Men Are Stupid...and They Like Big Boobs: A Woman's Guide to Beauty through Plastic Surgery

Men Are Stupid...and They Like Big Boobs: A Woman's Guide to Beauty through Plastic Surgery


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Red-carpet fashion laureate, comic icon, and outspoken superstar Joan Rivers is uniquely qualified to talk about plastic surgery—because she's one of the few celebrities unafraid to admit to the world what she's “had done” to keep looking so great. Now, in this no-holds-barred book, she gives women straight-talking advice on better living through looking better.

Joan Rivers' abiding life philosophy is simple: in the appearance-centric society of the twenty-first century, beauty is key—especially where men are concerned. Men like pretty women. And so, getting something lifted, tightened, adjusted, or removed is as fundamental as wearing makeup or using hair conditioner; it's become something we do to make ourselves look better. Now, for any woman considering her options, Joan Rivers takes the mystery out of cosmetic surgery with a practical overview, aided and informed by the country's top plastic surgeons, of almost every single cosmetic procedure legally performed in America today. She takes readers step-by-step through these entire processes, from fi nding the right doctor to the bruising truth about recovery and the facts about cosmetic surgery's very real risks.

But don't worry—there's dish, too. Filled with Rivers' personal anecdotes about life under the knife, Men Are Stupid...And They Like Big Boobs is also rife with Hollywood gossip about who's done what and how often. Part comic musing, part bitch-fest, and part hands-on advice, this is a bracingly funny, wildly frank, and genuinely passionate argument for a woman's right to do whatever it takes to be beautiful, to feel better about herself, and most of all to be happy — not only with who she is, but who she wants to be. Throughout the book, Joan Rivers is right there, guiding and encouraging with no apologies, no excuses, and absolutely no shame. Take it from the woman who enjoys having it all—done.

Product Details

ISBN-13: 9781416599241
Publisher: Gallery Books
Publication date: 12/01/2009
Pages: 304
Product dimensions: 5.26(w) x 8.32(h) x 0.88(d)

About the Author

Joan Rivers was an American comedian, actress, talk show host, businesswoman, and celebrity. She was known for her brash manner and loud, raspy voice with a heavy metropolitan New York accent. Rivers was the National Chairwoman of the Cystic Fibrosis Foundation and is a board member of God's Love We Deliver. Like the ground-breaking Phyllis Diller, Rivers's act relied heavily on poking fun at herself. She died in 2014.

Valerie Frankel had published fourteen novels, four non-fiction titles, and one memoir. Her titles include: Thin Is The New Happy, The Best You'll Ever Have, Fringe Girl, Hex and the Single Girl, The Accidental Virgin, and Smart Vs. Pretty.

Read an Excerpt

One Hello, Doctor!

Once upon a time, there was an average-looking girl named Joan living with her mother in Brooklyn. Joan did not have a boyfriend or much of a social life — lately she'd been sitting home collecting more dust than a Swiffer. Concerned, her mother took Joan to see the Broadway show Grey Gardens, a lighthearted little musical about a mother and a daughter who, in their youth, had bright futures but wound up spinsters living together in a dilapidated old mansion and pretending cat food was pâté. Horrified, Joan and her mother, "Big Joan," left the show fearful of their own futures.

The next night, still worried that her daughter might wind up dancing on the front porch wearing a turban made out of a t‑shirt fastened to her head with a diamond brooch, Joan's mother settled in to watch "Extreme Makeover-Home Edition." Hours later, after the makeover's reveal and getting a tad bit tipsy on a second glass of vino, she came to an amazing epiphany: what her daughter needed was a makeover! An Extreme Makeover from the ground up! She knew her sweet, kind daughter might have a great foundation, but it was time to rip all the boards off the structure and start from scratch.

Helpfully and generously, Joan's mother suggested a head-to-toe makeover and cosmetic surgery to her loving daughter. She reached into her bra and removed wads of cash to give to her.

Joan was thrilled about the money her mother presented for her makeover, but she decided in a flash that she wasn't going to waste her inheritance on cosmetic surgery.

Even though Joan wanted to take her mother's advice, in actuality she was terrified at the thought of going under the knife. She hated knives! She had always believed knives were dangerous, which is why she had never eaten at Benihana or paid to see a Las Vegas magic act. So, Joan insisted on bypassing all professional beauty facilitators and doing the makeover herself. She was good at fixer-uppers and scrapbooking and crafting, so this should be a piece of cake, she thought. But this is where her problems began.

Quick: Name one thing that you want done really well but can't do by yourself.

Besides sex, it's cosmetic surgery. And in order to have the best result, you need a great doctor.

