in by offering “Brotox parties,” where a number of friends will schedule at once to make the treatment a social event.

Z. Paul Lorenc, M.D., F.A.C.S., a plastic surgeon in New York City, says that “Brotox” is a result of men who have had a good experience recruiting their friends. “It’s kind of a support group,” he says. “They can interact in the waiting room. Men used to do this at parties, but that’s become passé. It was always a bad idea. You should never have alcohol involved.”

3. THEY’RE DRAWING LANDMARKS ON YOU.

Watch enough reality television and you’ll eventually spot a plastic surgeon taking a black marker to the bare torso of a patient. Matthew Schulman, M.D., a plastic surgeon based in Manhattan, says that surgeons are basically acting as topographers, marking areas of the body that may change shape or become less visible when a patient is lying down. “We’re drawing landmarks for ourselves because a person looks different when on the table,” he says. “I might circle where the fat is thickest, or where the nipple is while standing.” No special medical ink is used: It’s just a Sharpie.

4. BREAST IMPLANTS CAN CREATE “MOTION ARTIFACTS.”

There are several ways to insert breast implants, but Kress says that one in particular can create problems for patients who do a lot of jumping up and down. When an implant is inserted in a subpectoral incision under muscle tissue, it can give off the appearance of remaining stationary while the rest of the breast moves during physical activity, creating a visual ripple effect. “If there are big arm movements, or if they’re in front of people teaching or on television, I advise them of the potential consequences,” Kress says.

5. THEY CAN’T MAKE YOU LOOK PHOTOSHOPPED.

Schulman says that social media—especially the popularity of impeccably-proportioned Instagram models—has created a few headaches for his practice. “The problem with pictures is that they’re just a guide, but it’s not like picking a body off the shelf,” he says. “Half of the Instagram models are Photoshopped, so when you say you want to look like this, I can’t do it. I can’t give you an 18-inch waist.” Though Schulman does like having a visual reference for what patients have in mind, he prefers they understand it's a starting point, not a preview.

6. THEY DON’T WANT YOU TO LOOK GOOD ON THE TABLE.

“Everyone,” Schulman says, “looks great lying down.” But trying to achieve aesthetic perfection in the operating room is a recipe for disaster. “One of the first things we learn as plastic surgeons is that just because something looks good on the table doesn’t mean it’ll look good six months later. We want to make the result less than ideal to account for healing.” Breast implants, for example, might be placed higher than desired so they can “settle in.” Making them perfect during surgery means they’re likely to drop too low once the body recovers.

7. IT TAKES EXACTLY 90 DAYS TO GET USED TO A NEW FACE.

According to Kress, there’s a tremendous difference between a facelift and a procedure that radically alters the face. “In a facelift, you’re turning back the clock and people can adjust to it quickly,” he says. “But a new nose, a new chin, taking away a bump, you’re creating a person they’ve never seen before.” In his experience, it takes patients almost 90 days exactly to get used to the image in the mirror. “On day 87, they’ll see someone else’s chin. On day 91, it’s you. It’s freaky how accurate it is.” Kress will normally refuse to remove an implant (chin, cheeks, breasts) prior to the 90 days to account for this phenomenon.

8. MORNINGS ARE BEST FOR DETAIL WORK.

If you’re opting for cosmetic surgery and have a nose job scheduled for late in the day, you may want to reconsider. According to Kress, procedures that require fine motor skills like nose jobs, facelifts, or eyelid surgeries are best performed in the morning, while gross motor work like breast implants and liposuction can come later. “You don’t want to reverse the order because it can take between 45 minutes to an hour for fine-touch motor skills to return. I start with the most delicate surgeries first, have a good lunch, and do bodies later.”

9.  THEY CAN MAKE YOU LESS ANGRY-LOOKING.

Not all cosmetic surgery is focused on restoring the appearance of youth: Some people just want to look happier. “Many of my Botox patients coming in say that everyone thinks they’re angry all the time,” Lorenc says. “They want to correct a frown or a heavy brow.” Kress has also seen people ready to go on the job market for the first time in years who want to appear more awake—or sober. “Sometimes eyelids can make you look like you drink, or don’t get enough sleep,” he says.

10. THEY WORK WITH WITNESS PROTECTION.

That gangster-movie cliché of having to modify your face to avoid being spotted after offering damning testimony? It’s true. Kress has operated on several government witnesses, and they can forget about follow-up visits. “I’ve had Federal Marshals come in and tell me, ‘This is the only time you’re going to see this guy, so give him whatever instructions he needs,’” he says. Kress has also worked on covert military operatives who have had their name and image published in media and run the risk of being recognized. 

