Ugly Beauty (26 page)

Fillers are more dubious—or that, at any rate, is
Peter’s view. In fact, he thought they could sometimes be quite dangerous.
Gladys Deacon–type disasters are by no means inconceivable even now. The “trout
pout” that can result from having your lips plumped is a notorious risk. But, as
with Botox, these treatments are not permanent, and since they are both cheaper,
per treatment, than surgery, as well as far less time-consuming and daunting,
more and more people want to try them. “Supermarket workers, dinner ladies,
they’re all saving up for [Botox],” says Liz Walker. “And there are no holds
barred as to how far they’ll go for all the other stuff, either. We’re now using
machines they don’t even use in London in order to get more immediate
results.”

I asked Dr. Glancey if she had tried out her own
treatments. She admitted that she had: several of them, in fact. “We’re in a
sweetie shop here—you can’t resist,” she said. And it’s easy to see what she
means. Once you take the first step—iron out your frown lines, whiten your
teeth, plump out your cheeks or the backs of your hands—your body becomes a
blank sheet. What about those crow’s-feet, those baggy upper arms
. . . ? If something goes wrong, perhaps some further tweaking may
improve it. Once you begin, the possibilities for discontent are infinite,
perfection always somewhere around the next corner. And soon, in the excitement
of redesign, you’ve forgotten what you looked like in the first place.
Before-and-after photographs of surgery addicts show a terrifying disjunction
between the presurgery face and the end result of serial adjustments. “Most
surgeons have to convince people to have less,” said Luke Shepherd.

For some, the procedure rather than the result is
the important thing. In an extreme form, this pattern can be pathological: the
feeling of constant discontent with one’s body, and compulsion to change it, is
a syndrome known as body dysmorphic disorder. But even for nondysmorphics,
cosmetic procedures can be addictive. “I’m here for a wound check to make sure
I’m healing properly,” Lauren, forty-five, said as she waited for her
appointment at a large London practice.

I had a tummy tuck, had my implants changed
and I had a breast uplift. I had my first breast implants done 17 years ago
after I had my son. My boobs went from a C to an A and I thought, “I don’t like
that, they look like pita breads.” I was considering having a tummy tuck so I
thought while I’m there I might as well have my breasts done.
17

Mostly, though, the treatments are a means to an
end: feeling better about yourself. “I have completely re-invented myself and
Botox has played a big part in that,” said Lisa, thirty-seven, while Victoria, a
widow, age forty-five, said Botox “has given me the confidence to restart my
life after [my husband’s] death.”
18

Workplace issues are also important. Particularly
when times are hard, people feel that if they begin to look old they may lose
their job to someone younger. When the beauty business began, this fear was not
a woman’s concern, as men were the principal wage earners and most women’s chief
preoccupation was to catch a husband—as in a typical L’Oréal ad from 1923, which
showed a pretty girl sitting between two admirers: “The young are life’s
favorites. . . . Gray hairs don’t attract admiring looks.
And happy youth lasts longer for those who use L’Oréal.”

But priorities soon changed—and the letters written
by readers to the author of
Skin Deep
in 1935 and
1936, during the Depression, pinpoint the moment. These women’s principal worry
was no longer that they would fail to catch a man, but that they might lose
their job. Their earnings, formerly, like their bright-red lipstick, a badge of
newly gained freedom and independence, had become a vital part of the family
budget; and cosmetics and hair dye (once carefree banners for emancipation) were
now essential tools in the grim fight for employment. In those circumstances,
cosmetics played a vital role—whether by preserving the illusion of youth, so
that an employer would be less inclined to “let you go,” or because the wearer
felt—and so worked—better.
Skin Deep
’s researches
revealed that all the synthetic hair dyes on the market in America during the
1930s were more or less allergenic, some seriously so; but the ensuing
correspondence made it clear that many women felt they had to risk them, or else
face unemployment. “Due to the fact that my hair is prematurely grey, and even
more important, that if such a fact were known it would jeopardize my job, I
have in desperation and with much fear and trembling been using Inecto Hair
Dye,” confessed a worried reader in 1935. Inecto had been found to cause acute
dermatitis of the face, inflammation and irritation of the scalp, face, and
nose, dermatitis of the scalp, sores on scalp and face, swelling of the eyelids
and closing of the eyes, and “many other unpleasant consequences, including
toxic absorption extending down over the face, back and arms, followed by acute
nephritis, Bright’s disease and anaemia.”
19
Another wanted to know “if there is certain proof of injury to persons who have
used Grayban for a long period. My work makes it important that I look as well
as possible, and gray hair is not flattering to me, as many try to make me
fancy.”
20
Grayban was based on a salt of
bismuth, and poisonous when absorbed. But many users would tolerate any
discomfort to avoid being sacked.

