"I've been on the cover of every magazine in the world," says supermodel Janice Dickinson. "But as a young model, I never felt as beautiful as I looked. I masked it well with alcoholism. I grew up in an abusive home and was told on a daily basis by my father that I would never amount to anything and that I looked like a boy. One of the main reasons I had a lot of plastic surgery was because of the voice of my father. I've had my boobs and eyes done, my forehead lifted, and my stomach done. Every six months I fly to Dallas to get botox and I also get collagen injections. I'm addicted to cosmetic surgery! But plastic surgery hasn't stifled the voice from my father. Dr. Phil, how do I make this go away?" asks Janice.
"Both," answers Janice.
"I'm always interested in what the motive is and what the expectations are," says Dr. Phil. "Yours is layered. You sold your appearance. That was your livelihood. As someone who is so focused on appearance for their livelihood, do you think you confuse body image with self image?"
"Absolutely," says Janice. "I became addicted to the confusion."
At 18, Amy wants breast implants, a nose job, and is considering liposuction. "I really want breast implants," says Amy. "I wish I looked like a Victoria's Secret model. When I look in the mirror, I don't like what I see. Dr. Phil, how do I know if plastic surgery is right for me?"
Amy's mother Debbie is concerned about her desire to have plastic surgery and explains, "Amy started asking me about breast implants about a year ago after I had mine done. I didn't consider the influence it would have on her. I've always been insecure about myself and Amy has seen it. I look in the mirror and I don't like what I see. I had no clue that she was insecure. I feel responsible."
"Maybe I don't need it," says Amy. "But I would want it done."
"I'm not even sure a responsible surgeon would give you liposuction," says Dr. Phil.
Dr. Stoker explains, "The last thing a plastic surgeon wants to do is operate on someone who doesn't need an operation. When there is very little to improve, the benefits of the surgery wouldn't outweigh the risks."
"The way I feel about my body," answers Amy. "And my confidence."
"You just crossed a line because confidence has nothing to do with cup size," says Dr. Phil. "It may change your body image but it won't change your confidence. If you are standing there with a B cup and no confidence, you'll be standing there with a C cup and no confidence. You have to ask yourself what you think this is going to fix? If you have anxiety, depression or an emotional condition that an anatomical switch isn't going to fix, you aren't a good candidate for plastic surgery."
When Dr. Phil asks Amy to read from her journal, it becomes apparent that she is concerned about her weight is overly sensitive to comments that others make about her.
"Ask yourself, 'Why am I so vulnerable to comments from other people?'" suggest Dr. Phil. "You need to get past that and get in touch with your authentic self and the things that define you regardless of weight and breast size. You are looking in the wrong place to change your self-perception."
"I'm caught up in this," says Janice. "To me, this has been a cycle."
"What do you consider a wrong reason to get it?" asks Dr. Phil.
"To fill up the void inside of me," says Janice.
With a cup size of 42 HH, Della has been experiencing significant pain due to her breast size and has been considering breast reduction surgery for three years. "My husband is a boob man and doesn't want me to do it," says Della.
"When I first met Della she was a D cup," says Della's husband Paul. "I'm not one who is in favor of bodies being modified. I'm afraid she will not heal from the surgery. What kind of pain will she be in?"
"Don't tell me you're afraid of me not healing!" exclaims Della. "Tell me, 'I love big breasts! And I want you to keep them for me!' If he really was concerned about my health, he would want me to have a breast reduction."
Della explains that her dermatologist, gynecologist, general practitioner, and surgeon have all said that she should have the surgery. She has tried healthy alternatives, such as losing weight, and explains, "I lost 40 pounds but they don't get smaller, they just get longer. I would like to see my shoes!"
"When breast reduction surgery is indicated," explains Dr. Stoker, "it can be one of the most rewarding procedures because the patient can feel relief as soon as the following day. The healing process can be long but the potential benefits outweigh the possible risks...Insurance companies recognize this and often cover the procedure."
To Della's delight, her husband agrees that she can schedule an appointment for a consultation.
Tiffany, 27, had her first nose job at 19 in an effort to reduce the size of her nose. "I first started thinking of getting a nose job around the age of seven," says Tiffany. "The kids in school told me I was ugly. I was excited about my first surgery, but it never got smaller. The doctor said he would fix my nose no matter how long it took, but I would have to forego the usual anesthesia."
Tiffany says she underwent five more nose jobs, without anesthesia, which led to an infection that ultimately caused her nasal implant to fall out. "Without the implant to support the left side of my nose, it will eventually cave in," explains Tiffany. "My self confidence is very low. I've been out looking at wedding dresses, but when I look in mirror, all I see are problems with my nose."
"Looking back, what was your original motive for doing this? Did you think it would change your self-image?" asks Dr. Phil.
"Yes, I did," admits Tiffany. "I thought this was the only way to solve my problem — to have it made smaller. I thought that afterwards, every time I looked in the mirror I would like what I saw."
"It's been tough," says Tiffany's fiance Chad. "When I first met her, I didn't know. Then she told me about her nose. I couldn't figure out where the smell was coming from. Finally one night my daughter told her she had really bad breath."
"It was inside my nose and I could smell it every day but I had no idea that people next to me could smell it," says Tiffany.
"I'm sure that we can have you looking and feeling better in time for your wedding," says Dr. Platis.
Overcome with emotion, Tiffany turns to Dr. Phil and exclaims, "I think I need to hug you! Thank you!"