That nose, that chin, those lips

When Nino Dean looks in the mirror, the face staring back at him is eerily evocative of Vanessa Paradis, the French chanteuse and former paramour of Johnny Depp.

This is not a lucky roll of the genetic dice. Mr. Dean, a freelance fashion stylist in Manhattan, had surgery 13 years ago to have his visage molded to resemble, at the very least, Ms. Paradis’s second cousin, if not her identical twin.

"I wanted her baby face," said Mr. Dean, who is 37 but said most people guess he is in his mid-20s. "I still find her my favorite beauty of all."

Magazines and websites routinely publish photographs of people who have altered their faces to look like a movie star, pop singer, Mattel product, Egyptian queen or, in the notorious and perhaps unintentional case of the socialite Jocelyn Wildenstein, a wild animal.

While requests for these sorts of utter transformations do not take place every day, doctors say they do happen regularly.

"About once a month, someone comes in who wants to look like a family member, friend or celebrity," said Dr. Sam Lam, a facial plastic surgeon in Dallas. "One guy wanted to look like his cousin who was a model. Another guy wanted a chin implant to look like his older brother."

Though a striking or jarring similarity can sometimes be achieved, it’s impossible to recreate another person’s image. Bone structure, facial proportions and ineffable characteristics all factor into people’s looks.
"We really cannot make someone ‘pass’ for someone else," said Dr. Steven Teitelbaum, a plastic surgeon in Santa Monica, Calif., and a spokesman for the American Society for Aesthetic Plastic Surgery, a professional organization.

"At most, we can try to mimic a feature, such as a nice nose, or even to put in a grossly   disproportionate chin implant to mimic the nearly cartoonish visage of Jay Leno." 

It is possible, however, to repeat the same over-the-top procedure on different patients — say, "an overly high brow lift, excessive nasal reduction, excessively filled lips," Dr. Teitelbaum said. "You can go much farther to mimic features of a Michael Jackson, who is himself a plastic surgical joke, than to create a resemblance to someone who has never had surgery."

Paying homage to a specific body part is also an option. Patients often visit a surgeon’s office armed with a photograph of their favorite celebrity feature.

Stacy Shanahan’s fantasy doppelgänger is Heather Locklear, circa the Sammy Jo Carrington years. Ms. Shanahan, 49, an account executive for a packing company in Mission Viejo, Calif., would give her right cheekbone to acquire the luster of Ms. Locklear, with whom she shares the attributes of blond hair, blue-green eyes and delicate features.

"I know it sounds crazy, but I’d be happy being more like her," Ms. Shanahan said. "I wouldn’t miss how I look. She’s beautiful."

Ms. Shanahan was so determined that she asked Dr. Burr von Maur of Newport Beach, Calif., a plastic surgeon who had given her a breast lift, to help. Dr. von Maur ended up performing a nose job on Ms. Shanahan (the cost: $6,500) to evoke the "spirit" of Ms. Locklear.

"You can never duplicate something; you can’t clone somebody," he said. "It’s best to enhance the patient’s own features, so we can unearth the beauty that lies underneath without radically altering their appearance.

Doctors say that a significant part of their job is weeding out patients with a legitimate medical or aesthetic concern — arbitrary in itself — from those suffering from body dysmorphic disorder, an intense preoccupation with a minor or imagined flaw in one’s appearance.

"I had a patient who went from doctor to doctor trying to get surgery to look like Brad Pitt," said Dr. Amy Wechsler, a dermatologist and psychiatrist on the Upper East Side. "There was this sense of, ‘My life will be so much better if I had this person’s X, Y or Z.’ It can become an obsession."

Many doctors have ethical concerns about these sorts of queries. For example, what if a patient is deemed psychologically healthy and still wants to look like the devil? Should a doctor comply? Or what if a patient earns his living as a Michael Jackson impersonator, and wants surgery to enhance his career? A French artist, Orlan, after all, has used her face as a surgical canvas to question established notions of beauty.

"You respect a patient’s autonomy," said Leonard Fleck, a professor of philosophy and medical ethics in the college of human medicine at Michigan State University. However, if a doctor thinks the patient’s choice is misguided, "he is not morally obligated to follow their wishes," Dr. Fleck said. "He can say, ‘I feel that that’s a really bad idea. "

Joan Kron, the author of "Lift: Wanting, Fearing and Having a Face-Lift" and the contributing editor at large for Allure, said she believed that it was a doctor’s responsibility to fulfill a patient’s wishes, within reason, without imposing his or her own opinion.

"Most doctors are trained to ask you why you’re there," Ms. Kron said. "That’s usually the first question. If the doctor grabs you before you even open your mouth and says, ‘I’ve got to fix your nose,’ I would walk out."

As for the more outlandish requests, she questioned whether they were any worse than other culturally accepted modes of body modification.

"Is it worse to look like a cat or worse to be decorated on every inch of your skin with tattoos?" she said. If you want to look like a cat, she added, "maybe you should be encouraged to have a dress rehearsal with makeup first, to see if you really want to live with that look."

Liberace’s former boyfriend, Scott Thorson, said he thought patients should be able to do as they wish. When Mr. Thorson was 20, Dr. Jack Startz performed rhinoplasty on him, gave him a chin implant and restructured his cheekbones to look similar to Liberace’s.

Mr. Thorson, now 54, said that he was happy with his face, although he did remove the chin implant.

"I’ve gotten so used to it," he said. "People can do what they want to do. I don’t think there’s anything wrong with it."

Neither does Deborah Davenport, 41, who owns a real estate technology consulting firm in McKinney, Tex. For years, Ms. Davenport was told that she was a dead ringer for the actress Cameron Diaz, which did not please her.

"My nose just seems to get fatter and fatter every year, Ms. Davenport said. "I look at photos and I’m like, ‘Oh my God, what’s happening to me?’ "

She asked herself whom she would want to look like, and after scouring magazines and movies, the answer arrived: Kate Winslet. She went to Dr. Lam in Dallas, who shaved cartilage from her nose, injected the dermal filler Sculptra to plump out her cheeks and squirted a little Botox into her forehead and around her eyes to make her more Winslettish. The bill was $15,000.

Few things satisfy Ms. Davenport as much as when she is told she has a likeness to the Oscar-winning star. The irony hasn’ t escaped Ms. Davenport as she underwent a plastic surgery to look like someone who never had one.

    

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