In All About My Mother, a 1999 dramedy written and directed by Pedro Almodóvar, a character named Agrado delivers a monologue that’s somewhat prophetic:
“As well as being agreeable, I’m very authentic! Look at this body! All made to measure. Almond-shaped eyes: 80,000 pesetas[$566 or €480]. Nose: 200,000 [$1418 or €1200]. A waste of money. Another beating the following year left it looking like this. It gives me character, but if I’d known… I wouldn’t have touched it.”
She continues: “Tits – two, because I’m no monster – 70,000 [$495 or €420] each. But I’ve more than earned that back. Silicone in [my] lips, forehead, cheeks, hips and ass. A pint costs about 100,000 [$707 or €600]…so you work it out, because I’ve lost count.”
Agrado concludes with a phrase that could be the slogan of a beauty clinic: “You’re more authentic the more you resemble what you’ve dreamed of being.”
Surgery – and medicine in general – is usually meant for people suffering from some pathology, to fix something that isn’t working. Cosmetic surgery, on the other hand, is often performed on healthy people driven by a desire: to improve their appearance. And perhaps, as Agrado said, to fulfill a dream.
Jorge Javier Vázquez, a popular Spanish TV host, appeared on his show a few days ago with a different face. “Hello everyone, I’m Jorge Javier… even though it may not look like it,” he joked.
His case – like that of Courteney Cox, Mickey Rourke and many celebrities who don’t accept their natural look (or the passage of time) – illustrates the risks of a culture that encourages the pursuit of all aspirations, views conformity as a weakness of character, and increasingly relies on technology to fulfill all desires.
The desire for beauty and youth is as old as humanity. But today, we live with the feeling that it’s within everyone’s reach. In Spain, for instance, the number of cosmetic surgeries has more than doubled in the last decade. And, in the U.S. – where tech moguls dream that their money and knowledge will save them from death – the growth has been even greater.
Even though aesthetics are largely subjective, there have been attempts to evaluate the ability of facial surgeries to rejuvenate the face. For instance, a study published by the American Society of Plastic Surgeons used artificial intelligence to evaluate facial rejuvenation via surgery through “before” and “after” photos of women who were, on average, 58.7 years old. The algorithm estimated the apparent age reduction on the face as being 4.3 years. However, the result – similar to the three years calculated by another study that relied on human judges – was much lower than what the patients perceived. Based on their responses, they felt that they had shaved off almost seven years.
“Patients may tend to overestimate how much younger they look after facelift surgery – perhaps reflecting their emotional and financial investment in the procedure,” says James Bradley, a lead author of the study, which was published in the journal Plastic and Reconstructive Surgery. Meanwhile, another study showed that, although others perceived a reduction in the patient’s age, this didn’t necessarily mean they found them to be more attractive.
Until recently, aging and death were assumed to be unavoidable phenomena, which could only be endured with stoicism, or through belief in an afterlife. Traditional religions and classical philosophy warn that challenging the basic rules of life leads to unhappiness. But in the world of self-improvement – where “settling” is the greatest sin – traditional faith has been replaced by the desire to believe that willpower and technique can do it all. To ignore the fact that immortality isn’t yet in sight (and perhaps never will be), the cause of each individual death is identified – be it tobacco or alcohol use, a sedentary lifestyle, exposure to microplastics, or excessive sugar intake – and the years gained through intermittent fasting or daily weightlifting are carefully counted. Fighting the causes of death becomes the meaning of life.
Exercise and good nutrition – while not preventing death – have undeniable benefits. However, it’s more difficult to evaluate the benefits of cosmetic procedures. These utilize scalpels or needles, in an attempt to shape something as elusive as the psychological effects that our image produces when reflected back to us by a mirror, a camera, or the gaze of others. Human desires, moreover, are insatiable.
While physical attractiveness is clearly associated with youth, 29.5% of cosmetic procedures are performed on people between 18 and 29 years of age, according to data from the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery. And, according to the Spanish Society of Aesthetic Medicine, the average age for the first procedure of this type has fallen in recent years, dropping from 35 to 20.
Despite the rise of these surgeries, their effects – from a scientific perspective – are virtually unknown. A recent review of studies concluded that the psychological or social outcomes of these procedures haven’t been well-evaluated. The studies that have attempted this approach include few patients, are of low quality, or have follow-up periods that last only a few months. Some studies show some short-term satisfaction with the treated body part, but the results become contradictory when the full body image is questioned.
The only study with a long follow-up period – 11 years – observed a worsening of mental health. Everything suggests that the relief from touch-ups is fleeting. “There’s an urgent need to justify or refute advertising claims about the benefits of cosmetic surgery, which remain unproven,” the authors conclude.
Even if the effect of plastic surgery on clients’ long-term well-being is better evaluated in the future – and even if the results aren’t positive – this is unlikely to make a dent in the aesthetics business. This industry doesn’t sell objective results so much as the possibility of fulfilling a dream. A dream that’s fueled by our cell phones, by the omnipresence of perfect bodies and by an ideology that tells us that nothing is impossible… and that being ugly is for lazy people and poor people.
Perhaps it’s worth asking whether the brilliant speech from Pedro Almodóvar’s film wasn’t also hiding a trap. Because of this expectation, those who undergo surgery tend to repeat the procedure, in an endless cycle. Time, after all, never stops. Perhaps true authenticity lies in resisting the temptation to escape from oneself.
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