Pimp My Bod

I am standing topless in front of a photographer. My back is against the wall as she snaps picture after picture of my bare breasts. This is quite possibly the most embarrassing day of my life. Not only am I half-naked with a stranger, but the lighting in here is just terrible. Fluorescent. Harsh. Unflattering.

Moments earlier, the same photographer measured the "droopiness" of my breasts by seeing if a Q-tip would stay stuck underneath them. (It didn't. I'm a 24-year-old B-cup, and gravity isn't that cruel.)

I'm not at some weird bare-chested Q-tip fetish pornography shoot. I am at a plastic surgeon's office, pretending to want breast implants.

I've never considered plastic surgery before. In fact, I used to openly mock it.

Things have changed. At least, temporarily they have.

We all know the Scottsdale stereotype. The skinny, large-chested bottle blonde, perfectly manicured and bronzed from the tanning bed. Coach bag on her arm, Chanel earrings in her ears, Tiffany bracelet on her wrist, Juicy Couture on her ass. She's in the VIP room at Myst, turns up in the back pages of 944, shops at Electric Ladyland, and projects a precise and contrived image of wealth and beauty.

That is not me.

I dye my blond hair brown. I don't remember the last time I was at the mall. If I'm going to spend money on a purse, I'd rather buy a vintage Enid Collins than a monogrammed sack handcrafted in China of completely natural soft milled cowhide. The bars I favor tend to be located in central/downtown Phoenix strip malls. They don't have windows. They serve well vodka.

I know what some of you are thinking. But I like it.

And, hey, I've been to the VIP room at Myst and I spent the night fighting off the unwanted advances of a fiftysomething man named Walt, declining his lecherous offers to buy me a drink. His best line was, "I don't usually like brunettes, but you're hot." Then he told me all about his money. Gross. The whole mess left me depressed. I kept asking my friends, "Do people really do this? Every weekend? Really?"

It's just not my scene.

But what if it were? What would it take for someone like me to fit in someplace like Scottsdale? Obviously, a lot of people enjoy the luxe lifestyle there. They can't all be morons. There must be something to it. I decided to find out. And because image is the first and most important thing in Scottsdale, I started with a makeover. Or the idea of one, at least.

I am very aware that I am the polar opposite of what is generally considered "hot" in Scottsdale.

On a scale of bag lady to babe, I probably fall somewhere between librarian and theater actress.

I'm cute, not sexy. I'm okay with this — I hate the word "sexy." I exercise, but I'm not skinny. My body is what the men who hang out around the Circle K on Van Buren and 18th Avenue like to call "thick." (It's a compliment, coming from them. I think.) My nose is a little crooked and my two front teeth are very slightly chipped.

I like those things about myself. My nose and my teeth are my two favorite things about my face. But imperfections, no matter how adorable, are still imperfections. So I spent the past six weeks trudging from surgeon to surgeon to find out just how much work it would take to make me "perfect."

Let me tell you what I don't like about myself.

But first, let's talk shop. Of the 110 plastic surgery offices located in Arizona, 83 are in the Phoenix metro area. According to the American Society of Plastic Surgeons, the region Arizona is in accounted for the highest number of all plastic surgeries performed nationwide in 2006. We win the prize for the most breast implants, calf implants, chin implants, ear and eyelid surgeries, face-lifts, vaginal rejuvenations, tummy tucks, and liposuctions. To be fair, our region does include southern California, but there's no doubt that plastic surgeons in Scottsdale do a thriving business.

You hear stories all the time about this celebrity or that one flying quietly into town for a little work. I'd bet most of the tales are true. Rich people have been flocking here forever for it. When I was a kid, Elizabeth Arden still ran an exclusive spa (read: fat farm) perched on Camelback Mountain, called Maine Chance. Everyone from first ladies to B-movie actresses went there — very, very quietly.

These days, many people skip the fat farm and go straight for the knife. Not surprisingly, the most popular procedure nationwide is breast augmentation, followed by nose reshaping and lipo. When it comes to non-surgical procedures, Botox takes the top spot.

And it's not just desperate housewives trying to recapture their youth (and their husbands) who are getting these surgeries. Nationwide, more than 800,000 women in my age group (20-29) underwent cosmetic surgery last year.

