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Rodrigo Alves is known as "the human Ken doll" because of his surreal, plastic-like resemblance to Barbie's beau. But he's now in danger of losing his carefully crafted nose after dozens of surgeries left him with infections and scar tissue so extensive he can barely breathe.
Alves' 72 procedures have cost more than $750,000, and doctors have warned him that his surgical obsession may also cost him his health if he doesn't stop undergoing additional cosmetic procedures, he told the Daily Mail.
Alves said that as a result of tissue damage from multiple rhinoplasties, his nose is "sinking" and may collapse, leaving a hole in his face.
"I am scared, to be honest," he told the Daily Mail, adding that "each time is riskier than the last."
He explained that additional procedures were required to fix complications of previous botched surgeries.
"It used to be a want," he said of his procedures. "Now it is a need."
Cosmetic surgery, a specialization of plastic surgery, can have benefits for many people, including boosting self-esteem, said Dr. Alan Matarasso, a former president of the American Society of Plastic Surgeons. About 23 million cosmetic surgeries are done every year worldwide, and they're generally considered safe.
But like all surgeries, the procedures have risks including scarring, nerve damage, infection, and complications from surgical anesthesia. And having multiple procedures can compound the risk — one doctor told Alves on the show "Botched" in 2017 that having three surgeries in one year had "destroyed your tissue," adding that "the skin is no good."
"Ideally, you want to do the least amount of surgery that will make a patient happy," Matarasso told Insider. "Plastic surgery is safe. It's effective. It's ubiquitous. But it's not a haircut. All of these procedures have risks."
Many people have unrealistic expectations for cosmetic surgery, Dr. Dirk Kramer, a plastic surgeon in London, previously told Insider. But some can develop a psychological obsession with repeatedly getting surgical procedures, often for aesthetic reasons. This is rare, Matarasso said.
For some, the first surgery can open a "Pandora's box" of seeking additional procedures because they're never fully happy with the results, Kramer said.
That's why it's important to address an underlying issue of low self-esteem before considering cosmetic surgery, said Charlotte Markey, a psychologist.
"Self-acceptance is not just about how we look," Markey previously told Insider. "Data suggests that cosmetic procedures don't have a lasting effect on people's positive body images nor their general well-being."
If you have symptoms of body-dysmorphic disorder, a persistent feeling that one's appearance is flawed, you may be at a higher risk of surgical addiction, Matarasso said, adding that he works with psychiatrists to refer his patients to in some cases.
"Good plastic surgeons are psychiatrists with scalpels," he said.
Indicators that you should see a psychiatrist can include developing a strong, obsessive concern about a minor perceived flaw, having a history of other psychiatric issues, getting multiple procedures in a short period, and "doctor-shopping," or jumping from surgeon to surgeon for different procedures.
"The thing about plastic surgery is, as physicians, we shouldn't be operating on people unless they have realistic expectations coming in and a healthy and positive self-image," Dr. David Cangello, a plastic surgeon in New York City, told Insider.
Surgeons told Insider that if you're considering a procedure, start by finding a plastic surgeon certified by the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery and avoid people who won't list their specific certification or have another specialty.
Word of mouth is also a good way to find a good doctor, Matarasso added. He suggested asking a plastic surgeon in another city where they would go for a cosmetic procedure.
The internet, by contrast, isn't so reliable, since "everybody says they're board-certified in something," whether or not that's true or their certification qualifies them for the procedure you want, Cangello said.
At an initial consultation, a good surgeon should listen closely to why you want the procedure and what you're expecting from the results to help you decide what, if anything, best fits your unique needs, Matarasso said.
"If you're ethically doing your job well as a plastic surgeon, you're saying no to a number of patients when the risk isn't worth the outcome," Matarasso said. "The way I learned it is: I make my living on the people I operate on, and my reputation on the people I don't."
Ultimately, Matarasso said, the decision to undergo cosmetic surgery should not be taken lightly.
"Yes, plastic surgery can have emotional benefits or even physical benefits," he said. "But because it's an elective, unnecessary surgery, there are risks, and patients should be very rigorous about doing their homework."
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