November/December 2003
Skin Deep
Surgical Strikes Against Enemy Lines
by Ray Albrektson
We can rebuild him. We have the technology. We
can make him stronger, faster…and with a firmer chin, a thinner
nose and pectoral implants.”1
If the vintage sci-fi drama starring Lee Majors, The Six-Million Dollar
Man, were to be remade today, I doubt that the hero’s upgrades
would be limited to
the purely utilitarian. American society has fallen in love with plastic
surgery, and everyone from soccer moms to laid-off dads are taking surgical
steps to
remake themselves into the image of normally attractive people—like
Madonna.
Once the behind-the-scenes not-so-secret beauty treatment of the rich
and famous, plastic surgery has hit the mainstream. The ABC TV show, Extreme
Makeover,2 has become a huge hit in the ratings game among reality
shows, and unexpectedly large numbers of ordinary folks have flooded the
network with applications. A mandatory part of the application process
is a three-minute videotape in which the would-be perfect “10”
whines heart-wrenchingly about how ugly they presently are, and how a
surgical makeover would make their lives into one sweet, beautiful song.
One reason that the show has struck a nerve (not to mention gold ratings)
is that most people are unhappy with the way they look. Extreme Makeover
seems to steer clear from those in the Quasimodo category, but chooses
people who are basically average in attractiveness. Each seems convinced
that with a little liposuction here, a little off the nose there, a bit
more chin and maybe a tweaked belly-button, life will finally be worth
living.
And by the end of the thirty-minute episode, we see the truth of the makeover
gospel: God-like creatures emerge from the chrysalis of surgical recuperation
and immediately join the ranks of the “beautiful people,”
bursting with confidence, elan and reveling in their newly-minted status
as beauty icons. The contrast is emphasized by repeatedly displaying before-and-after
pictures that testify to the degree to which surgery can reshape, enhance
or otherwise alter what our grandparents would have been stuck with for
life.
It’s not just TV shows like Extreme Makeover that tell
us that the cosmetic surgery business is up—way up. Despite the
economic slowdown of the last two years, cosmetic surgery clinics have
boomed like never before. The number of procedures done annually in America
is approaching the ten million mark.3 Some of the most well-known surgeons
are booked up for months in advance. And don’t forget that almost
all plastic surgery is paid for from the patient’s own pocket—only
a tiny percentage is ever paid by insurance companies.
The top cosmetic and surgical procedure in 2001 was liposuction, which,
along with eyelid surgery, has overtaken breast augmentation as front-runners
in the surgical sweepstakes. But the new kids on the block are a host
of cosmetic procedures that don’t actually require surgery. Best
known is Botox®—a medicinized version of a paralyzing poison
that makes facial wrinkles vanish.4 A group of newcomers to the field
include injectable plastic beads, collagen and less-appealing concoctions
made from cadaver-skin or silicone.
These facial-smoothing and wrinkle-removing options are relatively low
cost, and make it possible to get much of the effect of a surgical face-lift
for a fraction of the cost. A surgical face-lift may last for a decade
before requiring touch-ups, however, while most of these injection-only
treatments must be redone at least annually, sometimes every six months.
Vanity Also Appeals to Men!
While women still outnumber men in the rush to surgical self-improvement
(by a seven to one ratio), more men than ever are getting on the bandwagon,
and the reason is partly economic. It’s always seemed obvious that
women would be drawn, moth-like, to the flaming promise of spectacular
beauty through cosmetic surgery, but men were thought to be immune to
a frontal attack on the vanity front. In fact, men seem equally interested
as women in pursuing a related goal—the illusion of eternal youth.
Whether it is truly age-discrimination, or simply a way of getting an
edge
on the next guy seeking a prize job, men have begun to do anything necessary
to turn back the hands of time. Gym membership soared in the 1980s, but
aging executives seeking a second chance at the brass ring are beating
down the doors at the cosmetic surgical suite.
The top choices for men are liposuction (gyms can’t do it all, evidently),
hair transplantation and eyelid surgery. This eyelid procedure is especially
popular for the fifty-and-up crowd, where more than a third of all cosmetic
procedures for this age group involve taking the sags and droops from
aging eyes. Why go into an important job interview—where, according
to conventional wisdom, a judgment is made about you in the first seven
seconds—wearing the body of some geriatric has-been when you can
have that young, lean and eager look that marks you as a shoo-in for the
key to the executive washroom? And in the increasingly competitive job
market, the appearance of youth has become a winning strategy.
For most of the 20th century, America gradually became a culture that
idealizes and idolizes youth. Take, for example, the slogans of a major
advertiser, Pepsi Cola. Their jingles emphasized good digestion in 1903
and being sociable in 1955, but hit a lasting theme in 1960 to the present:
Now it’s “Pepsi For Those Who Think Young.”5
The obsession with youthfulness has come to dominate every aspect of our
society—from entertainment to politics—and has recently begun
to have a significant impact on business. While it’s understandable
that entertainers would pursue the appearance of youth at all costs, recently
laid-off businessmen have turned to a surgical short-cut to roll back
their odome-
ter in hopes of landing a better job—or any job, for that matter.
