It's Time to Destigmatize Plastic Surgery in the Black Community

Black patients and Black surgeons are grossly underrepresented in plastic surgery. According to a 2020 report from the American Society of Plastic Surgeons (ASPS), only 11 percent of patients who get cosmetic surgery are Black, and less than three percent of plastic surgeons are Black. But as more Black and Brown people seek plastic surgery in recent years — 1.7 million in 2020 in comparison to over one million in 2010, according to the ASPS — it's high time we examine why Black people haven't always embraced cosmetic surgery.

To delve into the history of plastic surgery in the Black community, we sat down with three Black plastic surgeons to discuss the stigmas around the practice, the systemic racism tied to discouraging Black patients from procedures, and the questions prospective patients should ask before getting involved with a cosmetic surgeon.

The most common cosmetic procedures Black people seek out often mirror those requested by the general population, but with a specific focus on enhancing natural features while preserving cultural identity.

Michael Keyes, MD, founder of Celebrity Plastics, says this includes rhinoplasty aimed at reshaping the nose to maintain its ethnic characteristics and liposuction to contour the body. Hair transplants are another highly requested procedure in the Black community, used to address issues like traction alopecia, a form of hair loss and thinning, often from protective styles. Additionally, butt enhancements through fat transfer are very popular, reflecting a broader cultural appreciation for fuller figures.

The relationship between plastic surgery and Black people is a complicated one. For many, there is a stigma rooted in the fear of disowning one's Blackness. "There's a misconception that altering one's appearance equates to a rejection of racial heritage or an attempt to conform to Eurocentric beauty standards," Dr. Keyes tells POPSUGAR. But assuming that Black people are interested in plastic surgery to assimilate and conform to Eurocentric standards is not only insensitive but also inaccurate.

Of course, that doesn't apply to all Black people, but for many who are interested, the fear of backlash may stop them from opening up about the work they've done or committing to a surgery in the first place. We need to stop assigning regressive betrayal to Black folks that undergo plastic surgery. Simply put: you can be proud to be Black and get plastic surgery to alter or enhance your features; the two are not mutually exclusive.

Systemic racism plays into why Black people don't seek out plastic surgery as much as other ethnicities. Historically, people of color were critically removed from clinical research and trial studies — leading to a lack of quality education of the needs and approaches toward communities of color. "It is well known Black patients suffer higher complication rates in the medical field and misdiagnoses compared to other races," Dr. Keyes says. And because of the complicated relationship between healthcare systems and prospective Black patients, individuals are discouraged from seeking plastic surgery from surgeons who either don't share insight into their lived experiences or specialize in working with patients of color.

Aisha Baron, MD, a surgeon at Breast Body Beauty Plastic & Reconstructive Surgery, says the biggest myth she hears is that all Black people will form keloids, or thick raised scars, if they undergo plastic surgery. Although there is a chance for keloids, it's not a guaranteed side effect.

According to the ASPS, patients of color are more susceptible to adverse scarring and hyperpigmentation because of melanin, which is commonly found in areas around the breasts, chest, and shoulders. Dr. Baron says doctors should look at each patient's history of scarring and provide a scar treatment system to use in the postoperative period in order to ensure that the scars heal as well as possible. "Sometimes laser treatments, scar camouflage, topical and injectable medications can be used in order to reduce the appearance of scars if they are most noticeable," she adds.

It's no secret that Black folks have long faced medical gaslighting and racial disparities in healthcare. However, Dr. Baron believes in order to combat feelings of distrust, there needs to be open communication and a degree of cultural competency between a doctor and patient, from the consultation and throughout the surgical process. "Knowing how to talk to your patients so that they understand what is ahead of them and being sensitive to how the aspects of their culture may affect their decision-making is very important," she says.

Yes, the road to inclusivity is a long one, but that doesn't mean it's a lost cause. All three plastic surgeons we spoke to are optimistic about the future of plastic surgery in the community, thanks to social media. Anyone, regardless of race or socioeconomic status, can access information through platforms like Instagram, TikTok, and Facebook. Though there is room for misinformation on such large-scale operations, the visibility of doctors like Nneamaka Nwubah, MD (better known as Dr. Amaka), and Wilton L. Triggs II, MD, two surgeons on TikTok and Instagram who discuss the nuances of cosmetic surgery in a culturally sensitive context, "helps normalize cosmetic procedures and encourages a more inclusive and informed conversation around beauty and self-care," Dr. Keyes says.

Social media has not only ushered in sound education from professionals, it's also welcomed proud confessions from famous Black women like Kelly Rowland, NeNe Leakes, Cardi B, Vivica A. Fox, and Vanessa Williams, who've all celebrated the work they've had done over the years. This representation is decreasing the stigma and driving more acceptance around plastic surgery in the community. But we also need to see that representation reflected on plastic surgery websites and social accounts in before-and-after photos. "Some surgeons will show a good range, but some of them are just one race," Dr. Amaka said in a recent POPSUGAR interview. "If you don't see yourself in the before-and-afters, then you think this is just not for me." The cosmetic treatment information platform RealSelf is a great place to find patient before-and-after pictures submitted by surgeons around the United States.

As for future Black patients, Dr. Keyes encourages them to come with a comprehensive set of questions to all surgery consultations. Asking about the surgeon's experience with patients of similar backgrounds, specific risks related to skin type, how they plan to minimize their risks, access to aftercare routines, and more will ensure you are fully informed and manage your expectations. And lastly, make sure you are being heard. "It is important to understand the barriers to care and patience, desires, and fears regarding any particular procedure," says Steven Williams, MD, the president of the ASPS. "Every patient should expect to be listened to, and that is especially important in patient populations that have had less access to particular parts of healthcare, regardless of the reason."