If plastic surgery used to be taboo, it definitely isn’t any longer. During Monday night’s episode of “The Real Housewives of Atlanta,” cast member Nene Leakes underwent three cosmetic surgeries; rhinoplasty, liposuction and breast augmentation, in order to, as she claimed, relieve stress from her ailing marriage to Gregg and the roller coaster drama over her son Bryson’s future. While many might have turned up their unaltered nose to Leakes’ decision to get her nose done, the number of African-Americans going under the knife has risen dramatically. Over 985,000 African-Americans underwent cosmetic surgery in 2009, a gain of 5 percent over the previous year, according to the American Society of Plastic Surgeons. With popularity of plastic surgery growing in the Black community, ESSENCE.com chatted with Selika Borst, RN, Assistant Director of Clinical Research for Denova Research, a plastic surgery research firm based in Chicago, to find out why Black women are now taking the plunge and getting nipped and tucked now more than ever. ESSENCE.com: Why the rise in plastic surgery among Black Americans and Black women specifically? SEILKA BORST: While we don’t have specific numbers on Black women, I think we are more in the workplace now than ever. As Black women rise professionally, we are making our own money and becoming more educated about what we can and cannot do to enhance ourselves. So, the rise of professionalism and economic status of Black women has increased our awareness. We have the resources now if we wanted to change something. And because we see more women like us, like Kelly Rowland or Vivica Fox or Vanessa Williams, getting work done, the stigma is less than it has ever been. Black women are just more conscious visually than ever before and we are taking more care of ourselves these days, from our hair to our skin. We’re taking more pride in ourselves. Cosmetic surgery has sort of become just part of your beauty regimen. ESSENCE.com: NeNe Leakes pegged her desire to have plastic surgery on stress caused by her marriage and her eldest son’s legal dilemmas. Is stress a common reason given for wanting plastic surgery? BORST: Stress isn’t a common factor, from my experience. Whether it’s Botox or a nose job, many women just want to look fresh, often for the workplace. As for the surgical aspect, it’s something many women have wanted for a very long time. Usually, must medical professionals wouldn’t perform surgery unless someone seemed to be doing it for the right reasons. It’s not all about low self-esteem, like many think it is. ESSENCE.com: Really? How do you know if someone is getting surgery for the right reasons? BORST: You don’t want to do something on a patient that isn’t doing it for themselves. That’s like putting a band-aid on cancer. As medical professionals, many try to weed out people who have body dysmorphic disorder. We try to tell patients that this is not something they need, if they don’t need it. I’ve had women on the non-surgical side of things, and I’ve told them not to get Botox because they’re only 24 and they don’t need it. ESSENCE.com: What makes someone a good candidate? BORST: There are a couple major things. First, medical professionals check to ensure that the patient is physically healthy and can withstand major surgery. Then, doctors also want someone to be mentally stable. That means that the patient’s reason for augmenting their body is clearly defined and makes sense other than, “I just want to do it.” ESSENCE.com: Both NeNe and her friend Dwight Eubanks on “The Real Housewives of Atlanta” have had nose jobs. Is that the most popular cosmetic surgery that Black people ask for? BORST: Typically there are requests from African-American women for thinner noses, more often than other procedures. Many of us want thinner stomachs and thighs, so liposuction and tummy tucks are popular requests as well. A few want breast lifts or reductions, as we ethnically have more ample busts and want them to be tauter. But really, there’s just an influx of Black women doing more non-procedural processes, or non-injectables. We have thicker skin and more melanin, so we don’t have a lot of wrinkles until we’re older. However, because of this, there is a rise of Black women getting more Botox, typically around ages 40 to 60. ESSENCE.com: For Black women considering plastic surgery, what are some things for them to remember? BORST: First, you’ll want to know that someone has worked with your skin, meaning Black skin. It’s the same as hair; make sure they can work with your texture. Also, Google and research and do your homework. If the doctor has worked on patients that look like you, that is a sign this person is comfortable working with your skin type or body shape, and that has significant advantages post-surgery especially for Black women who are more prone to deal with keloids, dark spots, dark circles and scarring. ESSENCE.com: How do you know the doctor you select can work with your skin type, though? Are there certain questions to ask to make sure that doctor is right for you? BORST: You should definitely be asking questions. For example, patients should ask how many procedures the plastic surgeon has done of the type you’re looking for. Ask them if you can see the results from their previous surgeries. Ask if they are board certified and if they’ve ever had any fatalities. Anything you’d want to know you should be free to ask of the person performing major surgery on you. And of course, talk to more than one physician. Don’t just jump into a relationship with the first doctor you meet with. ESSENCE.com: Okay, so many Black women are making more money these days and can afford to have cosmetic surgery done to “enhance themselves.” Are we really recommending they get surgery? What should we really be considering? BORST: We encourage everyone to remember that it is a surgical procedure. It’s not something to be taken lightly. Do all of your research, and make sure you’re with the right doctor for you. Again, minority women have more financial independence now, and they have the right and the means to make the changes they’d like to make. We want to look just as good as everyone else does, so we say, Why not? It comes from hard work and sacrifice, not just insecurity about how we look. Many of our patients are attorneys and physicians and business professionals. Cosmetic surgery is about enhancement, not changing who you are. It’s not a need, but it is truly about enhancing the beauty that Black women already have.