The most important partner you'll choose in your entire life is, hand to God, your plastic surgeon — the man or woman who holds your life and looks in his or her hands, literally. (Henceforth, I'll be using "his" and "he" for convenience, and not because I think men are better at poking, slicing, and peeling, as I don't. We all know women have excellent knife skills — ask Lorena Bobbitt.)

Why do you need to have enormous trust and faith in your doctor or dermatologist (or, as I like to call him, your beauty facilitator)? Easy. If you buy a dress and then decide it's hideous, you can return it. But if you get bum Botox Cosmetic injections, you're stuck with the Kabuki mask-like face for months. A bad hair cut is temporary; a nose job could be forever. Your choice in doctor or dermatologist is perhaps the only time in your life when you must get it right the first time.

The trick is learning how to sift through the dross to find the good guys. It's tough sledding; I know. There are so many doctors doing plastic surgery in Los Angeles that if you haven't been approached by one, you are one. The California flag has stars and sutures, for God's sake.

And New York City is just as bad. People used to shoot up heroin in alleyways. Nowadays, they shoot up Botox Cosmetic in living rooms.

You've heard plenty regarding plastic surgery train wrecks like Tara Reid and Courtney Love, about how people with all the money in the world make such bad choices when it comes to picking their doctors? The reason is simple: They don't do their homework. You, darling reader, I hope won't be as foolish. Now here's the good news: plastic surgeon homework is pretty easy. It's not calculus, people. Even a chimp — who's wanted to deal with her facial hair for years — could do the research. And what's a little legwork, if you're going to have face work?

How to Find That Great Plastic Surgeon or Dermatologist

Start by asking everyone you know. And by "everyone," I mean:

Your hair stylist. He sees the hidden scars in hairlines and behind the ears day after day. He looks down blouses for hours, even though he's got absolutely no interest. He's seen good boob jobs and lousy ones. Believe me, he's an expert on who does great work and who doesn't. And I'll bet you he can rattle off names and phone numbers.

Your primary-care doctor, or gynecologist. He sees it all, he's heard all the horror stories, seen all the successes. But beware if he recommends himself to do your Restylane or other injections. Always go with a specialist!

Friends and acquaintances. They might be a close or just a casual friend. You might feel a tad uncomfortable going up to her at a party, pointing at her boobs, and asking where she got 'em. But if she has implants, I promise you, she's not a shy type, and would probably drop her halter to let you feel them while singing the praises of her surgeon. If so, check out her scars. Take the opportunities when they come. Most women are happy and proud to share. Be aware that women will tell you who did their breasts, while looking at you through newly lifted eyes, totally denying they've done anything to their face.

Google. For women who simply cannot bring themselves to get referrals from people, the Internet is your friend! Use it as often as your vibrator. Do Google searches (for example, "best plastic surgeons in NYC" or "best plastic surgeons in Wichita"). A lot of regional magazines do annual roundups on the best doctors in the area, so try a search for the article in the local publication's website. Also, go to one of my favorite resources — — to do a search of surgeons in your zip code, along with a coding system of recommendations and links to individual doctor's websites.

How to Crack a Tough Nut

Many women have a secret cosmetic surgery life. You know the type: Everyone knows she's having work done, but she refuses to admit it. You might even know a woman who claims her perfect skin is due to a vacation on the island of St. Bart's, when it was actually St. Bart's Medical Center. Robert Redford had a face lift but said he was just rested. That's partially true. He fell asleep on the operating table.

If a woman is out of the plastic surgery closet, you could ask her for her doctor's name. But if she's not, you can't. What you can do, however, is be circumspect, and try these strategies.

Give to get. Make like you have no idea she's been peeled/lifted/Botoxed, and confide to her that you fantasize about having skin just like hers. Go on and on about how much you hate your skin. Lay it on thick. She'll surely give you a referral, probably couched ("a friend of mine told me about Doctor X").

Go passive-aggressive. By that, I mean send an email. I get a hundred spam emails a day asking if my erections are as hard as they used to be (and, thanks to Viagra, I'm proud to report that they are). Or if I'd like to join the Hoodia revolution. Why can't you shoot off a note that reads, "Hello! How are you? I'm fine, thanks. Actually, I'm not fine. I have a hateful bump on my nose that I desperately want to change. I've been casting a wide net, asking for referrals, and since you're so together and polished, I thought you might have a friend who can give me the name of a great doctor."

She'll spill. Oh, yes, she will spill.

By the way, this formula (self-deprecation + flattery = putty in your hands) works on just about anyone, from a housekeeper to a federal court judge.

