16 Behind-the-Scenes Secrets of Plastic Surgeons

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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.

10 Secrets of Victoria’s Secret Employees

A Victoria's Secret retail store in an airport mall
A Victoria's Secret retail store in an airport mall
studioportosabbia/iStock via Getty Images

Victoria’s Secret was born out of an awkward shopping experience. Roy Raymond didn’t feel comfortable browsing for underwear for his wife at a department store, and he wanted to create a more upscale lingerie destination that was welcoming to both men and women. The first Victoria’s Secret location opened in Palo Alto, California, in 1977.

In the 40-plus years since, Victoria’s Secret has changed the fashion industry, launched the careers of supermodels, and made shopping for bras slightly less awkward for the people who don’t wear them. Behind the company’s success are the sales associates responsible for keeping panties neatly folded and finding customers bras that fit correctly. Employees may confess they don't really know what Victoria’s secret is, but they can tell you how to get them to let you shop in peace, where to go if they don’t have your size, and more insider information. We spoke with a couple of former employees to discover their most revealing insights.

1. Victoria’s Secret employees are trained to fit all body types.

The clientele of Victoria’s Secret is diverse, and employees are trained to help every person who comes into the store find a bra that fits them. According to Andrea, who worked at Victoria's Secret from 2015 to 2019, bra fitting specialists undergo about six weeks of training to prepare for almost every possible scenario.

“Whether you’re somebody who’s had a mastectomy, or somebody who’s transitioning, or somebody who’s getting a bra for the first time, that’s what we’re there for and that’s why we do our jobs,” she tells Mental Floss. “Let’s say you have somebody who had a mastectomy. You always measure for the breast that is there. That even goes for people who have uneven breasts. So if one breast is a B-cup and the other is a C-cup, we always measure to the C-cup. Also, if you’ve just had your breasts done, like a breast lift or implants, we would measure differently for that too because the bras are going to sit differently on your chest [compared to typical fitting]."

2. Victoria’s Secret employees are allowed to suggest other stores.

There are some scenarios where the only option employees have is to admit they can’t help a customer. Victoria’s Secret only carries sizes 30A to 40DDD, and if someone comes in looking for a bigger size than what’s available, associates are allowed to send them elsewhere. Andrea says she would recommend Torrid or Soma to people in need of larger bras. “We did give other bra places business because we feel like everyone should feel good in their bra, even if it doesn’t come from us," she says.

3. At least in the past, being conventionally attractive helped you get hired at Victoria’s Secret.

The Victoria’s Secret image is synonymous with ultra-thin supermodels strutting down a runway in lingerie and high heels. The company has struggled with sales in recent years, and some industry experts blame that in part on the brand’s limited view of what's considered “sexy." Victoria’s Secret is trying to combat this by experimenting with marketing featuring more diverse body types, but when Rita (not her real name) worked there roughly a decade ago, the old beauty standards were still enforced. The former sales associate tells Mental Floss, “They would hire someone pretty over someone smart or capable. It was definitely part of the ‘fantasy.’”

4. If you're shopping for your partner, Victoria's Secret employees might recommend something other than lingerie.

When people come into Victoria’s Secret looking for a gift for their romantic partner, they rarely have all the information they need. “For boyfriends, they usually never know their girlfriend’s size. Like, ever,” Andrea says.

Even a professional bra fitting specialist can’t guess someone’s exact size based on sight alone. That’s why employees might recommend skipping the intimates altogether and considering alternative gifts if you’re shopping for someone else at Victoria’s Secret. “For dudes shopping for their ladies, unless you know for a fact what their size is, do not buy them lingerie,” Rita says. She suggests gift cards, lotions, and body sprays as safer options. And if you’re absolutely set on getting your significant other something they can wear, Andrea recommends panties and bralettes, which tend to be more forgiving in the size department than underwire garments.

5. The people who work at Victoria’s Secret see more than they want to.

Employees at the chain want their customers to feel comfortable, but in some cases, guests can get too comfortable. Rita recalls a woman who shared a little too much when shopping for intimate wear. “She'd just reconnected with her high school sweetheart—she was probably in her forties/fifties—and she made a point to mention her recent boob job. Then all of a sudden she basically flashes me in the front of the store. ... It was definitely not a normal customer interaction.”

Some stories of unusual customer behavior are not for the squeamish. Andrea recounts one such example: “I had a woman come up to me and say, ‘Do you have a cup?’ And I was like ‘No ma’am, I’m sorry, I don’t have a cup. What do you need it for?’" The woman replied that she really needed to urinate. "And I was like, ‘Ma’am!’”

On a different occasion, a customer of Andrea's found a creative use for one of the pink bows used to decorate the bras. “She takes it and she flossed her teeth with it in front of me. I was like ‘No!’ It’s so gross.”

