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Cosmetic surgery varies by region – but does Philly have a ‘look’?


To Blair Manus, beauty surgery is just one other device to take care of her look – not in contrast to train, a nutritious diet or a full night time’s sleep.

Through the years, Manus has undergone Botox remedies and filler injections in her cheeks, nostril and chin. But she does so with warning, hoping to take care of a pure look.

“I always want to look like myself – kind of a more natural, enhanced look of myself,” stated Manus, 36, of Voorhees, Camden County. “I don’t want to run into somebody that I went to high school with, who will think, ‘Wow, Blair looks completely different.'”

Her angle towards beauty procedures mirrors that of many ladies dwelling in Philadelphia and, extra broadly, the northeastern United States. They like a extra delicate look, one which retains figuring out options whereas mitigating imperfections, in accordance with plastic surgeons within the region.

Cosmetic requirements range by region, formed by various cultural values, superstar influences and even local weather variations. Los Angeles and New York have developed distinct aesthetic appears that differ significantly. The appears of different cities – like Philadelphia – are maybe much less simply distinguishable, but regional variations exist.

“I think there’s certain cultural expectations in different parts of the country in terms of societal perceptions of the way people look,” stated Dr. Ash Patel, a plastic surgeon based mostly in Albany, New York.

These expectations affect the recognition of varied beauty procedures in cities throughout america. But do not anticipate anybody in Philly to brazenly talk about the procedures they have had achieved. That principally stays taboo – one other angle emblematic of the Northeast.

“Most of my friends like the natural look,” Manus stated. “I’m probably the only one who goes around talking about it. I’m like a walking commercial. Anything I love, I want to talk about.”


Three years in the past, The Hollywood Reporter requested plastic surgeons to explain the variations between the so-called L.A. and New York faces.

Ladies in Los Angeles desired a extra female look – greater lips, slender noses and lifted foreheads, plastic surgeons stated. Against this, New Yorkers sought a extra pure look outlined by stronger jaws, chins and noses.

But what about Philadelphia?

“I don’t think there’s one standard Philadelphia look,” stated Ryan Heffelfinger, co-director of the Herbert Kean Middle for Facial Aesthetics at Thomas Jefferson College. “I think that people, for the most part, in our area like to keep what defines them, to a certain degree.

Ryan_HeffelfingerRyan_HeffelfingerCourtesy of/Jefferson Health

Dr. Ryan Heffelfinger

“I’ve had individuals – even women who had a big hump on their nostril – who requested to not have the hump completely decreased. As a result of their mother and pop have it, or their sisters, they usually do not need to lose the household id. Our go searching right here is to look extra pure.”

To a sure extent, aesthetic requirements are pushed by a metropolis’s cultural values. Philly retains a working class vibe.

“In Los Angeles, there’s not the taboo on plastic surgery that traditionally has been the case in Philadelphia,” Heffelfinger stated. “I think in New York, it’s probably more accepting. Philly is a blue-collar town.”

But, these taboos are loosening, in line with Heffelfinger and different plastic surgeons. And the marketplace for beauty procedures is rising, notably as new applied sciences allow a extra pure look and sure facial procedures garner extra media consideration.

“If I had a patient of mine come in five years ago, they would typically just want to do one injection – and very conservatively,” stated Dr. Ivona Percec, affiliate director of beauty surgery at Penn Drugs. “Now, I have patients coming in asking me to do cheeks, lips, everything. They’re much more comfortable knowing they’ll get a more natural look than they would have five years ago.”

New, extra pure choices for breast augmentation and different widespread beauty surgical procedures have elevated her shopper’s consolation ranges with such procedures, Percec stated. One in every of her fastest-growing procedures is labiaplasty, a discount of the inside pores and skin surrounding the vulva.

“I think the comfort zone of Philadelphia is increasing,” Percec stated. “I don’t think it’s ever going to be a place that’s going to be overdone.”

Botox_treatment_LondonBotox_treatment_LondonPA Pictures/Sipa USA

In colder areas, individuals are likely to pay extra consideration to their faces than they do their butts or breasts, says Dr. Ryan Heffelfinger, co-director of the Herbert Kean Middle for Facial Aesthetics at Thomas Jefferson College. On this image, a London lady receives a pores and skin rejuvenation remedy.


Annually, the American Society of Plastic Surgeons releases an annual report that features a breakdown of beauty procedures per region. The info presents a glimpse into the best way beauty beliefs range throughout the USA.

Final yr, breast enhancements, liposuctions, rhinoplasties and eyelid surgical procedures all ranked among the many prime procedures in every of the 5 areas outlined by the society. Amongst minimally-invasive procedures, Botox remedies, chemical peels, laser hair removing and smooth tissue fillers every landed among the many commonest procedures in each region.

Nonetheless, about one-third of all procedures have been carried out within the West, with the Northeast and South Atlantic areas every comprising about one-fifth of all procedures. Maybe unsurprisingly, the Higher and Decrease Midwest areas accounted for the fewest procedures.