Once you have a short list of qualified doctors, narrow it down to three names. How to shrink an already selective list? With the precision of a surgeon's scalpel. It's a buyer's market. Surgeons, even qualified, experienced types, are a dime a dozen. Remember, you are in control. You are The Decider, so first of all:

Verify his qualifications. What you're looking for is board certification in plastic surgery, or board certification in dermatology, depending on what you want done. Board certification in a specialty means the doctor has had years of training in that specialty. Just as you wouldn't go to a plastic surgeon for a heart transplant, you shouldn't go to a podiatrist for a nose job. Or a dermatologist for a nose job, for that matter.

To extract the blackheads on your nose, yes, run to Dr. Skin. But to have the skin on the nose peeled back like a grape, go to a surgeon who has shaved hundreds if not thousands of nasal humps.

To check a doc's board certification and specialty, go to, the website for the American Board of Medical Specialties. Once there, you have to register your email address and a password. It's really simple. I did it myself, without having to hire another assistant. Then, you follow prompts to enter your doctor's name. And there he should be. Board-certified as a specialist in plastic surgery, just like the diploma on his wall says. For further refinement, go to, the website for the American Society of Plastic Surgeons. They list doctors who have specialties in plastic surgery, at least six years of training and experience in surgery, with three years specifically in plastic surgery, who are certified by the American Board of Plastic Surgery, who work out of an accredited facility (look for the American Association for Accreditation of Ambulatory Surgical Facilities' stamp of approval). It's as close to a comprehensive and complete credentials check as you can do online. Next,

Visit the doctor's website. I've got my own website (, and I take a lot of pride in its appearance and content. Keeping an updated blog and posting photos is the least I can do for my fans — well, fan. I expect a doctor to maintain a website as a service to potential customers. If he doesn't have one, or his website is cheesy and hard to navigate, forget it. In what other business is presentation more important? On his site, you need to find a nice gallery of "before" and "after" photos. Also, read some of the patient testimonials (often very touching; they might make you cry). Of course, check out the doctor's photo and feel free to judge him on his appearance. You've heard the expression, "Never trust a skinny chef." How about: "Never trust an ugly plastic surgeon," or "Never trust an acne-scarred dermatologist." Then:

Call his office. Who answers the phone? Is it a friendly, helpful person, or a disinterested snippy asswipe? If you wanted to deal with a rude, barely conscious robot, you'd seek out a saleslady at Chanel. At a doctor's office, you want to be treated with respect. Are you put on hold? Long enough to piss you off? Long enough to hang up? Or are you catered to, spoken kindly to, paid the proper attention? If you like them, make an appointment for a consultation. Some doctors charge for the initial office visit; most don't.

Last, you must meet the doctor face to face. Also important, you need to see his office and surgical facility. And his receptionist, as she'll be the one you'll be dealing with. And his nurses (likewise). In the waiting room, you'll get to talk to some of his patients, see how happy/unhappy they've been. Believe me, unhappy patients will be bursting to tell you their complaints. Often, in the waiting room, doctors have binders of before-and-after photos to flip through — an excellent way to pass time. His waiting room should also have comfortable, clean seating, current magazines, nicely arranged, and some soothing music piped in. You'll be spending a lot of time there. Why shouldn't every aspect of the experience be pleasant?

In your city, there are probably fifty doctors who would bareknuckle fight for your business. You should expect and receive the best.

Two Important Warnings

Warning #1: I beg you, do not be tempted by the classified ads in the newspaper, the type that screams, "Three-Area Lipo, No Money Down!" The low prices might catch your attention. But is hiring a surgeon the right time to go bargain hunting? As a plastic surgeon friend puts it, "Doctors know what they're worth, and they create a price list based on that." An expensive surgeon has the experience and results to back up his pricing. Listen to me! You get what you pay for in life, from shoes to surgeons. Inexpensive pumps fall apart in a season. A bargain boob job? In a year, you'll pay more to have the implants removed.

Cheap ends up expensive, and expensive ends up cheap.

Do not feel tempted to save a buck and go overseas to Asia or Eastern Europe for bargain-basement-priced plastic surgery. This new trend, called "surgery safaris," which combines a tourist vacation to, say, Thailand or Greece, with a nose job and breast lift, is a booming business of some $100 million a year. The problem(s) with having operations abroad: 1) there's no guarantee the doctor or hospital is up to standards, 2) you won't be able to go in for follow-up visits, and, the biggie, 3) if something goes wrong, like the account I read of a woman who went to a developing country for a face lift and came home with her ears behind her head, you will have to pay the full freight for a do-over (if possible) back home anyway.

For that matter, don't go for a bargain in the States, either. Say you go to an unqualified, inexpensive surgeon, and wind up with a nose job that looks like the roll of pennies you used to pay for it. You'll have to have it corrected with another surgery, and wind up paying more than you would have had you gone to the expensive surgeon in the first place.