At least I'm not alone. I decided to focus on the most popular procedures for my adventure through Scottsdale. Although this is not a story about botched plastic surgery, I did research each doctor before I visited. Each of them came highly recommended from online forums, like yestheyrefake.net, where women meet to exchange surgery tales and doctor names. I checked each doctor out with the state medical board, and though the records they keep go back only five years, none of my doctors faced any malpractice suits, though one had gotten into trouble for writing an unnecessary prescription for a family member. I've chosen not to reveal names here because no one knew what I was really up to.

I talked to two doctors about rhinoplasty (nose job), two about breast augmentation, two about liposuction, and another one about Lipodissolve. I consulted a couple of skin specialists and a tattoo-removal specialist (I have two tattoos — one I love, one I absolutely hate). Just to even things out, I also spent time with a personal trainer.

The consensus: They'd all happily work on me.

For around $25,000, I could have a completely new body, a reshaped face, smoother skin, and my stupid tattoo removed. If I felt like throwing in an extra $1,200, I could hire a personal trainer for 24 sessions.

But why would anyone drop that kind of money to fix flaws most people probably don't even notice? To find out, I had to track down Nik Richie, founder of dirtyscottsdale.com. Richie bills himself as the "first-ever reality blogger" on his site, which mocks Scottsdale socialites.

Richie's premise is extremely simple: People send in pictures of themselves or their friends partying in Scottsdale, and Richie writes mean things about them. It's hilarious. Cruel, but hilarious. I wish hipster-oriented photo sites like Cobrasnake or Last Night's Party came with this kind of commentary.

For example, one photo of a guy in his early 20s (perfectly gelled blond hair and all) and an older woman (complete with weird-looking implants) gets the caption, "Look ma, I caught a cougar." An overly tan man with a tattoo around his belly button gets this response: "You know you've made it in life when you have a tribal belly button." And a group of Scottsdale girls flashing their asses (and thongs) at the camera get this: "Burn whale tails . . . the girl on the right has the right idea . . . as a guy, they are so hard to take off especially if a chick is wearing jeans because it is a 2-part processes which gives her 2 chances to realize she should not be sleeping with you. That is why I am a very firm believer in miniskirts."

I wondered what he would say about me, so I sent Richie some pictures of me. I haven't heard back. I asked why, and he responded in an e-mail, "I don't want you to hate me."

Richie's identity has been a secret so far — he doesn't want to lose his day job because of the Web site. But, rumor has it, he plans on revealing himself soon at his "Pull Wool" party, scheduled for September 27, the day this issue hits the stands.

Dirtyscottsdale.com isn't a success just because it's funny. If Richie didn't completely understand Scottsdale culture, the mean-spirited joke would have gotten old fast. It seems to me the site works because Richie totally gets why people drop so much money on surgery, tanning beds, clothes, and cover charges.

Though it's turned into a full-time gig for him, the site started as a joke.

Of course, one could argue that the entire Scottsdale scene is a joke, and Richie was just smart enough to figure out the punch line.

"I was having lunch at Ra in Kierland [Commons] and eavesdropped on three different tables of chicks. One was talking about plastic surgery. One was reading and exchanging tabloids. One was talking about nightlife and who people went home with," he wrote in a recent e-mail interview. "That's when it clicked. Because everyone in Scottsdale wants to be somebody for 10 seconds."

He informed me that the quickest way a woman can elevate herself one point on his 10-point scale is lipo under her chin. Apparently, this surgery isn't very noticeable, and it makes your face thinner. If you're keeping score, implants can raise you two points on the 10-point scale. (I was a little surprised at this. Just two points? A good face really is important.)

Still, guess I better do something about these B cups.

I'm on the way to my first doctor's appointment and I'm rehearsing what I'm going to say. I've never considered breast implants before, so I don't know what someone who really wants them would say. I'm totally out of my comfort zone, emotionally and geographically — I never go to north Scottsdale.

As I walk into the building in my American Apparel T-shirt and jeans, still trying to decide what to say to the doctor, a pair of Armani-clad fake boobs (attached to a Botoxed older woman) pass me. I can't help but stare.

