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I Got Plastic Surgery To Compete In Pageants — & I'm Not Alone

In the pageant world, breast implants and nose jobs don't just come with the territory — they're offered for free to contestants who want a leg up.

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Barbara Santana was nervous, the good kind of nervous, as she prepared for her very first pageant in 2014: Miss Dominican Republic US, which takes place in New York City. She had found the perfect gown, dedicated herself to working out, and practiced her catwalk in the weeks leading up to the competition. Then, the pageant finally came around, and she walked away with the crown, never expecting what came next.
High off her win, Santana was ready for the next step, which included traveling to the Dominican Republic to compete on the national stage. She was meeting with her new pageant director to discuss her upcoming training schedule when the topic quickly shifted to plastic surgery.
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“The very first thing he told me was that I needed a nose job and a breast reduction,” she tells Refinery29. “That’s when I began to ask myself what I was willing to do and how far I would go in the world of pageants.”
Santana, who had just turned 19 at the time, followed through with the surgeries without giving them a second thought. “The pageant had a sponsored plastic surgeon, so the surgery would be completely free,” she says. “I was already very insecure about my breast size, and I was young, so I instantly agreed and went through with both procedures.”
Santana went on to compete in Miss World 2014 and Miss New Jersey USA 2018, but she wishes she would’ve postponed her decision to go under the knife. “I have nothing against plastic surgery, as it helps many people to boost their self-esteem," she says. "But I feel as though I only wanted it at the time so that I could be more accepted by the people constantly criticising me — not for myself."
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It’s no surprise that plastic surgery is common in beauty competitions. Despite the preliminary interviews with judges, the community service platforms, the on-stage questions, and many organisations’ efforts to the contrary, there is always a physical element that comes into play as the women take the stage to compete. In many cases, both a swimsuit and evening gown portion count towards a contestant’s total score.
According to the Miss Universe website, the swimsuit section is meant to display “dedication to a healthy lifestyle,” and the evening gown portion reflects how “confidently each woman presents herself.” Technically, confidence and lifestyle choices could reflect a range of physical appearances, but looking at the winners' circle, that's clearly not the case.
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Across pageants, both in the US and abroad, there remains a cookie-cutter image of what a beauty queen is supposed to look like: long hair, a slim waist, and curvy (but not too curvy) hips and breasts. And if a contestant doesn't fit that, surgery is the fastest solution. “If I’m working with a contestant who feels that a tweak here or there will boost her confidence, then we will do it,” Edgar Payano, former director of the Miss Dominican Republic US pageant, says. “Confidence is key when you’re competing in pageantry.”
As someone who competed in pageants for eight years, I can say that, just like Santana, I felt the same pressure to go under the knife to fit the judges’ narrow standards of beauty. And that pressure starts at a young age. In countries like Venezuela, which holds 23 victories in major international competitions, girls as young as 12 years old are getting surgeries as they enter the pageant circuit.
Photo: Frazer Harrison/Getty Images.
Left to right: Miss South Africa 2017 Demi-Leigh Nel-Peters, Miss Canada 2017 Lauren Howe, Miss Philippines 2017 Rachel Peters, Miss USA 2017 Kara McCullough, and Miss Venezuela 2017 Keysi Sayago
And it’s not just in Venezuela and the Dominican Republic. Vivian Herscovitz felt compelled to get plastic surgery while competing for Miss California Teen USA, which accepts applicants between the ages of 14 to 19. “I had fitness instructors and pageant coaches telling me that I should look into other options to help my stomach look more toned,” she says. “When I competed, I met multiple women that were explicitly told that they would need plastic surgery in order to win.” Herscovitz never went through with any of the surgeries, but she still can’t believe it was even a suggestion. “To this day, I am appalled that anyone would even hint at plastic surgery for a 16 year old,” she says.
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While directors aren’t necessarily forcing these surgeries, they do feel a responsibility for their delegates to win. “I have suggested surgery to my titleholders, but I've never forced it,” says Payano, adding that he recognises his influence as a coach. “The contestants have the final say, but my opinion does matter to these girls as a director.”
Shanna Moakler, executive director of Miss Nevada and Miss Utah USA, and Miss USA 1995, says that at the end of the day, it’s always the contestant’s choice. “It should be made with a lot of consideration as the pageant is just one night,” she says. “You will have to live with these changes forever.”
Illustration by Louisa Cannell
But with surgeries available for free as part of the prize winnings, it can be hard to tell if contestants are getting the procedure for the right reasons. “I always speak to the contestant again without the director present to ensure it’s what she wants,” says Jeffrey S. Yager, MD, a New York-based plastic surgeon, who has sponsored pageants in the past. “I make it quite clear that it is the contestant who makes the decision on her own.”
The most popular surgeries among titleholders, as seen by Dr. Yager, are breast augmentation and nose reshaping, with the occasional request for liposuction. For the doctors, sponsoring these surgeries can lead to referrals and good publicity. For pageant contestants, it could mean getting one step closer to the crown.
While some contestants regret getting plastic surgery, there are other women who are ultimately satisfied with their decision. Migbelis Castellanos, who competed in Miss Universe 2014 representing Venezuela and is the latest winner of Univision’s reality show Nuestra Belleza Latina, says that she didn’t feel the same pressure when she opted for breast implants and a nose job. “It was a personal decision," says Castellanos. "For these kinds of cosmetic changes to be successful, a woman needs to be happy with herself at the outset, because this is an enhancement of the beauty that is already there."
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The pageant is just one night. You will have to live with these changes forever.