Or, as my old Irish grandmother used to say, "Buy well, weep once."

Warning #2: Get ready for sticker shock. The flat belly of your dreams? It may cost you the price of a renovated bathroom. A breast reduction? That's your anniversary vacation in Paris. A year of Botox Cosmetic? Good-bye Hamptons rental. It's about priorities. Do you want a new face or a new patio? Even if you've got a two-hour commute, you've got a twenty-four-hour face.

As I've always said, take your pick: Is it better to have a new face getting out of an old car, or an old face getting out of a new car? If you're hankering for a change, put off your vacation and renew your lease on the clunker. Tolerate the hardwater stains on the tub for a bit longer, and get that cosmetic procedure.

Some other quick cautions about picking a doctor. Run the other way if:

• He carries a copy of Plastic Surgery for Dummies under his arm.

• His diploma is from Jugs "R" Us Academy.

• He jokes that his receptionist is his "patients' spare parts."

• His name is Dr. Frankenstein.

• Or Dr. Kevorkian.

• He's so cocky about his work, he signs his name on all his patients' rear ends.

• He has a sub-specialty in taxidermy.

The In‑Office Consultation

The great architect Mies van der Rohe said, "God is in the details." And he was right. Every detail of your consultation is relevant. Be as nitpicky as you wish. I gave this instruction to a friend who was looking for a plastic surgeon and sent her to three offices for consultations. Her objective was to judge each doctor by the Rule of Small Things. As it turned out, paying attention to detail made her decision much easier. I'll just let her tell it...

Doctor #1: We'll Call Him Dr. Roger

"I got Dr. Roger's name from my primary-care physician. I confirmed his credentials at the websites Joan gave me. Dr. Roger's office was only a few blocks from my apartment in Brooklyn Heights, so he got points for convenience. When I called for an appointment, the receptionist put me on hold twice. I took it as a sign he was in demand, which had to be a good thing."

"On the day of the appointment, I was pretty nervous. I'd been fantasizing about a breast reduction/tummy tuck for years. I probably never would have made the appointment if it weren't for Joan asking me to do this experiment. I was dying of curiosity about what Dr. Roger would say. I half hoped he'd take one look at my belly and say, 'You're fine. You don't need any work.' I soon came to learn, in my week of visiting plastic surgeons, that most of them are not in the business of sending you home.

"Anyway, I arrived on time at Dr. Roger's office. The receptionist was cute, young. I asked if she'd had any work done by Dr. Roger, and she said no. I asked if she had books of before-and-after photos I could look at, and she said Dr. Roger didn't like to show pictures to clients because everyone was different, and comparisons were meaningless. I then sat and waited twenty minutes to be called in to see the doctor, which kind of annoyed me as I was his first appointment of the day. Since Joan told me to be petty and demanding, I took to checking my watch aggressively and sighing loudly, but the receptionist turned up the volume on her iPod and ignored me.

"Finally, I was shown into Dr. Roger's office. Like the waiting room, it was clean but cold. Dr. Roger himself was decent-looking. Tall and slim, attractively put together, and nattily dressed. He didn't smile at all, though. And he seemed irked that I had a notepad and a list of questions. He suggested I hold off until after he'd examined me.

"Off we went into the exam room. He gave me a surgical gown. I undressed except for my panties. He returned, asked me to stand up in front of him — he was seated on a stool — and to open my robe. Yikes. I've never really felt a hundred percent comfortable naked with strange men, even doctors. If Dr. Roger sensed my nervousness, he did nothing to alleviate it. After looking at my boobs for a minute, he said, 'You don't need a breast reduction. You need a lift.' Using white surgical tape, he hoisted my left boob and affixed it to my upper chest. It was higher, and tighter. He said a lift and a small amount of lipo would make my boobs manageable. Since my complaint was their unwieldiness, the lift idea made sense. We were having this whole conversation with one breast taped up, and the other sagging halfway down my chest.

"Then Dr. Roger asked me to lie down on the exam room table. He grabbed handfuls of my belly and called the upper abdominal load 'hard-pack fat,' which, although true, wasn't very nice. The lower abdominal pouch, he said, was 'loose skin left over from pregnancy. You'll never get rid of it, even if you lost a lot of weight.' He recommended a full tummy tuck, with lipo of the love handles (which I hadn't even asked about). I got dressed and met him back in his office.