Turning Losers Into Winners?
The goal for both men and women is not just an outward metamorphosis,
but a transforming boost in their inner selves. They seek a surge of confidence
and a sense of belonging that assures them that they truly are one of
the beautiful people, the ones about whose lives we read as we furtively
skim the tabloids at the checkout counter of our grocery store. It is
this inner craving for belonging, admiration and respect that fuels the
engine of our makeover mania.
But—does it work? In other words, can these procedures turn an unattractive
loser into a Brad Pitt stand-in? Judging from the outcomes of the candidates
selected for Extreme Makeover, the answer is clearly, YES. Men emerge
from backstage exuding confidence, radiating high-power smiles from newly-laminated
teeth, striding boldly onto the stage with the air of one born to lead.
Women step forth arrayed with every feminine symbol of desirability, finally
secure and contented in having achieved the ideal of physical perfection.
But the sad truth is that all plastic and cosmetic surgery ultimately
disappoints. It’s not that the doctors and cosmetic surgeons have
failed medically—far from it. Most cosmetic surgical outcomes are
extremely good, despite the very real risk involved in major surgery.
And most patients are satisfied with the outcome. In fact, the satisfaction
rate for breast augmentation is very high—greater than 90 percent.
The ultimate failure of cosmetic surgery doesn't lie with the doctors,
but with the expectations of the patient.
Here’s the problem: Even the finest eyelid surgery begins to droop
after another decade. Newly reconstructed breasts eventually begin to
sag, and liposuctioned thighs don’t last forever. And that’s
exactly the problem: It’s not that the surgery goes wrong, but that
the human body itself doesn’t last forever. If we base our hope
for wholeness and happiness on physical perfection, then we’re setting
forth on a track that is certain to end in a train wreck.
Consider the situation of those who have been disfigured by a burn or
serious accident. They go to a cosmetic surgeon with a completely different
set of hopes—to be once again “normal.” If they’re
not beautiful after the procedure, they’re still delighted, because
their hopes were appropriately set.
The current bubble in cosmetic surgery isn’t inflated by people
hoping to correct significant physical defects, but by an irrational hope
that cosmetic surgery represents a high-tech fountain of youth. This hope
fails to recognize that even a good result is only paving the way for
even higher expectations. If the treatment is successful in perfecting
one part of the body, then another part moves into position as a focus
of bodily
discontent.
Cosmetic Surgery Is Addictive
The Hollywood community serves as a ready-made model of how this cycle
of discontent has turned reconstructive surgery into a highly-addictive
activity—the surgical equivalent of crack cocaine. The beautiful
people of the entertainment industry come as close to physical perfection
as mere mortals can achieve—yet they are constantly submitting themselves
for surgical improvements. No matter how many features were previously
fixed, there is always a long list of those remaining. If health, technology
and finances permitted, surgery junkies would pursue their mania for fighting
off all signs of age and imperfection until they dropped dead—leaving
the coroner with what appeared to be the body of a twenty-something who
died of old age.
It’s no coincidence that the cosmetic surgery carnival pulled into
town at just the same time that body image disorders, especially bulimia
and anorexia, have also peaked. Our grandparents, if they subscribed to
magazines like Look, or Life, saw only a handful of images of handsome
men and beautiful women in the course of a week. Now we’re bombarded
daily with thousands of retouched images of human perfection. Millions
of voices tell us, “This is beauty—and you don’t look
anything like that.”
While not solely to blame, television is a major source of images apparently
calculated to make normal people feel ugly and unattractive. A Harvard
Eating Disorders Center study6 noted that in Fiji, where eating disorders
had previously been unknown, an epidemic of anorexia and bulimia burst
onto the scene shortly after the introduction of TV.
The impact on how we think about our bodies is enormous.
The current vision of the “ideal man” or “ideal woman”—at
least, as projected by Hollywood and the advertising industry—has
become increasingly unattainable without surgical intervention. As ordinary
men and women see themselves as increasingly distant from the cultural
ideal of beauty, their self-dissatisfaction grows. In a futile attempt
to hit an ever more distant target, they flock to gyms, spas and—the
last stop—surgical suites.
We are being systematically programmed to be unhappy with the way we are,
whether justified or not. While some of our media-induced body-loathing
can be
alleviated with a better haircut, regular trips to the gym or a few outfits
more stylish than relaxed-fit khaki Dockers, there is no way for the average
woman or man to suddenly metamorphose into
Barbie and Ken.
If It Makes Us Feel Better
And Look Better—
What’s Wrong With It?
So why not jump on the cosmetic bandwagon? Since technology has made it
possible to rebuild ourselves, why not use all the cosmetic techniques
available to fit in as many upgrades as possible? Here are a few thoughts
to mull over before slipping under the knife.
