toni tonight on "nightline," anyo nip/tuck, and nip again. from bursting breast implants to failing facelifts. the number of plastic surgery doovers is on the rise, but why? and is going under the knife again really the answer? simon says -- and everyone listens. he may be the biggest force in entertainment. and this british idol is about to kiss america's top show good-bye, without a single regret. it's the economy of simon cowell. plus, game on. super bowl sunday is nearly here, so, let the guiltless calorie consumption begin, from wings to a cheese burger in paradise. it's the "nightline" guide to

schumer bowl grub. >> announcer: from the global resources of abc news, with terry moran, martin bashir and cynthia mcfadden in new york city, is is "nightline," february 4th, 2010. >> good evening. for miions of americans, the quest for beauty might well begin with makeup, but often ends up in the operating room. there were more than 10 million cosmetic procedures in 2008, with patients spending almost $12 billion. and an increasing amount is now coming from repeat business, patients who are no longer satisfied, and want to go under the knife again. but is there any guarantee that it will work second time around? ryan owens now reports. >> make the pocket a little bigger. >> it doesn't deate right away. >> reporter: ten years after she had breast impants, this 32-year-old woman is back at the

plastic surgeon. >> little by little. but you do feel a small kind of pop or something. i was watching tv and i was like, huh, looks different. >> reporter: her implant literally popped, and it's more common than you think. >> it's not subtle. woman wakes up, gets out of the shower, safes, where did my breast go? she calls, typically runs in. it's not a medical problem. it's clearly an emotional one. >> it does affect you. you know, because you have one boob. >> reporter: we're calling her l.b., because she asked us not to use her real name. >> that is the new lift. and that will correct the pull to the back. >> reporter: this dallas woman has spent three decades trying to perfect her face. >> chin down just a little. perfect. >> i notice that i was sagging again and sagging through the neckline. >> reporter: she had a nose job in her 20s, a facelift in her

40s, and now, she's back again. >> people constantly ask me why i was frowning when i was not. >> reporter: so what are you going to have done? >> i'm going to have a facelift. >> reporter: again. >> again. my second. >> reporter: we're calling her martine. she asked us not to use her real name. she's part of a very real trend. the plastic surge riredo. >> there's a sub-specialty now within the practice of revisions. >> reporter: the recession has cut into the business of e l elective plastic surgery. not redos. this doctor says are dos keep him busy during the durturn. >> we found 35% of the surgeries i've done in the last few months have been revision surgeries. okay. here we go. >> reporter: l.b.'s surgery takes a lot less time. >> and here's the deflated

implant. it sprung a leak. so, she's got a flat tire. we'll fix that now. >> reporter: the doctor says he's not just having to fix old implants, but no ones put in by unqualified surgeons. >> a number of people are coming in for revisional surgery following implant deflations like this, but even more coming in following bad surgery. we're seeing a number of people dabbling in this marketplace who are unqualified. both here and outside the country. medical tourism is contributing to revisional surgery as well as non-board certified plastic surgeons doing this type of surgery. >> reporter: her procedure takes less than an hour. >> little lower. little fuller. and she's a d-cup. >> reporter: dr. sam hamra will perform martine's facelift.

were you happy with the results originally? >> yes, but i would determine it a cream puff job which -- >> reporter: what does that mean? >> well, he was a fine surgeon, and he makes you look really great for just a few years. where as dr. hamra's effects are long-term and lasting. >> the young person has full eyes. >> reporter: these days, more than half of his surgeries are redos. he sees so many disappointed with his first lift, he wrote a book about it, called "the facelift letdown." what are the most common complaints you hear from women? >> most of it, it didn't last long, or i don't look as pretty as i wanted to, or my eyes are sort of funny looking. you have to remember this is not chiselling in marble. the faces continue to age. so, whatever technique, mine or others is going to age. >> reporter: what is it going to take? >> well, you know, there's no price too high for beauty.

