{ "id": "ep2j7kevvk", "slug": "skin-decision-before-and-after", "title": "Skin Decision: Before and After", "updated": "2026-11-01", "topic_path": [ { "id": "culture", "label": "Arts and culture", "api_url": "https://www.edgepedia.org/api/v1/topics/culture" }, { "id": "culture.performance", "label": "Screen and stage", "api_url": "https://www.edgepedia.org/api/v1/topics/culture.performance" }, { "id": "culture.performance.screen", "label": "Film and television", "api_url": "https://www.edgepedia.org/api/v1/topics/culture.performance.screen" }, { "id": "culture.performance.screen.series", "label": "Series and fictional screen worlds", "api_url": "https://www.edgepedia.org/api/v1/topics/culture.performance.screen.series" }, { "id": "culture.performance.screen.series.series_unscripted", "label": "Unscripted, reality, and web-native series", "api_url": "https://www.edgepedia.org/api/v1/topics/culture.performance.screen.series.series_unscripted" }, { "id": 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"label": "Screen and stage", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.us.t2001.culture.performance" }, { "id": "geo.us.t2001.culture.performance.screen", "label": "Film and television", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.us.t2001.culture.performance.screen" }, { "id": "geo.us.t2001.culture.performance.screen.series", "label": "Series and fictional screen worlds", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.us.t2001.culture.performance.screen.series" }, { "id": "geo.us.t2001.culture.performance.screen.series.series_unscripted", "label": "Unscripted, reality, and web-native series", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.us.t2001.culture.performance.screen.series.series_unscripted" }, { "id": "geo.us.t2001.culture.performance.screen.series.series_unscripted.celebrity-lifestyle-court-reality", "label": "Celebrity, family, lifestyle, and court reality series", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.us.t2001.culture.performance.screen.series.series_unscripted.celebrity-lifestyle-court-reality" } ] } ], "excerpt": "Skin Decision: Before and After is a 2020 Netflix reality series, one season of eight 40-minute episodes, starring plastic surgeon Dr. Sheila Nazarian and Nurse Jamie, who choose surgical or nonsurgical treatments for clients.", "snippet": "Skin Decision: Before and After is a 2020 Netflix reality series, one season of eight 40-minute episodes, starring plastic surgeon Dr. Sheila Nazarian and Nurse Jamie, who choose surgical or nonsurgical treatments for clients.", "node": "culture.performance.screen.series.series_unscripted.celebrity-lifestyle-court-reality.lifestyle-dating-and-docusoaps.wealth-real-estate-and-lifestyle-series", "markdown": "# Skin Decision: Before and After\n\n**Skin Decision: Before and After** is an American reality television series that premiered on Netflix on July 15, 2020, in which skin-care expert Nurse Jamie (Jamie Sherrill) and plastic surgeon Dr. Sheila Nazarian use surgical and nonsurgical procedures to help clients address skin and appearance concerns.[1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after) • [2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review) The show ran for one season of eight 40-minute episodes, all released on the same day.[1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after)\n\n| Key fact | Detail |\n|---|---|\n| Premiere | July 15, 2020, on Netflix; all 8 episodes of season 1 released that day[1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after) |\n| Format | Each episode follows two subjects who consult both experts, who debate whether surgery or nonsurgical treatment suits them[2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review) |\n| Hosts | Dr. Sheila Nazarian, a board-certified Beverly Hills plastic surgeon, and Nurse Jamie (Jamie Sherrill), a registered nurse and celebrity skin-care expert[2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review) • [3](https://www.commonsensemedia.org/tv-reviews/skin-decision-before-and-after) |\n| Episode length | 40 minutes[1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after) |\n| Genre and rating | Reality TV; rated TV-MA[4](https://watch.plex.tv/en-GB/show/skin-decision-before-and-after) |\n| Audience