It’s often thought that celebrities who have had plastic surgery hide that fact at all costs. But as stars from Ronnie Ortiz-Magro and Ariel Winter to Kelly Rowland and Courteney Cox have shown, that assumption isn’t always right.

Some Hollywood actors and reality TV stars — hello, Real Housewives! — who have gone under the knife are proud of it and love to celebrate the fact. Others simply don’t want to perpetuate the stigma of shame that can come from getting aesthetic procedures and see no point in keeping them a secret. Then, of course, in cases like Heidi Montag’s 10 procedures in one day, the before and after pictures would have made a denial impossible!

Sometimes, a little nip/tuck or some facial fillers can help with aging; but other celebs have talked about getting nose jobs at a young age or breast enhancements or reductions that have helped with everything from confidence to pain relief. In other cases, the reason is purely aesthetic — liposuction for better abs for the best beach body possible; injections for plumper lips; chin implants for a balanced look. And in still other instances, stars such as TV journalist Julie Chen were told changing their features would help their careers.

At times, stars admit they’ve gone too far with face-lifts or have had plastic surgery nightmares. Montag, for example, had developed health problems from her surgery and had changed her mind about beauty ideals. After getting some of her enhancements reversed by a different plastic surgeon, she told Us in 2013 that she had even considered not doing that. “I just didn’t want to go back under surgery because it was just so traumatic and something I never — I’m so sick of being the surgery girl. It was the last thing I wanted to do: re-bring that all up; it’s just been such a nightmare in my life,” she said. But she realized she had to do it: “I was like, ‘Well it’s not really a choice because now it’s affecting my health.’”

Jillian Michaels, on the other hand, has talked about the joy of getting a nose job at the age of 16. “And I’ll be honest,” she said in 2015, “it did change my life.”

Scroll through to see celebrity plastic surgery before and after photos — and hear what these stars had to say about the process and changes.

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