"It's kind of the lifestyle we live and people are gonna say nasty and judging things," Heidi says.
Montag's nip/tuck was performed by Beverly Hills plastic surgeon Dr. Frank Ryan -- and "Dr. 90210" star Dr. Robert Rey tells "Extra" the reality star is in good hands.
"The doctor who did this operation is one of the best hands in Hollywood," Rey says. Her doc may be good at what he does, but Dr. Rey adds that it is not normal for a healthy 23-year-old to want so many procedures.
"What I worry about is -- what message are we telling little girls?"
Heidi's fellow star Emmy Rossum has criticized Heidi about being a good role model -- but Montag dismisses any unfavorable opinions. "The most important thing for me is for me to feel good because people can say whatever they want. I'm the one living in my skin."