On the ground floor of this building, there is a surgery center for people who actually have things wrong with them. You know, real medical problems. Even though I'm not going to go through with the implants, I still feel a little superficial and vain walking past them.

When I get upstairs, it's obvious I'm out of my league. The receptionist is flawless. It doesn't look like she has implants, but her skin is absolutely perfect. I don't covet breasts, but I've always been jealous of good skin.

She hands me some forms. After a quick look at them, I decide to lie about certain things. Specifically, the questions asking about smoking, drinking, and recreational drug use. I'm here for boobs, not a lecture.

As I'm filling out my paperwork, I spot a couple of photographs of the doctor. He's in his early 50s, but looks better than half my friends in their 20s. I have no idea what work he's had done, but no one looks this good naturally. I find the picture unsettling. Unfortunately, I won't get a chance to judge this guy's youth in person. This appointment is with his assistant, and this doc only meets patients face-to-face when they agree to surgery. I find this unsettling, too.

I meet his assistant, the Q-tip-testing photographer, and we chat about risks, benefits, and types of implants.

It turns out silicone implants are, once again, all the rage. In 1992, they were pulled off the market. The FDA declared a moratorium on silicone because it was suspected the implants caused cancer and connective tissue disease. Though silicone is preferable to saline implants (which go in deflated and then get pumped up), use was restricted only to reconstructive patients and clinical trials.

But in 2006, the FDA reversed its decision and surgeons everywhere raised their scalpels in joy. The doctors I spoke with tell me that it's preferable to work with because silicone feels more natural and makes a better shape.

I have to agree: The implants are fun to play with.

I got my chance after "Q-tip" was done photographing my chest. She gives me a bra to wear and we start stuffing it with silicone.

"We're going to have you try on implants and you tell me, too big, too small, and perfect," she says. She hands me two implants and I shove them into my bra. I feel like I'm at some kind of bizarre slumber party. She gives me a shirt to try on over them.

I look weird. I already think they're too big, but I have to play along, so I ask for the next size up.

"Okay, just lean forward for me, though," she says. I assume she's just checking the placement, but between the leaning forward and the Q-tip test, I'm starting to think she's making fun of me.

We go up 50cc's. Now I look truly ridiculous. The thing is, I really like my breasts how they are. I think they're the perfect size — small but shapely, according to an old friend of mine.

I tell her I think these are a good size.

"Let's go just a little larger," she urges. "I think that looks nice on you, but let's go just a little bigger. We want to keep going until we say that's too big."

We go through this twice more. I'm feeling super-weird and I tell her so.

"Let's go one bigger," she says. "Is that your natural curly hair?"

That's it. She's totally mocking me (and, by the way, it's not. I use sponge rollers most every night — told you I was kind of like a librarian.)

I am now packing 500cc's of breast inside my borrowed bra. And I look terrible. It's just excessive. I tell the assistant I liked the second set and she writes that down. I get dressed and ask if I can talk with the doctor before I schedule anything. She says I might be able to meet with him for five minutes or so, but not for another month.

I think that is crazy. Although this is just a hypothetical surgery situation, I can't imagine anyone agreeing to pay for surgery before they even get to meet the doctor.

I leave the office knowing two things for sure. One: I will never, ever get implants, if only for the sheer fact that I look bizarre with big boobs. Two: I want my dignity back.

Unfortunately, I've got much lower to go.

A couple of days later, I pull up outside the Fig Center, again in north Scottsdale. I am here to learn how injecting a soy-based protein into my thighs can dissolve fat. The Fig Center is the only place in town that offers the treatment. Since it came out in 2005, Lipodissolve has been marketed as a way to slim down without surgery or dieting. The compound is injected into the chosen area, where it absorbs the fat cells, breaks them down, and then gets rid of them like normal human waste.

It sounds too good to be true.

It kind of is. First, the compound is not FDA-approved, and some surgeons argue that without proper clinical trials there's no way to prove that it works. Lipodissolve's creators say there's no reason to assume it's unsafe. After all, it's been available for more than a decade in Europe.

Enticed by the free consultation, I decided to pay a visit and find out for myself. At the clinic, I meet with a nurse who looks like pre-surgery Cher. I like her immediately because of that and because of the fact that when she weighs me, she informs me I am an "excellent weight."

