Each of the women questing for the ‘Bridalplasty’ prize has a wish list of cosmetic procedures they would seek should they beat out the competition, in addition to ideas for their wedding cake, dress, invitations and more.

According to an article in the Chicago Sun-Times, the show’s oldest contestant, Allyson, is a 33-year-old who plans to claim a wedding suited to her “old-school rocker chick” tastes and other prizes in the form of liposuction, a breast lift, a breast reduction and Botox, as well as some cosmetic dentistry, if named the show’s victor.

Before I was pregnant with my son, I was in the best physical shape of my life,” Allyson says. “I would love to get back to that and I’m sure [my fiance] would NOT mind some smaller perky boobies on me. I’m 33 and they sag down to my belly. What will happen when I’m 50? Will I have to roll them up and tuck them in my bra?”

Many women face the same troubling physical changes after undergoing the rigors of pregnancy and childbirth, however they are rarely so public as on reality TV shows.

The Sun-Times noted some particularly cringe-worthy scenes on Bridalplasty, such as the one where Allyson uses the spare tire of fat around her stomach to tell Dr. Terry Dubrow, the plastic surgeon featured on the show, “Help me, please. Suck me out.”

Dr. Dubrow is also shown using a marker to circle the problem areas on his topless patients, a scene that, according to the Sun-Times, calls to mind the behavior of a “sorority mean girl.”

“There is something beyond sensational with these cosmetic surgery makeover shows.  There is some indignity involved in the process,” says Owensboro cosmetic surgeon Dr. Gerald Edds.

Although, as Dr. Edds points out, there are certainly humiliating undertones present in Bridalplasty (and most other reality TV shows, for that matter), he like most critics acquiesces to the makeover competition, saying, “As long as the result is good and there are no complications, I suppose it is a win-win for both the ‘winner’ and the celebrity cosmetic surgeon.”

He also acknowledged the complexity of combined breast lift and augmentation procedures and encouraged surgeons to let each patient’s unique goals, breast anatomy and degree of breast ptosis, or sagging, dictate surgical incision placement and procedure(s) used to enhance the breasts.

“For many reasons, simultaneous breast lift and augmentation is one of the most difficult of all cosmetic surgery procedures. First, no two breasts are the same, and each patient is seeking a different endpoint, sometimes with unrealistic expectations,” says Dr. Cuzalina

For Owensboro breast enhancement patients, Dr. Edds uses the Regnault classification system to determine which procedure(s) are needed to provide optimal breast enhancement results.

Patients with the most severe ptosis (grades III and IV), breast tissue is often ample and a breast lift alone is needed. However, some patients who have sagging, deflated breasts may opt for breast enlargement as well as a lift.

Incisions for patients with a greater degree of sagging are usually a lollipop pattern (around the nipple and vertically along the bottom of the breast) or an inverted-T pattern (lollipop incision plus incision along the inframammary crease).

In patients who have a lesser degree of ptosis (grade I and grade II), a breast lift is also recommended, and may be performed with or without implants depending on the amount of natural breast tissue present.

However, patients with less breast droop typically require less extensive incisions that are placed only around each nipple (periareolar) or in a lollipop pattern. Patients who choose silicone breast implants may require an incision in the inframammary crease or along the underarm.

Finally, in patients with “pseudoptosis,” where the nipple is above the inframammary crease on each breast, breast implants alone will often correct mild sagging by increasing breast projection.

In all cases where mastopexy (breast lift) is combined with breast augmentation, Dr. Cuzalina reminds doctors and patients that the procedures can be staged to ensure safety.

“While there is no dogmatic way to approach the simultaneous procedure, it is helpful to remember a few basic guidelines,” said Dr. Cuzalina. “Avoid the temptation to always do a periareolar mastopexy in order to use the shortest incision possible, understand that it is sometimes good to also remove tissue to maintain implant position long-term and while patients may resist the idea, keep in mind that a staged approach, performing mastopexy first and then augmentation three months later, is always an option with a tried-and-true safety record.”

Sponsored by the American Academy of Cosmetic Surgery, the nation’s largest medical society of cosmetic surgeons, the 3 day workshop focused on procedures such as breast augmentation, breast lift, and breast reduction surgery. “Our breast course has earned excellent recognition and is one of the most popular breast courses in the Academy,” said Dr Mandell-Brown.

The doctors discussed the latest development in cosmetic breast surgery.  Through a combination of lectures, surgery, and anatomy labs, the visiting physicians can improve their skills.  “Its a great way to showcase Cincinnati to our visiting doctors” observed Therese Holden, Nursing director.  She added, “we really strive to make this an outstanding educational experience for the participants.”