The Untold Truth Of Botched

Of all the varied reality shows vying for the attention of television viewers, there's never been a series quite like "Botched." First making its debut in 2014, the show introduced a unique premise that had never been attempted on television before. In each episode, two top plastic surgeons — Dr. Terry Dubrow and Dr. Paul Nassif — are introduced to patients seeking to correct previous plastic surgery procedures that have left them disfigured, destroyed their lives, and, in some cases, made them desperately ill. 

The show proved to be a hit with viewers over the course of seven seasons, bringing them face to face with some seriously shoddy cosmetic surgery. Using all the surgical skills at their disposal, the physicians right the wrongs inflicted on these desperate patients in ways that are both heartwarming and life-changing. 

After all those seasons and all those surgeries, there's still much that even the most ardent fans may not know about the show. To find out more, read on to discover the untold truth of "Botched." 

Aficionados of reality television may have noticed a link between "Botched" and the "Real Housewives" franchise. That shouldn't be surprising, given that Drs. Terry Dubrow and Paul Nassif have each married women who have, at one time or another, been part of a "Real Housewives" show.

Nassif, in fact, was married to Adrienne Maloof, who was a member of the "Real Housewives of Beverly Hills" cast for its first three seasons, recalled Us Weekly. In July 2012, reported People, the couple separated, with Nassif filing for divorce the following month. Their parting was particularly nasty, with Nassif alleging in his divorce filing that Maloof was "unpredictable" and "physically violent" in her behavior, and a "toxic" influence on their kids. The divorce was ultimately settled later that year.

Meanwhile, Terry Dubrow has been married to "Real Housewives of Orange County" star Heather Dubrow since 1999. The two share four children and remain together. Speaking with Page Six, Dr. Dubrow shared the secret behind the longevity of his marriage.  "You have to learn how to fight," he said, adding, "...it's natural to have disagreements and big fights, it's just how you navigate those fights."

Paul Nassif's contentious divorce from Adrienne Maloof wasn't the only litigation involving "Botched" and a "Real Housewives" alum. As viewers of the 16th season of "The Real Housewives of Orange County" saw in the season premiere (via Page Six), cast member Shannon Beador brought up a years-old lawsuit that Nicole James (one of the show's "friends of") allegedly launched against Terry Dubrow. 

According to Page Six, Dr. Dubrow confronted James (who was known as Nicole Weise at the time she sued, claiming to have experienced problems after he performed breast augmentation surgery on her). While she admitted to launching the suit, James also said she never felt Dubrow "did anything wrong," insisting that attorneys pressured her to sue him when she was young (she subsequently dropped the lawsuit).

The doc's wife, "Real Housewives of Orange County" star Heather Dubrow, dismissed the fracas in a confessional interview (via Page Six). "Doctors get sued. It's not a big deal. It was years and years ago," she explained. "Nicole's our friend. She's allowed to have a fresh start. We all are."

If the television rapport between "Botched" doctors Terry Dubrow and Paul Nassif seems unforced and natural, that's because the two surgeons are real-life pals — and were long before they began working together on the show. As Nassif recalled in an interview with Page Six, he first met his future co-star in 1999, after his mom and sister called him and said they'd met a charming plastic surgeon in Newport Beach and thought the two docs would hit it off. When they did meet, Nassif said, the duo were destined to be "friends forever."

Their onscreen bickering and bantering isn't an act, but is essentially an extension of the friends' real-life relationship — which, like the television version, includes mutual chop-busting. Nassif may not hear a word from Dubrow for an entire month, then suddenly, Nassif joked, "I get this text of him insulting me just like he does now. Nothing has changed in 20 years!"

Dubrow's wife, "Real Housewives of Orange County" star Heather Dubrow, shared her own insight into her husband's relationship with Nassif. "I love their friendship. I think it's adorable," she told Bravo's Daily Dish. "...I feel like he's the brother I never wanted."

In their respective practices as plastic surgeons, Drs. Paul Nassif and Terry Dubrow often receive requests from patients to make some of their body parts resemble those of celebrities — especially the Kardashians. This was particularly true of Kylie Jenner's revelation that she received lip injections, Dubrow explained in an E! interview. "She started a trend of young girls coming into our office with pictures of Kylie, showing her lips, wanting her lips," he said.

