Getty / Mavocado Catherine Delahaye Erik Von Weber and Photo Illustration: Keila Gonzalez
When the reality TV show, “Botched,” premiered almost 10 years ago, it introduced viewers to extreme cases of plastic surgery gone wrong. Still airing today, the series follows two LA-based plastic surgeons who attempt to reverse and correct botched plastic surgeries. While often dramatized, the episodes underscore the importance of seeking highly experienced plastic surgeons and the dangers of discounted cosmetic procedures.
Despite the exponential rise in aesthetic surgeries post-pandemic – which has increased a whopping 41.3 percent over the past four years, according to a 2022 survey by the International Society of Aesthetic Plastic Surgery (ISAPS) – and ample media coverage and education around cosmetic procedures, botched plastic surgeries remain a growing concern. As the demand for reliable solutions intensifies, the role of skilled and empathetic doctors becomes increasingly pivotal in guiding patients through their journey to recovery. But can all botched surgeries be fixed?
We spoke to several plastic surgeons about the realities of botched procedures, including what surgeries can and cannot be fixed.
Experts Featured in This Article
Oren Tepper, MD, is a board-certified plastic surgeon and cofounder of Greenwich Street 497 Aesthetics in New York City.
David Shafer, MD, FACS, is a double board-certified plastic surgeon and the founder of Shafer Clinic Fifth Avenue in New York City.
Ramtin Kassir, MD, is a triple board-certified facial plastic and reconstructive surgeon, and founder of Kassir Plastic Surgery and Inside Beauty Spa
How Does Someone Become “Botched?”
Just because someone is not happy with their results or their procedures didn’t turn out as expected, does not necessarily mean that they are botched, says board-certified plastic surgeon Oren Tepper.
According to double board-certified plastic surgeon David Shafer, the most common way patients become botched is by traveling outside of the country for surgery and not allowing for adequate recovery time or follow-up. Other times, it’s from patients seeing non-core physicians – like physicians and practitioners who aren’t board-certified plastic surgeons, dermatologists, or ENT doctors – or when patients are prioritizing low prices over credentials when seeking their treatments. Dr. Tepper adds that a patient can end up with a botched procedure when they have gone to the extreme – referring to any over-the-top surgery, like extra large implants that aren’t suitable for the patient’s body.
The Most Commonly Botched Types of Plastic Surgeries
Though any plastic surgery can technically be botched if proper skills and standard of care are not provided, Ramtin Kassir, MD, a triple board-certified facial plastic and reconstructive surgeon, says that he tends to see more face-related surgeries that are botched.
“When somebody gets botched, they’re entering the world of reconstruction – potentially for aesthetic reasons – but they now need reconstructive surgery.”
Rhinoplasties, or nose jobs, in particular, are the most botched procedures Dr. Kassir sees in his practice. “At least one out of three rhinoplasties I’m doing are revisions from somewhere else, whether it’s a first-time revision or multiple revisions,” he says. He explains it’s likely because rhinoplasty is a “difficult procedure to do, and very few people know how to do it properly as they don’t have the experience to manage the aesthetics and the function of the nose.”
In addition, he says he often sees botched facelifts and eyelid lifts He adds that face and neck lifting can be easily botched because many doctors try to perform popular facelift methods such as deep plane facelifts without the proper training.
Plastic surgery procedures on the body can also become botched, says Dr. Tepper, especially when they are overdone or multiple surgeries are performed at once. Examples include if breast implants are way too large for a person and/or positioned incorrectly, or if liposuction was way too aggressive, and performed at the same time as a tummy tuck. He adds that silicone injections from overseas injected into various parts of the body as a means of enhancement are extremely dangerous and can cause permanent and irreversible damage. “[They’re] really hard to remove and [require] such an extensive cleaning up of tissue that it leaves somebody totally botched,” says Dr. Tepper.
Though non-surgical, Dr. Kassir notes that less invasive procedures and treatments like Morpheus 8 and Ultherapy can cause botched results, like hyperpigmentation and skin issues from lasers and energy devices. Due to the growing popularity of these devices and the overpromising of results, they’re often seen as substitutions for surgeries, when that is simply just not the case, he says.
Ultimately, any surgery can become botched if not handled with expert care. “There’s a lot of nuances that go into these surgeries that novice doctors or even some experienced doctors who haven’t done these procedures enough or who are not specialized in these fields [can lead to complications],” Dr. Kassir says.”For example, if somebody who does a lot of body plastic surgery and does an occasional facelift or an occasional rhinoplasty doesn’t have the experience to do it at a high level, you may have complications and not receive the best results.”
Can Botched Plastic Surgeries Be Fixed?
As is the case in “Botched” the TV show, plastic surgeons often attempt to reverse or correct the damages from a botched procedure. When a patient is botched from a plastic surgery procedure, Dr. Tepper says that corrective surgery for said procedure tends to fall under the category of reconstructive surgery; however, the latter is not always classified as the former. “When somebody gets botched, they’re entering the world of reconstruction – potentially for aesthetic reasons – but they now need reconstructive surgery,” he says.
In surgical discourse, reconstructive surgery refers to repairing “parts of your body affected by defects you were born with, defects that have developed because of disease, or defects caused by an injury.” Dr. Tepper says. “Cleft lips and palate repair and breast reconstructions are examples of reconstructive surgery. He adds that reconstructive surgery could also refer to “some complication that was unforeseen or unlikely.”
While no statistic covers the exact number of botched surgeries or surgeries gone wrong, the numbers for reconstructive surgeries (which, again, can include fixing botched surgeries) performed in the U.S. are astounding. In a 2020, Plastic Surgery Statistic Report, an estimated 6.8 million reconstructive procedures were performed by the American Board of Plastic Surgery (ABPS) surgeons. The report noted that the aforementioned statistic is three times more than the 2.3 million aesthetic surgeries performed that year.
Which Botched Plastic Surgeries Cannot Be Fixed?
The answer isn’t super clear. It depends on each individual case and just how botched a patient is, so it’s important for patients to manage their expectations. Dr. Tepper explains that most “overdone” surgeries are extremely difficult to fix, especially when cutting skin off is involved. Once the skin is cut off from the face, you can’t exactly place it back on. He says that many facial procedures such as facelifts, nose jobs (in which too much skin is removed), lip lifts, and upper eyelids that are overdone to the point where you can’t close your eyes all the way are extremely difficult to fix, and are truly dependent on the procedure and individual case. For a lip lift, “it’s extremely hard to lower the lip, and it’s very hard to undo an overdone facelift,” he adds.
However, he says there are some things you can do to improve botched surgeries. For example, you can add filler to a botched lip lift to help lower the lip. In some cases, such as with an overdone facelift, “the problem is you need some sort of way to restore the tissue and in certain cases, you sort of have gone too far.” He adds that this is not to say that you can’t make someone look better, but “getting them back to where [a patient] hopes to be can be very difficult or not possible.”
Be sure to do your research and seek out a board-certified plastic surgeon. “With people outside of their scope of practice or outside of their lane, they don’t realize what they may or may not know and how much things can go wrong,” Dr. Tepper says.
Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well+Good.
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