Plastic Surgery Doesn’t Work — but Neither Does Our Standard of Beauty

Face-lifts may make recipients look slightly younger, but not more attractive. That doesn't mean people should stop getting them

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For a long time, I didn’t quite “get” plastic surgery. Well, I got it, but I rejected it because, in my mind, cosmetic intervention was so offensive a technological advance, so damning a commentary on individual vanity and collective insecurity, that it was deserving of my total and blithe dismissal, even contempt. Plastic surgeons and their patients were an alien species to be kept at arm’s length: curiosities to be regarded with confusion, amusement and more than a little pity.

That was then and this is now, and now is my fourth decade of existence, which means that I’m all too understanding of the fact that life — and our ideas of how we interact with and move about in the world — are a lot more complicated. So I read with interest the news that a study just published in the Journal of the American Medical Association (JAMA) Facial Plastic Surgery found that plastic surgery barely made its recipients look more youthful in the eyes of others. Forty-nine patients who were photographed before and after getting brow-lifts and face-lifts were assumed to be only three years younger by a group of reviewers. And there was no difference in their perceived attractiveness before and after the surgeries.

(MORE: Plastic Surgeons Say Women Want Arms Like Michelle Obama’s)

My initial reaction, which I’m not proud of, was a default dismissal, an echo of the snickering, knowing posture I’d adopted long ago. Of course plastic surgery is a waste of money and an expression of privilege and self-absorption that doesn’t provide real, meaningful results, I thought. Did it really take a study to tell us this?

The problem with that attitude is that it’s unclear what “real,” “meaningful” or, for that matter, “attractiveness” even mean. After all, some of the most traditionally “beautiful” people I know are also some of the most miserable, and no matter how you spin it, that isn’t attractive at all.

(MORE: Holmes: Serena Williams and the Theater of Public Apology)

All this is to say that there’s something interesting going on here, and perhaps a missed opportunity. On the one hand, the results of the JAMA study make a distinction between youth and attractiveness, which feels somewhat revolutionary in America’s youth-obsessed atmosphere. On the other, the study itself feels somewhat pointless, because if patients feel better about themselves post-op, it doesn’t really matter how 50 strangers poring through binders filled with cosmetic surgery before-and-afters define, well, anything.

What would have been really interesting is if the study’s administrators had taken the independent reviewers’ ratings and gone over them with the actual patients in the photographs. I think that sort of feedback would have been more revealing, because I suspect that the majority of plastic-surgery recipients aren’t so much trying to look younger or more beautiful as they are trying to look more like themselves: the heavy-lidded middle manager and weekend triathlete who is fatigued only in appearance; the empty nester whose jawline has succumbed to gravity in what feels like an acute act of betrayal. I get it. And much as I believe we should encourage healthy self-esteem and the concept of aging gracefully, we should also make room for the idea that plastic surgery is not always at odds with those things. It may, in fact, be a natural extension of them.

33 comments
Rotosnitter
Rotosnitter

This article is a stretch at best. Hey if you want plastic surgery get it. It's your body and money. Justification unnecessary.

RobinYuan
RobinYuan

Using the global term plastic surgery is confusing. Plastic surgery is a medical specialty, it does not necessarily define what is specifically done to a specific patient. Even what is specifically done, varies from patient to patient (i.e. one facelift is not the same as another). Goals are different for different patient (i.e one patient whats to look like a more youthful version of herself, while another wants to change her whole appearance). The decision of what to specifically do to a specific patient varies from one surgeon to the another, but it is the most crucial decision. See my book on cosmetic surgery that addresses this crucial process: http://www.psnextra.org/Articles/Cosmetic-Surgery-Book.html.

HarenJoshi
HarenJoshi

Reconstructive Plastic surgery work NOT Cosmatic

WilfTarquin
WilfTarquin

Surely there is a qualifying "some" missing in the headline, because fixing, say, a cleft pallet sure works. So do, on another level, rhinoplasty and boob jobs.