We go into a consultation room and I'm relieved when no one asks me to change into embarrassing paper clothing. No body parts will be exposed today. No pictures taken. I like it here.

"Cher" asks me what I want done and I tell her I'd like to have thinner thighs. I'm sad to find out I can get the injections only in the inner and outer sides of my thighs, not in the back (where I think they really need it) because there's a risk they'd inject muscle and not fat.

For a second, I'm a little disappointed until I remember I'm not actually going through with the procedure.

She gives me the rundown about how it works and what I can realistically expect. She explains that there are side effects. Mostly, there's a lot of swelling for "three to four days" following the injections.

One surgeon I spoke to, who doesn't perform Lipodissolve, says the swelling lasts much longer than that.

After we run through the side effects, "Cher" drops a bombshell on me: The procedure usually takes about nine treatments to see results. Each treatment consists of 14 "micro-shots" into the area. That's 126 injections. And about 18 weeks of pain (the shots are administered every two weeks).

I learn something else unsettling. The doctor listed on the Web site as the person in charge isn't the one who actually does the injections. He's simply the medical director who stops by a few times a week; nurses and physician's assistants administer the shots.

I guess this doesn't bother many people because the center treats about 100 to 125 people per day.

She informs me that the procedure works so well because we have only a certain number of fat cells in our bodies. The number never increases. She goes on to talk about something else, but I miss it. I'm way too excited at the thought of not being able to produce new fat cells. I think "Cher" can tell I'm not listening anymore. She finishes her sales pitch and shakes my hand.

"It should be a very good result," she tells me. "You have tons of collagen and you're not above your ideal weight."

I like how she keeps reassuring me I'm not fat.

She leaves the room and sends someone in to talk finances. Before I find out how much it's going to cost, I'm actually considering the procedure. Never mind the fact that I could achieve the same results at the gym, or the fact that I'm already in debt and can't afford to pay someone to dissolve my fat for me. I want this! I need this!

Then I hear the price. The center is running a "sale" for the month of August, so I can get it done for around $3,500 for both thighs. Or $317.54 per month. Thighs are usually $2,200 each.

I pretend that this price tag doesn't faze me. But inside all I can think is, "$317.54? That's the same as two car payments." And then, "How am I going to get out of this?" Clearly, I cannot fake the rich-girl mentality. I mumble a really lame sounding excuse about having to talk the price over with my dad (rich kids get everything from Dad, right?) and say that I will call them back in a few days and hustle out to the parking lot, and my dust-covered Civic.

As I prepare to battle rush-hour traffic back to my central Phoenix apartment, I call a friend of mine in Tucson. She is just as excited at the news about our limited number of fat cells. Before I started this story, she and I shared the same biases about plastic surgery (meaning, we both thought it was a waste of money) but she agrees with me that Lipodissolve sounds tempting. Until I mention the price and the 14 shots.

Her response to the thought of 126 injections was something along the lines of, "Girl, are you crazy?"

She has a point. Plus, armed with my new knowledge about the function and structure of fat cells, I feel more confident I can shrink them with exercise. As long as I know they aren't conspiring to multiply, I can defeat them.

It's a good thing I'm feeling so exercise-oriented. I have a meeting with a personal trainer a few days later.

I made the appointment because it seems to me someone my age should be able to get in amazing shape without surgery or excessive expense. Plus, to be honest, I wanted to pick up some info I could take and apply to my normal workouts.

Here's the thing about exercise. I have a gym membership and I do use it. I like feeling healthy, and I smoke a lot, so I figure I owe my body. It's a trade-off. But my workouts are pretty standard: an hour of some kind of cardio and then whatever I feel like doing on the weights (which usually isn't that much).

As I drive to my appointment in north Scottsdale (where else?), I try to picture what my trainer will look like. Based on the way he sounded on the phone, I'm picturing an enormous man who could double as a bodyguard for Tony Soprano. I'm a little scared. Is he going to laugh at my skinny arms and make me do pushups? Is he going to spout awful clichés about pumping me up? When I get to the gym, there are plenty of men there who fit that description. (I'm almost surprised none of them is wearing a gold chain while working out.) But my trainer isn't one of them. He's about my age and isn't as intimidating as I thought he would be.