"By now, the fantasy of getting surgery had already turned into a clinical reality. Dr. Roger's manner wasn't comforting, or encouraging. In his office, he leaned back in his chair and dispassionately explained the recovery for each procedure. He avoided a description of the operation itself, even though I asked. Did he think I couldn't handle it? For the breast lift, he quoted $9,000. For the tummy tuck: $12,500. For both at once: $20,000. I must have looked shocked. He said, 'I don't do bargain surgery. For that price, you get the best of everything. You'll be well-medicated.' So he gives expensive drugs? Should that sell me? I felt vaguely offended and demoralized. Dr. Roger came off rather cocky about his skills. But if he was so sure of himself, why didn't he show before-and-after photos? I told him it was a lot to think about, thanked him, and left. He'd spent a total of thirty minutes with me. Counting the wait, I'd been there just under an hour. The receptionist said she'd call in a few days to follow up.

"I said, 'Don't call me; I'll call you.' "

Doctor #2: We'll Call Him Dr. Josh

"I found Dr. Josh by doing a zip code search on All the doctors in this search engine are board-certified specialists with accredited facilities. Dr. Josh had a blue dot next to his name, meaning he was a standout. I was very impressed by Dr. Josh's website, which included an extensive before-and-after gallery, and by his office's Central Park West address. His receptionist was beyond friendly when I called. As promised, she emailed me downloadable video programs about tummy tucks and breast reductions. The videos lasted about twenty-five minutes each and detailed the operations in graphic — but not gnarly — detail. Highly instructive! So far, so good! I couldn't wait to tell Joan.

"I arrived at my appointment fifteen minutes early and expected to twiddle my thumbs. That wouldn't have been terrible, actually. The waiting room had plush couches and tons of reading material, including current issues of intelligent magazines. Just as I was getting comfortable, I was called into the exam room. No waiting! In the room, a nurse gave me a gown and paper panties. She told me Dr. Josh had done her nose, her chin, and her tummy tuck. On her birthday, she was going to get thigh lipo. The nose job looked pretty good. And her belly was flat, as far as I could tell. The exam room, like the waiting room, was beautiful, fully loaded with equipment and magazines, and had a big leather chair in lieu of a cold exam table.

"Dr. Josh arrived promptly and read my paperwork. He was a compact guy, nicely dressed and neatly shaved. Instead of asking about my boobs and belly, his first question was, 'You're a writer? What kind of stuff?' And then we talked about my career and our favorite authors. He acted like he had all day to kibitz with me. After ten minutes, he smoothly transitioned into shop talk. 'As a novelist, you have flexible hours. That's good for your recovery. So let's have a look at your breasts.' I felt more comfortable showing my body to him. Unlike Dr. Roger, Dr. Josh used tools to measure me. A caliper and measuring tape. He took notes and asked me what my vision was for my breasts. He suggested a lift with minor reduction, just as Dr. Roger had. For the belly, he took more measurements and recommended a full tummy tuck with love handle lipo. He spent a total of forty-five minutes with me.

"He left. I dressed, and the receptionist came back in with three printouts breaking down the costs of just a breast lift ($8,500), just a tummy tuck ($9,000), and both at once ($14,500). She handed each sheet to me, explained what was on it, and asked me to sign a copy to keep in my file should I go ahead with surgery. She spent another fifteen minutes talking to me about how she got from thinking about having surgery to actually doing it — a giant step, I was realizing.

"I left feeling comforted and catered to. If I were to go ahead with the operations, I was confident I'd be well cared for by Dr. Josh and his staff. I also liked his prices."

Doctor #3: We'll Call Him Dr. Mark

"Just for variety, I thought I'd see a guy who advertised in the local newspaper classified section. I called his office and spoke to his receptionist. She seemed a bit ditzy, but sweet. I told her I was interested in a tummy tuck and breast reduction. She made the appointment and called twice to confirm.

"I showed up on time, filled out the forms. Dr. Mark's office was a mess. His receptionist apologized and said they were in the process of moving. I sympathized. Moving is never fun. But having to sit amongst half-packed boxes and garbage bags didn't fill me with confidence in Dr. Mark. If he were professional about it, he would have rented a transitional space. I was nervous.

"A chubby, older guy in a rumpled shirt with the sleeves sloppily rolled up found me in the cluttered waiting area and introduced himself. This was Dr. Mark? Points off for personal appearance. I followed him to the exam room. He told me he was a retired ob/gyn surgeon. 'I spent thirty years doing hysterectomies and Caesarians. So many women came to me after their pregnancies for referrals to plastic surgeons to get rid of their bellies, I figured, why not learn how to do tummy tucks myself?' he said.

"I asked, 'So you're not board certified in plastic surgery?'

"He said, 'I am board certified.'

" 'But not in plastic surgery?' I repeated. He shrugged it off. I remembered Joan's warning about doctors doing plastic surgery without obtaining a specialty in it.

