How Botched Star Terry Dubrow Found His Higher Calling

Mikeal was no stranger to going under the knife when she scheduled her plastic surgery trifecta: a tummy tuck, thigh lift, and liposuction, all in one 13-hour marathon session. This was August 2020 in West Virginia, seven years after she’d gotten gastric sleeve surgery, a procedure that shrinks the stomach to about 15 percent of its original size and is designed to help severely obese patients lose weight.

In the years after her gastric sleeve surgery and a gastric bypass procedure, Mikeal managed to drop 130 pounds—before that she weighed 290—but the operation left flaps of loose skin on her stomach and thighs that made her self-conscious. She was hoping to finally date again, as she’d spent much of the past decade in mourning: In 2008, her husband suddenly died in an explosion at the chemical plant where he worked. Now that Mikeal’s two kids were all grown up, she was ready to get out there again.

But Mikeal’s plastic surgeon was hesitant about performing all three procedures at once. Thirteen hours is a long time to be under general anesthesia, she says he told her. But Mikeal wasn’t too concerned. There was one time she was out for 12 hours straight as surgeons worked to re-attach three fingers that she had accidentally sawed off with a bandsaw while making a fence.

But when Mikeal was finally on the operating table to have her loose skin removed, things quickly went south. Her surgeon had managed to complete all three procedures, but after the operation, she says her blood pressure bottomed out and she spent two days in the ICU. A few days after that, she says she was discharged from the hospital when her sister, a nurse, noticed that there seemed to be something very wrong with her wounds. Her thighs were blistering, deep red, and warm to the touch. Mikeal was in tremendous pain and felt weak, all of which were signs of infection. A CT scan revealed deep pockets that were badly infected, which necessitated antibiotics. 

Her procedures had left her body deformed. She no longer had a belly button. Her stomach was Frankensteined together with skin grafts. Even though her wounds were closed, she was in constant pain, especially when her clothes would rub against her skin grafts. The simple act of sitting down and getting back up felt like agony, and Mikeal was convinced that she might never live a normal life again. 

Some of the medical establishment would see Mikeal’s case as a lost cause. But not Dr. Terry Dubrow. He saw Mikeal’s case as an exciting challenge, and agreed to take on her case for an episode of his hit E! show Botched, which returns with new episodes this summer.

This past fall in Newport Beach, CA, Dubrow operated on Mikeal in order to remove her painful skin graft, which left her vulva floating in a sea of red, a condition she previously called “vagina island.” He would fix the graft and restore her long lost belly button, which took approximately three hours. 

The day after the surgery, I was watching him inspect her wounds from the control room down the hall from the examination space, surrounded by the show’s producers. We were all anxiously glued to the monitors, eager for Dr. Dubrow to peel off Mikeal’s dressings, holding our collective breath like we were watching Osama bin Laden’s compound get raided.

The bandages came off. Dubrow scrutinized her incisions, and declared the skin to be 100 percent alive.

“Yessss!” several of the producers shouted. It felt like we'd just landed on the moon. The operation appeared to be a success. Once again, Terry Dubrow seemed to have pulled off the impossible.

Dr. Dubrow is one of the most skilled plastic surgeons in the world and a longtime reality TV star, someone who has legitimate influence over the way we think about cosmetic surgery. In a Kardashianized world where these elective operations are becoming increasingly normalized, Dubrow has become an unlikely voice of caution. Botched is a show about the tremendous downside of plastic surgery, a reminder that it's not all rainbows and sunshine and ski slope noses and perfectly round breasts. It’s gory and risky and, oftentimes, upsetting. Almost two decades ago, when Dubrow began his television career, he worked on shows that presented plastic surgery in a positive, airy, almost blasé light. But the world changes, and so do we. And I wanted to find out how Dubrow became the anti-plastic surgery plastic surgeon. 

