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.
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.
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.