6. Victoria’s Secret employees get sweet perks.

If they’re willing to deal with the occasional gross encounter, Victoria’s Secret employees can take advantage of benefits many retail workers don’t get. One of them is paid time off. “Even though I was only a part-time associate, because I worked so many hours, they did give me paid time off,” Andrea says. “Most places I’ve worked for, you only get paid time off if you’ve been there for a year or are a full-time associate, so being a part-time associate and being able to have paid time off without being there for a year is really rare and something that we really appreciated as associates.”

The pay is also competitive compared to similar businesses. According to Andrea, “Victoria’s Secret has a yearly raise, and I went from making $11.50 to $22.14 when I left [after four years].”

7. The holidays at Victoria’s Secret are as crazy as you’d expect.

Victoria’s Secret has been known to ring in the holiday season with deals designed to lure customers into stores. For shoppers, this means cheap bras, but for associates, it means congestion, disorganized displays, and the rare scuffle. “Holiday time is crazy,” Andrea says. “I’ve literally seen grandmas punch each other in the face.”

8. There’s a trick to getting Victoria’s Secret employees to leave you alone.

To shy shoppers, or those just craving a bit of peace, there are no worse words in the English language than “What brings you in today?” If the thought of getting this question from a Victoria’s Secret employee fills you with dread, know that it isn’t their goal to harass you. “It’s not that we want to bother you, that’s what we’re supposed to do,” Andrea says. “And most likely we don’t want to come up to you as much as you don’t want us to come up.”

But if you ever do get over-eager sales associates, Andrea has an insider’s tip for getting them off your back. “A good trick if you don’t want help is to remember the name of the person who you’re introduced to. So if the first person is like ‘Hi, my name is Stephanie,’ and then two or three more people come and say ‘Do you need more help?’ just say ‘Stephanie’s helping me, thank you,’ and they will leave you alone.”

9. Victoria’s Secret smells like body spray for a reason.

If you’d rather shop for lingerie without walking through a cloud of perfume, too bad: Spritzing the store with the brand’s latest scent is part of the job for sales associates. Rita says, “If we were working the front rooms, we had to wear ‘beauty belts’ with the latest body spray in them to spray around the room (cue the headache) and carry around the newest bra." And in case the constant spraying wasn’t aggressive enough already, Rita was also instructed to pitch it to customers—along with apparel and the Victoria’s Secret credit card. “We basically had to accost anyone who walked in with ‘Have you seen the new bra? Have you smelled the new perfume? Do you have the angel card? Why not? Don't you want exclusive offers? Blah blah blah blah,’ and it scared a lot of people off.”

10. Victoria’s Secrets ends up with items it can’t sell.

Victoria’s Secret has a generous policy when it comes to returns: Stores offer a full refund for items brought back within 90 days of purchase as long as you have a receipt (without a receipt, the policy may vary). According to Rita, some customers take advantage of this policy by bringing back garments that are clearly not fit to be resold. “People will try to return anything, claiming they just bought it last week and it ‘just didn't work out’ when it's clearly not a bra we even carry anymore and it's super worn and gross.”

Some customers ruin clothing without buying it first. “The worst part was having to damage out [retail slang for swapping out an irreparable item] underwear that girls had tried on without leaving their own underwear on," Rita says. "Happened all the time. It was absolutely disgusting.”

13 Secrets of Halloween Costume Designers

vadimguzhva/iStock via Getty Images
vadimguzhva/iStock via Getty Images

For consumers, Halloween may be all about scares, but for businesses, it’s all about profits. According to the National Retail Federation, consumers will spend $8.8 billion this year on spooky goods, including $3.2 billion on costumes. “It’s an opportunity to be something you’re not the other 364 days of the year,” Jonathan Weeks, founder of Costumeish.com, tells Mental Floss. “It feels like anything goes.”

To get a better sense of what goes into those lurid, funny, and occasionally outrageous disguises, we spoke to a number of designers who are constantly trying to react to an evolving seasonal market. Here’s what we learned about what sells, what doesn’t, and why adding a “sexy” adjective to a Halloween costume doesn’t always work.

1. Some Halloween costumes are just too outrageous for retail

For kids, Halloween is a time to look adorable in exchange for candy. For adults, it’s a time to push the envelope. Sometimes that means provocative, revealing costumes; other times, it means going for shock value. “You get looks at a party dressed as an Ebola worker,” Weeks says. “We have pregnant nun costumes, baby cigarette costumes.” The catch: You won’t be finding these at Walmart. “They’re meant for online, not Spencer’s or Party City.”

2. … but there are some lines Halloween costume designers won’t cross.

Although Halloween is the one day of the year people can deploy a dark sense of humor without inviting personal or professional disaster, some costume makers draw their own line when it comes to how far to exceed the boundaries of good taste. “We’ve never done a child pimp costume, but someone else has,” says Robert Berman, co-founder of Rasta Imposta. Weeks says some questionable ideas that have been brought to the discussion table have stayed there. “There’s no toddler KKK costume or baby Nazi costume,” he says. “There is a line.”

