With the release of a new reality TV show about “extreme makeovers” involving cosmetic surgery, some plastic surgeons are concerned about prospective patients’ expectations when it comes to changing their appearance. Most plastic surgeons strive for natural looking results rather than drastic change, and some of the alterations seen on the show are due more to makeup and attire than to surgical change. While plastic surgery can offer patients dramatic improvements in appearance, it behooves any potential patient to discuss their goals and expectations with a qualified plastic surgeon prior to making a decision for surgery.