Similar fears resurfaced in the economic crisis
year of 2008. As always in a time of recession, the beauty business boomed. In
America, a total of 12.1 million cosmetic procedures took place—despite the
recession, a 3-percent increase over the preceding year. People were, however,
less inclined to go for pure “bling”: Dr. Richard Baxter, a plastic surgeon in
Washington State, noticed a marked decrease in the size of breast implants as
the economy started to go downhill. Before the recession, fewer than a third of
his clients chose a B cup implant; after, about half picked a B. “People have
turned to more natural-looking things,” he said.
21
But men as well as women now turned to the beauty industry in
hopes that it might make them seem more desirable to employers. In 2008’s first
quarter, one big U.K. cosmetic group reported a 17-percent rise in male
face-lifts, while over 5,200 men consulted for other youth-enhancing
procedures.
22
In the last three months of
that same year, a time when thousands of workers in financial institutions lost
their jobs, there was a 10-percent rise in face-lifts for men countrywide as
sacked bankers used their severance packages to buy plastic surgery.
23
“There was this notion in the City [of London]
where the older partners felt threatened by the younger partners,” said Dr.
Glancey (who also saw a marked increase in the number of men coming to her for
treatment). “They didn’t want to look too tired. That tells everyone you’re not
going to be as good as a young person. If your face doesn’t give that message
then perhaps they’ll forget how old you really are.”

Naturally this becomes even edgier if everyone else
in the office has had the signs of advancing years removed. It’s a classic
example of positive feedback: once your competitors have had “work done,” the
notion of what’s acceptable changes, and you’re obliged to go down the same
route merely in order to stay in the game.

For as youth increasingly becomes a necessary
qualification for success, aging, even for the happily partnered and employed,
has become frightening and unacceptable. “I’m not alone in thinking the idea of
being 50 is an absolute outrage,” confessed journalist Christa D’Souza. “If you
were to look at [my] photograph and tell me you see an attractive middle-aged
woman (for that technically is what I am at 46) I’d not be merely insulted, I’d
feel, on some level, that I had failed.”
24
But
at what? At holding back age itself? Does looking younger make people feel
younger? It is true that as longevity increases, forty will genuinely become, as
we’re constantly told, the new thirty. In 2000, the average German was 39.9
years old and could expect to live another 39.2 years; middle age could
therefore be said to occur at age 40. But by 2050, the average German will be
51.9 years old and will live, on average, another 37.1 years, pushing middle age
back five years.
25

Face-lifts, then, may help reconcile people not
only to the inevitability of getting older, but of being old longer. Writer
Linda Brown said that when she first had her face-lift she felt her face no
longer really belonged to her—it was simply “the face.” “I wanted me back,” she
said. “I couldn’t reconcile myself to the woman in the mirror—I just couldn’t
relate to this woman at all.” That is easy to imagine, for we have all met that
woman, and she is oddly unnerving: neither old nor young but rather,
indefinably, outside age. Hers is the face of cosmetic surgery, the face of our
times. And however familiar on others, to meet it in the mirror must inevitably
be an odd experience. As the weeks passed, though, Brown got accustomed to it.
“I now look like ‘me.’ I don’t care about the red marks, I think for the first
time in my life I don’t have to compensate.”
26

I can personally attest to the irresistible allure
of cosmetic surgery. I was brought up to assume that one made the best of what
one had been given: in my case, large breasts. I’ve always hated them, but the
thought of doing anything about them (other than wearing a good bra) never
seriously crossed my mind. Perhaps that was stupid: Peter the surgeon thinks
breast operations almost always leave the woman much happier than before. But my
bikini-wearing days are over, nor do I any longer lust after strapless or
spaghetti-strap dresses. It seemed inconceivable I would ever consider such an
operation now.