Several hours after Mikeal’s post-op examination, I met with Dubrow for dinner in Brentwood. He had traded his lab coat for a black leather jacket. His teeth were perfectly straight and blindly white, and his skin was remarkably smooth for someone in his mid-sixties. He has a wide nose and a big, warm smile. “A face for radio,” he said. He has a tendency to speak in idioms. 

We sat down and he talked for nearly three hours. There was no subject he wouldn’t broach. He told me about the nerve wracking time he performed plastic surgery on his young daughter, fixing a facial injury she incurred at preschool that busted her lip open. “I went, Get your shit together, idiot,” said Dubrow. “She was little," and it was “freaky.”

Dubrow has been on television since the early 2000s, but it was only in 2014, when Botched premiered, that he found his niche and became not just a well-known plastic surgeon, but a widely beloved one. On the show, he and Dr. Paul Nassif fix patients whose procedures have gone very, very wrong. Each episode follows the same structure: We typically meet three patients, one of whom had a bad facial surgery (say, a nose job that renders them unable to breathe) that Nassif will fix. The second patient is someone who has perhaps had bad body surgery (everything from breast implant complications to a Brazilian butt lift gone very, very wrong), which Dubrow corrects. The third patient is often a plastic surgery addict, someone who wants the doctors to do something medically unsafe for them, like make their enormous breast implants even bigger. The doctors will usually reject the last person’s request, and warn them that if they continue down this plastic surgery path, they risk deformities at best and at worst, death.

I’ve been obsessed with Botched since its inception. After I graduated college, before I got a place of my own, I have fond memories of spending hours lying on my mom’s cozy velvet couch with my sister, binging episode after episode, enamored with the gory surgery footage. When I introduced Botched to my fiancé in 2020, my appreciation only deepened. Soon, I wasn’t just idly watching the lurid plastic surgery show, but discussing the intricacies of proper nose cartilage sculpting and abdominal fascia stitching with the person I loved most in the world.

After spending more hours watching Botched and thinking about Botched than perhaps anyone else in the world aside from the people who actually work on the show, I have come to the conclusion that it is the most perfect television product in American history. 

What separates Botched from other plastic surgery shows is that Dubrow and Nassif are fixing people who many in the medical establishment consider to be unfixable, which gives the show its heart. “These doctors are helping people that can’t be helped anymore,” showrunner Matt Westmore said. “These people have exhausted all of their resources financially, emotionally. They don’t have anywhere to go.”

And Dubrow’s patients seem to love him. “I felt cared for, I felt heard,” said Shannah McLeod, one of his patients on Botched. She decided to go on the show because she had complications with the breast implants she received following a double mastectomy. She told me that her previous plastic surgeon responded coldly when she would complain that she was in pain. “Dr. Dubrow knew exactly [where] the pain was coming from, and was quick to help relieve the scar tissue that was capsulating my breast implants,” she said. “He was very gentle and sensitive.” Rod Aissa, the Executive Vice President of unscripted content at NBCUniversal, was a fan of Botched before he started working on the show four years ago. “There’s this levity to it. There’s no judgment to it, but it’s not a dry procedural plastic surgery show,” he told me. “Terry’s not a guy who’s just using this TV show to promote a product or himself. He’s actually using this TV show to say something about plastic surgery.”

And the message he’s saying is: don’t get plastic surgery if you can help it. The risks, according to Dubrow, can often outweigh the reward. 

I told him that I never really wanted plastic surgery before watching Botched, and the show has all but guaranteed that I’ll never go under the knife. “Isn’t that fantastic?” he said. “No matter how negative we go, we’re never going to stop plastic surgery. It’s like a forest fire. But if we can put a screen in front of the sparks coming off of the flames? Great.”

Dr. Dubrow’s take on plastic surgery is unusual considering his profession. He told me he doesn’t like butt lifts— isn’t a fan of anything that “doesn’t exist in nature,” really—but especially the butts, since the Brazilian butt lift is one of the highest risk cosmetic procedures you can get. He’s also quick to point out the risks of more common procedures, like breast implants. “Breast implants go south all the time,” he said. 

