Extreme Makeover

I knew nothing about plastic surgery prior to meeting Dr. Garth Fisher. His instructional skills and rapport with patients are equally matched with his skills as a master surgeon.

—Howard Schultz, Creator and Executive Producer of Extreme Makeover

Primetime Pressure
Thanks, But No Thanks
Extreme Makeover Begins
Facing the Fallout
Breakout
Never the Same Again

2000 Primetime Pressure

The reveal that launched a legacy.

Before Extreme Makeover, Garth’s media career began with a rhinoplasty on Leeza. He operated on a patient whose transformation would be unveiled live, just seven days later. “I was so nervous,” he recalls. “I kept thinking—what if this thing is horrendous?” But when the splint came off, it was flawless. The moment launched his media persona, led to an appearance on Good Morning America, and had his practice booked out a year in advance. It was the spark that lit everything that followed.

Early 2002 Thanks, But No Thanks

Extreme Makeover wasn’t an immediate yes.

In early 2002, producer Howard Schultz walked into Garth’s office with an idea that could change television: a reality show chronicling full-scale plastic surgery transformations. Garth wasn’t interested. “I didn’t want to do anything that might harm my practice or exploit patients,” he recalls. Schultz respected the answer—but didn’t stop there. He spent the next six weeks touring the country, searching for someone else who could carry the show. Still, none of them felt right. During that time, he kept returning to watch Garth work in the OR. Eventually, he came back with the same ask: he still wanted Garth.

Late 2002 Extreme Makeover Begins

A new era of plastic surgery emerged.

When Howard Schultz returned after weeks of searching, Garth listened. He wasn’t swayed by the spotlight—but by the opportunity to shape how plastic surgery would be portrayed. He agreed to join the show on one condition: full developmental control. That trust laid the groundwork for a series that balanced storytelling with surgical integrity. Together, they shaped Extreme Makeover into something that didn’t just entertain—it educated, elevated, and redefined an entire field.

Early 2003 Facing the Fallout

The surest sign of success? Envy from your peers.

Just weeks after Extreme Makeover premiered, Garth came under attack from professional societies who called the show unethical. But behind the scenes, many of those same voices were quietly trying to get on the show themselves. Garth didn’t flinch. Instead, he walked away—not from the show, but from the societies, staying focused on what he believed mattered more: bringing honesty, expertise, and hope to a national audience. While others played politics, he helped change the conversation.

2003-2007 Breakout

Extreme Makeover didn’t just take off—it changed the landscape.

Extreme Makeover became a runaway hit, airing in over 100 countries and captivating millions. In its first year alone, plastic surgery procedures increased by 35%. By the second, that number had climbed to 65%. The show tapped into something deeper: people were rethinking what was possible. It redefined the public’s relationship with plastic surgery, bringing it out of the shadows and into the cultural mainstream.

2007-onward Never the Same Again

The field of plastic surgery would change forever.

By the time Extreme Makeover ended in 2007, the field of plastic surgery had already transformed. Surgeons across the country began rethinking how they communicated with patients, presented their practices, and understood the deeper emotional motivations behind cosmetic procedures. Words like “empowerment,” “restoration,” and “confidence” began replacing taboo whispers. Patients came in better informed, more open, and more emotionally invested. And the surgeons who adapted weren’t just responding to public demand—they were following a new standard set in motion by the show. Garth’s influence extended well beyond the screen, helping shift plastic surgery toward something more personal, more human, and more transparent.