He takes me to a room where we talk about my "fitness goals" (to not feel like an out-of-shape wuss) and diet. Then comes the awkward part. The trainer takes my measurements — including, for some reason, the circumference of my neck — which is actually just as embarrassing as having my breasts photographed. It's odd to have a complete stranger measuring my thighs. I'm silently grateful I shaved my legs. These appointments are starting to feel like a series of way-too-personal first dates.

After we're done talking, we get to the hard stuff: the workout. I'm in decent shape, so I expected to be able to perform the exercises without much of a struggle. I was wrong. He broke me in easily enough — lunges across the gym a few times — but by the last set of the last exercise, my kind feelings for the guy had evaporated.

As I was sweating through some draconian move I don't know the name of (it had me bouncing on and off an elevated platform, holding a medicine ball) I glanced up at the TV. An ad for Lipodissolve was on. I've never really been a proponent for the easy way out, but after half an hour with this guy, 126 shots to the thighs didn't sound so bad.

Of course, by the end of the session, it was time to talk money. And, of course, it's out of my range: One session is $70, and 24 sessions cost $1,200. And he recommends I come twice a week, to start.

I'm a little sad I can't sign up — I have no doubt this guy would get me in great shape. Plus, I'm starting to feel bad, getting to know these people, using their professional time and then crapping out on the follow-through. Luckily, I've gotten good at the "I have to talk to my dad" excuse.

The next day, I wake up cursing the trainer. I can hardly move my legs. I wish he'd had me stretch. I'm sore and swollen for the next few days. Unfortunately, there's no time to wallow in my aching muscular pain. I have another doctor's appointment to go to. This time, we're talking rhinoplasty.

A few words about my nose: It's extremely cute. When I mentioned to someone I was thinking about a nose job, his response was, "Why? You have a perfect nose."

And it's true. People get nose jobs to get my nose. But it is crooked (though most people don't notice until I force them to stare at it for a while). To be honest, I'd never change it, even if someone else was willing to pay for the $8,000 surgery.

I booked my appointment with a doctor known around town for his facial work. He does nothing but reconstruct and change faces, and from what I hear, he's the best. I figured if anyone could talk me into hating my nose, it would be this guy.

At his office, I grab pamphlets for every procedure they offer: nasal surgery, eyelid lift, chin implant, and so on. I laugh to myself when I see the chin-implant guide.

"Who would get a chin implant?" I ask in my head. "That is so, so weird."

I'm picturing an army of large-breasted Jay Lenos.

I also grab the brochure for permanent makeup. I'm slightly disturbed by the answer provided under the heading, "Does it hurt?"

"Most people find the method very relaxing," it says.

I'm not sure how that's possible. Having eyeliner tattooed on seems like pretty much the least relaxing thing I can think of.

When I'm called into the doctor's office, I'm offered water and chocolate. I decline the candy. My legs are still aching from my session with the trainer, and all I can think about is my calorie intake.

I didn't get to meet the breast implant or Lipodissolve doctors face-to-face, and this is the first plastic surgeon I've shaken hands with. He is exactly what you expect a plastic surgeon to be: good-looking, strong handshake, polite but cocky. He's Christian from Nip/Tuck.

We talk about my nose, and he agrees it's crooked. He thinks he can fix it by breaking it in several places and realigning the bones around it. He informs me that the angle between the bottom of my nose and my lips is perfect — it's the exact shape they strive for during surgery.

But before I can gloat about the superb angles of my face, the doc informs me I need a chin implant.


Since my teenage years, I've carefully recorded my faults. If pressed, I can tell you everything I don't like about myself, from my eyebrows down to my long second toe. But my chin never made the list.

The doctor tells me it's weak, and an implant will make my profile much stronger. He illustrates this on the computer. I sort of see what he's talking about in the "before" picture, but I think the "after" implant picture makes me look a little witchy. (And it would cost about $2,500 — a discounted price for getting it with the nose job.)

The "after" picture of my nose doesn't look any different. It still looks crooked to me.