Another oft-requested body part belongs to Jenner's half-sister, Kim Kardashian. As Dubrow told the Daily Mail, "She changed the aesthetic of the buttock area." The surgical procedure to enhance one's derriere to Kardashian-like proportions, Dubrow told Australia's News 24, is known as the "Brazilian butt lift," in which fat is taken from places in the body where it's not wanted and is injected into the butt. However, Dubrow warned this can be far more dangerous than most people realize. "When you take fat from one part of the body and inject it in the buttock, it can get into the large veins in the buttock, it can travel to the heart and into your lungs, and be fatal," he warned.

When E! first greenlit "Botched," it was clear the network was taking a wait-and-see attitude about the show's prospects; when the show was first announced, noted The Hollywood Reporter, just eight episodes were ordered. 

Those eight episodes proved to resonate with viewers, and "Botched" was enough of a hit that E! renewed the show for a second season. Before the second season had even finished airing, Deadline reported that "Botched" would be returning for a third, citing a viewership of 1.8 million for one episode, of which 1.1 million were in the coveted 18-49 demographic. Then, in 2016, Deadline reported that the show was being renewed for a fourth season, noting that the premiere episodes of "Botched" consistently ranked within primetime's top 10 shows for the target women's demos.

"'Botched' continues to be one of E!'s most successful series and we are thrilled to bring our audience more shocking patient stories and remarkable transformations," declared Jeff Olde, E!'s executive vice president of programming and development, in a statement at that time.

In 2015, Entertainment Weekly reported on the E! network's plans for a "Botched" spinoff, "Botched by Nature." As the name suggested, "Botched by Nature" took a slightly different approach than the original series, in which Drs. Terry Dubrow and Paul Nassif did what they could to repair the damage of a previous cosmetic surgery gone bad. In the new series, they were focusing on working with patients born with genetic defects or who required plastic surgery due to an accident. 

The doctors were filmed undertaking "the ultimate house call" as they examined their patients' lives to get a better understanding of their unique situations before inviting them to undergo surgery in Los Angeles. "We are excited to build on the mega-success of the 'Botched' franchise with 'Botched By Nature,'" said E!'s Jeff Olde of the spinoff. "Dr. Dubrow and Dr. Nassif will continue to inspire viewers as they transform the lives of patients who are brave enough to share their stories."

The new series, reported E! News, followed three specials — organized as "Botched: Post Op" — in which the docs, joined by Dubrow's wife, Heather Dubrow, discussed what happened behind the scenes of an episode that had just aired.

Dr. Terry Dubrow has been starring in "Botched" since the series first debuted in 2014, but there was a point where he nearly talked himself out of taking the job. Interviewed by the Daily Beast, Dubrow — who already had a successful, thriving practice in place — worried that the television exposure could potentially show him in a bad light if surgeries didn't work out as hoped. If that were to happen, Dubrow feared the negative impact that it could have upon his business. 

"As a plastic surgeon, you're not judged by the before vs. after. You're judged just by the after," he explained. While Dubrow's success rate as a surgeon is enviable, he was quick to point out that no surgeon is perfect, and sometimes an operation doesn't go as planned. "At the end of the day it is serious and scary," Dubrow added. "It could go very wrong."

Ultimately, Dubrow relented when it became clear that the premise of "Botched" wasn't one that would encourage people to have frivolous plastic surgery. "We always say on 'Botched' that plastic surgery is real surgery," he told Cheat Sheet. "It's really serious and can have serious complications."

One reason behind Dr. Terry Dubrow's initial reticence to appear on "Botched" was likely the fact that he had previously appeared on reality television — and it hadn't gone so well. As Dubrow's official bio confirmed, he was one of the surgeons at the center of "The Swan," a 2004 Fox reality show in which "ugly duckling" women receive cosmetic surgery to emerge as titular swans, and then compete in a televised beauty pageant.

Television critics found plenty to hate in "The Swan," which the New York Post recalled had been described as "the most sadistic reality series of the decade." In critic Robert Bianco's review for USA Today, he described the show as: "Hurtful and repellent even by reality's constantly plummeting standards..." Years after the show was canceled, Entertainment Weekly deemed "The Swan" to be one of the 10 worst reality TV programs in the history of the genre. "After all, what good is watching a sad woman with a warped sense of self nip and tuck her face and body into oblivion if the results aren't compared and judged before a national audience?" snidely asked EW.

