Outer peace: The search for perfected self

Photo by Steve Marcus | Digital Manipulation by Wes Gatbonton

When you look hard at Megan Fox, you realize she’s technically not that hot. Taken apart piece by piece like a glamorized Mrs. Potato Head, she has few “ideal” features in the language of golden ratios and divine angles. Yet cosmetic plastic surgery seekers bring in photos of the former FHM Sexiest Woman in the World, asking for her nose, her lips and the curve of her jaw, hoping the sum of their parts will somehow equal her iconic whole. In fact, Fox was the template for my digital makeover on this week’s cover. Whether she should be—whether any of us should alter ourselves for cosmetic reasons—is a question with as many answers as there are opinions about beauty.

When I was 16, that question burned much hotter. Along with a gangly body, cystic acne and braces, I had a nose you might liken to a beak or a hatchet, Groucho Marx glasses without the mustache. My mother tried to convince me I was just exotic, and I almost believed her until I overheard a boy saying I’d be pretty if it weren’t for the schnoz. After that, I started hiding behind my hair. In class or at stoplights, I kept my head slightly turned so no one would catch my full profile. Finally, my father called my bluff.

“If you hate it that much,” he said, “I’ll take you in for a rhinoplasty consultation. But really think about it.”

I thought about Jennifer Grey post-nose job (Baby’s still in the corner), the risk that I wouldn’t look like me. I thought about other risks, like anesthesia and complications. I thought about what it would mean to be the kind of person who subjects herself to surgery without the excuse of a deviated septum. I thought of the way I judged Michael Jackson and the lady down the street whose skin was so tight she always looked surprised. And in the end, I decided to make peace with my appearance rather than do something I could never undo.

As they say, I grew into the schnoz. For years I didn’t think about it. But at 31, I once again find myself holding my finger up to the bridge of my nose and wondering what if?

When I was a kid, the only cosmetic surgeries I heard about were face-lifts and tummy tucks. Now, we switch our belly buttons from outies to innies. We shorten our toes and dimple our cheeks. We can make our most intimate parts bigger or smaller; we can even change the shape of our eyes.

The American public is split on whether we should. Data compiled by the American Society for Aesthetic Plastic Surgery shows that 51 percent of all Americans now approve of cosmetic surgery, and 67 percent would not be embarrassed to admit to their friends and family they’d had it done. Both ASAPS and the American Society of Plastic Surgeons reported that 1.6 million cosmetic surgical procedures were performed in the U.S. by board-certified physicians in 2010, totaling more than $6 billion.

Walter Yeo


Noble Roots
Walter Yeo was 26 when German artillery changed his life. He was manning the guns on a British ship during WWI’s Battle of Jutland, and his skin was blasted from his forehead to the tip of his nose, with his eyelids totally destroyed. In 1917, Yeo was one of the first to benefit from the pioneering techniques of Harold Gillies, a doctor credited with taking cosmetic surgery from a curiosity to a modern wonder. The industry that grew includes reconstruction and enhancement.

That blockbuster industry is rooted in the wounds suffered by Allied soldiers during World War I. Many young Brits were in the blast radius of German shells, and survivors lost jaws and noses, eyelids, ears, sometimes their entire faces. They would have stayed that way were it not for Harold Gillies, a pioneering New Zealander credited with taking cosmetic surgery from an ancient curiosity to a modern wonder. His radical grafting techniques enabled stunning reconstructions for 5,000 physically and emotionally traumatized soldiers.

It’s difficult to connect that solemn history to Heidi Montag, who had 10 elective cosmetic surgeries in a single day when she was just 23. And it wasn’t the first time she’d gone under the knife.

“We all want to feel attractive,” Montag said in a People magazine spread that showed her before and after photos. “So who is anyone to judge me?”

Montag’s outcomes were “optimal,” in surgeon speak, but most wouldn’t say the same for Sheyla Hershey, who had nine operations and more than a gallon of silicone added to her chest to win the dubious distinction of world’s largest enhanced breasts at 38KKK. The 10th operation allegedly sent her to the hospital with life-threatening staph infections.

That kind of fixation, says Las Vegas plastic surgeon Dr. Lane Smith, is one of the things he pays closest attention to when meeting prospective patients. In 11 years of practice Smith says he’s gotten better at spotting surgery addicts and sufferers of body dysmorphic disorder, which causes obsession over perceived defects. He also keeps his eyes open for those seeking surgery to please someone else, and young people who might not be mature enough to make such a serious, permanent decision. Such candidates typically are told that services cannot be rendered. He’s even been sued (unsuccessfully) for not operating on a woman he later learned had 20 prior surgeries and lied about them, endangering her own life in the process.

