Plastic Surgery Is Going the Way of the Ugg Boot

Plastic surgery sometimes gets played, pedaled and plugged as an irresistible tsunami overpowering its primary targets, women between 35 and 50.

But this year we have some gratifying news to digest: The tide has been turning.

Half of plastic surgeons report their practices were down last year. That was before the worst of the recession, so it's not just a matter of cost or insurers who only cover operations that fix "deformities" or improve healthy functioning.

From 2004 to 2005, liposuction was down 5 percent; eyelid surgery down 20 percent. Even less-invasive procedures such as microdermabrasion and chemical peels were down in that same time period, by 7 percent and 50 percent respectively, according to the American Society for American Plastic Surgery.

It's also a matter of growing cultural aversion toward the results. "Scary" is emerging as an increasingly common adjective for the surgeons, procedures and -- more frequently -- the results.

'Before and After' Galleries

Web sites with names such as "Plastic Surgery Disasters" and "The 15 Worst Celebrity Plastic Surgery Disasters You Will Ever See" have developed cautionary before-and-after galleries.

"Before" shows attractive men and women of all ages, including celebrities. "After" shows women with cavities in Barbie-sized breasts; men with hyper-wide eye-lifts. One Flickr site invites, "Caption This Disaster."

The anti-plastic tone can often be cruel and jeering: "You wanted this look? You think this looks good?" Sometimes it's rueful, such as a recent New Yorker cartoon of a young couple lovingly holding hands. "I want someone I can grow old and have plastic surgery with," she says.

"Anti-aging surgery" is becoming a misnomer. Dr. Pauline Chen, the surgeon who wrote "Final Exam," describes an older surgeon, after "countless submissions" to the knife, as having skin "like plastic wrap stretched tightly over a bowl." Designer Isaac Mizrahi says, with ageist malice, "If you want to look 70, get a facelift."

The pushback extends to stars such as Ashley Tisdale. In People recently, the young actress went out of her way to say her five-hour operation to repair a deviated septum wasn't plastic surgery, which she wouldn't recommend to anybody.

Resistance can also take the form of support for those who resist "getting done."

The thoughtful film critic Wesley Morris, for instance, praises the face of Melissa Leo, a 40-year-old actress in "Frozen River," for its "amazing and unlimited capacity for solemnity, grief, despair and rage. If you've been to a movie lately, you know what an un-nipped, untucked, Botox-free miracle that face is."

Resisters in the Majority

This type of feedback and commentary is complemented by a majority who oppose surgical fixes for themselves. According to a Nielsen study of women around the globe, 80 percent would never "go under the knife." Data from the American Society for Aesthetic Plastic Surgery itself indicate that 69 percent of U.S. women do not think it an option for themselves.

Why don't we ever hear that nonusers -- many of them resisters -- far outnumber potential users?

People actively opposed have a point of view that rarely gets heard and a social milieu that is entirely supportive of them.

According to interviews collected by sociologist Abigail Brooks for her absorbing 2007 Boston College dissertation, resisters are often dismayed at the way surgery survivors look.

A woman in Brooks' study described a friend who lost "the most gorgeous, beautiful eyes, they were her redeeming feature. . . The bags are gone but the shape is different." "Her eye is crooked, definitely," another of Brooks' interviewees reports thinking. A woman with an eye-lift looked as startled as a "deer in the headlights." Another said she found it "exhausting" to interact with a woman whose facelift gave her an intense "wind-tunnel" look.