Here is a confession: At 44 years of age, I have the face and body I deserve. My upper arms are fleshy and fulsome, bearing no resemblance to the sleek undulations of gym-honed muscle I paraded in my 20s. My post-caesarean belly protrudes over the waistband of my skinny jeans, pleading for the forgiving maternity styles I wore with pride eight years ago as I carried my then-unborn daughter.
I have a bumpy nose that looks fine from the front, but makes me shudder if I see it in profile. I have a “well-defined jawline” — or a pointy chin, if you ask for my description. There are a few furrows on my brow, lines around my eyes and the outsize bags beneath them would do Joan Collins proud checking in at Heathrow airport. My complexion reflects more than three decades of suffering from acne. In short, my face is, well, my face. It tells an honest story of a life lived. My life, and there’s the rub.
There should not be anything unusual in that, but increasingly, I am aware that I am in the minority when I mix in certain circles. Arriving at some social events or work appointments, I find unfamiliar faces looking back at me from people whom I know well. These are women who appear one day with startled expressions, unable to smile warmly as they used to, their skin taught, waxy and translucent — like glassine paper.
Illustration: Tania Chou
Having “work” done is the new norm, you see, and I am conscious that, while I am content to look my age and confidently declare myself an intervention-free zone, I frequently stand out from the scalpeled, Botoxed crowd as the one “who doesn’t.”
This is not some self-indulgent plea for validation, but an observation that the Stepford-style masses are becoming the acceptable face of womanhood. The insidious march of cosmetic intervention in everyday life has concerned me for some time and then last week I read a piece in Time magazine confirming its alarming prevalence in the US.
“You’re going to have to do it and not all that long from now,” the article says. “Probably not a full-on, general anesthesia bone-shaving or muscle-slicing, but almost definitely some injections into your face. Very likely a session of fat-melting in some areas and then possibly moving it to some other parts that use plumping. Not because you hate yourself, fear aging or are vain. You’re going to get a cosmetic procedure for the same reason you wear makeup: because every other woman is.”
No way, I thought to myself, and plowed on, indignant. It proved sobering reading: In the US, doctors performed more than 15 million cosmetic procedures last year, a 13 percent increase on 2011 and more than twice as many as in 2000. Dermatologists are no longer considered to be medical clinicians, but beauticians, with 83 percent of them providing Botox or similar treatments.
What was once the preserve of Joan Rivers and a handful of Ladies Who Lunch in Beverley Hills is now accessible to secretaries in Salt Lake City, who nip into the local medispa in their lunch hour for a manicure and a facial filler.
That quick “fix” offers a euphoric high that soon wears off and sees them coming back for a more. I believe that cosmetic intervention is addictive and, because we gradually lose sight of the person who once looked back at us in the mirror, all perspective starts to go.
“I think people chase compliments and once we start getting those, we want more,” said Frances Prenna Jones, a London-based cosmetic doctor who counts a plethora of magazine beauty editors and celebrities, including Davina McCall and Louise Redknapp, as clients.
“Most women come to me and their concern is that they look ‘tired.’ They might not feel tired on the inside, but they want the outside to reflect how they feel. Increasingly, I am using vitamin injections to give a natural, fresh-faced radiant appearance. Volume replacement [using hyaluronic acid] is popular, too, but you need to take into account the naturally changing proportions of the face. If what you see is markedly different to what you expect, then it jars,” she said.
TV presenter and journalist Anne Robinson, herself no stranger to the cosmetic surgeon’s scalpel, said that “anything that allows women to feel better about themselves is worth it.”
Clearly, many of her compatriots are with her on that one.
According to the most recent figures from the British Association of Aesthetic Plastic Surgeons, which represents one in three cosmetic surgeons in the UK, 50,122 surgical procedures were performed in the UK in 2013, excluding walk-in treatments such as Botox. The audit noted an “impressive double-digit rise in all cosmetic procedures” and that not a single individual procedure saw a decrease year-on-year.
The British Department of Health predicted in 2013 that the value of the cosmetic surgery industry in the UK would rise from ￡2.3 billion (US$3.58 billion) in 2010 to ￡3.6 billion this year.
Katharine Wright, assistant director of the Nuffield Council on Bioethics, is setting up a working party to explore the increasing use of cosmetic procedures and is linking with the Beauty Demands network to assess the pressures of beauty ideals in society.
