When The Real Housewives of Atlanta star NeNe Leakes had her nose job documented on the hit Bravo reality show in 2010, she told People, “I still wanted to look like NeNe, the black woman that I am, but a better version.”

The outspoken reality star also had her breast implants reduced, a breast lift and liposuction around her waist. “I’m very comfortable and confident in myself,” the 43 year old confessed. “I just wanted a tune up.”

The Atlanta housewife’s attitude reflects a shift in the view many African Americans have toward plastic surgery.

In 2010, the American Society of Plastic Surgeons (ASPS) reported that 1,047,420 African Americans had cosmetic or plastic surgery procedures and accounted for about 8 percent of the total 13 million Americans who underwent cosmetic procedures. Nose reshaping, liposuction and breast augmentation were the most commonly requested cosmetic procedures for African Americans. In 2002, the number was significantly lower, and just 375,025 African Americans reportedly opted for cosmetic or plastic surgery procedures.

Meanwhile, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) reported that of the four most popular plastic surgery procedures – facelifts, blepharoplasty, ablative skin resurfacing and rhinoplasty – African Americans and Hispanics selected rhinoplasty, 78 percent and 62 percent respectively.

So what has caused the spike in plastic surgery rates among the African American community?

There’s Less Stigma

Monte O. Harris, MD, FACS, says most of his African American patients aren’t trying to completely change the way they look. “The motivation,” he says, “is to enhance and add balance to the face.”

The board-certified facial plastic surgeon based in Washington, D.C., explains, “People in general are trying to have vital lives and be well, and the idea of cosmetic enhancement doesn’t have the same level of taboo it [once] had in the African American community.”

“People used to think you were denying your ethnic heritage. But the two aren’t mutually exclusive. [Whereas] the platform for beauty was predominantly a Euro-centric platform, now we have a more global culture and the platform for beauty has broadened.”

Increased Access to Cosmetic Surgery

Accessibility, adds Harris, is also a key factor to the upswing in plastic surgery amongst African Americans. “The internet and media have played a significant role in making cosmetic treatment enhancement acceptable as a whole.”

“We [no longer] just have isolated poster children for plastic surgery like Michael Jackson and Patti LaBelle. It’s not just limited to celebrities. [Now] we have friends who’ve done it,” says Harris.

Less Invasive Procedures

The advent of minimally invasive and non-surgical procedures including Botox, injectable fillers and chemical peels that have less risk of scarring is also appealing.

“The facelift used to be the only option for facial rejuvenation and to restore youthfulness,” Harris says. “This was an operation [that required] an incision in the ear. For many African American patients, aging happens along the eyes and cheeks. The facelift deals with jaw and neckline, so it didn’t address their concerns.”

Culturally Sensitive Practices

At his culturally-diverse practice, the Center for Aesthetic Modernism, Harris specializes in cosmetic enhancements tailored to meet the needs of his African American clientele, including hair restoration.

“For African American women, this is a big deal,” he says of hair loss caused by the tension and pulling of tight hairstyles such as braids, locks and extensions. “You can come here and have a surgeon who is sensitive to your cultural and ethnic identity.”

The center’s method of hair restoration for women and men uses low-level laser therapy and includes in-office and at-home treatments. According to Harris, over 15 years of clinical research shows that low-level, cool-laser therapy can increase hair density by 40-60 percent. This painless treatment has also shown an 85 percent success rate in stopping the progression of hair loss.

Additionally, Harris’ office specializes in 3D surgery simulation as a tool to show patients what to expect from a customized rejuvenation plan.

“There’s a growing number of African American cosmetic surgeons,” says Harris. “My practice shines a light that it’s okay to meet the needs of a particular community and not alienate the mainstream.”