Plastic Surgery Horrors: Is Cosmetic Surgery Finally on the Decline?

It was a shock to find after I had a squamous cell carcinoma removed from the side of my nose, that I needed cosmetic surgery . As I feared, the repair didn’t go well: the scar is red and bumpy, with a "pincushion effect" so common it has a name. The pleasant symmetry of my face is not what it was. Aging I can accept--a splash of white reminding me of Susan Sontag; a fine set of laugh-lines. But I can’t believe anybody undergoes this voluntarily.

It may be hard to believe, but like me, American culture is turning against cosmetic surgery. Even in the movie business. In the cartoon Sylvia, two "Bad Girls" are chatting. One says, "Actresses used to have plastic surgery to be beautiful enough to get the good parts. Now if they’ve had surgery it works against them." She holds a newspaper saying, "Only actresses with natural breasts need apply."

‘Natural" is beginning to look good. Websites make fun of botched surgeries, showing photos of people’s unwanted post-op appearances--men as well as women. People report they look worse After. Characteristic consequences--the "wind-tunnel look," the mismatched tiny chin, "waxworks," skin like plastic wrap–are now uncool. America the Beautiful, one scary documentary, lets a former anchor describe how facial surgery gave her permanent neuralgia, destroying her health and career. Many users do it only once. "Never again."

Potential clients rationally fear death. When Kanye West’s mother died, and Olivia Goldsmith, author of the First Wives’ Club, the lethal consequences began been piling up. Although there is still no register of mortality statistics, there are more exposes, like HBO ‘s special, "Plastic Disasters." Even finding a surgeon who is certified and experienced is no guarantee. Sherwin Nuland, the author of How We Die, pointed out the irony that "doctors who choose to perform an operation that is solely cosmetic are willing to accept mortality and complication rates significantly higher than those who restrict their interventions to those required for the treatment of disease."

Ageism is a killer in this as in other ways. Most cosmetic surgery is driven by fear of aging-past- youth. In 2007 the average age of those receiving cosmetic surgery in the United States was 42.6. Most were women. "Passing" as younger was promoted for decades by surgeons who didn’t have enough reconstructive work. The Federal Trade Commission under Nixon and then the Supreme Court made it illegal for the AMA to forbid surgeons from advertizing. Third-party financing of procedures brought operations within the reach of lower-income women.

Fashion and celebrity magazines made seeking slender youthfulness seem obligatory. "Forcibly lowered self-esteem looks to the sufferer like real ‘ugliness’," Naomi Wolf explained. It began to be said that every narrow departure from the ideal, including normal processes of female maturity (e.g., change in size after pregnancy, wrinkles) could be sold to consumers as a deformity. Other kinds of doctors without appropriate training or certification moved to supplement their practices by pursuing anxious patients’ discretionary income. Promotors said, gaily, This is an unstoppable trend. Feminists, gagging, agreed.

This should be considered a public-health emergency, since the ugliness effect impinges on people only because they are growing older, people who would never visit a surgeon.

Yet the good news is that the trend is finally going the other way. Fact: The number of cosmetic surgeries stalled around 2004-2005. Surgical procedures dropped from a peak in 2005, and the total of all procedures from a peak in 2004. Breast augmentation numbers dropped 11% from 2007 to 2008. Liposuction rates dropped 5% and chemical peels 50% in one year. The numbers dropped even before the economic crisis of 2008.

After the age of fifty, the percentage of women obtaining surgery drops by half. The older half of the "Boomers" has aged beyond the high-risk period--ages 35-50--at which women are most vulnerable. Ads by surgeons now offer "noninvasive," "unfixed"-looking procedures. But nonsurgical procedures like Botox also dropped, 12% in 2008. 

Growing popular distaste also involves heightened aversion to danger and care for health. "First, do no harm," critics enjoin cosmetic surgeons.

Why is "natural" looking better, aside from the fear of pain, deformity, death, and looking unfashionable? Nonusers, interviewed by sociologist Abigail Brooks, not only find the "fixed" looks of others repugnant, they resist the ideologies behind the ageist beauty myth. They may be inspired by feminist theory, women’s-health activists, or the positive-aging movement. "Natural" to them means accepting and appreciating the body's own processes and valuing maturity on many other measures. Maybe some female Boomers are indeed changing aging-past-youth in America, one refusal at a time!

The trendline seems clear. In 1992, despite normalizing trends, the number of cosmetic surgeries in the US was still relatively small. By 2005 it had grown enormously and then started to drop. There are still powerful forces promoting the procedures to women of a certain age–including the companies that fire employees in their middle years on the assumption that they are "too old." And then, falsely promising a response, are those surgeons who call the procedure "anti-aging." Make no mistake, millions still go under the knife. But eventually we may say that the Era of Normalized Sexist Ageism lasted not much more than 13 years.

Copyright Margaret Morganroth Gullette

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