11. THEY HAVE SIGNATURE NOSES. (AND BUTTS.)

Many surgeons get into the cosmetic field because of an artistic impulse: They don’t want to perform cookie-cutter procedures and like to improvise. But a certain segment can also offer procedures with a dependable aesthetic outcome that becomes a kind of signature. “Some doctors are known for noses I can spot across the street,” Schulman says. “I do a lot of butt-lifts and make them look like an upside-down heart. Patients come in because they want that result.”

12. CALF IMPLANTS ARE A THING.

And not just for men, either. Lorenc regularly sees patients of both genders who want to rectify their genetic misfortune and sport shapely, powerful-looking calves. “I’m one of the few surgeons who does them,” he says. “The stereotype is that it’s only bodybuilders, but that’s not true. They make up only a percentage. Some people just can’t develop them in the gym no matter what they do.”   

13. BEING A SMOKER IS A REAL NO-NO.

One universal truth of cosmetic surgery: Operating on a smoker is never a good idea. Nicotine constricts small blood vessels, which can delay healing and open up the door for complications. “Every good plastic surgeon will require a patient stop smoking before a procedure,” Schulman says. His patients sign an agreement requiring them to cease any kind of smoking four weeks prior and for eight weeks following an operation. “They agree I can nicotine-test them [via urine] and if they’re positive, the operation is canceled and I keep their money.”

14. THEY’LL WORK ON KIDS FOR ONE REASON.

There are very few cases of surgeons electing to work on anyone under the age of 18 for purely cosmetic purposes, with one key exception: protruding ears. Kress says that ears that stick out too much can become a psychological burden and that there’s a sweet spot to get them pinned back. “Around age 5 or 6, the ear has gotten big enough to work on and see a lot of the underlying structure,” he says, “but it’s also before they get into grade school and the taunting really starts.”  

15. THEY THINK TRANSPLANTS ARE THE FUTURE.

While fat transplantation is an increasingly popular and effective alternative to artificial fillers—adipose tissue can be harvested from unwanted areas and injected into the butt or face—Schulman sees the future of plastic surgery being far more radical, and less focused on aesthetics. “I think in the next ten years, we’re no longer going to be doing reconstructive work for trauma,” he says. “If you need breast tissue after a cancer operation, it will be from a donor. Things like face transplants and hand transplants are being led by plastic surgeons, by microsurgeons. I see full limb transplants. The possibilities are endless.”

16. THEY’RE NOT REALLY STRESSED.

Lorenc finds it amusing when friends or acquaintances remark that being a surgeon must be one of the most stressful jobs you can have. “When I step into the operating room, it’s like nirvana,” he says. Barring the rare complication, no one is in critical condition, bleeding to death, or under any extreme duress. Surgeons tend to work at their own pace, sometimes with a soundtrack. “I listen to Pink Floyd, the Allman Brothers, Jimi Hendrix. Sometimes reggae.”  

All images courtesy of iStock unless otherwise credited.

Amazon's Under-the-Radar Coupon Page Features Deals on Home Goods, Electronics, and Groceries

Stock Catalog, Flickr // CC BY 2.0
Stock Catalog, Flickr // CC BY 2.0

This article contains affiliate links to products selected by our editors. Mental Floss may receive a commission for purchases made through these links.

Now that Prime Day is over, and with Black Friday and Cyber Monday still a few weeks away, online deals may seem harder to come by. And while it can be a hassle to scour the internet for promo codes, buy-one-get-one deals, and flash sales, Amazon actually has an extensive coupon page you might not know about that features deals to look through every day.

As pointed out by People, the coupon page breaks deals down by categories, like electronics, home & kitchen, and groceries (the coupons even work with SNAP benefits). Since most of the deals revolve around the essentials, it's easy to stock up on items like Cottonelle toilet paper, Tide Pods, Cascade dishwasher detergent, and a 50 pack of surgical masks whenever you're running low.

But the low prices don't just stop at necessities. If you’re looking for the best deal on headphones, all you have to do is go to the electronics coupon page and it will bring up a deal on these COWIN E7 PRO noise-canceling headphones, which are now $80, thanks to a $10 coupon you could have missed.

Alternatively, if you are looking for deals on specific brands, you can search for their coupons from the page. So if you've had your eye on the Homall S-Racer gaming chair, you’ll find there's currently a coupon that saves you 5 percent, thanks to a simple search.