"So we're in the exam room — which, disgustingly, had used gloves and detritus on a tray nearby — and I showed him my belly. He looked at it for ten seconds and then said I could lower my shirt. 'Don't you need to see my breasts?' I asked. He said he didn't work on breasts but he knew a doctor who did. I distinctly remember telling his receptionist about wanting a tummy tuck and a breast reduction. A bait and switch?

"We went into his office. He had to move a box so I could sit down. Dr. Mark said he'd done two 'girls' whose bellies looked like mine recently, and he pulled up their before-and-after photos on his website. This part of the presentation was impressive. He had loads of pictures, from many angles, including some graphic pictures from the actual operations.

"Dr. Mark said I'd need upper abdomen lipo, and a mini tuck for the lower abdomen. My belly button wouldn't need to be relocated — a different recommendation than Dr. Roger and Dr. Josh, both specialists in plastic surgery. Next, Dr. Mark recited a speech about the wonders of liposuction and how a tummy tuck would change my life, how a lot of women used it as a jumping-off point to eating right and exercising. Meanwhile, he hadn't asked me a thing about my lifestyle and health. As he babbled on, at one point, he glanced at his watch! The next thing he said was the most shocking, considering his credentials, office, and the rushed exam. For the mini tuck and lipo, he wanted $10,000! Less surgery than either Dr. Roger or Dr. Josh, and more money. I thanked him and left. I'd been there for a total of twenty-five minutes.

"When and if I move forward, I'll go with Dr. Josh. He was superior in every regard. He was the only doctor who talked to me like a person. He and his staff seemed to understand a patient's need to feel comforted and assured that the process would run smoothly. Interestingly, the doctor with the nicest office was charging the least."

My friend now understood the value of face-to-face meetings with potential doctors. At the end of the day, every woman has to pick a doctor she likes on a personal level. I'm not impressed by a doctor who's brilliant but a bastard. You need to make a human connection, to believe he sees you as more than a piece of meat with a price tag. Silly as it sounds, I've always believed that a doctor will take better care of you if he likes you, and you'll be able to express your desires more clearly if you like him.

The Ultimate Litmus Test on Choosing a Doctor

Even after your round of consultations, you might still be on the fence about making a choice. A great litmus test is the doctor's collection of before-and-after photos. Besides the vicarious fun of looking at the breasts and noses of complete strangers and comparing yourself to them (as in, "I'm not nearly as bad as her," and "Look at the size of those flapjacks!"), before-and-after pix tell you oodles about your prospective doctor. His handiwork, his aesthetics, how many procedures he's done. I like to go to a doctor's office and find a huge binder of photos, organized by procedure, in the waiting room. It's amazing to see the incredible diversity of the human form. And there are some great clues to pick up on your doctor skills if you look carefully. For example, watch out if:

1. Every patient has Halle Berry's nose, as if the doctor makes body parts from a mold and glues them on every patient. Now, Halle Berry has a gorgeous nose. But it might not work on your face. The doc's photos should show that he pays attention to the needs of each individual patient. In a word, you want to see noses that "go."

2. Make sure you see visible improvement. Subtlety is good. But if you're spending all that money and time in recovery, you want to see results. There's a famous doctor in Los Angeles who made such subtle changes, it was a joke that he had to do everyone twice. "Conservative change" is great. After a good face lift, you should look better, brighter, more rested, but still look like you. However, there is a big different between subtle and "no difference." The point of having plastic surgery is to see improvement. If the patient looks fifty years old in the "before" shot, and forty-nine years old in the "after," that is not a good sign.

3. All of the photos appear to be the same handful of patients. It's a major red flag if you don't see a big range of patients and procedures. Seeing the same woman over and over again (on page 1, her eye lift; page 5, her nose job; page 10, her lip augmentation) makes me wonder how much experience the surgeon has — or doesn't have. Since the choice is yours, go with a doctor who's helped hundreds of women.

Doctors Are the New Lawyers?

Used to be, a doctor was considered to be the most honest and trustworthy member of society. My father was a doctor from the old school. He cared about his patients; he worried about them; he actually knew their names and histories, so it pains me to say the sad truth: Some unscrupulous quacks will do anything for money.

Cosmetic surgeries and procedures like Botox Cosmetic, collagen, and Restylane injections are very lucrative. The bad apples see an opportunity for easy money, and they take it. They'll lie, swindle, and sweet-talk you for your business. They'll claim to be board certified but won't say in what specialty.

One friend of mine heard of a proctologist who was performing face lifts! Although, for some people, having a face that looks like an ass would be an improvement. One of his patients got a lift so extreme, every time she said, "Hello," people thought she farted.