In a spirit of inquiry, however, and for the
purposes of this book, I arranged a consultation with one of the
cosmetic-surgery practices whose ads, plastered throughout the London transport
system, encourage travelers to “Shape up for summer!” Adorned with photos of
improbably self-supporting cleavage, the advertisers imply that buying new
breasts is no more problematic or significant (though a little more expensive)
than buying a new swimsuit. The ad gave a phone number and urged tube-riders to
call for a free consultation. So I did.

The practice was located in London’s Harley Street,
the traditional address of Britain’s grander doctors, and one of the planet’s
most expensive parcels of real estate. A quick trawl through the Internet
revealed at least thirty-two different plastic-surgery clinics and practitioners
located there, and even more in the surrounding streets. Presumably Harley
Street’s aura of oak-aged respectability offers a counterweight to cosmetic
surgery’s still somewhat tacky image, compounded of dubious outcomes, tasteless
advertising (one such ad, urging customers to “Make Yourself Amazing,” offers
£750 off breast augmentations if they take a late booking and fill a vacant
slot), medical tourism, and easy finance.

The group with which I had my appointment started
out twenty years ago with one clinic. Now it has sixteen nationwide. In the
waiting area, which takes up the entire ground floor, every seat was occupied,
with a six-deep queue at reception. Most of the patients were women, though
there were a couple of young men. (In fact, I was told, 40 percent of this
group’s clientele is now male.) Many of those waiting were clearly habitués, in
for a quick touch-up: “Vicky, you know your way downstairs—thank you, honey,”
the receptionist trilled. I had never met her, and was there to discuss what is
in fact quite a serious operation, but I, too, was unhesitatingly greeted by my
first name: “Hallo, Ruth.”

When I got to see the nurse I was quite open about
my reason for being there, and assured her there was little chance I would
actually have the operation. But we agreed that she would nonetheless take me
through the consultation as though I were one of her more usual customers—who
generally, once they’ve saved up the money, can’t wait to get it done. The
booklet she gave me to take away urged patients to “take a period of 7–14 days
to consider,” which must mean that many don’t. We began with pictures—befores
and afters—and then the nurse explained what the procedures would be, and the
costs. With one night in hospital, a breast reduction would cost me £5,720
($9,180), with two nights, £5,990 ($9,600), plus another £300 ($480) for a
subsequent necessary injection. That is serious money, for which I have other
uses. But as we went on, and against all expectation, I found myself wondering
whether, perhaps, I mightn’t have the operation after all. Was it too late, even
now, to release my inner Venus de Milo? If I’d still been in the spaghetti-strap
market, I’d almost certainly have done it.

Vanity, vanity. But research shows that this desire
to attain something nearer one’s ideal physical self is more than that. Our
preference for attractive people over plain ones is hardwired. When newborn
infants as young as one day old are shown pairs of photographed faces, one
judged attractive by adult subjects, one judged plain by the same subjects, the
babies spend more time looking at the attractive face.
27
Such innate preferences must affect how others judge us, yet
until now we have never been able permanently to alter our less attractive
physical characteristics.

Which would seem to imply that the real gift is
agency: the fact that we are now able to take the necessary action. A 1995 study
of cosmetic surgery included one woman whose breast augmentation went
disastrously wrong, leading to multiple correctional operations and scarring.
But she was still pleased she had had the procedure done. Before it she had seen
life as a downward spiral over which she had no control; after, she felt
determined to keep going.
28
Next time, it would
turn out better. In our age of infinite choice, a new and better possibility is
always available, in bodies as in everything else. And there can always be a
next time. And another. And another. . .