L.A. vs. Europe Plastic Surgery Wars: "My Patients in France Live in Fear of the Hollywood Look"

Illustration by Amanda Lanzone

European plastic surgeons have until now avoided (and derided) "overdone" L.A., but with social media has come "lip idols," Brazilian butt lifts and Londoners clamoring for Meghan Markle's nose.

Though the French haven’t earned a reputation over the years for being modest, when it comes to plastic surgery, they are positively demure in contrast to Angelenos. “My patients in France live in fear of the Hollywood look,” says Parisian plastic surgeon Olivier Claude. “Sophie Marceau is in her 50s and looks wonderful — nobody knows what she had done. People in the U.S. think Nicole Kidman and Megan Fox look good, but we think they look overdone.” Christophe Lepage, also a plastic surgeon based in Paris, adds, “An actress here [in France] wants to look her age but better: Isabelle Huppert just had a face-lift and looks healthier and more relaxed. In L.A., they want to look younger. We think if a facelift shows, it’s a disaster.” 

Beverly Hills plastic surgeon Brent Moelleken counters that the Hollywood emphasis on a youthful appearance is a necessity, not a luxury, and that what Europeans may regard as “overdone” is merely professional maintenance.

“Actresses here are very proactive, and at the slightest sign [of aging], they get a little something done or they won’t work or stay relevant,” he says. “Nicole Kidman is 50, and she wouldn’t be on the cover of magazines if she didn’t have anything done.”

Plus, in Hollywood, there is a premium placed on looking like a star, observes Zurich plastic surgeon Enrique Steiger: “European actresses want to look like Audrey Tautou or Emma Watson; in L.A., they want to look more glamorous, like Angelina Jolie.”While face-lift techniques are the same on both continents, in L.A., “the approach is more dramatic: America has some of the best surgeons technically, but they go further.”

According to Lepage, many French people in the entertainment industry opt for a less drastic thread-lift (from $2,500) rather than a full face-lift, while Claude maintains that French women “think wrinkles can be cute and show expression, but in L.A., they hate wrinkles.” Parisian plastic surgeon Nelly Gauthier, with a clinic just off the Champs-Elysees, says Plexr — a new noninvasive treatment that uses infrared heat to lift the eyes (from $600) — is gaining popularity over less subtle surgery. 

Overall, there are more nonsurgical options in Europe: “We have 30 or 40 brands of filler because we just need the CE [Conformite Europeenne] mark, which is easier to get than FDA approval,” says Lepage.

Bodies, too, are more modest, especially in France. Breasts that fit into a champagne glass always have been the ideal, and a waifish form is prized over a voluptuous figure. “The average volume for implants in France is 200 to 300 ccs [of saline or silicone]; in L.A. it’s 300 to 400,” says Lepage.

Adds Parisian plastic surgeon Jean-Brice Duron: “The average size of [breast] prostheses in the U.S., compared to what we use in France, is almost double.”

Instead of implants, says Steiger, “HD contouring, where we take small amounts of fat from some areas and inject it into breasts or other areas, is a hot new thing and gives a softer effect” (from $12,000). 

But the tide seems to be turning, according to Marina del Rey plastic surgeon Grant Stevens, who has worked in France: “French women want a smaller breast size, but now Americans are moving in that direction. I call it the French effect: This year, women are downsizing, with implants removed.”

All signs point to there being a parallel Hollywood effect in Europe as well, particularly in the U.K. “Where before, everyone was about slender lips and silhouettes, everyone now wants the fuller lip, a bigger bum,” says London-based plastic surgeon Tijion Esho, who cites Emily Ratajkowski and Rosie Huntington-Whiteley as “lip idols,” as are the Kardashians.

Esho blames social media for driving this change: “People are even bringing altered images of themselves using Snapchat or Instagram filters and saying, ‘I want to look like that.’” 

Esho says Meghan Markle already is a major plastic-surgery reference in the U.K.: “A lot of people want nose shapes like her — she’s going to be the new princess, and how much bigger can you get than that? People are in love with her, and with her being a new royal, it dictates trends.”

As for Kim Kardashian West, her biggest European legacy may be behind her: “Now, everybody is looking at nonsurgical butt lifts, the Brazilian butt lift, or BBL” (from $1,380), says Esho, who adds that minismart lipo — which melts fat using a laser rod (from $6,900) — is surging as the procedure to trim waists for that infamous hourglass figure: “Everyone wants a more dramatic change between the hip and the bottom ratio.” 

This story first appeared in the May 2 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.