>> good morning. >> good morning. >> ready for surgery? >> yes, i am. >> reporter: her surgery took nearly five hours. recovery will take months. the next day, l.b. is recovering well, and happy with the results. >> any nausea or anything? >> no. >> fantastic. >> you won't see anything at this point. no cute, sexy black dress. >> i'm not going anywhere. no boyfriend. >> yet. >> reporter: it's been six weeks since martine's facelift redo, and as you can see here, her recovery takes time. >> good to see yougain. your eyes were a little bit hollowed out. >> reporter: as they look at the before and after photos, the doctor and martine say so far so good. >> everybody tells me i look 20,

30 years younger. i feel great. i get so many compliments every day. >> i wouldn't be very happy until six months or almost a year goes by, because the whole theory is that this operation is very stable and everything we've created here should stay for a long, long time. >> reporter: she does have a few skarps but the doctor promises they will fade. >> this is hidden inside the ear so you will never see a scar in front of the ear and the only thing that is new would be the top of the forehead. that line listen very light and the advantage is we narrowed her forehead significantly, rather than given her a terribly high forehead and that's part of a beautiful face. >> reporter: martine says it's a small price to pay for what she now seeps in the mirror. >> overalli feel like i have a much more youthful look. ill just think this area is so smooth. >> reporter: are you afraid you're going to be here in ten years? >> no, dr. hamra has been a fine

surgeon wi a wonderful reputation for years and i know it will be long lasting. >> reporter: a redo she's hoping won't have to be redone. i'm ryan owens for "nightline" in dallas. >> an expensive and endless fight against the inevitability of aging. our thanks to ryan owens. and when we come back, fortune, fame, and that "american idol" scowl. we look at the big business that is simon cowell. ♪ the wrightnows uncle hector, i baked your favorite banana bread. i hate bananas. i want to watch a movie. okay, let's watch a movie. an action flick. musical. how 'bout an awesome rad comedy? alright! alright! alright! me and mr. putty wanna watch a scary movie. [ purring ] [ male announcer ] netflix now delivers unlimited movies 2 ways -- instantly to your tv, plus dvds by mail. bad teddy. [ roaring ] [ male announcer ] watch as many tv episodes and movies

as you want for only 9 bucks a month. trying toe announcer ] watch as many tv episodes and movies be good to your heart? so is campbell's healthy request soup. low in fat and cholesterol, heart healthy levels of sodium, and taste you'll love. guy: mmmm! chef: we're kind of excited about it. announcer: campbell's healthy request. host: could switching to geico 15% or more on car insurance? host: does elmer fudd have trouble with the letter r? elmer: shhhh, be very quiet; i'm hunting wabbits. director (o/c): ok cut!!!! uh...it's i'm hunting "rabbits," elmer. let's try that again. elmer: shhhh, i'm hunting wabbits. director (o/c): cuuuuut! rabbits. elmer: wabbits director (o/c): rabbits. elmer: wabbits. director (o/c): rabbits with an ""r." elmer: aw...this diwector's starting to wub me the wong way. vo: geico. 15 minutes could save you 15% or more. you can blow your nose but nothing comes out! advil cold & sinus knows that

the real problem isn't always mucus. it's often swelling caused by inflammation in your nasal passages. the right medicine for the real problem is advil cold & sinus with a strong decongestant that reduces swelling to relieve sinus pressure plus the power of advil for the pain. advil cold & sinus. the right medicine for the real problem. ask for the red box at the pharmacy counter. it whitens and i bet your breath will still feel fresh after the movie. [ female announcer ] new crest extra white plus scope outlast. for a fresh breath feeling that lasts up to 5 times longer. still fresh? yip. i want to be mad but it's tough with that smile. [ female announcer ] crest ext. investors are demanding more for their money. good. this time, i'm watching fees like a hawk. i hate hidden fees. why should i have to pay for something that i shouldn't have to pay for? td ameritrade's pricing is clear and it's straightforward... it's spelled out upfront. no hidden fees... no bait and switch. no gotchas. and there's one flat rate for online equity trades... for big accounts... or small ones. that's the way it ought to be. time for fresh thinking.

time for td ameritrade.

an b he can be cranky, he's often blunt, and he's most certainly the multimillion dollar man behind "american idol." in the process, he's made himself a huge amount of money, and also created superstars like adam lambert and kelly clarkson. sadly for some, this is simon cowell's last season on the show, but fear not. he's not going far. as john donvan reports on "the economy of simon cowell." >> reporter: it's the hunger, really, that makes american idol what it is. the hunger you can see screening the auditions. people desperate for fame and for fortune. and while only a very few ever reach this point where they pick the best, the show's biggest winner, season after season, is the british gentleman who sits in judgment. >> you look a little odd. your dancing terrible.

