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

The makeover — the total overhaul of a woman’s appearance — has become commonplace in women’s magazines. On daytime television, mostly female audiences still yelp with pleasure when a woman — or man — is transformed into a new and better person through makeup, hairdo, wardrobe. There are more makeover-themed television shows than ever: Queer Eye for the Straight Guy, Extreme Makeover, The Swan, A Makeover Story, Cosmetic Surgery Before and After. For teenage boys, there’s Pimp My Ride, in which a team of Southern California auto mechanics transforms the most broken-down jalopies into the most pimp ride ever.

Even a television program like Trash to Cash — a cable program on FX in which the host, John DiResta, takes discarded belongings and makes treehouses, sewing machines, cars, anything — has gotten into the art of the human makeover. On one recent episode, Amanda, an aspiring actress, had only $250 but wanted breast implants. Fortunately, John and his brother Jimmy stopped short of performing the surgery themselves and hosted a “breastival” to raise money for Amanda’s cause. When one of the brothers referred to “implants,” the actress demurred.

“Enhancement,” she said, speaking in the euphemistic jargon of the plastic surgeon.

Making oneself over — one’s home, one’s car, one’s breasts — is now a part of the American life cycle. Doctors have sold us on the notion that surgery is no longer an issue as crass as mere cutting and suturing; it is merely part of the journey toward enhancement, the beauty outside ultimately reflecting the beauty within. The notion that we can enhance our looks is terrifically appealing to insecure Americans. And there are in fact more reasons cropping up to contribute to our growing self-loathing: we’re getting fatter and older and more unhealthy by the minute. A wealth of mini-industries and leisure activities has sprung up around the cosmetic surgery industry, dictating everything from what we read to what we watch to how we think.

The global beauty business — an industry that includes products for the skin and hair — is growing at a rate of 7 percent a year, double the rate of the developed world’s gross domestic product. The global skin care industry generates $24 billion a year, cosmetics $18 billion, hair care products $38 billion. Perfume alone is a global market worth $15 billion.

The marketing and packaging of beauty products has taken on a fetishistic cast. Cosmetics are no longer merely powder and lipstick; they are a compulsion, whether that compulsion takes the form of a $25 Chanel lipstick or $500 skin cream from La Prairie. Writing in Allure, Daphne Merkin remarked on her thirteen-year-old daughter’s obsession with collecting new, expensive lip glosses and then leaving them pristine, in their original packaging, merely objets to fondle, never to actually insult with use. “She has been known to take a freshly purchased item, still nestled in its tissue paper inside a small lilac Bergdorf’s bag, into the bathroom and lock the door to study it. ‘Using it isn’t even that great,’ she explains. ‘The best part is seeing it in the package, knowing you have it, and it’s untouched. Once you touch it, it’s all over.’ ”

While the cosmetics industry continues to grow, it is difficult to estimate the size of the global cosmetic plastic surgery industry, although some economists put the worldwide figure at $20 billion, more than four times the gross domestic product of Somalia. Cosmetic surgery in the United States alone is an industry that as of 2005 constituted $13 to $15 billion a year.

(A brief note on terminology: Plastic surgery is a broad term and is often, to the dismay of plastic surgeons, a misused one. It is sometimes considered, incorrectly, to be synonymous with aesthetic, or cosmetic, surgery — that is, surgery performed solely to improve the appearance of healthy patients. Plastic surgery encompasses the subspecialties of reconstructive plastic surgery — in which, for example, a breast might be reconstructed after a mastectomy or a face put back together after an automobile accident — and what is referred to as cosmetic surgery, or elective surgery that is medically unnecessary but produces pleasing aesthetic results. For the purposes of this book, I use the phrase cosmetic surgery to refer to elective surgery that is intended to enhance patients who are otherwise healthy.)

Excerpted from “Beauty Junkies,” by Alex Kuczynski Copyright © 2006 by Alex Kuczynski. Excerpted by permission of Doubleday, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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