DR. HARRIS:  Tradition has always said that black don’t crack.

PATIENT:  Of course you are going to get older.  You can't stop mother time, but you can slow it down a little bit.  Most people are not going to say you have a big nose.  You need to get that taken care of soon.

PATIENT'S SISTER:   For so long we were told that we were ugly.  That we weren’t beautiful.  That black was always associated with the negative.

HOST:   If you are bothered by your natural look or your opinion to be acceptable, that is a problem we have to question.

On this TV-One special presentation we explore the myths, misconceptions and the realities of cosmetic surgery. 

Join us for Black Don't Crack, the cosmetic surgery today.

As black women have found their identity and the confidence to express themselves, they are discovering that beauty does not just come in a bottle and that they can do more to enhance their beauty.  Coming up on “Black Don't Crack,” the trailblazers of cosmetic surgery.

Although Americans have been getting cosmetic surgery since the 1950s, the industry remained in the closet for years and when it came to the African American community, the procedures were almost unheard of.

Growing up in Indiana, Dr. Harris did not think plastic surgery would be his career choice.

DR. HARRIS:  I thought I wanted to be an architect at one point.  I realized that engineering and architecture is fine but I did not like math as much as the biological sciences and I ended up in medicine.  I feel now that through this merger of my past and where I am now, I am an architect.  I'm just an architect of the face.  I have always had this appreciation for balance and harmony and got a sense of fulfillness when I saw things that looked appealing.

HOST:  Afraid of being judged or misunderstood as trying to conform to the European standard of beauty, cosmetic surgery was taboo among African Americans.  Although Jill Smith was confident in the final result, her family did not quite understand why she wanted a nose job.

PATIENT:  They weren't too happy.  My sister, for example, wanted to know who I was trying to look like, there was nothing wrong with my nose, I'm just fine.  What is the issue so to speak?

PATIENT'S SISTER:  I did not take her seriously.  I thought it was just an extension of her early childhood that she wanted to be something different and that this was another fad or phase she was going through so I basically black fed her.  I told her there was nothing wrong with your nose.

PATIENT:  My father's biggest concern was you are doing away with my nose, those are my genes.  What are you doing?

PATIENT'S FATHER:  The nose was the nose.  I mean, we are black folks and we have certain characteristics.  To be ashamed of it and to want to change it because you are ashamed of it, means that you are ashamed of your mother and father and your community.

PATIENT:  There is not really a lot of support which is pretty common with rhinoplasty.  Most people are not going to say you have a big nose, you need to get that taken care of soon.  You are not going to get a whole lot of support like you would perhaps for other types of surgery.

PATIENT'S SISTER:  I do think we get caught up in trying to look like something other than what we are, who we are.  I think natural beauty is not appreciated unless it is on other folks.  Yes, I do feel that there is pressure on African Americans to look a certain way and it does play a role on our self esteem.

HOST:  Eventually the family came around but they still had their reservations.

PATIENT'S SISTER:  My biggest fears about her having surgery was just the risk of having surgery and also getting an end product that she was not happy with. 

In talking with Dr. Harris he pretty much explained that it would not be anything major.  That all she would or close family members would notice a difference but it would be enough to make her happy.

PATIENT'S FATHER:  I saw certain African Americans in the community have plastic surgery and it looked like a horror show.  One person in particular comes to mind.  I certainly didn’t want her to have this done to her and then regret it in the aftermath.

HOST:  When Jill Smith decided on plastic surgery, she knew she needed the right doctor and knew she could find one in Washington, D.C. where 60% of its population is made up of African Americans.  No other city in the country embodies power and beauty for blacks quite like D.C.

PATIENT:  My biggest concern was that I would not find a physician that would understand what my needs were, that would probably overly pinch the nose or perhaps make my nose too narrow and just not a nose that went with my face.

HOST:  There Jill met with plastic surgeon Dr. Monte Harris and got all her questions answered.

DR. HARRIS:  Jill presented with not concerns, but wanting to improve the balance and shape of her nose.  Her goal was to just achieve a little bit of narrowing in the bridge and a little bit more refinement in her tip.

HOST:  Dr. Harris put Jill at ease after discussing the procedures and giving his own natural-look approach.

DR. HARRIS:  It is not the type of operation that I want people coming up to my patients and saying "Hey, did you have your nose done?"  My patients really recognize the changes that we have made and appreciate the changes. 

The taboos of cosmetic surgery with African Americans primarily relate to this loss of cultural identity or racial identity and from the standpoint of those type of procedures that may have that impact primarily centers on rhinoplasty or nose reshaping and people that may endeavor to change the shape of their nose somehow that causes them to lose a little bit of who they are as an individual.  The majority of the taboo has focused around rhinoplasty for African Americans.

HOST:  Most importantly for African American faces, Dr. Harris is a specialist in facial plastic surgery.  He provides for his patients a security that white plastic surgeons cannot offer.

DR. HARRIS:  We have a similar, to some degree, aesthetic understanding of what it means to have a black nose.  What it means to have more African facial features and that plays out.

HOST:  In spite of the still existing taboos, African Americans are having cosmetic surgery and loving the results. 

Another reason for the boom is that surgeons are minimizing the incisions they make, thus reducing the possibility of infections and bad scarring.

DR. HARRIS:  We have all these wonderful new tools that do not have the same risk related to keloid scarring as in the past that can preferentially reverse aging in the areas where women of color age.  We have more of a targeted approach to facial rejuvenation and we have surgeons that now appreciate that the aging process is different and it differs to some degree based upon ethnicity.

HOST:  One major difference Dr. Harris found comes hand in hand with an old African American myth.

DR. HARRIS:  Tradition has always said that black don't crack and truthfully black does not really crack but there are signs of aging that are beneath the surface of the skin.  In some cases we actually age a little bit worse in the areas of the eyes and cheeks and we age less around the neck line and in the jowls.

The interesting thing is that procedures related to cosmetic surgery in the past have primarily focused around the neck and the jowls and that is why there has not been a need particularly for women of color to do those types of procedures.  That was not where we were aging.  The art of cosmetic surgery truly is matching the patient's expectations with reality.  Despite what patients will see, they will watch extreme makeovers and they will say I want to get a rhinoplasty or a nose reshaping or a facelift or breast lift, or liposuction. 

It is up to me to say realistically these are the types of things that you can expect to do in one setting and we can map out a pathway for you to achieve those goals but achieve them in a more of a realistic manner.

HOST:  After a successful surgery and a painful first week, Jill Smith finally got a glimpse of her new nose.

PATIENT:  It was really, really exciting because I could immediately start to see the size of the bridge sort of come together, a little more narrowing, but it still was not obviously where I wanted it to be.

HOST:  Today Jill's recovery is still in its beginning stages but Dr. Harris' work is already noticeable.

DR. HARRIS:  She is sort of right in that period of time about six weeks out or so when you can see this is a pretty significant difference from where I was before.  She is quite pleased.

PATIENT:  When I look in the mirror, I know that it is not the finished product yet.  It is a long recovery process and it can take up to 12 months before you see what the final end result will look like.  But so far, even with my nose swollen, it is still smaller than what my nose was before so I am very pleased.

HOST:  In spite of the inherent risks involved and the stigma that is still attached to cosmetic surgery, more and more African Americans are considering going under the knife.  As in the case of Jill, her rhinoplasty did more than raise her self esteem.  It also shifted her father's point of view.

PATIENT'S FATHER:  It changed my opinion of about how black people look at plastic surgery and if it really helps black people to enhance their self image and how they feel about themselves, I would seriously suggest to tell black people that they need to consider a procedure.