Not every "Botched" patient has walked away happy. Such was the case with an unnamed patient, reported Page Six in 2018, who allegedly tried to shake down Dr. Terry Dubrow by demanding $3 million in exchange for not suing over surgery he performed on her for the show. 

According to Page Six, the patient underwent an illegal procedure that injected silicon into her buttocks, and subsequently became severely ill. She then received surgery to extract five pounds or more of "foreign material" from her derriere, which unfortunately wrecked her butt muscles. That was when she applied to be on "Botched," and was accepted. Dubrow performed surgery that reportedly left the woman's condition improved by around 85 percent, until she was unsatisfied with how things turned out and refused to show off her final result for the show's end-of-episode reveal.

Interestingly, that wasn't the only time a patient attempted to extort Dubrow. In 2020, Page Six reported that another patient (who hadn't appeared on the show) was allegedly harmed by a butt lift he performed, and demanded $5 million. She ultimately sued for $10 million for her injuries, reported TMZ. Dubrow subsequently countersued, reported Fox News, alleging defamation.

The patients who appear on "Botched" in the hopes of having their personal plastic surgery disasters repaired receive some monetary compensation for being on the show. Curiously, according to a profile on the show for Allure, the patients don't actually get to keep that money, but must hand it over to the show's doctors as a partial payment for whatever surgeries they'll receive. According to Dr. Terry Dubrow, being paid for their work isn't because of greed, but has to do with medical ethics. "We have to get paid to do the surgery," he said.

While Dubrow didn't divulge how much of an appearance fee the patients receive, he did confirm that the surgery they pay for is far from inexpensive. "So the procedure, revisional surgery of the type we do, would vary between $30,000 to probably $90,000 or $100,000," Dubrow told Cheat Sheet. 

The reason why "Botched" surgeries are so pricey, Dubrow explained, is this: "We do extraordinarily difficult...high-risk visual plastic surgery, which is more costly in general because the risks are greater."

The cases the doctors tackle on "Botched" are far from typical, and often require Drs. Paul Nassif and Terry Dubrow to venture outside the box. For example, noted a profile on the show in Allure, Dubrow utilized an unorthodox method to pull excess blood out of a patient. "You need three leeches every 45 minutes," declared Dubrow of that patient. 

In addition, said Nassif, the docs have also called in an unusual consultant when dealing with patients who "have had too many unnecessary operations" for whatever reason: Justin Jedlica, deemed "the Human Ken Doll" due to undergoing hundreds of plastic surgeries. The doctor has hired Jedlica on a consulting basis, despite the apparent body dysmorphia that would compel someone to go under the knife so many times. Because a number of those procedures involved implants that Jedlica designed himself, Dubrow told Allure, "He's an expert on body implants." 

As Dubrow told Cosmopolitan, these unorthodox cases require coming up with unconventional solutions. "These cases are not found in any textbook. You can't call any surgeon and say, 'Have you ever seen this?' because no one has ever seen this," the doctor shared.

Of the numerous patients to have appeared on "Botched" over the years in hopes of having their plastic surgery disasters repaired, some have been celebrities. According to IMDb, one of the first famous folks to appear on "Botched" was supermodel Janice Dickinson, who, noted the Daily Mail, appeared in the first season seeking reparation of a decades-old breast enhancement gone wrong. Described by Dr. Terry Dubrow as "my most challenging case overall," the surgeon contended that she was incredibly difficult to work with. 

Other celebs who've sought help on "Botched" include television personality Maria Menounos, former "Baywatch" actor Nicole Eggert, and "Mama" June Shannon of "Here Comes Honey Boo Boo," whose request for a tummy tuck was refused by the "Botched" docs, who deemed her body mass index to be too high and insisted she lose 75 pounds beforehand (via the Daily Mail).

Reality TV personality Farrah Abraham also appeared on "Botched," but it did not go well for her. As Hollywood Life reported, she sought permanent lip implantation after experiencing what she called "an extreme reverse reaction" from getting lip fillers. She was rebuffed by the doctors, however, who pointed out that any additional surgery would just cause even more damage.

