Cosmetic Surgery Goes Ethnic

In those days, Battle said, there were few cosmetic options available to women of color. Mostly "what we could offer was a bleaching cream and Cetaphil," Battle said, referring to a skin cleanser often recommended by dermatologists to patients of all races. (Bleaching cream is used to even skin tone and minimize the appearance of dark patches.)

Battle, 50, left a career in international marketing at IBM when he was 34 to enter medicine. A graduate of Howard University and its medical school, he completed a laser dermatology fellowship at Harvard Medical School and displays an evangelical fervor about ethnic skin care. While at Harvard he helped develop laser treatments now widely used to treat dark skin.

First-generation lasers, he recalls, were designed for light skin and dark hair -- and the risks of scarring dark or tanned skin were well-known. But the newer lasers that he helped pioneer mean "I can treat the darkest African and Indian skin safely."

Celebrity Clientele

Equal parts glossy retail cosmetics counter, candle-scented day spa and white-coated medical practice with a stable of 30 lasers, Cultura treats about 85 patients six days a week.

They include former Miss America Ericka Dunlap, who flies in from Nashville for treatments of acne flare-ups and other skin care; tennis stars Venus and Serena Williams; and basketball stars Patrick Ewing and Alonzo Mourning. Some patients have come from as far as Turkey, Iran and Brazil.

"This place is a mini-U.N.," Battle said, referring to its clientele and staff.

The growing acceptance of cosmetic procedures reflects a change in attitude, particularly in the black community, surgeons say.

Until about five years ago, said Chicago plastic surgeon Julius W. Few, cosmetic surgery was typically regarded as worse than frivolous in the African American community -- and often associated with the race-effacing look of Michael Jackson.

"There really was a sense of taboo, that if you were looking at plastic surgery you were seen as being ashamed of your ethnicity," noted Few, an associate professor of surgery at Northwestern. "I've seen a tremendous swing."

Many patients, he said, flatly tell him they don't want to "look white. Most people want to preserve their original look," while making subtle changes.

"There are indeed cultural differences," observed Baltimore plastic surgeon Ricardo Rodriguez, chief of plastic surgery at Greater Baltimore Medical Center.

White women favor a thinner silhouette, Rodriguez said, "while Hispanic and African American women want to be more curvy."