I touch my chin, trying to picture a little ball of implant in it, and tell the doctor I'd like to think about it. He agrees, I shouldn't rush into anything. Then he mentions there are several skin-care specialists on his staff. Would I care for a complimentary consultation?

My skin is a touchy subject. It's probably my worst feature, thanks to a rough bout of acne that began when I was 12. It looks okay now, but just okay. I agree to talk to one of his specialists just to get the doctor out of the room before he talks me into an eyebrow lift or cheek implants.

I'm sent to talk finances with his office manager. I much prefer her to the doctor. She informs me that she had a chin implant a couple of years ago.

"A lot of people leave the office with a complex because they never thought about it before," she tells me.

No kidding.

I use my now-perfected talking-it-over-with-Daddy line, book an appointment for a skin consult, and get the hell out of there.

During the whole drive home, I stare at my chin in the rearview mirror.

My consultation with the skin-care specialist is much less ego-crushing. I already know my skin isn't the greatest, so what she tells me isn't news. I'm actually really interested in the procedures they offer, and if I had $150 to spare every six weeks, I'd already be a microdermabrasion fanatic.

She also tells me about a shot called Restylane that I can get for the low, low price of $510 a shot. Restylane is a dermal filler (which means it will fill in my deeper scars, whereas microdermabrasion just buffs the skin) normally used for wrinkles. It stays good for six months. I know — because the doctor told me — that this particular skin specialist has the same kind of skin as me. She's been getting Restylane shots, and she looks amazing. Unfortunately, I have to chalk this up to another "if I could afford it" experience, and leave without booking an appointment.

I notice that my opinion on this stuff starting to change. I mean, I really would go for the Restylane injections if I could.

But by this point in my experiment, the doctor visits are starting to wear me down. I'm finding it hard to make it to them on time because I'm tired of pretending not to like myself. I'm also sick of wasting my cute panties on these appointments.

Plus, my previously held standards of beauty are starting to morph. I notice myself constantly evaluating every body that crosses my path, wondering if the person has had work done, making note of what I think they should consider.

I'm also perpetually late to appointments because I just can't seem to learn my way around Scottsdale. It's with great relief that I arrive (almost an hour late) at my second-to-last plastic surgeon appointment.

I'm here to talk about real liposuction and find out what the doc thinks of Lipodissolve. I throw in a boob job just for fun.

The doctor in this office was licensed just a year ago, so we're within 10 years of each other. This makes things more awkward when it comes time to strip. But before I don the now-familiar paper robes, we have to talk about what I want. I am so bored with these conversations.

As I sit in the examining room waiting for him to enter, some crappy pop star is singing about releasing your inhibitions and feeling rain upon your skin.

I'm rewriting the lyrics in my head to say, "Release your inhibitions, feel the blade upon your skin."

This is what too many plastic surgery consultations can do to a girl.

The doctor comes in and I ask what he thinks about Lipodissolve. He practically jumps out of his chair. Apparently, this is a touchy subject among surgeons.

"Lipodissolve is a compound previously used to dissolve gallstones. Someone decided to see what happens when they inject it into the skin," he says. I can tell from the gallstone reference, he doesn't think highly of the procedure. "They get results, but it's very limited. Plastic surgeons aren't doing it because it's not proven. I know surgeons who have done it to themselves to see, and they had no results but an extreme amount of pain."

Okay. No Lipodissolve. We settle on traditional liposuction and possible breast implants. He tells me the recovery period for lipo is about two weeks and that I will have to wear a "garment" during that time. He says it's like bike shorts, but every time he says the word "garment," I'm picturing Mormon wedding underpants. Hot.

He glosses over the painful part, but I've done my homework. If I were to get the procedure, he would make several incisions in my thighs and insert an instrument that digs the fat out and sends it shooting out of my body via a tube. It's not as invasive as other surgeries, but it's nothing to take lightly. Some women have bruising up and down their legs for weeks.

Now it's time for him to take a look at what I've got, and what he'll be "fixing." He sends in his assistant to bring me some "clothes" to put on. The panties are especially humiliating — they're made out of paper and have only a string of elastic holding them together. I'm not sure why I have to wear them because you can see my legs just fine in my own underwear, but I decide not to argue.