Facelifts on the other hand, well...

orangeplasticfish
orangeplasticfish

I was born with a birth defect. My entire body is deformed. Most women say I am ugly. Moreover, for 40 years, I didn't take my shirt off at the beach to avoid stares and ridicule. Finally, last year, I got plastic surgery for one part of my body. I am still ugly, but I can take my shirt off at the beach without much public ridicule. I still get stares, but I don't feel as odd and unacceptable as before.

Unknownian
Unknownian

I have a few issues with the writer here. The article is well written, but the title contradicts the article; and I don't agree with some info being offered as facts. I have a friend 70 years old. He has has multiple face lifts at various times during his life.

He started with an upper lid job in his 40s, and has recently removed his "Turkey Neck", redid his upper lids, took the bags off his lower lids, and pulled back the skin on his face to remove his wrinkles. I've know the man for almost 40 years, and to say that his surgery only makes him look a few years younger, would be a gross understatement. 

Face lifts "do" work, depending on the Doctor doing the surgery, and just how much skin pulling he decides to do. If you don't have a Doctor that pulls a "Kenny Rogers" face job on you; chances are you will look at least 10 years younger. Personally, I would not subject myself to the pain and recovery suffering my friend endured. It's not for everyone for sure. 

The biggest problem with face lifts is going too far. Look at Joan Rivers. She looks like a Cartoon. Burt Reynolds ruined his eyes, and countess others make the same mistake. A slight and tasteful removal of sagging skin makes the patient feel better about himself, and that's all that matters. However,  I do agree with one point made by the writer: 

Attractiveness is subjective. What the patient might think of his/her final "look" after the surgery, may not be what others looking at him/her might perceive the same way. Nature has a natural way of aging us. If we were "attractive" in our youth, odds are we are still attractive as an older individual. If we were not attractive in our youth, odds are surgery isn't going to change that fact  much, unless you are removing a Goiter from your neck, or a giant growth of some kind on your face.

In summery........it's all about the way it makes the individual feel about himself. Those looking at him probably wouldn't care one way or the other, unless the surgery was overdone. Then, "It Matters".

commonwoman
commonwoman

I just turned 30 and don't wear makeup on a daily basis. I don't like the smell of it, the feel of it, the idea of all those chemicals on my face, the expense of the decent brands, or the amount of time it takes to do it right. I take care of my skin and show up to work well dressed and well groomed and that is as far as I am going to go.  If I have a meeting at work, a date with my hubby, or some other special occasion I will make an exception otherwise I figure that someone who is going to think less of me for this is not worthy of my respect. I think it is time that women stop allowing themselves to be defined by their appearance and start working on their character.

BrakeFastClub
BrakeFastClub

My God!  3 paragraphs in and I still dont know the point of the story!  Learn Journalism!

thenewmp2214
thenewmp2214

I'm a 25 year old woman who just had plastic surgery. I had a belt lipectomy and mastopexy (lower body lift and breast lift) after losing 130 pounds, and let me tell you, it was worth every penny. I was raised with a poor diet and was fat from the ages of 7 to 20. I spent the past five years losing weight naturally (no pills, no surgery), and was left with a horror show of a body; loose, droopy skin, a floppy stomach I had to tuck into my pants, breasts that belonged on a woman three times my age. If it makes me vain to want to be rid of that and finally, for the first time in my life, have an age-appropriate body and healthy body, then so be it.

MannyFuentes
MannyFuentes

Plastic surgery works, ask Latoya Jackson.

lythium
lythium

I have to disagree with this article.  Back about  2 years ago when I was 47 I got a MACS lift (which is not a full lift) and I was thrilled at the results.  It really did drop years off my appearance.  People I meet assume I'm in my 30's and I've been hit on by guys in their 20's.  When I told my doctor how old I was he was shocked and told me I carried my age very well.  A person's age SHOULD not matter but unfortunately it does to many.  It's just how it is.  Most of my life I have exercised and taken care of myself somewhat so maybe that helped with the results.  Plastic surgery can make a huge difference.  Look at Christie Brinkley - do you think she looks like she does at age 59 without it?