the singing was horrendous. and you look like one of those creatures that live in the jungle with those massive eyes. >> reporter: because simon cowell's act has earned this man of fame and a great deal of eal fortune. >> that was painful. >> reporter: his total wealth, estimated to be close to $200 million. forbes magazine says his salary for sitting on the stage telling people they can't sing is $45 million, the most paid to any man in primetime, forbes says. his total pay, when you throw in all his other business ventures comes to $75 million. built on the fame that came from being the difficult judge. ♪ >> do you have any idea what that sounded like? >> i mean, no offense, but nobody watches "american idol" for randy. nobody wants to see him sort of, you know, another judge who is just saying, good job and maybe

work on this. >> i think there's something there. >> they want so ceci mon cut people down. >> you sing like a 3-year-old girl. >> it's not just "american idol" that's made simon cowell. it's america, period. a decade ago, he was as unknown here as anyone that's shown up for an audition. he was a london-based recording executive and doing well at it, but he was a businessman, behind the scenes. then, when another british simon, simon fuller, launched a tv show in the uk called "pop idol," he recruited cowell to be a judge, but one with a little personality. >> i do think that it is the, for you, as well, your weakest week and i think the nerves have kicked in. >> reporter: it's a personality that dave karger has engaged with several times. so, the story goes, simon fuller brought the idea to the u.s. with simon cowell.

>> he told his lawyers a couple of weeks before the start of shooting "american idol" to get him out of it. he spoke to a friend that told him he had to do it. >> you can be big in britain, but you want to be big in america. if you want to be famous, you have to be famous in america. >> reporter: so, he did just that. he got famous in america. but something he didn't have, ownership. >> you know, for simon, ownership has always been really important. he has wanted to eventually own a piece of his show. >> reporter: but in hollywood, it's not that common for a business person also to be the face of their company. few have actually been good at it. >> you're watching abc and "american bandstand." >> reporter: dick clark, an exception, staed out as the host, and nehis company now own new year's eve. and, this young woman. >> welcome to the very first national oprah win free show.

>> reporter: who by owning her own show eventually became one of the richest people on tv. >> you get a car. you get a car. ♪ some people search forever >> reporter: in 2004, cowell produced his first show, "the x factor." >> leona lewis, noonly can you have talent, you can be a nice person. >> reporter: a program that's been created with discovering leona lewis. but he didn't stop there. he went on to create "britain's got talent." >> ready when you are. >> reporter: the show that gave birth to paul potts and just last year, the amazingly successful susan boyle. ♪ her album, "i dreamed a dream" sold 8 million copies in just six weeks. cowell has now worked with artists who have sold 180 million albums and more than 150

number one records. think simon realizes that his tv stardom not only grants him money and fame, it helps his real business, which is being a record company guy, because he gets right of first refusal on susan boil, leona lewis, on all of the winners of the shows that he owns. >> reporter: that's in the c contra contract? >> oh, yes. when susan boyle becomes the most viewed person on youtube history, he's behind it every step of the day. >> i think that when you look at people on television, simon cowell is about as recession-proof as you can get. >> reporter: recession-proof, indeed. in 2005, "american idol" had 30 million viewers. now, they have 20 million, and cowell makes $45 million. now cowell has announced he will

be leaving "american idol" to work on a u.s. version of "x factor." he talked to "extra" about his decision. >> i was offered a lot of money to stay on the show. i felt like something doing new. just being an already fabulously wealthy guy is not enough for him. >> i think he wants more. he wants more money. this is a guy who is 50 years old. never been married no kids. money is the love of his life. >> everything has become so huge for him. coming here to america, who would have thought that, you know, none of his artists in the uk crossed over to america, and then the success of the show. he's masterful. he's a teacher on how to parlay and climb that ladder. >> reporter: so, simon cowell, who came to the u.s., perhaps hungry himself, is now quite a few rungs up the ladder, and if you listen to him, he's only just started climbing. i'm john donvan for "nightline" in washington.

