Under the Knife

"Here I am/Perfect as I’m ever gonna be/You’ll see/Love me for me"
–Ashlee Simpson c. 2004
"Everything about me is fake … and I’m perfect! "
–Janice Dickinson

In my opinion, the only thing shocking about Ashlee Simpson’s recent nose job is the big media fuss it caused—mostly as a result of her unwillingness to admit to the plastic surgery straight-up. By turning a coy cheek (and an improved profile) to the press, the 22-year-old Simpson sidestepped the debate over whether cosmetic surgery is appropriate for teens and young adults.

But the truth is, her über-publicized transformation is hardly exceptional. According to the American Society of Plastic Surgeons (ASPS), around 300,000 rhinoplasties were performed last year—that’s 18 percent fewer than five years prior.

Don’t cry for the plastic surgeons just yet. Nearly 2 million cosmetic surgical procedures took place in America last year, along with over 8 million* of the less-invasive procedures such as Botox injection.

With regular makeover exposés, magazines like People and Us Weekly love to remind us that celebrity perfection is often bought, not born, and audiences eat it up like comfort food. Cosmetic surgery is both sensationalized and normalized in reality TV shows like Extreme Makeover, The Swan, Dr. 90210, and MTV’s I Want a Famous Face, along with the addictive drama Nip/Tuck.

In short, the plastic surgery phenomenon has become an unavoidable facet of our culture. Though its ubiquity is certainly disheartening in the context of the larger women-are-still-objectified issue, I don’t personally have any strong judgments about it. As long as consumers are well informed about the risks involved and not driven to drug-dealing to support their plastic-surgery addictions. After all, it’s a free country, and we should feel empowered to mutilate ourselves at will.

And that’s exactly what I’m going to (pretend to) do.

Would You Like a Lobotomy With that Tummy Tuck?

This matter calls for some undercover investigation. In the name of journalistic novelty, I’ve decided to subject myself to a pseudo-plastic surgery consultation. I’d rather avoid having my breasts unnecessarily groped, and a nose job just seems so overdone, so I go with the liposuction angle. After a quick Google search I’ve got an appointment with “Dr. S,” chosen for his snazzy Web site and convenient location. (For the record, I realize this is not the most intelligent way to go about it. Later I’ll discover that his credentials are less than stellar.)

The morning before my consultation, I’m a little stressed out. As levelheaded as I may try to be in matters of the aesthetic and superficial, I am still a young American woman and thus the receptacle for many twisted beauty ideals. I try to brace myself for this experience, keeping in mind that it’s the surgeon’s job to encourage me to undergo complete Barbie-fication. But still, I can’t shake the image of my face and body branded with one of those hateful surgeon’s markers like some insane football play.

In order to draw out the greediest, most exploitative side of “my” surgeon—in other words, for pure entertainment value—I’m tempted to flounce into his office all wide-eyed and ditzy, espousing Hooters-girl dreams and clutching a picture of Gisele Bündchen. I want to unleash a caricature of a plastic surgeon, with dollar signs in his eyes and a menacing scalpel shivering in his grasp ….

But when I enter the office, I’m disarmed and amused to find not the silver-haired, silver-tongued doctor who I had imagined, but … a guy, who could pass off as one of my friends. Sans lab coat, he seems capable of playing beer pong and owning a PlayStation—or at least looking right at home on Scrubs.

We remark suspiciously on each other’s youth, and he tells me I’m pretty. (How very Dr. 90210; this must be a disarmament tactic they teach in plastic surgery school.) Dr. S goes through a checklist of generic questions about my health habits, which I answer vaguely; he seems more interested in finding out how I was “referred” to him.

The unexpectedly minute age gap between us makes stripping down to my undies pretty awkward, but I proceed with valiance and attempted nonchalance. (After all, I am earnestly requesting that this man/boy slice and dice my midsection whilst I lie etherized on a steel table, am I not??)

After a quick once-over, I’m declared a “perfect candidate” for the procedure—apparently it’s not too hard to make the cut. Would I like to go ahead and set a date? This is easier than getting on the pill. I stall, throwing out some concerns. For example, is invasive cosmetic surgery really appropriate for a physically normal 21-year-old? I mean, shouldn’t the whole diet-and-exercise thing still be applicable here? Au contraire. I’m told that surgery at my age is not only quite common, it’s recommended because “there are fewer health risks involved.”

Suppressing the sass that is fast-rising in my throat, I ask if Dr. S ever turns away prospective patients. “Sure,” he responds with textbook prudence, “if they have unrealistic goals or are mentally unstable.” Does compulsive lying count as a neurosis?

A week later I receive a price quote for “my” surgery, along with a letter congratulating me on my candidacy for violent disfigurement (or something like that). I’d better head over to the gym and break the news to the girls—we’ve entered the Plastic Surgery Age, and we are far, far beyond the salvation of a paltry treadmill.

Perfection at a Price

Okay, so getting cosmetic surgery may seem prosaic these days, but that doesn’t mean we should all go jumping under the scalpel at the first sign of physical imperfection. There are still some thorny issues at hand. Is aesthetic “improvement” justification for undergoing a serious medical procedure with serious risks?

Caitlin** had the bump in her nose “fixed” when she was just 16 years old. She describes it as a decidedly positive experience.

"I never actually thought about it until a few months before I actually had it done. But my self-esteem was super low and I'd always look at myself in the mirror sideways and try and cover the part of my nose that stuck out to see what it would look like if it were gone. Once I decided I wanted it done and my mom (wholeheartedly, thank goodness) agreed, I never once had second thoughts."

"(After the surgery) my self-esteem skyrocketed. Seriously, if you look at pics of me before and after, I was a completely different person. I started wearing nicer clothes and taking better care of myself…I mean, I still have a tiny indentation where the bone didn't quite grow back all the way, but all-in-all, my confidence levels soared afterwards…I never regret it."

Caitlin added that she doesn’t think all plastic surgery procedures—such as breast implants—are appropriate for teens, whose bodies will continue to change for a few years.

Does the Nip/Tuck Fad Have a Shelf Life?

In the 21st century, is there anything sacred about the human body? This might merely be a modern conflation of two trends that are very much a part of our human history: the need to surgically probe and alter the body in order to preserve its life, and the more frivolous practice of modifying our appearance so as to be more attractive to society (which is, indirectly, just another mode of survival).

So does this mean that the impulse for a nose/boob/

lip job lies in some happy, inevitable place between brushing your hair in the morning and receiving emergency open-heart surgery? Or is it destined for the annals of patently objectifying the beauty-is-pain trends á la Chinese foot binding, Victorian corsets, and carcinogenic tanning beds?

Only time will tell.

*Data accounts for the number of surgical sites on the body, not number of individual patients.
**Name changed at interviewee’s request.