"The biggest issue today in this business is individuals who call themselves cosmetic surgeons without getting adequate training," said Robert Singer, M.D., past president of the American Society of Aesthetic Plastic Surgery, past chairman for the American Society of Plastic Surgery, and current president of the American Association for Accreditation of Ambulatory Surgical Facilities Education Foundation. He's also a surgeon with thirty years of experience at his clinic in San Diego. "Don't be fooled by 'cosmetic.' Anyone can call himself or herself a 'cosmetic surgeon,' having taken a one-week course on liposuction. Even less invasive procedures like fillers and peels have real risks that require the judgment and experience that only board certification in plastic surgery can provide." Singer has made it his mission to encourage patients to educate themselves about procedures and doctors. He wants to make his industry as safe and assessable as possible. For every great doctor out there, there's a quack with a shingle and a buzz-saw.

Don't believe Dr. Singer? Then believe me. I've got stories...

Horror Stories

If you don't believe that picking a skilled, certified, trustworthy doctor is a critically important decision, I've got three words for you: Kanye West's mother.

Horror story #1: Donda West dreamed of a flat belly and perky boobs — and who doesn't? She sought out a doctor who could do a tummy tuck, breast reduction, breast implants, and liposuction. Problem was, Donda West was obese (5 feet, 2 inches and 188 pounds), had high blood pressure, and a cardiac artery blockage. By multiple accounts, Donda was turned away by, allegedly, at least two reputable doctors who pre-screen potential patients for health conditions that rule out elective surgery.

Enter Jan Adams, M.D., a surgeon who'd appeared on Oprah, Extra, and his own reality-based TV show about his life as a California plastic surgeon. Despite Donda's pre-existing conditions, Adams was willing to do the five-and-a-half-hour surgery on her. A day later, West was dead. Cause of death? According to published reports, her bad heart couldn't handle the stress of surgery.

In the days after her death, more information was revealed about Jan Adams, M.D. Turned out, he wasn't board certified in plastic surgery. Adams did have a certification in "general" surgery, which, according to California law, means a doctor can do plastic surgery. But it doesn't guarantee the doctor has been adequately trained. It also came to light that Adams had a nasty DUI habit. He was arrested — twice — for drunk driving. He'd been found guilty of malpractice — twice — and had to pay huge payouts. Although there was no evidence Adams botched the surgery on West, the big question is: Should he have done the surgery in the first place?

The moral of this story: Just as any reputable doctor pre-screens patients to make sure they're viable for surgery, every patient should pre-screen her doctor to make sure he's viable to operate. If Donda had done minimal investigation on Adams, she might be alive today. Last I read of Adams, he'd left the West Coast and now practices in Palm Beach, Florida. This is a good thing, since the people there are so old, most of his patients are already dead.

Horror story #2: Totie Fields, the huge comedienne — in many ways — of the 1960s and '70s, searched and searched for a doctor to get a face lift. This was thirty-five years ago. Face lifts have come a long way, but even in that day, no doctor worth his golf balls should have agreed to operate on her: Totie had diabetes and a heart condition. Eventually, she found a doctor who told her of the risks. But Totie insisted, and, finally, he gave in. The surgery caused a blood clot to lodge in her leg, which had to be amputated above the knee. And you know what she did? She sued the doctor! Was she right to do this? Some people feel the answer should be "yes." It was the surgeon's responsibility as a good doctor never to have let her walk through the door of the operating room. Totie died two years later, after having a few heart attacks that might have been accelerated by the trauma of amputation.

In our list of perils, so far we have death and dismemberment. Now let's add permanent pain.

Horror story #3: Ten years ago, a friend of mine got liposuction from a doctor she met at a cocktail party. They hit it off, and she made an appointment with him the very next day for major liposuction on her waist. The doctor went in too deep, and she's had pain in the spot ever since. It was only later after the damage was done that she found out he had a bad reputation among other doctors.

Then there are scars that won't heal properly.

Horror story #4: A decorator friend of mine got an acid peel in return for helping to redo the doctor's wife's living room. The doctor applied too much solution. It took months for her skin to recover, and it never looked normal again. She was so eager to get the procedure on the cheap; she trusted anyone in a white lab coat.

She should have looked on the lab coat's pocket and seen the emblem reading "Howard Johnson's."

Horror story #5: A friend, who's also a plastic surgeon, told me the story of a famous male movie star who went on vacation in South America and got so hammered at a party that he was convinced by a "surgeon" to let him work on his face that very night. When the actor woke up, the skin of his face had been severely lifted.

His lift was so high, he could see behind himself.

The star had to put his career on hold for two years, stay out of the public eye, until he had the problem fixed (not nearly enough).