He remembers going to a meeting with a dozen or so other plastic surgeons, hosted by a pharmaceutical company that was inquiring about their practices, and being asked, “How many of you have capsular contracture?” It's one of the more common breast augmentation complications, in which hard scar tissue forms around a foreign object, in this case the implant. Dubrow says he was the only surgeon in the group to admit that he did. “I go, ‘Liars!’” he said. “And I know they’re telling their patients, ‘I never get capsular contracture,’ which has nothing to do with the surgeon!”

Dubrow will try to steer away a prospective patient who, for example, has “really good,” slightly droopy breasts. “The enemy of ‘really good’ is anything,” he said. “Scars, general anesthesia, a chemical coma. I don't think it’s worth the risks.”

And despite all that, there is nothing in the world that Terry Dubrow would rather be doing. “I love being a plastic surgeon,” he said. “It's my calling.”

By the time he was a teenager, Dubrow knew he wanted to practice medicine. He and his brother, Kevin, the late lead singer of the heavy metal band Quiet Riot, were raised by a single mother in Los Angeles. His mother was a secretary, and early in their childhood, Dubrow became attuned to his family’s struggles. He told me a story about giving milk to a stray cat who lived in the alley by his childhood home. “Every night the cat would scratch on the screen door for more milk, and my mom wouldn’t let us have the cat,” he said. “And I thought to myself, Oh my god, I am gonna be this cat, this stray cat living in an alley unless I do something with my life.”

He first considered going into dentistry. (“Being a dentist is low key. They do really well. You’ve always got work.”) So in high school, he started volunteering at the University of Southern California’s School of Dentistry, which was “deathly boring.” One day, they let the students volunteer in the USC emergency room. As soon as he walked in, he was smitten by the smell, the thrill, the commanding aura of the residents. They seemed to exude importance. 

So he went to UCLA Medical School intending to become a cardiac surgeon. “​​I'm kind of a hair on fire guy,” he explained. “Like if I was in the military, I'd want to be a fighter pilot.” And then he met a plastic surgeon named Malcolm Lesavoy. In his second year of med school, Dr. Lesavoy—suave, tall, sporting cowboy boots, an overall “beautiful human being,” said Dubrow —gave a presentation about plastic and reconstructive surgery in war. Dubrow was enamored. Dr. Lesavoy quickly became his mentor.

After getting certified as a plastic surgeon, Dubrow had a series of small breaks before his really big one. He was working in a more established plastic surgeon’s practice, who operated on a lot of celebrities. Dubrow explained that he would work on the right side, while the other doctor would do the left, and his celeb patients took note of his meticulous work. In 1996, about six months after graduating from UCLA’s plastic surgery program, Dubrow said he was featured in a magazine article recommending the best surgeons in Los Angeles plastic. 

Around that time, Terry met his future wife, Heather Dubrow (née Kent) of Real Housewives of Orange County fame. “I’m probably the only wife of a plastic surgeon who still has real breasts,” she told me. She loved watching him in action at his practice in Newport Beach: “I saw him in his office, and it’s sexy to see someone in their natural habitat and the scrubs, and needles are flying.”

At the beginning of their courtship, Heather, a television actress, was the famous one. They married in 1999, the same year Heather starred in the sitcom Stark Raving Mad, which ran for a single season on NBC. Five years later, in 2004, Terry had his big break and became a TV star too, when he was cast on Fox’s The Swan.

The premise, particularly by today’s standards, is appalling: a group of women who feel bad about their physical appearance (“ugly ducklings”) undergo an extreme plastic surgery makeover to become great beauties (“swans”), and then subsequently compete in a beauty pageant at the end of the season.

Mind you, this was back during the Iraq war era: a time when Shrek 2 was the most popular movie in the United States and Mark Zuckerberg launched a website called The Facebook. Reality television was just beginning to explode in popularity—American Idol was one of most watched shows in the United States—and Americans were willing to tune into anything. The more outrageous, the better. 