Thanks to the ever-increasing popularity of "Botched," being accepted as a patient on the show is highly competitive. As Allure pointed out, in the show's first season, there were just a few hundred applicants to appear in one of the season's eight episodes. By the second season, that number climbed sharply to 6,000 people in search of restorative plastic surgery. 

As the seasons progressed, so did the number of people vying to appear on "Botched." Dr. Terry Dubrow revealed in an interview with Distractify, "By the time the show got known for the second, third, and beyond, we had around 10,000 applicants."

Beyond the casting process, sometimes the doctors steer patients from their respective practices to appear on the series. As Dubrow told Distractify, when he encounters a patient dealing with odd or desperate circumstances who doesn't have the financial wherewithal to pay for the necessary surgery, he'll ask if they're open to publicly displaying their stories on "Botched." "Nine times out of 19, they say that they'll do it," he added.

Of the thousands upon thousands of people who apply to have their ruinous plastic surgery repaired on "Botched," there are those who are deemed inappropriate for a variety of reasons. One of those reasons carries forth from the practices of Drs. Terry Dubrow and Paul Nassif, with the latter telling Celebuzz! that they turn down about 10 percent of potential patients. Those patients, he explained, held "unrealistic" expectations of what can be achieved via plastic surgery, and will inevitably feel disappointed regardless of the quality of the work received.

Then there are patients who request surgery so extreme it could physically harm them, Nassif said, noting, "We're not going to operate on patients that have psychological or physical issues." In addition, Dubrow clarified in an interview with Zwivel, the docs don't take patients younger than 21.

Ultimately, Nassif told Celebuzz!, "The doctor has to like the patient and feel comfortable operating on them. If they don't like the patient and red flags go up in their mind, then we usually don't do it." Of course, the patient should be at ease with the doctors, too.

As viewers of "Botched" have no doubt ascertained, the patients selected to appear on the show are dealing with serious damage to their bodies inflicted by their past operations. Yet, as damaged as these patients are by their previous plastic surgeries, sometimes the problems they're experiencing need to be exacerbated before they can be improved.

"We warn the patients on 'Botched' very carefully and say, 'I may send you down a road that will botch you, but in order to get you un-botched, I may have to make you worse before I can make you better,'" explained Dr. Dubrow in an interview with Distractify.

As Dr. Paul Nassif added, this requires more than just surgical skill, but also the ability to communicate with patients in a transparent and convincing manner so that they have a clear understanding of what to expect. "Our bread and butter is taking someone who is possibly unrealistic or someone that we know can get some improvement, and bringing their expectations down to normalcy," he explained.

When Dr. Paul Nassif and Terry Dubrow first explored the idea of bringing their medical skills to television in "Botched," they were adamant that the show avoid presenting plastic surgery as a no-risk quick fix to improve one's appearance. Unlike previous reality series based around plastic surgery, such as "The Swan" and "Bridalplasty," their goal was to demonstrate the risks and hazards involved with going under the knife, emphasizing the importance of seeking out qualified surgeons to grasp how badly things can go when these complex procedures are not done precisely right.

"The difference between this show and other plastic surgery shows is that we're not glamorizing plastic surgery," said Dubrow in an interview with the Daily Beast. "In fact, we're providing a scare about plastic surgery."

Nassif concurred, explaining that he understood that the appeal of "Botched" lay with the plastic surgery disasters they'd be trying to repair. He stated, "Unfortunately, people like to watch train wrecks. But if you can take a train wreck and then add the inspirational aspect of having a good result or a happy ending, I think that fills a void [in reality TV]."

There's an assumption that Drs. Paul Nassif and Terry Dubrow, after all those seasons of "Botched" and all their years in private practice, have seen it all. And while that assumption isn't necessarily incorrect, the docs have also confessed that they're still capable of being shocked by the horrific results on patients who've experienced plastic surgery gone awry. 

That, Nassif admitted in an interview with Cosmopolitan, was particularly true in the show's earlier seasons. "I would say 60 percent of the cases on 'Botched' this season for Paul and I, we're floored," said Nassif, discussing the show's then-upcoming second season. He continued, "It was jaw-dropping, mouth open, 'Are you kidding me!?'"