To discover all the deals you have been missing out on, head over to the Amazon Coupons page.

Sign Up Today: Get exclusive deals, product news, reviews, and more with the Mental Floss Smart Shopping newsletter!

12 Secrets of Spirit Halloween Employees

Spirit Halloween stores are a sign Halloween has arrived.
Spirit Halloween stores are a sign Halloween has arrived.
Mike Mozart, Flickr // CC BY 2.0

When Joe Marver founded Spirit Halloween in 1983, he probably didn’t have any idea his seasonal Halloween store would eventually grow to over 1300 locations in the United States and Canada. But now, seeing a Spirit pop-up materialize in a vacant building has become as much of a Halloween tradition as pumpkin carving.

In order to assist shoppers with Halloween costumes, decorations, and animatronic creatures, Spirit employs a small army of seasonal workers. To get a better feel for what goes into this spooky vocation, Mental Floss reached out to several current Spirit Halloween team members. Here’s what they had to say about everything from customers making a mess to the hazards of trying on a mask during this pandemic-heavy Halloween.

1. Most Spirit Halloween employees really, really love Halloween.

Why take on a seasonal job with no potential for year-round work? If you love Halloween and the macabre, it’s a dream job. “I've never once worked with an employee that didn't love Halloween,” Kota, a five-year veteran of Spirit Halloween in Kentucky, tells Mental Floss. “It's something that all employees have in common from my experience … It's a perfect place to meet people with the same interests.”

2. Spirit Halloween employees are supposed to open costume packages for customers.

Spirit Halloween employees are happy to help with your costume selection.Courtesy of Spirit Halloween

If a Spirit Halloween employee is eyeing you with a little bit of consternation, it might be because you ripped open a costume package. Owing to issues of loss prevention and hygiene—even before COVID-19 struck—Spirit’s policy is to let employees open items and then package them back up. But not every customer is willing to wait.

“Our employees are supposed to deal with opening and closing each and every package,” Kota says. “This way we don't have to worry about things coming out or going into the packages that aren't supposed to. Although we try hard to make it as easy and friendly as possible, some customers would rather do it themselves wherever they may be standing in the store.”

3. Spirit Halloween employees can’t keep astronaut helmets in stock.

Every season brings a different phenomenon to Halloween shopping. In 2018, it was the popular video game Fortnite. This year, it’s an astronaut helmet. Not the suit, just the helmet. The trend is due to the popularity of a smartphone game titled Among Us, which puts the player in the role of a space explorer.

“Despite what you might think, the suits themselves seem significantly less popular than the helmets themselves for reasons beyond my comprehension,” Derek, a Spirit Halloween employee in New Jersey for the past three years, tells Mental Floss. “It's still just a bit too early to say, but if the helmets keep shipping out at the rate they are, in-store stock will probably remain at a near-constant zero. If I'm recalling it right, all of the stores in my area currently have one helmet if any, and no more than five are being shipped to each store.”

4. Spirit Halloween employees can’t believe customers are still trying on masks.

It's probably not a good idea to try on Halloween masks this year.Mike Mozart, Flickr // CC BY 2.0

Despite newfound concerns over touching surfaces or being exposed to infectious particles, customers are still willing to try on masks in the store, even though someone else may have already been wearing it. “Ultimately the pandemic hasn't affected my store, aside from everyone needing to wear face masks while they're inside,” Jayme, a Spirit Halloween employee in Florida who’s worked there for four years, tells Mental Floss. “But people still ask to try things on and … they do still put masks on despite orange signs everywhere saying not to.”

Derek agrees. “If you've bought a mask from Spirit in any of the past seasons, there's a very high chance you're one of at least five people who’s worn that mask, and that's a conservative estimate for some of the masks. Despite the rule, I think I've seen that many people trying on [fictional creepypasta internet character] Jeff the Killer masks just in this past week.”

5. Spirit Halloween employees have seen some spooky things.

While a store full of scary costumes and props is a Halloween lover’s dream, some Spirit Halloween employees say it can also be the site of some spooky events. “An associate and I have both seen things swaying on the shelves as if someone walked by it, though nobody else is in the store,” Jayme says. “We've seen a few shadow movements as if people were hiding behind [a] corner. The funniest one [was] at closing time. One of my associates yelled ‘whoo’ and we heard a guy's voice say something in response. It totally freaked him out. It was one of our sound-activated hanging [animatronics].”

