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Wendy Lewis, a consultant based in New York who advises clients who are considering cosmetic surgery, said that it's not an isolated phenomenon. Ms. Lewis says, she often advises the career-minded to acknowledge that they have had at least a little bit of work done, on the grounds that people can see the results anyway. Ms. Lewis also advises clients to consider carefully how they will fit an operation, or upkeep, if a client is having Botox injections or other small treatments, into their work schedules.