>> the high flying world of mr. cowell. our thanks to john donvan. and when we come back, 3,000 calories here, 50 grahams of fat there, but who cares? it's super bowl sunday, and we've got the perfect recipe for the big game. hi, may i help you? yes, i hear progressive has lots of discounts on car insurance. can i get in on that? are you a safe driver? yes. discount! do you own a home? yes. discount! are you going to buy online? yes! discount! isn't getting discounts great? yes! there's no discount for agreeing with me. yeah, i got carried away. happens to me all the time. helping you save money -- now, that's progressive. call or click today. you can take the heat. 'til it turns into heartburn, you've got what it takes: zantac. it's strong, fast lasting relief. so let them turn up the heat.

you can stop that heartburn cold: (sssssssss!!!) zantac. you can stop that heartburn cold: (sssssssss!!!) trying to be good to your heart? so is campbell's healthy request soup. low in fat and cholesterol, heart healthy levels of sodium, and taste you'll love. guy: mmmm! chef: we're kind of excited about it. announcer: campbell's healthy request.

>>ouncer: "nigh >> announcer: "nightline" continues from new york city with martin bashir. >> more than 100 million americans will watch the new orleans saints battle the indianapolis colts this super bowl sunday. with the game will come big appetites. and there's no shortage of mouth

watering dishes to delight. just ask josh capehorn. he is tonight's "plate list." >> game day is super bowl sunday. you call me on game day, you don't say hello. you say game day. because i will not respond to anything else. i have had an annual super bowl party probably started about 14 years ago. we actually made a pretty big decision and cut the wives out because they really just got in the way. they didn't watch the game. they didn't care about the game and i don't like feeding my boy and worry about them over there getting the diet cokes and, you know, do you have any salad. i'm like -- this is just all wrong. we're in the kitchen now, going to get things going. chopped tomato, red onion, peppers. we're going to hit this with

lime and lemon. we're going to hit this with fresh black pepper. little corner salt. going to toss that up. what you have there is essentialessential ly a little salsa. keep it on the side. going to add the fresh avocado. looks good. boom. beautiful pregame. serve that with some warm chips and you're good to go. game day, baby. game day. i definitely enjoy eating. i think if there was one wish i could have in life, it would be able to eat with impunity. i could be 500 pounds tomorrow. hey, go for it. let's go. we have probably the most important guy on game day, the chicken. so, what we're going to do is turn this into a hold holly pop.

now, just gently remove one out of the two bones and what you are left with is a beautiful lollipop. if you try to copy this, i'm going to come after you. hit it with flour. we're going to go to the deep fryer. just hit them with our famous hot sauce. just a touch of butter. toss them up a little bit. serve with the homemade blue cheese and you're ready to go. game day. i was a busboy and one morning the breakfast line cook di't show up. and the owner was walking around this local diner, freaking out. i kept looking at him, i said, i can can do it. he's like, you're a busboy, what are you talking about? i said, i can do it, it's eggs, toast, i can do it. after not much of a choice, he said, do it, get back there. i did it, i was making apple fritters for the regular

customers, he was like what's going on here? and everybody really enjoyed that and since then i haven't looked back. what we have here is a six ounls patty. a little dijon mustard. it cooks up into the burger. the burger has been cooking. we have some absolutely beautiful carmelization. we're going to do the secret sauce. carmelized onion and bacon jam. sliced dill pickles. medium race. a good time to put on the cheese. when you judge the temperatures of meat. there's an old saying, you go here for medium rare, here for medium and here for well. because when proteins cook up the more you cook them, the firmer they get. that's what i spent $40,000 on a culinary education for. rare, medium and well. so, this baby is feeling good. pull it off the grill, right to the bun.

halftime, baby. i never saw myself zillionthing behind a desk with a suit and tie on. i think the best question anybody ever asked me on a job interview was a chef said to me, he said, how do you feel about working while the party is going on, and i said, the truth is, i ways have a good time. i like to make sure everybody else is having a good time. it who i am and what i'm about. everybody's happy. let's do it. game day. if you put in of this in i swear to god. >> touchdown dance there. and when we come back, it's a steep drop for the dow, but first, here's jimmy kimmel with what's coming up next on abc. >> jimmy: thanks, martin. tonight, eric dane, kourtney kardas

(announcer) pillsbury grands! biscuits, so warm and fluffy. make the most out of the most important meal of the day. made with gooey hersheys mini-kisses. spontanious joy may occur.