What happens when plastic surgery becomes an obsession?
Q: Why do some celebrities become obsessed with plastic surgery?
A: It’s not surprising that celebrities seem to get so much cosmetic surgery. The body has become a zone of perfectibility for all of us, and no more so than for celebrities, especially women, whose bodies are a significant part of their commerical appeal. Moreover, celebrity culture is very unforgiving, and so female celebrities who do not “keep up” with their appearance, so to speak, are fodder for tabloid finger-wagging. (How many tabloid covers have revealed which celebrity women have cellulite, and who is getting fat?) We have ever-new standards of beauty and youth to reach, and there is a cultural imperative for us to keep looking young and “beautiful.” This is especially true for public figures, but they are now setting the standards for the rest of us, too.
Unfortunately, cosmetic surgery can’t always do what it promises—to make us look younger and more beautiful. There is a limit to its effectiveness, and there are downsides which are not discussed often enough by cosmetic surgeons and their industry. Botox will seem to make wrinkles disappear, but it will also freeze our faces. Collagen injections can plump lips, but do they really make us look like Angelina Jolie? Tummy tucks often come with bad scars; liposuction can make the skin appear rippled, chemical peels can make us look burned. But some of us have too much faith in the cosmetic surgery “miracle.”
Q: How do women become “hooked” on cosmetic procedures?
A: My sense is that once a woman has a positive experience with plastic surgery, it is often normal—not necessarily pathological—for her to consider other procedures. If she is pleased with the result of a procedure, she may believe that other procedures are also effective. And if she has a cosmetic surgeon who is willing or keen to give her more, she might listen to him or her. Unfortunately, every time we go under the knife, there are potential complications.
While many are quick to blame patients for being too eager to get cosmetic surgery, I think it’s important to remember how aggressive cosmetic surgeons are these days in selling their products. They often “package” products, selling a tummy tuck with a breast lift, for example, and encouraging patients to get more than one procedure. No where else in medicine are procedures sold to the public so aggressively, and with the profit motive so glaringly obvious. We are told by cosmetic surgeons that procedures are safe; we are told that they are effective; in various ways we are told that they are necessary. Why wouldn’t women want to do something they think is safe, effective, and necessary to improve their looks? I am not a big fan of cosmetic surgery, but I think it’s vital that we put the blame where it belongs when it comes to people having ‘too much’ cosmetic surgery.
Q: When does this cross into dangerous territory, such as Body Dysmorphia Disorder?
A: Body Dysmorphia is a serious problem for those who have it, but it is not an illness that is inherently tied to cosmetic surgery. We began hearing about it in the late 1980s, and it wasn’t until much more recently that we began to suspect that cosmetic surgery patients might have BDD. The DSM (the diagnostic bible for psychiatrists) says that BDD is rare; but it has become a buzzword and we are now quick to worry that anyone who has had a lot of cosmetic surgery is a candidate for BDD. This actually follows a historical trend: Psychologists and psychiatrists, and even some cosmetic surgeons, have long considered cosmetic surgery patients mentally suspect, and there is a long list of disorders that they supposedly are prone to have. I think this reflects how controversial cosmetic surgery is, and how it violates social norms that suggest we are not supposed to indulge our vanity, nor are we supposed to transform our appearances permanently using technology. According to the DSM, someone who has BDD is obsessed with an imaginary or slight defect in their appearance (often their nose or their skin); this obsession is significant enough to disrupt their ability to function. If a person does not have these symptoms, they probably do not have BDD. (Someone who is simply a huge fan of plastic surgery, or someone who has a general sense of insecurity or a self-image problem, or someone who thinks a tight face lift and overly plumped lips look great, does not meet the criteria for BDD).
Q: We here at Mom•Logic think plastic surgery can be a positive experience…many Moms here have had tummy tucks or nose jobs that boosted our self confidence. Do you feel cosmetic surgery can be positive in certain cases?
A: Yes I do. I’ve had cosmetic surgery myself—a rhinoplasty I undertook while I was writing my book Surgery Junkies. It was a difficult experience in many ways, and taught me that cosmetic surgery has many downsides, but I am happy with the aesthetic result. My criticisms of cosmetic surgery include that it is too aggressively sold to us, it is underregulated and therefore more dangerous than it should be, and that some people are pressured to have cosmetic surgery—aging women, for example.
Q: What is your opinion on the “mommy makeover”?
A: Having just had a baby myself five months ago, I understand that pregnancy brings huge bodily changes. Even though I’ve lost most of the baby weight, nothing is in the same place anymore. I wouldn’t rule out cosmetic surgery at some point. But I resent the “mommy makeover” because it seems to be another example of cosmetic surgeons aggressively marketing their products; in doing so they are denigrating the bodies of mothers. In addition, I think packaging procedures is unethical; it encourages women to get multiple surgeries, even ones they don’t think they really need. Cosmetic surgeons are getting cynical and greedy in pushing us to consider that we need “makeovers” after pregnancy. I say to cosmetic surgeons: Give us more respect and let us decide for ourselves what we think of our post-baby bodies. If we need you, believe me, with all of your advertising, we know where to find you.
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