JohnSmith18
JohnSmith18

I don't care if my face ages. I just want my hair back. 

doovinator
doovinator

eat right, stay away from meats and sweets, and exercise.

Chicago7
Chicago7

A few points:

1)  I agree that our standard of beauty is an airbrushed impossibility.

2)  But overall, a younger person is more attractive than an aged person.  That's life.  

3)  And a younger person looks younger and much more attractive than an aging person who has had a couple of facelifts (you always have to repeat them when the previous one begins to sag - that's how one's eyebrows end up on one's scalp) and those puffy lip jobs that ruin the look of a person's face.  

4)  And repeated plastic surgeries turn a person into a freak.  That repeated plastic surgery patients like Michael Jackson and Joan Rivers fail to see this when they look in the mirror indicates that plastic surgery for some people is addictive. 

Woody_Brown
Woody_Brown

Of course you remember Totie Fields.  For years she joked about her perfect looks.  Like Phyllis Diller and Joan Rivers, it seemed as if Totie was immune to vanity, a body-image in need of repair or the insecurities of aging in front of an audience.

Yet, like Diller and Rivers, sadly, no.  Totie just had to have that facelift...and, you know, the blood-clot killed her.  Not before it demanded the amputation of her left leg though and gave her that second heart-attack to think about.

Not that this kind of calamity occurs much with cosmetic surgery.  It doesn't.  Happens about as often as a successful terrorist attack...so, nothing to fear.

Vanity, insecurity and an eternally unsatisfactory body-image...really these aren't good reason to have a facelift.  They're good reasons to see a therapist.  Just think of the number of Americans with disposable incomes...

No need to give that money to the homeless, sick or starving.  Better to spend it on a panic room and facelift.  Lord knows you wanna look good for that much needed rest at Betty Ford.

MichaelBall
MichaelBall

I'm sixty-four and retired. Last summer a sheriffs deputy stopped and talked with me in front of my house for a few minutes. He asked if I was off work that day. I replied I was retired. Retired? he said. And asked how old I was. When I told him, he said I looked like I was in my early forties. I get that a lot. My physical stamina is much more than my age too. Aside from genetics, I would explain it to everyone, but no one will listen because next week there will be some new miracle face thing, or exercise program touted to make you live to be a hundred and everyone will jump on that.

Think ahead with your head. And good luck to everyone.

spaghettijimmy
spaghettijimmy

I suspect that the majority of plastic-surgery recipients aren’t so much trying to look younger or more beautiful as they are trying to look more like themselves


Except, of course, as we age...we do look like ourselves, this is what it means to get older, the longer you live, the experience shows on your face--one can accept that salient fact, or one can try and fight it, but that is the unfortunate fact. Of course smooth and pink is aesthetically more pleasing than grey and wrinkled, and I don't necessarily reject surgery if that is what will make the individual happier, I just choose to be a realist, I will never look like I did when I was 20 no matter what I could have done and I accept this. I will say that some actresses have gone too far and probably scare little kids in the street, LOL, rather than creating the effect that they hope, that is "young and beautiful, and not old," the only effect they produce is one bleating "I'm desperate," I feel only pity for them. 

IceToes
IceToes

It was weird to me that the military offered certain kinds of plastic/cosmetic surgery, under certain conditions, but I then realized that it was important that the surgeons got the practice. It helps them be ready for the hard work they do with wounds and trauma. The best not only do the repair so that it is just done and functional, but also can make it look as close to normal that you could hope for. Art, and a psychological lift in its own way.

JPB
JPB

Beauty is solely based on our physical perception; how our five sense perceive it

Attractiveness is more of how our emotions feel about the other person; their energy, spirituality, vibe, whatever you want to call it. 