scores | IMDb 6.0 from 508 votes; JustWatch user rating 7%[5](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after) |\n| Status | Ended, with one season[1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after) |\n\n## Spoilers\n\n### Format and premise\n\nEach episode introduces two people with a specific concern they want to change about their appearance. Once each participant's story has been shown, Nazarian and Sherrill sit down with them to weigh the case together, determining if surgery carried out by Nazarian would serve them best, or if a course of noninvasive options like laser work and fillers given by Nurse Jamie would be the more suitable route.[2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review)\n\nThe subjects' reasons vary widely. Several had survived traumatic incidents that left major scarring: Katrina, shot by her ex-husband, wanted scars including a bullet wound addressed; Marla had been slashed in the face during an attack; Nicholas sought to reduce facial scarring from a car crash. Sanaz had dealt with severe acne for half her life, and Atticus sought gender-affirming top surgery. Others came after major life events such as giving birth to quadruplets or turning 50.[2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review) • [6](https://www.rottentomatoes.com/tv/skin_decision_before_and_after/s01)\n\nThe eight episodes were titled \"These Scars Do Not Define Me\", \"Car Crash & Quad Mom\", \"Beauty Isn't Dangerous\", \"Feeling Like Myself\", \"I Always Look Pregnant\", \"I Want My Smile Back\", \"Fixing My Face\", and \"Implant Removal & Excess Skin\".[7](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after/season-1)\n\n## Reception\n\n**Professional response was positive.** A Glamour review by beauty editor Bella Cacciatore called it the first show she had seen handle plastic surgery with care and nuance rather than as a joke, praising its emphasis on education and empathy and describing it as closer to \"beauty as therapy\" than a makeover show.[2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review) The American Society of Plastic Surgeons highlighted the series as challenging misconceptions about plastic surgery; Nazarian, an ASPS member, said her favorite aspect of the show was its \"class and integrity\" and that it treats patients with respect.[8](https://www.plasticsurgery.org/news/blog/new-netflix-reality-series-transforming-lives-through-plastic-surgery)\n\n**Viewer criticism focused on the reveals.** Audience reviews on Rotten Tomatoes, where the season's Popcornmeter stood at 53% with fewer than 50 ratings, repeatedly objected that the \"after\" shots showed subjects in full glam makeup with heavy filters, making the results hard to evaluate in a show about skin.[6](https://www.rottentomatoes.com/tv/skin_decision_before_and_after/s01) On the aggregate scores, the show held an IMDb rating of 6.0 and a 7% [JustWatch](https://www.edgepedia.org/justwatch) user rating.[5](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after)\n\n## Place in the makeover-show genre\n\nThe series arrived after two decades of cosmetic-surgery reality television that began with ABC's *Extreme Makeover* in 2002 and included Fox's *The Swan* (2004) and E!'s *Botched*. Earlier shows drew criticism for extreme makeovers, pageant-style competition, and unrealistic patient expectations, and the American Society of Plastic Surgeons had engaged with the genre as early as 2003, consulting on *Extreme Makeover* to press for informed consent and proper patient selection.[9](https://journalofethics.ama-assn.org/article/plastic-surgery-real-not-reality-tv/2007-03) • [10](https://www.isaps.org/articles/isaps-blog/2017/plastic-surgery-on-reality-television-how-real-is-it/) *Skin Decision* positioned itself against that tradition: the ASPS described it as not a typical makeover show, and reviewers noted its focus on consultation, patient stories, and less extreme procedures rather than total physical transformation.[8](https://www.plasticsurgery.org/news/blog/new-netflix-reality-series-transforming-lives-through-plastic-surgery) • [2](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review)\n\n## Availability\n\nThe series streams on Netflix and Netflix Standard with Ads in the United Kingdom, Canada, France, Brazil, and other markets, with no free streaming options listed as of late 2026.