Today's aesthetic industry offers many surgical and non-surgical options. In general, both are on the rise.


Popular procedures are listed below, with prices based on national averages of surgeon/physician fees reported by ASPS.
• Abdominoplasty (tummy tuck), $5,130
• Blepharoplasty (eyelid revision), $2,828
• Breast augmentation, $3,351
• Buttock lift, $4,379
• Cheek implant, $2,739
•Face-lift, $6,231
•Liposuction (fat removal), $2,884
• Lower body lift, $7,247
•Mentoplasty (chin augmentation), $2,000
•Otoplasty (ear revision), $3,054
•Rhinoplasty, $4,306

You have to wonder why anyone would go to such lengths to undergo what essentially looks like medieval torture.

“It turns out that, unfortunately, those who are beautiful live a different life than the rest of us and by a long ways,” Smith says. “Hence the value of cosmetic surgery, why people go through the pain even if they’re not sure why.”

Smith says the way we perceive beauty goes back to our DNA. He talks about a caveman looking at two cavewomen. The one with the curves and symmetrical features will get chased every time, because she appears more fertile and free of disease.

“Beauty is linked to proportions,” he says. “With noses, we know certain angles are nice. A nose should be tipped up between 100 and 110 degrees for a woman.”

I stop him on the word should, a word that sticks in America’s individualistic craw. Smith was referring to the mathematical ideal used as a surgical baseline and says he would never recommend something a patient didn’t ask for, but hearing how my nose should look makes me want to defend its honor. I believe beauty has a zillion shades. So does Smith, but he has seen the way people respond to its absolutes. Brigitte Bardot, he says, is as beautiful to an Aborigine as she is to me.

“Beautiful people are automatically perceived as being more intelligent. In general they have higher incomes and lower rates of divorce, suicide and depression,” Smith says, citing peer-reviewed studies on the impacts of physical attractiveness. “They’re better socially. All of these things, because it starts at birth.”

That was the subject of a landmark collection of studies on physical attractiveness by researchers at the University of Minnesota. Psychology professor Ellen Berscheid was a lead investigator and observed the surprising similarities between identical twins reared in very different environments. She also experimented with phone conversations in which study subjects were told whether the person they were talking to was attractive or unattractive. Those they believed were attractive were judged to be more poised, sociable, interesting, independent and humorous, and Berscheid said such perceived advantages can translate to real ones.

“That our physical appearance should make an important difference in our lives is not a fact that makes most of us very comfortable,” Berscheid said in a 1981 interview with the New York Times. “Genetic determinism is anathema to Americans, who want to believe everyone is born equal, with an equal chance for a happy life. It’s simply not so.”

Entering photos of me into a digital morphing program, Smith adjusts the bump running the length of my nose, called a dorsal hump, until I have an idea of what I might look like without it. It’s me, but with bigger eyes, sharper cheekbones and a softer smile, none of which were altered. My nose just got out of the way.

“When I do this procedure, I want the nose to look nice but not noticeable. You want to look past it,” Smith says.

He offers two more possibilities, one that brings the tip down slightly and another that adds a subtle slope to the bridge. He asks which I like best, reminding me that the morphed images will not exactly match the surgical outcome. I choose No. 2, marveling that the tiniest stroke can change the whole picture.

“The difference between really beautiful and average is just millimeters,” he says.

Unless we’re talking about breasts—then it’s a matter of cubic centimeters and cup sizes. ASAPS and ASPS reported that breast augmentation continues to be the most popular cosmetic surgical procedure, with ASPS data indicating 38 percent of the 2010 total came from the region that includes Nevada and California. The No. 1 reason women across the country do it? “Purely cosmetic.”


Top Five Cosmetic Surgeries For Men
Men still account for a small percentage of those seeking cosmetic surgery, but their numbers are growing. Stats differ from survey to survey, but here’s what ASAPS said men did most in the U.S. in 2010:
• Otoplasty, No. 5 (Repositioning the ears)
• Blepharoplasty, No. 3 (Modifying the eyelids)
• Rhinoplasty, No. 2 (Reshaping the nose)
• Gynecomastia, No. 4 (Reducing over-developed male breast tissue)
• Lipoplasty, No. 1 (Removing fat from various parts of the body)

But within that category, how many cosmetic desires are driven by emotional ones? Las Vegas plastic surgeon Dr. Frank Stile has more than 5,000 patients in his practice, some of whom have surgically addressed deep feelings of insecurity or inadequacy related to their breasts. Their circumstances range from basic asymmetry and severe underdevelopment to post-baby droop, though many just want to be bigger or perkier. Whatever the motivation, Stile says quite a few women struggle with the idea of a “boob job,” the social stigma that can come with augmenting this hyper-sexualized part of the female form.