Shanna Moakler
For Keysi Sayago, Miss Venezuela 2016 and Top 5 at Miss Universe 2017, the decision to get rhinoplasty and liposuction at the age of 22 was a mixture of both personal and external factors. “Many times we believe that if we don’t do it, we won’t achieve the goal. That’s why we say yes to the suggestions of procedures that are brought to us," she says. "Although I had my doubts at first, I liked the result and appreciate how natural it looks.”
Five years later, I'm also happy with the results of my surgery. While my coach initially suggested I shave down my hips and get a brow lift — which was horrifying to me as a 21 year old — I did accept a free breast augmentation. At the time, I knew it wasn't a temporary decision, but something I'd be satisfied with in the long run. Going from an AA- to a C-cup allowed me to fit more proportionally into my clothes and, ultimately, gave me a new sense of confidence that I didn't have before the procedure. I definitely felt pressure to fit a physical standard while competing, but enhancing my breasts wasn't for anyone but myself.
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While there are mixed reactions to plastic surgery among pageant contestants, the larger organisations are facing heightened scrutiny over the narrow definition of beauty that they tend to promote. Last year, Miss America scrapped its swimsuit portion to be more inclusive — a move that proved to be controversial. Miss Universe flipped the script with a woman-led panel of judges. And Nuestra Belleza Latina recently changed its format to welcome women of all ages, sizes, and skin tones. “I think there are strides being made in the right direction towards promoting inclusivity,” says Miss Universe Canada 2017 Lauren Howe. “The standard of beauty being promoted is no longer the tall, thin, Caucasian, blonde woman.”
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It's a conversation that could change the landscape, and the rates of plastic surgery among both the competitors and the young women watching. “Women with purpose and strong stories are being considered, and it’s not just the girl with the perfect height and body anymore,” says Santana. “For many years, women have felt ashamed of who they are because they don’t fit a mould, and I look forward to seeing things change.”
But Payano says that it’s not quite perfect yet. “Yes, pageants are sending a new message that beauty comes in all shapes and sizes. However, the same type of beauty keeps winning,” he says. Howe echoes this sentiment and knows that these pageant queens are sending a message that affects young women all around the world. “We are setting a standard that trickles down and results in people developing an insecurity because they don’t look like the women they see on television, which means they may have an increased desire to go under the knife," she says. "Breaking that mold could spark an incredible wave.”
We have reached out to the Miss Universe organisation for comment, and will update this piece when we hear back.
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