One more horror story, #6 (I know, six of them is a lot to take): Priscilla Presley. Did you see her on "Dancing with the Stars"? More like Dancing with Madame Tussaud's Wax Figure.

In 2003, Presley fell under the influence of a "gigolo" (hey, TMZ said it first, not me), an Argentinean physician named Daniel Serrano. Serrano arrived in Hollywood and immediately started touting his miracle wrinkle eraser as God's gift to women.

I was immediately suspicious, since we all know God's gift to women is the vibrator.

The stuff in his syringe, what he called "better than Botox," was a low-grade silicone used to lubricate auto parts in Argentina, and most definitely not FDA approved for use in a human body. Can you imagine having your face pumped with the same stuff that kept Evita's 1939 Packard zipping through the streets of Buenos Aires?

Among Serrano's alleged clients were Larry King's wife, Shawn, and Lionel Richie's wife, Diane. They'd round up their friends for a Serrano lube job party, where he'd inject his "miracle" for $500 a shot. He quickly became known as Dr. Jiffy Lube. Eventually, he was arrested for illegally importing his poison, and served fifteen months in prison. A week after his release in 2008, he was arrested again by immigration officials who will most likely deport him.

It's tragic, how a gorgeous woman like Priscilla Presley can be scammed. Reportedly, she's having corrective surgery to get the silicone out. Good luck to her.

And you? You won't need luck. You'll have referrals, credential checks, office consultations, among other research, to rely on. When it comes to choosing a doctor, luck has got nothing to do with it.

Black Balls

I'm not talking about Billy Dee Williams or a Heidi Klum sex toy! I'm talking about disqualifying factors for plastic surgery. There are a lot. Here's a pretty good list of the health factors that would give any reputable surgeon SERIOUS pause.

• high blood pressure
• bleeding disorders
• heart disease
• hepatitis
• heart valve disorders
• diabetes
• multiple sclerosis
• smoking
• lupus
• drug addiction
• arthritis
• alcoholism
• scleroderma
• pulmonary disease
• anorexia
• anemia
• obesity

These are just the physical reasons not to operate. Any patient who is emotionally unstable or mentally not-all-there should be shown the door by a doctor — and I don't mean the door to the operating room.

Bottom line: If you're high-risk, and go ahead with surgery anyway, you might not live to regret it. If three doctors tell you "no," don't go looking for a fourth.

Copyright © 2009 by Joan Rivers and Larry A. Thompson

Table of Contents

Intro: Welcome to My World

One: Hello, Doctor!
Some people call them doctors. I call them life-savers.

Two: Botox, Baby!*
Miracle in a needle.

Three: Plump It Up: Lips*
Permanent or temporary ways to get smoochable lips.

Four: Filler Up: Wrinkles*
Wrinkle-erasing, collagen, Restylane, Juvéderm, and other fillers you need to know about. Plus: mole removal. On Cindy Crawford, the mole looks good. On you? Not so much.

Five: You're So Smooth: Skin*
Skin resurfacing peels, microdermabrasion, laser zapping, freckle nixing, rosacea fixing, and getting rid of broken capillaries, acne scars, and every blemish under the sun. Plus: the ugly truth about cellulite.

Six: More Where You Want It, Less Where You Don't: Hair
Laser body-hair removal and head-hair transplants.

Seven: About Face Lifts*
Face lifts of every flavor — full, mini, and feather — facial implants, and revolumizing fat transfers. Plus: how to get better teeth to go with the uplifted face.

Eight: When You Care Enough to Send Your Very, Very Breast*
Boob jobs, boob jabs, lifts, reductions, and all you ever wanted to know about how to tweak a nipple.

Nine: Bobbing for Noses*
Nose jobs: smaller, bigger, straighter, sharper, narrower. Also, what the hell happened to Michael Jackson?

Ten: Sucks to Be You: Lipo!*
Liposuction: how the fat gets out of your belly, butt, chin, knee, wherever it lurks.

Eleven: Cutting Out the Middle*
Tummy tucks, mommy makeovers, and how to get your pre-preggers body back.

Twelve: Eyes Wide Open*
A wake-up call for drooping eyes and brows. Also, how to get torn lobes and jugheads fixed.

Thirteen: Arm and a Leg*
Body and face of a thirty-year-old, limbs of Mother Teresa? Extreme makeovers, for extremities.

Fourteen: Vaginas and Butts
Vaginal rejuvenation and butt lifts. Also, how to work out your vagina. 

Fifteen: Finishing Touches
Now that you're gorgeous, some tips and tricks for staying that way.

Acknowledgments *Asterisks indicate chapters that include procedures I've done personally.
That's a lot of asterisks!

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