The debate over whether reality TV influences its audience is settled. According to a study published in July's Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), first-time patients seeking cosmetic plastic surgery are directly influenced to have a procedure by the plastic surgery reality television shows they watch.

"Despite widespread unease about the effects that reality television shows have on patient decision making and expectations, no data existed on how these shows affected potential patients," said John Persing, MD, ASPS Member Surgeon and study co-author. "The majority of patients reported being directly influenced and, interestingly, ethnicity also played a role in how frequently these shows were watched and how they influenced patients."

The study examined 42 cosmetic plastic surgery patients. Fifty-seven percent of patients were considered high-intensity viewers of plastic surgery shows, regularly watching at least one ongoing program. Patients in the high- intensity category reported a greater influence from television and the media to pursue cosmetic plastic surgery, felt more knowledgeable about plastic surgery in general and believed plastic surgery reality TV shows were more similar to real life than low-intensity viewers did.

In addition four out of five people reported television directly influenced them to pursue a cosmetic plastic surgery procedure, with nearly one-third very much or moderately influenced.

Cultural differences also appeared in this study. Almost 75 percent of Hispanics and 70 percent of African Americans surveyed were high-intensity viewers while only 36 percent of Caucasians fell into that category. Also, 50 percent of Hispanics surveyed reported they were very much or moderately influenced by television to pursue cosmetic plastic surgery versus seven percent of Caucasians.

Shows considered in this study included Extreme Makeover (ABC), The Swan (FOX), I Want a Famous Face (MTV), Plastic Surgery: Before and After (TLC), Dr. 90210 (E!) and Miami Slice (Bravo).

"It is unfortunate that patients are turning toward the entertainment industry for educational information -- we had hoped for different results," said Dr. Persing. "These shows may create unrealistic, unhealthy expectations about what plastic surgery can do for you. Although it's called reality TV, it may not be reality."

Nearly 11 million cosmetic plastic surgery procedures were performed in 2006 -- up 7 percent from 2005, according to ASPS statistics.