Plastic surgery doesn't make you more attractive, but it does make them more beautiful although degree of changed beauty may vary


KFJ
KFJ

Well, it does keep an army of plastic surgeons in their large homes

joelcairo
joelcairo

Another safe, middle-of-the-road essay from the makers of Time magazine.

bojimbo26
bojimbo26

' Face lifts ' just keep your face looking the same until you die . Breast implants keep the breasts looking the same when the rest of the body ' sags ' .

gumshoo
gumshoo

@orangeplasticfish I read your words.  I can't see your face, but your soul is beautiful.  I bet you are a fabulous person... to hell with the outside!  The ONLY important thing is what lies beneath our skin.  The rest is pure luck.  Stay strong and know there are people out here who are rooting for you.  I accept you the way you are.  Onward!  Have a groovy day!

KFJ
KFJ

@Unknownian You can have an issue with the writer, but the research was published in a plastic surgery journal. It is the culmination of statistical research, not one writers opinion. It is a a general statement. I am sure there are some who look much  younger, and some who look older. But most, apparently most don't get as much benefit as they expect

MaryMitch
MaryMitch

@commonwoman Yay for you, but wearing makeup isn't a just vanity thing for most women. Unfortunately, women are judged in part by our appearance, and women who don't wear makeup often look tired or pale or "unfinished." I wore as little makeup as I could get away with - mostly because I'm a little lazy - but I always used eyeliner and lipstick.

LoraPfundheller
LoraPfundheller

@commonwoman  I have never worn makeup regularly either. I use it primarily as an accessory when my husband and I are dressing up to go out, perhaps two or three times a year. Otherwise, what you see is what you get, and I've been happy that way. However, now that I'm approaching 50, I would consider plastic surgery.  I don't want to look smooth and wrinkle free--to do that would be to deny all the life I've lived--but I would like to stop the sagging in my eyelids (genetic) and maybe firm up my throat. I don't care what other people think, but it's weird to look in the mirror and see my mother!

gumshoo
gumshoo

@lythium How do you know you don't look only 3 years younger (as the author explained).  Most people lie when they tell you they think you look younger.  I am 45 and everyone says I look like I'm in my 30's.   I think people who have HAD surgery are not exactly unbiased. 

LoraPfundheller
LoraPfundheller

@doovinator That's a great plan if you start in your 20's but not at all helpful if the damage is already done.

KyleEckert
KyleEckert

@doovinator Organic chicken breast and wild salmon and fish is good for protein. No red meat or processed meats.

JandiSmith
JandiSmith

@Chicago7 only women can be that vain.  time to tell the truth: MANHOOD101. C O M

LoraPfundheller
LoraPfundheller

@spaghettijimmy I'm getting close to 50, and when I look in the mirror I don't look like my mental image of myself. Granted, I've aged A LOT during the past 18 months, due to a number of circumstances, so maybe my brain hasn't had a chance to catch up. But I would definitely pay to have someone make me look like the picture in my head. The funny thing is, that picture isn't all that young. I'd like to look like I did ten or so years ago, that's what I expect to see when I look in the mirror. It isn't about how other people see me, I don't know how old I'd look to someone else if I had the face I want. I just know it would feel right to me again.

lythium
lythium

@gumshoo @lythium When I looked in the mirror after my surgery (after the bandages came off and I healed up) I could see the difference.  I looked at pictures of myself at age 37 (I looked young then guess it's good genes) and pictures taken right after the surgery and I looked about the same.   It made me happy and that's all that mattered.  The compliments were just icing on the cake.  If people are happy with how they look that's great. I didn't do it for anyone else and I don't care what anyone thinks - I did it for me.  Plus the fact that I have a very good looking 35 year old boyfriend should speak for itself.  If someone elses results aren't what they expected maybe they need a new plastic surgeon.  If people are content with the signs of aging more power to them.