3. Designers can produce a Halloween costume in a matter of days.

A lot of costume interest comes from what’s been making headlines in the fall: Costumers have to be ready to meet that demand. “We’re pretty good at being able to react quickly,” says Pilar Quintana, vice-president of merchandising for Yandy.com. “Something happening in April may not be strong enough to stick around for Halloween.”

Because the mail-order site has in-house models and isn’t beholden to approval from big box vendors, Quintana can design and photograph a costume so it’s available within 72 hours. If it's more elaborate, it can take a little longer: Both Yandy and Weeks had costumes inspired by the Cecil the Lion story that broke in July 2015 (in which a trophy hunter from Minnesota killed an African lion) on their sites in a matter of weeks.

4. Beyonce can help move stale inventory.

Extravagant custom tailoring jobs aside, Halloween costumes are a business of instant demand and instant gratification—inventory needs to be plentiful in order to fill the deluge of orders that come in a short frame of time. If a business miscalculates the popularity of a given theme, they might be stuck with overstock until they can find a better idea to hang on it. “[In 2016] we had 400 or 500 Zorro costumes that we couldn’t sell for $10,” Weeks says. “It had a big black hat that came with it, and I thought, ‘That looks familiar.’ It turned out it looked a lot like the one Beyonce wore in her ‘Lemonade’ video.” Remarketed as a "Formation" hat for Beyonce cosplayers, Weeks moved his stock.

5. Women don’t usually wear masks as part of their Halloween costumes.

Curiously, there’s a large gender gap when it comes to the sculpted latex monster masks offered by Halloween vendors: They’re sold almost exclusively to men. “There just aren’t a lot of masks with female characters,” Weeks says. “I don’t know why that is. Maybe it’s because men in general like gory, scary costumes.” One exception: Hillary Clinton masks, which were all the rage in 2016.

6. Food costumes are always a hit for Halloween.

At Rasta Imposta, Berman says political and pop culture trends can shift their plans, but one theme is a constant: People love to dress up as food. “We’ve had big success with food items. Bananas, pickles. We did an avocado.”

7. Adding ”sexy” to a Halloween costume doesn’t always work.

It’s a recurring joke that some costume makers only need to add a “sexy” adjective to a design concept in order to make it marketable. While there’s some truth to that—Quintana references Yandy’s “sexy poop emoji” costume—it’s no guarantee of success. “We had a concept for ‘sexy cheese’ that was a no-go,” she says. “'Sexy corn’ didn’t really work at all. ‘Sexy anti-fascist’ didn’t make the cut this year.”

8. People ask for some weird stuff when it comes to Halloween costumes.

In addition to monitoring social media for memes and trends, designers can get an idea of what consumers are looking for by shadowing their online searches. Costumeish.com monitors what people are typing into their search bar to see if they’re missing out on a potential hit. “People search for odd things sometimes,” Weeks says. “People want to be a cactus, a palm tree, they’re looking for a priest and a boy costume. People can be weird.”

9. Halloween costume designers have workarounds for big properties.

Go out to a Halloween party over the past few years and you’re almost guaranteed to run into the Queen of the North. But not every costume maker has the official license for Game of Thrones. What are other companies to do? Come up with a design that sparks recognition without sparking a lawsuit. “Our biggest seller right now is Sexy Northern Queen,” Quintana says. “It’s inspired by a TV show.” But she won’t say which one.

10. People love sharks.

From the clunky Ben Cooper plastic costume from 1975’s Jaws to today, people can’t seem to get enough of shark-themed outfits. “We do a lot of sharks,” Berman says. “Maybe it’s because of Shark Week in the summertime, but sharks always tend to trend. People just like the idea of sharks.”

11. Dead celebrities mean sales.

It may be morbid, but it’s a reality: The high-profile passing of celebrities, especially close to Halloween, can trigger a surge in sales. “Before Robin Williams died, I couldn’t sell a Mork costume for a dollar,” Weeks says. “After he died, I couldn’t not sell it for less than $100.”

12. The Halloween costume business profits from people shopping at the last minute.

Ever wonder why food and other novelty costumes tend to outsell traditional garb like pirates and witches? Because costume shopping for adults is usually done frantically and they don’t have time to compare 25 different Redbeards. “People tend to do it at the very last minute, so we want something that pops out at them,” Berman says. “Like, ‘Oh, I want to be a crab.’”

Weeks agrees that procrastination is profitable. “We make a lot of money on shipping,” he says. “Some people get party invites on the 25th and so they’re paying for next-day air.”

13. It’s not actually a seasonal business.

Everyone we spoke to agreed that the most surprising thing about the Halloween business is that it’s not really seasonal on their end. Costumes are designed year-round, and planning can take between 12 and 18 months. “It’s 365 days a year,” Quintana says. “We’ll start thinking about next Halloween in December.”

This piece was first published in 2017 and republished in 2019.

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