Dr. Sobel Reacts to RHWOSLC’s Heather Gay’s $200K Cosmetic Journey

When Real Housewives of Salt Lake City star Heather Gay recently opened up to Bustle about spending around $200,000 on cosmetic procedures over the years, I found myself genuinely appreciating her candor. In an industry where so many people quietly undergo procedures and then credit their results to “good genes” or “drinking lots of water,” Heather’s willingness to be transparent is refreshing.

For those who aren’t familiar, Heather is a 51-year-old reality TV personality and owner of Beauty Lab + Laser in Salt Lake City. She joined RHOSLC in 2020, and viewers have watched her physical transformation unfold over the show’s six seasons. Her recent interview breaks down every procedure she’s had, what she spent, and—perhaps most importantly—her honest reflections on how these changes have (and haven’t) affected her confidence.

Let’s walk through her journey together with both compassion and education in mind.

Heather’s Cosmetic Procedures: A Comprehensive Breakdown

Heather’s cosmetic journey started well before she became a “Housewife.” Here’s what she’s shared:

Two Rhinoplasties (~$12K each)

Heather had her first nose job in 2015 after a plastic surgeon she was doing social media work for offered the procedure for free. She’d been inspired by NeNe Leakes’ nostril refinement on Real Housewives of Atlanta and thought, “That’s what I want!” When she wasn’t happy with the results, she had a revision the following year—also complimentary from the same surgeon.

Here’s where I want to pause and commend both Heather and her surgeon: when she wanted a third rhinoplasty, he wisely advised against it due to scar tissue concerns. This is exactly the kind of professional guidance patients need to hear. Scar tissue from previous surgeries can significantly complicate subsequent procedures and compromise results. Sometimes the best surgical decision is knowing when to stop.

Blepharoplasty (~$2,500) 

Around the same time as her nose surgeries, Heather had an upper eyelid lift to open up her eyes. This is one of the more straightforward facial rejuvenation procedures, removing excess skin from the upper lids to create a more alert, youthful appearance.

Mommy Makeover (~$30K total)

During her marriage, Heather’s ex-husband paid for her to have a tummy tuck (which she estimates was $18-20K) and breast augmentation ($8-12K). She mentioned that he wanted her to have these procedures done. As she put it, this is why she “looked so good on the cover of Us Weekly in a swimsuit”—the foundations had been surgically enhanced.

A note here as well: If you’re opting to undergo cosmetic procedures, please be sure it is for yourself and not because a friend or family member is encouraging you to. Of course, having their support is wonderful, just be sure you’re doing it for you.

Botox

Heather started getting Botox quarterly in her 30s as a preventative measure. She wishes she’d started even earlier, and now increases frequency when she’s filming the show. This preventative approach is something I often recommend to patients—starting Botox earlier, with smaller amounts, can help prevent deeper lines from forming in the first place.

• Related: You may be disappointed if you only get Botox in the forehead. A cosmetic surgeon explains why

Fillers and Sculptra

She gets lip filler once or twice a year, plus regular facial fillers. She also invests in Sculptra, which she describes as a collagen stimulator using “big long needles on your face.” Heather estimates Sculptra costs around $800-1,000 per vial, with treatments running about $4,000 when you factor in the multiple vials often needed. Sculptra works differently than traditional fillers—rather than simply filling space, it stimulates your body’s own collagen production over time for gradual, natural-looking volume restoration.

Veneers (~$30K)

For what she calls her “fourth season glow-up,” Heather spent around $30,000 on veneers. She sees this as part of the “required uniform of a Housewife”—perfect teeth, lashes, and hair are non-negotiable in her world.

GLP-1 Weight Loss Medications (~$500/month)

Over the past three years, Heather lost 30 pounds using GLP-1 weight loss medications. She now uses them intermittently if her weight starts to creep up.

• Read the American Board of Cosmetic Surgery’s guide to GLP-1 medications and cosmetic surgery

Regular Maintenance

She also gets facials and laser hair removal—including what she calls her “Labzillian”—twice a year at her own medical spa.

Dr. Sobel’s Professional Perspective

On Her Honesty

What strikes me most about Heather’s interview isn’t the dollar amount, it’s her willingness to pull back the curtain. When public figures are transparent about their cosmetic work, it helps normalize these conversations and reduces the shame that sometimes surrounds aesthetic procedures. It also sets realistic expectations for other women who might be considering similar treatments.

Too often, people see dramatic transformations and think they’re failing because they can’t achieve the same results “naturally.” Heather’s honesty helps combat that unrealistic comparison.

On the Investment: Is $200K a Lot for Cosmetic Surgery?

Context matters tremendously here. Heather’s $200,000 wasn’t spent all at once, but it accumulated over many years and includes everything from major surgical procedures to regular maintenance treatments. For someone whose career involves being on camera, where every angle is scrutinized and high-definition close-ups are routine, these procedures became a professional investment as much as a personal one.

The reality is that quality cosmetic work requires investment. Board-certified cosmetic surgeons with proper training, accredited facilities, and proven track records aren’t going to be the cheapest option, but they should be the safest. Cosmetic surgery isn’t an area to prioritize savings over expertise.

The Confidence Question

Despite all these procedures, Heather shared that she actually had more confidence in her earlier RHOSLC days when she weighed more and had undergone fewer procedures. She told ABC News, “I look at those pictures of myself and those episodes and think, I love that girl. That girl was braver and stronger and had more confidence being overweight than I did after taking medication.”

This matters because cosmetic procedures can change your appearance, but they don’t automatically change your relationship with yourself. As mentioned above, I always encourage patients to examine their motivations before any procedure. Are you doing this because you want it, or to meet someone else’s expectations? Cosmetic enhancement should complement your life, not become the foundation of your self-worth.

If you’re considering any of the procedures Heather mentioned, I’d love to have an honest conversation with you about your goals, expectations, and what’s realistically achievable. Every person’s journey is unique, and what worked for Heather may not be right for you. 

At our Seattle cosmetic surgery practice, we prioritize individualized care, realistic expectations, and patient safety above everything else. Whether you’re interested in surgical procedures like rhinoplasty or body contouring, or non-surgical treatments like Botox and fillers, we’ll work together to create a plan that makes sense for your unique anatomy, lifestyle, and goals.

Give us a call at (425) 453-9060 to schedule your complimentary consultation, or contact us online. 

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