A Niche Social Site That's More Than Skin Deep How Tom Seery is trying to change the world, one nip and tuck at a time -- and what Web startups can learn from his business

"I am nervous. I have read more than 100 reviews on this site from the good, to the bad, to the absolute unthinkable. I am hoping to get into a bikini by maybe July or August. I want better confidence, a fresher more youthful appearance. I want to be able to sit in a chair without pulling my shirt down to cover my flab/folds."

So begins one woman's four-month diary of a tummy tuck. It is personal, painful, emotional and an often brutally honest chronicle. It also generates dozens of responses, both sympathetic and critical. It is accompanied by expert advice, before and after photos as well as video journals of others who had the surgery. Though the writer admits to many days of doubt and fear along the journey, her last posting reads: "It's been a happy trail."

Welcome to RealSelf, a social-media website that offers detailed, first-hand reviews and comments by real people who've undergone a cosmetic treatment or procedure, or who are thinking about it. Treatments are rated on how much it cost, the pain involved and whether it was worth it or not worth it--one of the most popular and unique sections of the site. Medical responses are provided by a community of board-certified plastic surgeons, as well as by specialists in everything from Botox to braces, and all are done on a voluntary, unpaid basis. RealSelf doesn't sell leads to doctors, either.