[5](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after) It was added to Netflix USA on July 15, 2020, with audio tracks in English, French, German, Italian, and Spanish.[11](https://flixboss.com/series/skin-decision-before-and-after-81038987) In Germany it is titled *Hautentscheidung: Vorher – Nachher*, and in Hungary *A bőrödre megy: Előtte és utána*.[12](https://www.prisma.de/streaming/Hautentscheidung-Vorher-Nachher-sgM5rXVWv) • [1](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after)\n\n## References\n\n1. [Skin Decision: Before and After, TVmaze](https://www.tvmaze.com/shows/48868/skin-decision-before-and-after)\n2. [Netflix's 'Skin Decision: Before & After' Review, Glamour (Bella Cacciatore, July 15, 2020)](https://www.glamour.com/story/netflix-skin-decision-before-and-after-review)\n3. [Skin Decision: Before and After, Common Sense Media](https://www.commonsensemedia.org/tv-reviews/skin-decision-before-and-after)\n4. [Skin Decision: Before and After, Plex](https://watch.plex.tv/en-GB/show/skin-decision-before-and-after)\n5. [Skin Decision: Before and After, JustWatch (UK)](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after)\n6. [Skin Decision: Before and After: Season 1, Rotten Tomatoes](https://www.rottentomatoes.com/tv/skin_decision_before_and_after/s01)\n7. [Skin Decision: Before and After Season 1, JustWatch](https://www.justwatch.com/uk/tv-series/skin-decision-before-and-after/season-1)\n8. [New Netflix reality series transforming lives through plastic surgery, ASPS (Kendra Y. Mims, August 7, 2020)](https://www.plasticsurgery.org/news/blog/new-netflix-reality-series-transforming-lives-through-plastic-surgery)\n9. [Plastic Surgery is Real, Not Reality TV, AMA Journal of Ethics (Richard D'Amico, 2007)](https://journalofethics.ama-assn.org/article/plastic-surgery-real-not-reality-tv/2007-03)\n10. [Plastic Surgery on Reality Television: How Real Is It?, ISAPS](https://www.isaps.org/articles/isaps-blog/2017/plastic-surgery-on-reality-television-how-real-is-it/)\n11. [Where to watch 'Skin Decision: Before and After (2020)' on Netflix, Flixboss](https://flixboss.com/series/skin-decision-before-and-after-81038987)\n12. [Hautentscheidung: Vorher – Nachher, Prisma](https://www.prisma.de/streaming/Hautentscheidung-Vorher-Nachher-sgM5rXVWv)\n\n---\n*Topic: Encyclopedia › Arts and culture › Screen and stage › Film and television › Series and fictional screen worlds › Unscripted, reality, and web-native series › Celebrity, family, lifestyle, and court reality series › Lifestyle, dating, and docusoaps › Wealth, real estate, and lifestyle series*\n\n*Initially written Oct 3, 2026 · Reviewed: Oct 25, 2026 · Edited: Oct 15, 2026; Oct 25, 2026; Nov 1, 2026 · Last review: Oct 25, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n", "same_as": [], "url": "https://www.edgepedia.org/skin-decision-before-and-after", "markdown_url": "https://www.edgepedia.org/skin-decision-before-and-after.md", "license": { "name": "Edgepedia Community License 1.0", "url": "https://www.edgepedia.org/edgepedia/license", "summary": "Free with credit, commercial use included. AI training is open to everyone. For other uses, organizations over USD 100M in revenue or 100M monthly users license separately.", "spdx": "LicenseRef-Edgepedia-Community-1.0" }, "credit": "\"Skin Decision: Before and After\", Edgepedia (EdgeChat), https://www.edgepedia.org/skin-decision-before-and-after. Edgepedia Community License 1.0.", "credit_md": "\"[Skin Decision: Before and After](https://www.edgepedia.org/skin-decision-before-and-after)\", Edgepedia (EdgeChat), [https://www.edgepedia.org/skin-decision-before-and-after](https://www.edgepedia.org/skin-decision-before-and-after). [Edgepedia Community License 1.0](https://www.edgepedia.org/edgepedia/license).", "credit_html": "\"Skin Decision: Before and After\", Edgepedia (EdgeChat), https://www.edgepedia.org/skin-decision-before-and-after. Edgepedia Community License 1.0.", "speakable": "Skin Decision: Before and After is a 2020 Netflix reality series, one season of eight 40-minute episodes, starring plastic surgeon Dr." }