Despite its rising popularity and acceptance, plastic surgery is still largely treated like a joke when it comes to TV shows and movies. But Netflix’s new reality show Skin Decision: Before & After, now streaming, is the first to handle plastic surgery with the care and nuance usually reserved for other medical issues. On the surface, Skin Decision is a makeover show in a similar vein to What Not to Wear or How Do I Look? Each episode features two different subjects with something specific they like to change about their appearance. After we’re introduced to their stories, they meet with two experts: Sheila Nazarian, a board-certified plastic surgeon, and Nurse Jamie Sherrill, a skin-care expert and registered nurse who works with celebrities like Lisa Rinna and most of the Kardashians. The experts will meet with the subjects, and then debate whether the person is a better candidate for a surgical procedure or not. The reasons the subjects appear on the show are as varied and complex as why people seek out plastic surgery in real life. Overall, the show paints a positive and realistic picture of what cosmetic procedures can do.