It was still a pre-Kardashian world, and most celebrities didn’t cop to getting cosmetic procedures and plastic surgery, which was nowhere near as mainstream as it is today. Then the success of Extreme Makeover, an ABC program where regular folks radically transform their appearance via plastic surgery, led to the show getting renewed for a second season. Following the show’s success, Fox greenlit The Swan, which creator Nely Galán originally conceived as a show for Telemundo. It premiered on Fox in 2004, and it was a smash hit.

What makes the show especially upsetting is the twist: during their recovery, patients are forbidden from looking in the mirror. “They were all kept in this apartment complex in Marina del Rey. They fogged the mirrors, fogged the spoons, so they really couldn’t see what they were looking like,” Dubrow recalled. There is a big reveal where each contestant looks in the mirror for the first time in months, and a few of them sob. This particular aspect of the show, Dubrow told me, “was creepier than you could imagine.”

Dubrow remembers one instance that wasn’t caught on camera where “they had this woman’s kids there. She hadn’t seen them in three months,” he said. “They wanted her kids to see her as she saw herself. And they open up the mirror and they’re supposed to go, ‘I’m so happy.’ She turns to her kids and her kids look at her like, ‘Who are you?’ and they started crying.” 

After that, he said, “there were no kids at the reveals anymore.”

As Dubrow explained it, he was a “newish” plastic surgeon when he was cast on The Swan. Landing the show was a huge opportunity to grow his practice. Becoming a good surgeon, he argued, is all about volume. Being on The Swan provided him with lots of exposure, which meant more patients, which meant doing more surgery, which meant becoming a better doctor.

According to the American Society for Aesthetic Plastic Surgery, plastic surgeons average 320 operations a year, as of 2021.  After Dubrow appeared on The Swan, he told me was performing 700 annually.

The show had a big audience, which is why Dubrow agreed to return for its second season.  “The show was a gigantic hit,” he said. “I literally became famous overnight.”

“I really loved Terry right away, because I felt like he was really good at plastic surgery, but also really good at explaining it,” Galán told me. “He was a delight to work with. If he had problems with [the show], I never knew about it.”

“It wasn’t as disgusting then as it is today,” Dubrow said. “There was so much crazier stuff on TV. Who’s Your Daddy? That was a show where, if I remember correctly, they would get these people who were adopted and find their biological parents and make a game out of it. The more outlandish, the more crazy, the more it sold.”

After The Swan, Dubrow continued to build his practice in Orange County and periodically appeared on television. In 2010, he appeared on Bridalplasty on E!, another questionable plastic surgery reality show where 12 fiancées competed in various challenges in order to win plastic surgery for their big day.

Unlike The Swan, Bridalplasty was poorly received and was canceled after one season. Dubrow expressed reservations about his participation in both The Swan and Bridalplasty, particularly the latter: “That show was not right,” he said, and it’s not something he’d ever do again.

Dubrow became disenchanted with the profession. “I was very popular,” he says. “I had a gigantic practice. And I became very, very disillusioned with plastic surgery. I used to go to my wife and say, ‘All this training. All these years.’ I trained for nine years after medical school. I trained in microsurgery. All these amazing skills, to take a bump off the nose, and to suck some fat out of the thighs.” 

He was tired of making small adjustments on rich people. He fondly remembered his days as a chief general surgery resident, when his operations would save lives.

And then the phone rang.

About ten years ago, Nassif called his pal Terry with a far out idea. The two men had been friends for many years and had a lot in common—Paul’s ex-wife, Adrienne Maloof, was also a Real Housewife—and according to Dubrow, they used to work together way back in the day, when Nassif hired him to work at his practice.

Nassif had a pitch: a plastic surgery reality show where the two of them would fix people whose lives had been destroyed by bad plastic surgery. 

It was the “the stupidest idea I’ve ever heard,” Nassif remembers Dubrow telling him. 

Nassif is recounting the inception of Botched over lunch outside the Brentwood office building where they film the show. Nassif and I are eating takeout from Goop, the most Los Angeles thing in the world, while Dubrow, a zealous intermittent faster, is eating nothing at all. (Dubrow also only sleeps four hours a night.)