But not all employees get creeped out. “As much as I want to say that I've experienced anything creepy or paranormal, the store's about as creepy as a former Circuit City can be,” Derek says. Still, he's seen some strange things. “The lights used to turn off at the exact same time every day for about a month, there's always been the occasional inexplicable bang or creak, and some of the aisles do get messy a bit too quickly. One time, I was working at the fitting room. I sent a kid back with a previously unopened, dry Morphsuit costume [a full-body spandex outfit] and it came back warm and moist.”

Wet costumes aside, Derek won’t declare any paranormal activity just yet. “If I see a kid go flying across the store, I'll let you know.”

6. Spirit Halloween employees wish customers would stop making a huge mess.

Spirit Halloween employees like to keep stores neat.Courtesy of Spirit Halloween

Owing to the nature of pop-up stores or the excitement over the holiday, customers at Spirit Halloween stores tend to make messes. Big ones. “You could've just finished putting every mask neatly back on the racks, and half of them will be back on the floor before you've caught your breath,” Derek says. “It seems like everyone takes a little pride in the sections they helped set up and the animatronics they built, and that definitely manifests in how we feel about customers messing with those things.”

7. Spirit Halloween employees would prefer you not use the aisle as a dressing room.

Some customers like to try on outfits in the aisle instead of the dressing room, a habit that predated the current pandemic. (Spirit Halloween fitting rooms are closed this season.) Employees would still prefer you not try to dress—or undress—in the middle of the store. “It's very common to find people, mostly kids, trying on costumes in aisles,” Kota says. “We [did] have multiple fitting rooms to try to stop this from happening, but once again, people would rather do things themselves sometimes.”

8. Spirit Halloween employees move a lot of licensed animatronics.

Animatronics are a popular item at Spirit Halloween.Courtesy of Spirit Halloween

Among the most popular items in Spirit Halloween locations are the life-sized animatronics that provide a scary atmosphere for homes or parties. “Animatronics are one of our largest-selling items,” Kota says. “There's a certain group of people that love them and look forward to them annually. Some of our buyers buy them and use them for their haunted attractions. It's always nice to go to one and see a familiar face.”

While Spirit offers a number of original animatronic concepts—the Harvester of Souls being among the more popular—Kota says that customers usually gravitate toward licensed characters. “I've noticed that the most popular animatronics are our licensed ones. Pennywise [from 2017's It] and Sam [from 2007's Trick 'r Treat] have been huge sellers this year as was Michael Myers a few years ago. I've also noticed the ones that stay behind at the end of the season are almost always the swinging animatronics. I think they're interesting, but they don't sell as often as the others do.”

9. Spirit Halloween employees might sell you a used animatronic, but you need to get lucky.

Come the end of the season, Spirit Halloween locations often unload animatronics that were on display and no longer being manufactured. “Older animatronics, if I recall correctly, will stop being manufactured and then sold until it runs out,” Jayme says. “As for the displays, we do sell those at the end of the season. It's just a matter of putting your info on a waiting list.”

10. Spirit Halloween employees meet a lot of cosplayers.

Cosplayers are frequent shoppers at Spirit Halloween.Mike Mozart, Flickr // CC BY 2.0

It’s not just Halloween customers that Spirit Halloween stores service. According to Kota, cosplayers looking for that perfect accessory sometimes show up. “Spirit actually gets quite a bit of cosplayers and I personally think it's a great place to go for more specific items,” Kota says. “I'm sure we get even more cosplayers than I'm aware of since some customers like to talk about it and others don't say much about it.”

11. Spirit Halloween employees get a steep, steep discount once Halloween is over.

Between the standard employee discount and the after-Halloween fire sale available to customers, Derek says that he can go shopping in November and save a considerable amount of money. It’s one reason he keeps coming back. “It's hard to say no to an 80-percent discount during the November clearance sale,” he says. (The regular discount is 50 percent, and employees get an additional 30 percent.) “There's nothing like rewarding yourself after a busy season by spending $150 on, like, five or six things.”

12. Spirit Halloween employees sometimes get holiday shoppers.

Halloween means holiday shopping for some people.JJBers, Flickr // CC BY 2.0

For some customers, a Spirit Halloween store is a perfect place to start their holiday gift shopping. “I made a friend last year with a kid who comes in weekly to see if we have anything new in yet,” Kota says. “He's maybe about 7 years old and [he] and I go around the store almost every time he comes in and talk about new things and animatronics we have. His parents then secretly go around and buy him animatronics and props as Christmas presents. It's so nice to see his love for Halloween all year round. It reminds me of myself when I was his age.”