“The Nuffield Council hosted a workshop on ‘professionals, practitioners and beauty norms,’” Wright said. “We brought together academic experts on body image and fashion, psychologists, philosophers, lawyers, surgeons and GPs [general practitioners] to debate the role of professionals in responding to the changing requirements of ‘beauty’ and the consequent changing uses of procedures that have traditionally been regarded as ‘medical’ in order to attempt to achieve beauty norms.”
If we simply accept these “ideals” as purported by the media, and go to such great lengths and take risks to conform to them, what are the implications? With society’s compulsion to share selfies, often distorted using photo-manipulation software and always curated to display our “best self” — whatever that is — is this tsunami of cosmetic surgery just the next phase in a vanity-obsessed culture?
“Over a very short period of time, what is considered normal and required practice in terms of ‘routine maintenance’ has changed dramatically,” said Heather Widdows, an ethicist professor at Birmingham University who is researching her book Perfect Me!
“The assumption that a beautiful, more perfect self is a happier, more successful self is deeply ingrained in popular discourse and the language used is exceptionally value laden — we are urged to be ‘the best we can be’ and to strive for our ‘best selves.’ We should do this because we’re ‘worth it’ — the implication being that, if we don’t, we are culpable and blameworthy for ‘letting ourselves go,’” she said.
Polly Vernon, author of Hot Feminist, believes that women have the right to choose and take ownership of their appearance.
“But I would say that at this point in time women are succumbing to cosmetic surgery because they feel a pressure to,” Vernon said. “When we inject our faces with stuff, that doesn’t come from the same place as putting on a colorful lipstick. We are navigating a new world, where we are much more conscious of our image, and we must own it and delight in it, rather than do things because of social pressure. Appearance should be an extension of who you are, not about trying to be someone you think society wants you to be.”
Recent findings by the British Association of Plastic, Reconstructive and Aesthetic Surgeons identified a range of factors driving aspirations for cosmetic surgery — 53 percent of those who have had surgery believe celebrity cosmetic treatments had made it more aspirational and 45 percent felt there was social pressure to consider it.
“I do hear women talking about the pressure to look good,” said Susan Harmsworth, founder and chairman of beauty company ESPA, who recently celebrated her 70th birthday and proudly says she is regularly mistaken for a woman in her 50s — without having done anything other than led a healthy lifestyle with regular facial massages and skincare regime. “I know lots of high-profile, successful, intelligent women who have had work done, especially in the City, in banking and law, because they feel they need to look a certain way in the workplace, but once you start messing with your face, you start to look strange.”
With a seven-year-old daughter, I fear for the expectations of the next generation of women, who are likely to have little respect for the glorious beauty of age and the natural lines that come with wisdom.
Psychologist Ros Taylor, author of Confidence at Work, said: “The availability and accessibility of cosmetic procedures, the lack of stigma about having work done and the rise in women’s disposable income has meant the gateway is clear for this to become normalized, and it is only going to increase. I feel a little like King Canute seeing this wave coming and being unable to stop it.”
“Women are always blaming themselves for their lack of success, or not being tall enough, slim enough, beautiful enough,” she said. “We constantly compare and contrast ourselves to other women, and although we are mostly fine as we are, we constantly desire to be different. The psychological impact of seeing someone different in the mirror can’t be underestimated.”
It is this broader impact of cosmetic intervention that Mark Henley of the British Association of Plastic Reconstructive and Aesthetic Surgeons said led to the organization’s Think Over Before You Make Over campaign to educate the public on safe cosmetic surgery.
“One of the things we have to do is give people a reality check on what are normal human behaviors and values, and what is social pressure,” Henley said. “They may have perfectly reasonable reasons for wanting surgery, but we mustn’t enthusiastically accelerate them toward the theater as a commercial commodity.”
“We must get it right in terms of counseling, preparation and information about potential risk and benefits. We need to ensure the patient has a good mental insight and understanding of the limitations of proposed surgery, and they have to be in the right frame of mind — no divorce or deaths, which make them emotionally unstable and vulnerable,” he said. “If I think someone is addicted to the high of procedures, I want them to see a psychologist or their general practitioner. No one ever said [former British prime minister] Margaret Thatcher or the queen should have a facelift. If in doubt, don’t. That’s a really good starting point.”
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