But Nassif couldn’t get a word in edgewise. Dubrow couldn’t help but take over the conversation. The ease with which the latter interrupts the former is part of the duo’s chemistry. They balance each other out: Dr. Dubrow is the dominant one with a big personality, and Dr. Nassif plays the straight man.

Dubrow says he initially shot down the idea for Botched because “these are patients who have had two, five, seven, eleven surgeries that have all failed, have pushed the envelope, have had the worst complications known, so the chance of being able to fix them is extraordinarily low… And you’re going to put that on national television?”

In return, Dubrow says he pitched Nassif another idea: a show where the two of them fix congenital deformities. They went back and forth for a while, until Nassif was ultimately able to sell him on Botched.  

The show was an immediate hit, and so began a new phase of Terry Dubrow’s career: fixing the unfixable. It gave him a renewed sense of purpose. “I was not only doing something that matters,” he told me. “What you did was life-changing. You were there to save lives. And Botched is saving lives.” 

Doing seemingly impossible revisional surgeries now makes up the majority of his practice. “Nobody gets good at doing high-risk revisional plastic surgery. You know why? Because the volume is so low,” said Dubrow. “So nobody gets good at it. Unless for some reason, you get a lot of it.” Which is what happened after he became known as the Botched guy.

Being the Botched guy does have the occasional drawback. Every few years or so, Dubrow says that a former patient will attempt to extort him. The person will come in requesting a “very difficult high risk surgery.” He’ll ask if they really want to do this, and they will tell him, yes, they want the surgery, and they will offer him a lot of money to operate on them. After they sign various waivers and consent forms, he will perform the surgery. 

One of two things can happen next, according to Dubrow: (A) They have a complication he predicted they would have, or (B) They don’t have any complications but are unhappy with their result. Then they call up a personal injury attorney, who will threaten to sue Dr. Dubrow.

“No problem. Sue me. I’m a medical legal expert,” Dubrow said. “I’ve been an expert on the California Medical Board for 23 years. Sue me. I didn’t do anything wrong.” As Dubrow explains it, a lawsuit isn’t really what they’re after.  The real threat is bad publicity.

For what it’s worth, Terry Dubrow does not seem too bothered by that kind of stuff. It is but a blip in his otherwise very charmed life.

He has everything he could possibly want. He loves doing surgery and has a steady stream of work. He is very happily married with four children. He is extremely rich. He has no shortage of self-love. He does not strike me as at all neurotic, a genuine achievement for a Los Angeles Jew working in an extremely competitive field. (That’s the vibe that I, an extremely neurotic New York Jew working in a differently competitive field, get.)

He loves being on TV. Really, really loves it. Being famous, he tells me, is like being the quarterback of your high school football team. “Everybody knows you. You’re not so fancy that they won’t say anything to you. Nobody’s mean to you,” he said. “Nobody’s jealous. Everybody’s nice.”

He considers himself a very lucky guy. His theory as to why is simple: “I’m a very nice person,” he said. “I always do things for the right reasons. If there’s a choice between greed—plastic surgeons are very greedy—and making the good decision that will involve making no money, I always automatically make that decision, even to my detriment.” He believes his good karma is why he got to marry Heather. “I’ve always spiritually done the right thing,” he adds. “I think.” The Swan and Bridalplasty were mere bumps in the road, experiences that led him to the righteous path. 

Most of all, he gets to help piece people back together, one of his favorite things to do in the world, hundreds of times a year. He likens himself to an artist in the operating room, a sculptor. “You're in the flow and lost in it, and nothing else is going on but that. There’s total immersion, and total mindfulness.”  

Dr. Dubrow smiled. “There’s nothing else in your life but that.”

Eve Peyser is a writer who covers weird culture, sports, and consumerism. She’s been published in The New York Times, Vanity Fair, New York Magazine, and many other outlets.