On her way out, the assistant tells me they remind her of edible panties. I laugh nervously. I get dressed and am pretty much dying of embarrassment when both the doctor and the assistant come back in (it's bad enough having my nipples measured with one person in the room).

Yes, that's what he does. The doctor pulls out a sliding ruler and measures my breasts and my nipples. I now know how large my areolas are in centimeters. I think it's safe to say that I could have probably gone the rest of my life without that knowledge.

Unfortunately, the worst part is not over. He pulls out a camera, and I repeat my previous photo shoot — only this time, I'm even more naked, thanks to the stupid paper panties.

The assistant diverts her eyes. When she notices my embarrassment, she assures me, "I know how you feel." She got her implants in 1986. I'm starting to like her better.

As the doctor snaps pictures of every uncomfortable angle of my body, Nickelback is singing a song about gold diggers and models. I hate Nickelback, and the singer's terrible vocals are only making this moment worse for me.

But I pick up on a line of the song: "We all just wanna be big rock stars, live in hilltop houses, driving 15 cars. The girls come easy and the drugs come cheap. We'll all stay skinny cuz we just won't eat."

It's a shitty song that sums up a shitty worldview, but it crystallizes the reason I'm standing topless, bored and blushing, in this office right now.

I never thought I'd say this, but Nickelback has given me an epiphany.

What happens in these offices is just the beginning. Along with the lipo and the breast implants, the nose job and the new chin, comes a whole lifestyle. The pressure for perfection is intense, and once one part of the body is "fixed," it's easy to focus on another flaw.

I'm struggling to see the point. I decide it's time to call the experts.

Maybe Nik Richie, the Dirty Scottsdale guy, is right. Maybe everyone just wants to feel famous, even if it's only to a bunch of has-beens and never-weres in the local bar scene. It certainly makes sense, the way he explains it.

"They want a local celeb status. It's easy to be famous out here in the Scottsdale scene. Every girl or guy wants to be talked about," Richie says. "So if a girl is getting so much attention and she looks a certain way . . . when in Rome. I look at women in two different ways: a girl I would sleep with and never talk to again, and a girl I would go horseback riding with and see if they will accept this rose."

I guess it comes as no surprise that Richie is a fan of plastic surgery.

"I love plastic surgery on women. I am all about it," he says. "If a chick wants to make herself look and feel better, go for it. Competition in the world is what makes our country the best. We strive for perfection."

It turns out, I agree with him. Sort of. I do think working to make yourself feel better is fine, and how you decide to do that is up to you. But I do worry that the availability of surgery, and the image of total physical perfection it promotes, isn't healthy.

Alyssa Mandel is a psychotherapist who treats body dysmorphia, as well as other body-image and eating disorders, at the Mandel Center in Phoenix. She says many of her patients consider "fixing" their problems with surgery.

"They come to me saying, 'I hate my body. I'm obsessing over my thighs. I want to do something to them. I'm not getting a job as a result of my thighs.' It can be any part of the body," she says. "Once you get that part of your body fixed, it changes. If it's your nose and you get a nose job, you decide your lips are too small."

Mandel concedes that not everyone who gets plastic surgery has body dysmorphia. But she does think anyone considering surgery needs to ask themselves very serious questions — questions that are deeper than "Do I want a C cup or a D?"

Consider how much this surgery is really going to change your life. Get ready not to have the exact results you want. Get ready to go into debt. I can only assume most people don't pay for their surgery up-front. Every doctor I visited discussed financing with me.

It's a high cost for self-esteem, but Mandel says the drive for perfection isn't going to slow down.

"Does it run as a theme in our society? Yes. Our obsession with the external — we all internalize that," she says. "It's rampant. You can drive yourself insane. And people do."

Insane is exactly how I feel at the moment. I am trying to find my last appointment, and from the second I got in my car today, I've been trying to come up with excuses to miss it.

I never want to see the inside of a doctor's office again. I don't want to fill out any more forms. I don't want to pretend to care about procedures I don't want or need. Right now, I really just want a nap and a car that can fly, because Shea is really backed up.

Somehow, I force myself to the office.

