Beauty's in the eye of the ... plastic surgeon

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Dr. Suzanne Levine, a podiatrist on the Upper East Side of Manhattan, is known as the city’s “foot face-lift” doctor. She shortens toes, offers microdermabrasion for feet, and will inject collagen into the sole of the foot so that it can withstand the consistent, daily pounding shock of high heels.

“People come to me and they say, ‘I want to wear my Jimmy Choos, I want pretty feet, I hate that long skinny toe in the middle,’ ” Levine said in an interview one wintry afternoon. “ ‘I’m divorced. I need my feet to look good. I can’t get in the shower with a new man with these feet.’ The foot thing is all about love, really. We live in a culture where women have to compare themselves every day to these women ...”

Her hand swept the wall, with its framed testimonials and grinning pictures of Joan Lunden, Katie Couric, and Star Jones.

“These women are on television,” the doctor continued.

“Their bunions can’t show.”

Levine considers herself something of a romantic counselor to single women across the city, although the advice she offers is probably not that practical in the long run.

“We live in a fifteen-second culture,” she said. “That’s how long it takes, I believe, for a man to look at you and decide if he will be in love with you. That is it. And if you’re wearing stiletto sandals and your feet look like hell, he’s not even going to give you the time of day.”

A man won’t love you, Levine reasons, or even give himself the chance of falling in love with you, if you have a bunion peeping out of your $500 evening sandal. Tough town, I said.

“Tough town, that’s for sure,” she said. “It sets its own standards. People overreact. I had one woman come in who wanted me to do liposuction of the toe. I mean, that’s even over the top for me.”

What happened to the patient?

“I told her to go see a shrink instead,” Levine said.

When I left, Levine asked me if I knew any good single men.

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Fat. Happiness. Youth. Death. Wrinkles. Love. Bunions. The endless struggle against looking old, the inability to accept the changing body and face. All form a part of the mosaic that makes up the $15 billion cosmetic surgery industry in America. Our superlative narcissism extends around the planet. From Poland to Pittsburgh, most human beings on the planet, whether they know it or not, have seen pictures of people — movie stars, models — who have surgically altered themselves for the purpose of beautification.

On billboards and movie screens from Hong Kong to Bonn to Iowa, breasts are buoyant, manipulated no longer by mere padded bras but by surgically sutured underpinnings of nylon, silicone, and saline. Cheekbones are thrust forward with the help of Gore-Tex strips — the material your L. L. Bean winter jacket is made of — implanted underneath the skin. Lips the world over are plumped with collagen grown, in a football-sized petri dish in California, from the stem cells of one little boy’s foreskin; or from the cadavers of people who have donated their bodies to science; or from farm animals that live in cloistered herds and flocks monitored by the Food and Drug Administration. During the mad cow disease epidemic of the late 1990s, women in Europe and the United States accustomed to routine collagen plumping sessions panicked when they were cautioned temporarily by their doctors against using the substance, much of which, at the time, was derived from cows.

In Paris, doctors sew filament into the tissues of the face — the so-called gold-thread face-lift — to hoist it up. In Los Angeles, women who have tucked and pumped and stretched every stray piece of skin back into the position it was in when they were twenty-five are no longer limiting themselves to the areas of the body that the public sees; the new operation of choice among Hollywood housewives is the labial rejuvenation, in which the lips surrounding the vagina are snipped and sculpted, giving the patient the feeling of “revirginization.”

As a culture we are increasingly concerned with and insecure about looking good. In 2003, more than half of Americans — 51 percent — said that they were not quite comfortable to not at all comfortable with their appearance, according to a Roper study.

Looks are the new feminism, an activism of aesthetics. As vulgar and shallow as it sounds, looks matter more than they ever have — especially for women. It’s a terrifying admission. But I am a reporter, not an ideologue, and we live in a terrifying culture, a world in which images hold more power than words and language has been replaced with symbols and sound bites. For a long time it has been a part of the American spirit to embrace the world of the visual: in a caricature, Ralph Waldo Emerson was portrayed as a huge eye set atop a pair of stiltlike legs. We are, above all, creatures who arrange our world before us in visual categories. We make sense of the world by moving toward the appealing and away from the ugly. Marketers talk of getting “eyeballs” on their products and television shows. In the twenty-first century, cosmetic surgery is the embodiment of that American dream, the success story of getting eyeballs on one’s self, of self-transformation.

Ordinary Americans may be flabbier and grayer than ever, but we have also never before in our history been surrounded in such completeness by images of conventional perfection. Plastic surgery, hormone replacement therapy, and other enhancement technologies now offer us a youthful fix. Specialists of all types cannot hang out their shingles fast enough. And despite the international origins of that branch of plastic surgery we call cosmetic — and its apparently increasingly international future, as Asians begin to become obsessed with the changes it offers — its story is essentially, and peculiarly, American.

Cosmetic plastic surgery today offers a particular appeal to Americans in general, not just the fashion slaves, the well-to-do, and the socially ambitious who have long sought it. We are a tribe of people who not only admire transformation but hunger for it. Easily bored, we prefer our heroes and heroines to reinvent themselves every few months. And because of programs like Extreme Makeover and the D-level celebrity confessionals that now fill tabloid magazines (“Kathy Griffin Shares the Pain — and Gain — of Her Recent Plastic Surgeries”), the plain members of the middle and working class can imagine what a transformation might do for them.

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