My friend “Diana” spent years going back and forth. She has a willowy frame with a disproportionately curvy backside, and she felt awkward to the point of avoiding relationships through high school and part of college. She got over it, but her curiosity about breast augmentation always smoldered.

Without any enhancement, Diana is the kind of beautiful that picks you up and slaps you around—that Eastern European bone structure, those cat eyes and swan neck. A lot of women probably resent the freelance model anyway, and resentment can turn to outrage when a naturally beautiful woman dares to change herself. But modeling on the Strip last summer, Diana was probably the only A-cup.

“In the Midwest you don’t see that many boob jobs, and if you do they’re not that extreme. In Vegas, bigger is better,” she says. “Being here inspired me to go after it.”

Now, she says her C-cup breasts feel like they have always been there.

“Sometimes I forget about them because it feels like me, but if I catch my reflection I look balanced. I feel more complete,” she says. Diana preferred to be anonymous in this story because she still hasn’t decided if or how she wants to tell people. “It really is such a personal thing, I don’t think I’d be able to explain fully why I did it. It felt right for me.”

Karla Joy, before surgery

Karla Joy, before surgery

Karla Joy, after surgery

Karla Joy, after surgery

For K.J. Cunningham (Miss Karla Joy), explaining her surgery is as easy as displaying an old bra. One 36G cup swallows a human head with room to spare. This might sound good to the editors of Playboy, but Cunningham says it was intensely painful for her body and spirit.

“I was a C in 8th grade. A friend’s mother had a boob job and I was that size,” she says. “They would not stop growing. I kind of felt like the girl in Willy Wonka, the blueberry girl who just kept ballooning. Because of that I had no self-esteem.”

With support from her family (and amid protests from some male friends), she scheduled a breast reduction. Then, despite years of hiding, she entered the Las Vegas burlesque pageant Miss All Tease No Sleaze. She’d always admired the art form and decided to send her breasts off right by unleashing them on an audience. She won the pageant, and it gave her such a boost she almost didn’t have the surgery.

Now a full D, Cunningham remembers the first time she went shopping with her mom and sister post-op. She tried on a dress without a bra, and they all cried in the dressing room.

“Now you can see me, that I’m not just a walking pair of boobs. I was completely detached from them. They were like parasites. I gained a part of myself back,” she says, adding that those who disapprove of cosmetic surgery—whatever the impetus—are forgetting something essential. “It’s my body, my temple, and I’m going to decorate however I want.”

“What do you see?” asks Dr. Stile, looking with me into a mirror. I see my dorsal hump, and we talk about rasping it down to a softer line, which he draws with a marker right where I’ve always put my finger.


Faces of Change
The many famous faces of cosmetic plastic surgery include those so natural you would never know and others who set an example for what can happen when you go too far. In a refreshing turn, more and more people who have work done are opening up about the process, helping to reduce the stigma that can accompany altering your physical self.
Michael Moretti, founder of leading trade publication The Aesthetic Guide, has been studying the industry for close to 20 years. He had this to say about how far it has come:
“Aesthetic medicine has changed dramatically and grown exponentially. Procedures are continually becoming more accessible, more affordable, and the public has embraced these changes wholeheartedly. At the beginning, aesthetic medicine was a luxury, considered to be only for the upper class in wealthy areas of the nation. Now, our events are attended by practitioners from every market who offer their services to everyone.”

He shows me before/after shots of other female patients. They look like themselves in the afters, their altered noses equally attractive but distinct. He tells me mine has a “dancing” tip, meaning it bounces when I talk. It’s an imperfection I would keep, and Stile says that kind of personal choice, even if it’s not the “ideal,” is the essence of cosmetic surgery.

“A lot of patients ask me if I think they need certain procedures,” Stile says. “I tell them my whole world is built on things people don’t need. I do things people want.”

I’m not sure what I want. And even though it’s a trail some of the strongest women in my family have already blazed, I still have trouble admitting I’m the kind of person who would get cosmetic surgery for purely cosmetic reasons.

“What kind?” Stile asks. “A happy one?”

After I leave I sit in my car and think about that. I am happy, but to this day I hide my profile. It’s a reflex, one that makes me feel ridiculous when I see someone who’s truly disfigured. There is risk associated with any surgery, and aside from that boy in high school, I doubt anyone cares about the shadow my nose throws. But that doesn’t matter, because the only good reason to change would be to please myself.

Stories like this inevitably end with the completion of a much-debated procedure or a reaffirmation capped with a George Eliot quote on the peculiar temptations of plainness. I am split down the center, loving myself as I am on one side and wishing I could look a little more like Brigitte Bardot on the other. And both are the real me.


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