When they encounter these extreme plastic surgery disasters, the doctors do become affected emotionally. "We get angry... our emotions are mixed. From anger to ... you feel horrible for that person," Nassif admitted to the Daily Mail, musing, "It's a combination of feelings that change throughout the whole process."

Not only do "Botched" doctors Paul Nassif and Terry Dubrow perform plastic surgery on patients; each of them has also been on the receiving end of similar procedures. Dubrow, in fact, revealed that he received some cosmetic facial enhancements, but ultimately regretted it.

Speaking with Cheat Sheet, Dubrow recalled getting fillers and Botox in his face just before embarking on a book tour with wife Heather Dubrow. As he recalled, he foolishly didn't allow enough time to elapse before appearing on TV, which left those cosmetic enhancements far more noticeable than he would have liked. "It just goes to show you that even a plastic surgeon can be an idiot," Dubrow admitted. "If you're gonna do any kind of procedures or have injections, give enough time so that the swelling can settle down..."

Nassif, however, has no remorse about the work he's had done. "I've had numerous things done, especially reconstructive to my nose," he told Cheat Sheet, adding that he'd been giving himself Botox injections for several years, and Dr. Dubrow had helped him with hernia repairs. "Do I regret anything?" he asked. "No, I don't." Dubrow told Larry King in 2020 that it was safest to not have a procedure at all, although Nassif chimed in, "But if you had to pick something, I'm gonna say a little bit of Botox, because it goes away."

Having spent years repairing shoddy plastic surgery on "Botched," Drs. Terry Dubrow and Paul Nassif have plenty of advice to offer prospective patients seeking out a surgeon in order to get a nip or tuck. The key advice Nassif offered, via an interview with Page Six, is to verify that the surgeon is board-certified for the particular surgery at hand.

According to Dubrow, the key is to find a surgeon with extensive experience in the particular procedure to be performed, comparing a surgeon's skills to that of an athlete. "It's very much like being a tennis player or a football player," he explained. "And if you don't do it all the time, if you don't do hard cases, you're not in shape."

As Nassif pointed out to Page Six, plastic surgery is not a field in which prospective patients should be seeking out bargains. "That's where people are getting mistakes," he said. "They go for the lowest cost and then you don't know what you're getting." Speaking to Allure, Nassif reiterated, "Don't have cheap plastic surgery. ... Don't go to Tijuana."

While both doctors have been emotionally impacted by the horrible plastic surgery disasters they've repaired during multiple seasons of "Botched," Drs. Paul Nassif and Terry Dubrow can recall some that they found to be particularly heart-wrenching.

In an interview with Allure, Nassif pointed to one patient who'd undergone multiple rhinoplasties over the course of her life, beginning at age 10, and was still dissatisfied with the state of her nose. By the time she made it into Nassif's office for her "Botched" consultation, he recalled, "She was devastated. She started sobbing, and if you have any bit of sensitivity, you start tearing up a bit."

The emotion that the doctors feel translates onto the screen, contributing to what Dubrow described to Allure as the show's "cautionary tale" aspect. "It makes people think twice before having plastic surgery, because it is as dangerous as any other surgery," he said, encouraging anyone seeking plastic surgery to know what their motives are.

The rise of social media over the past number of years is something that "Botched" doctors Terry Dubrow and Paul Nassif see as having contributed to the increasing popularity of plastic surgery.

In an interview with BuzzFeed, the surgeons discussed how the apps and filters used on social media have also led to some unrealistic expectations. "We call it Selfie Dysmorphia, where patients are trying to look like an idealized version of themselves, not the way they actually look," said Dubrow, referencing patients who show him selfies and request surgery that will make them look like the enhanced images they see on Instagram. "Well, that's a filter and last time I checked, a scalpel is not a filter," Dubrow explained. 

As Dubrow told Fox News, celebrities and social media influencers have become "insecure" about the disconnect between the versions of themselves they present to the world and what they actually look like in real life — Instagram versus reality. "I think what's happening is that [influencers and celebs] get kind of called out [because] they did not look like their image on social media," added Nassif. "They're not being authentic."