The immensely popular Dr. Robert Rey, seen on the E! Channel’s hit series “Dr. 90210” says the show is in trouble because it is being thrown against the CBS mega hit, C.S.I. Additionally, Dr. Rey reveals a little of what viewers might see during the coming “Dr 90210” season -- which begins on February 28th -- and some of the new trends he sees establishing themselves in plastic surgery.

“I receive many letters and emails from fans saying, just when they are getting into an episode, the program ends,” Dr. Rey told CosmeticSurgery.com, and HealthNewsDigest.com. “So an hour is welcome.”

But there’s worse news in constant struggle for T.V. ratings.

“The E! Channel is putting the show against C.S.I. Miami on Monday nights,” Dr. Rey says. “There is no way a small cable program like “Dr. 90210” can compete against such a huge hit so I’m asking, begging really, my loyal viewers, 90 percent of whom are women, for their help. The first few episodes will determine if our show lives or not.”

Dr. Rey wants to remain in his comfortable Sunday night time slot at 10 p.m. where he, his wife Hailey and their two toddlers have become famous worldwide as interest continues to surge in all types of television programs about plastic and cosmetic surgery.

“Moving the new season of “Dr. 90210” from April, 2005, back to this coming February 28th means that I have been putting in 12 hour days on Saturdays as well as every day during the week,” Dr. Rey says.

A film crew follows Dr. Rey from his home and personal life and into his office where he meets with patients and later performs surgery. In one new episode, Dr. Rey meets with a 100-pound, 15-year-old girl who is suffering from a condition known as “gigantomastia” and has 38 triple D breasts. The teen has been hounded so badly at her high school, she has dropped out and is seeking a breast reduction from Dr. Rey so she can resume a more normal life. That case is one of many in which the popular surgeon donates his services to people who could not otherwise afford plastic surgery.

“Actually, my family and I was a bit guarded last season around the film crew while they were shooting at home,” Dr. Rey says. “But since, we have become friendlier with them, so the moments they have captured on film are rawer, revealing moments during the life of the Rey family.”

Overall, the new season will follow the first appointments, surgery and outcomes of twelve plastic surgery cases.

Back in 2000, Dr. Rey learned at Harvard Medical School a new method of breast enhancements wherein the implants are inserted through the patient’s belly button under the skin to the chest. The method, known as Transumbilical Breast Augmentation (T.U.B.A.) leaves no scar but requires, in additional to special training, certain surgical tools and an endoscope, an instrument with a tiny camera and light so the surgeon can see under the patient’s skin.

He was among the first surgeons in Beverly Hills to offer T.U.B.A. and became extremely busy after word got out about the lack of scars involved in the method. His office says he does 12 various cases a week, which he estimates is twice the work load of most plastic surgeons. Dr. Rey also does butt lifts, tummy tucks, nose jobs (rhinoplasty) facelifts and other plastic surgery operations.

But with constant filming in his personal and professional life, isn’t the quality of his work somehow affected?

“I actually turn down 30 percent of the patients who make a first consultation appointment,” Dr. Rey says. “I turn away the angry, the litigious, those who have other medical conditions and may not heal well and others who want plastic surgery for the wrong reasons. So my patients get great results.”

“Wrong reasons” in plastic surgery can include mothers who want their teen daughters to have larger breasts or smaller noses, teens who want to look like a celebrity, heavy smokers and the overweight who could first lose some weight through diet and exercise before going under the knife.

One of the leading hot button issues in plastic surgery is teenage cosmetic surgery, Dr. Rey says. While the American Society of Plastic Surgeons says only four percent of all cosmetic procedures involve somebody 18 or younger, Dr. Rey still sees red warning flags.

“Another very sobering statistic is from last June when the most requested gift from graduating high school seniors was plastic surgery,” he says. “Most asked for breast augmentations, nose jobs and ear pinnings. I find that troubling because only a small number of teens need a plastic procedure. I think giving breast augmentation to women under 18 is tantamount to a crime because her breasts can still grow.”

A more appropriate age for breast augmentation, he says, would be the early 20s when growth is complete.

Other hot topics in plastic surgery include network plastic surgery reality shows. Dr. Rey says the major reason he agreed to allowing television cameras into his private life for “Dr. 90210” was to show the viewing public that not all plastic surgeons are “hypersexual, immoral beings” as he believes are shown in “Nip ‘n’ Tuck.” He also knocks the idea that patients can seemingly be totally made over, like the participants on “Extreme Makeover” or “The Swan,” in a scant twenty minutes of prime time viewing.

“Plastic surgery is real surgery and that often includes longer recovery times than you would like and the occasional painful complication which takes longer than normal to heal,” Dr. Rey says.

Other leading items rising on the doctor’s radar screen include more people having an operation known as body shaping to remove yards of stretched out skin left after the person has lost massive amounts of weight – often over 150 pounds. That much weight has been dropped due to a risky procedure known as gastric bypass in which surgeons reduce the size of patients’ stomachs to hold only about a half cup of food. More people are having gastric bypass which leads to yet more body shaping procedures.

The doctor also sees more ethnic groups – Afro-Americans, Asians, Hispanics and others – coming in for plastic surgery although most of those groups have had until very recently strong cultural taboos against rejuvenation surgery. Yet another trend in plastic surgery is the many injectibles – from Botox to Restylane – that patients receive during shorter appointments. Most injectibles only last three to six months but accomplish 70 to 80 percent of the look of a surgical facelift. Because most of the substances wear off, patients must return to the doctors’ office for additional treatments. Dr. Rey additionally predicts that Thermage will become more popular. That’s a non-invasive facial (and sometimes body) rejuvenation technique that uses certain radio frequencies to spur internal tissues into new, firmer skin growth. The effect is smoothing wrinkles and furrows for about two years.

“So I see more plastic surgery patients headed toward fewer and fewer invasive procedures that involve incisions, stitches or anesthesia,” Dr. Rey says. “Another trend I see is toward slightly smaller breast size. Last year, most women I saw asked for 500 cc implants. This year, many are stepping back to 400 cc’s and 450 cc’s.”

Yet another tendency is bothersome to the surgeon: Because the field is growing so rapidly, more medical professionals of all ilk – even dentists – are hanging out shingles that read, “Plastic Surgeon.”

“I operated on one patient who had four breast surgeries performed by a dentist,” Dr. Rey says. “All were botched and needed repair.”

The procedure is more serious than meets the eye because breast augmentation surgery is only a thin layer of tissue away from the lungs and heart of the patient. So nicks, mistakes and slips of the hand can be fatal, he says.

“A breast augmentation operation may look simple on T.V. but it is only really simple in the right hands,” says Dr. Rey who salutes Arnold Schwarzenegger, the golden state’s governor, for squashing a bill that would allow oral surgeons to perform cosmetic surgery on the face.

“But what’s really needed are my loyal viewers following the show to its new time,” he says.

Dr. Rey’s website: http://www.drrobertrey.com

Cosmetic Surgery’s website: http://www.cosmeticsurgery.com

© 2005 HealthNewsDigest.com