“It’s actually less nowadays of Jennifer Aniston’s nose and people like that. I don’t see as much celebrities. It’s more Facebook pictures or Instagram pictures of noses they’ve liked.” – Ryan Heffelfinger, Thomas Jefferson College 

“I think there’s definitely a geographic preference for an aesthetic look,” Percec stated. “Certainly, in Southern California, we kind of have the extreme of what’s being done in plastic surgery from an aesthetic standpoint. Like the ‘Kylie Lip’ has become huge and now a term we use very frequently,” referring to Kylie Jenner of the Kardashian clan.

“I think some of those trends trickle to us, but I think the Northeast is certainly a lot more conservative.”

Amongst particular surgical procedures, breast augmentations, tummy tucks and liposuction have been much more widespread out West, in line with the report, which relied on member surgeons to precisely report their very own knowledge. So have been facelifts, eyelid surgical procedures and chin enhancements.

Rhinoplasties and lip enhancements have been commonest within the Northeast, as have been breast discount surgical procedures in males. For no matter cause, butt lifts have been commonest within the Higher Midwest.

The hole closed a bit when contemplating minimally-invasive procedures. Almost as many delicate filler injections have been carried out within the Northeast because the West. Botox remedies and chemical peels weren’t too far behind.

Ivona_PercecIvona_PercecCourtesy of/Penn Drugs

Dr. Ivona Percec

“The cold weather states, it seemed like people cared more about their face,” Heffelfinger stated. “In the warmer ones, they cared more about their butts and breasts. I think that rings true in Philadelphia, given that we have cold weather for much of the year.”

In Philly, the look of the face and nostril typically supersedes consideration to breasts and butts, Heffelfinger stated.

Equally, Percec stated face and eyelid lifts, in addition to injectables, rank amongst her commonest procedures. She additionally frequently does breast augmentations, but she stated most girls usually are not requesting giant, unnatural breasts.

“If you look at the way Philadelphia dresses, most of them are not very exposed,” Percec stated. “You’re not seeing people walking around in little gold stilettos and skimpy dresses in Center City. That’s just not what we see. If you’re walking down Beverly Hills, you’re going to see a little different profile.”


Even inside Philadelphia there are totally different aesthetic requirements, Percec stated. Foremost Line and Rittenhouse Sq. residents are typically extra conservative of their strategy and fewer prepared to confess they have undergone beauty surgical procedures.

Against this, Percec stated, Society Hill residents have a longer historical past with beauty surgical procedures and injectables. In the meantime, neighborhoods recognized for his or her hipster populations, like Fishtown, largely keep away from it.

“I think we have pockets of the city that have an up-and-coming aesthetic and others are more conservative,” Percec stated. “Each area is going to behave a little differently.”

But, over time, Percec anticipates geographic variations might grow to be extra minimized – notably on a nationwide degree. Social media might play a massive position in that transition.

Sufferers commonly convey footage of individuals whose options they hope to emulate, surgeons stated. Celebrities like Blake Energetic, Jenner and her Kardashian siblings maintain appreciable affect. But social media allows individuals to deliver footage of on a regular basis individuals whose options they admire.

“It’s actually less nowadays of Jennifer Aniston’s nose and people like that,” Heffelfinger stated. “I don’t see as much celebrities. It’s more Facebook pictures or Instagram pictures of noses they’ve liked.”

“As a plastic surgeon, what we try to tell people about cosmetic surgery is this is not vanity. It’s about people wanting to feel better about themselves, gaining self-confidence.” – Dr. Ash Patel

Extra sufferers are requesting surgery in hopes of enhancing the best way they seem in selfies, based on a research revealed in August. The researchers discovered footage with filtered faces negatively influence self-worth, probably even inflicting physique dysmorphic dysfunction.

Because of social media and video platforms like FaceTime and Skype, Patel stated individuals probably see extra photographs of their faces than in earlier many years. That, he steered, has made them extra self-conscious.

“I think people have become more conscious of their noses,” Patel stated. “I think they’ve been more conscious of the way their chins look and even the fat underneath their chin going into their neckline.”

But, Patel stated plastic surgeons should mood sufferers’ expectations, reinforcing that everybody is totally different and that beauty surgery can’t utterly rework somebody’s look.

“As a plastic surgeon, what we try to tell people about cosmetic surgery is this is not vanity,” Patel stated. “It’s about people wanting to feel better about themselves, gaining self-confidence.”

Carroll - Plastic SurgeryCarroll - Plastic SurgeryThom Carroll/PhillyVoice

Blair Manus says she views beauty remedies as one other software to take care of her greatest look – identical to exercising and maintaining a healthy diet.


That’s precisely why Manus stated she undergoes beauty procedures.

“If there’s something that you feel insecure about, or you don’t like about yourself, I think cosmetic surgery, within reason, is a way to make yourself feel better about yourself,” she stated.

As a saleswoman, Manus sits in entrance of individuals day-after-day. And she or he needs to look her greatest.

That is why she sometimes sees Dr. Howard Krein, a plastic surgeon at Jefferson Well being whom she trusts will assist her keep a pure look. Beneath his watch, she makes use of Botox to melt wrinkles and fillers to realize a extra symmetrical look to her face.

“I really look at getting injections as doing something to take care of yourself – much like eating healthy, getting enough sleep and working out,” Manus stated. “I’m a full-time, working mother. Sleep isn’t something I have the luxury of doing eight hours a night. I think this is a great way of getting the bright-eyed and bushy-tailed look.”

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