But it's the wrong one. Oh, it's a plastic surgeon — you can't throw a rock in north Scottsdale without hitting a plastic surgeon's office — it's just the wrong plastic surgeon's office.

I'm staring at the building directory, trying to figure out where I am and whether I just drove to the wrong place. Letters swirl in front of me: FACS, DDS, OB-GYN, MD, PhD, CPPC, BSN, MC. This is a building full of people with a lot of degrees who make a lot of money.

One title stands out to me: PSYCHIATRIST.

I feel like I need one right now.

I catch a glimpse of myself in the mirrored window. Even though it's a thousand degrees outside and I'm freaked out with stress, I think I look pretty good. My legs look nice today. I can thank hours at LA Fitness for that. (The fear of writing this story gets me to the gym every day now.) My big sunglasses are hiding my crazy eyes.

I have one thought: Fuck this. I want to go home, scream into my pillow, curse my job (and poor sense of direction), and go for a frustrated run. But I force myself to suck it up and find my last doctor.

Miraculously, I find the office a couple of blocks away. But I'm still feeling surly. In fact, I feel like smashing into the new Audi I park next to. I decide to just let it rip at this appointment. No more lying about my bad habits and no more insecure little rich girl routine. It might be the heat getting to me, but at this point, I feel like puking at the thought of spending more than the GNP of some entire nations, just to fix my "imperfections."

I'm feeling particularly hateful as I fill out my forms.

"What is the purpose of this consult?" it asks. I want to write, "What do you fucking think?" Instead I write "rhinoplasty and liposuction."

"Have you ever received treatment for a mental condition?"

Yes. (On all the other forms, I said no.)

"Do you smoke?"

A pack a day.

One question in particular bothers me: "Please describe your health. Height __ Weight __."

Call me crazy, but it seems like there's a lot more to describing my shape than just noting my height and weight. I sigh and fill it in. I am totally prepared to hate this doctor.

But when I meet him, I can't. He turns out to be the most responsible doctor I've met. When we talk about my nose, he tells me that, realistically, he doesn't think he can correct the crookedness. He takes photos to show me how it's not just my nose, but the bones in my face that shift slightly in one direction, then back again. He refuses to do the rhinoplasty.

"Your nose is exactly over your lip. The tip aligns perfectly. But up here, your face is over here," he says. "All I can say is, if you decide to have it done, make sure you get it done by someone who understands that your face is crooked. I personally wouldn't recommend it. But look at the tip! It's beautiful. You're a very pretty girl."

I appreciate his reassurance that I'm not a monster, considering he just informed me that my face is slightly crooked. Even more than that, I appreciate his honesty, and the fact that he won't sign me up for surgery (or try to up-sell me a chin).

Back in his consultation room — which, by the way, is lit very well — he gives me a real robe to change into, and we talk about liposuction. I decide to tell a huge lie and say I was thinking about a tummy tuck.

He laughs at me: "That's ridiculously excessive."

I'm liking him more by the minute. It's funny that the doctor I've been surliest to is the one who has made me most comfortable. We conclude that liposuction would be an option if I decide I want it, and he quotes me a price.

On the way out, he gives me the best advice any doctor has so far.

"There will be a result you're happy with," he says. "As long as you're realistic about your expectations."

Driving home, the words "realistic expectations" continue to ring in my ears.

Is any part of this lifestyle realistic? Is it realistic to expect that bigger breasts or thinner thighs will change your life? Is it realistic to care about local celebrity status as much as Nik Richie says so many people in Scottsdale do?

We are so obsessed with image. I've actually seen signs that ask, "Got Botox?" A recent article in the New York Times Magazine talked about a new technology that would allow parents to genetically engineer a skinnier baby.

That freaks me out. Yet, I have to admit, if I had the spare $510, I'd probably have booked a Restylane injection already. And when you break it down, I guess that makes me the same as the breast-augmentation girls, and the women who get tummy tucks. It's all vanity, no matter how noninvasive the procedure is.

I recently saw Cedric the Entertainer on TV, talking about the same thing.

"People are getting this shit done just because they can," he said. "They're getting their eyebrows rotated. It's like a human Pimp My Ride."

I know he was making a joke, but he speaks the truth.

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Megan Irwin
Contact: Megan Irwin