• The pursuit of beauty is a race in which somebody keeps changing
the location of the finish line. If we surgically alter ourselves to today's
standards, you can be sure that the standard will be different in a decade
or two. Remember those blue-haired ladies with tattooed eyebrows hinting
at a permanent state of astonishment? That seemed like a good idea in
1968, but eyebrow fashions have come a long way since the Lucille Ball
look. If we were to take a critical look at movie stars from postwar decades,
few of them would rate a second glance today, but they all represented
the pinnacle of beauty—according to the standards of their era.
• Cosmetic procedures don’t come cheap! Close to eight
billion dollars was spent on cosmetic surgery in 2000. Want a new chin?
Plan on dropping a few thousand dollars. Breast augmentation costs over
$3,000—and even more to
remove the implants if you change your mind. Even the trend in
wrinkle removal using Botox® or injectable collagen will cost around
$400 per injection, and a bit more for a chemical peel.7
• Some oppose cosmetic surgery on religious grounds. The reasoning
is that since God created us a certain way, we should not tamper with
God’s handiwork. In fact, there are several important theological
issues that should come into play as we consider whether or not to undergo
cosmetic surgery.
While the human body is a miraculous creation of God, we all live in a
world that is corrupted with evil. Accidents happen, and a once-perfect
child now has a serious scar. Just as genetic diseases can be passed on
by unwitting parents to innocent children, so significant physical characteristics
can be inherited that have the potential to devastate a young life.
Would it be wrong to heal a genetically carried blood disease through
technology? Jesus was asked a similar situation with regard to a man born
blind. “Who sinned, this man or his parents, that he should be born
blind?” (John 9:2). Jesus denied that either was at fault and immediately
healed the blind man. Of course it would be appropriate to heal even a
genetic disease, but what about genetic appearance defects?
I went to grade school with a boy who was mercilessly teased about the
size and shape of his nose. One day, seeing the boy’s father, I
understood the source of his unusual nose. At that time most parents would
not consider a surgical solution to the problem, but that is a very real
possibility today. A modern father might go with his son and have the
surgery himself to show the boy that it’s all right—and I
think Jesus would approve.8
If we are considering cosmetic surgery, we must be sure that we don’t
mistake
ordinary (but non-spectacular) features for defective ones that need surgical
repair. Certainly Adam and Eve, fresh from the sculpting hands of their
Creator, would not have needed improving. But if we could somehow observe
them by means of some kind of trans-temporal television, however, we might
not agree that they represent perfect “10”s when it came to
physical beauty. We might tend to judge them based on our own contemporary
cultural standards. “Adam’s chin could certainly use a little
more definition—and wouldn’t a set of gluteal implants look
wonderful on Eve?”
• It is significant that the Bible records very few comments
on the physical appearance of even the most important people in the Bible,
including Adam, Noah, Moses, David and Jesus. Some of those remarked upon
for their good looks often had sadly defective characters (Saul and Absalom,
for example). It’s reasonable to conclude that what really counts
is inner beauty, including a godly character and a relationship with our
Creator that is continually transforming who we are on the inside, not
just the outside.
• The search for beauty, love and belonging that drives people
to plastic surgery and beyond is ultimately doomed to disappoint. The
fact is that nobody, in their own eyes, is ever as beautiful as the cultural
ideal. Remember that the so-called beautiful people are always a few operations
away from the body that they would really like. And what about aging?
It’s wonderful how youthful a fifty-year-old can look thanks to
modern surgery, but nobody asks eighty-year-olds to pose for centerfolds.
Taking Care Of, Not Remaking Our Bodies
There’s an old story about the minister (often attributed to J.
Sidlow Baxter) who was asked if it was wrong for a Christian to wear makeup.
“If the barn needs painting,” he advised, “then paint
it.” With modern technology we can go far beyond “painting
the barn.” God has given us a responsibility to care for our bodies—they
are even referred to as God’s Temple.
Most modern Christians would allow that it would be all right to have
braces to straighten crooked teeth, undergo reconstructive surgery after
an accident or to remove an unsightly mole. We would celebrate and honor
a surgeon who repaired a newborn’s cleft palate, or separated conjoined
twins. In those cases we recognize that individuals have been touched
by evil as a result of living in a fallen world, and through surgery the
impact of that evil can be reduced.
Body modification through weight management and exercise also seems within
the scope of our duties as stewards over our bodies. What becomes less
clear is whether or not God’s temple needs a forehead lift or calf
implants. Since now there is almost no limit to the extent that surgeons
can reshape our bodies, we have to learn where to draw the line.
We can be sure that our youth-dominated culture will not draw the line
in any appropriate place. We must decide for ourselves—appropriately
guided by wise friends and advisors—how to decide what is broken
and should be fixed and what is not broken and should be left alone.
But we must also look beyond our outward appearance. Is there a beautiful
person on the inside? Our cultural obsession with youth and beauty disregards
every aspect of what’s inside—and who we are on the inside
is what really matters in the long run. It’s said of Jim Morrison,
now-
deceased lead singer of The Doors, that his goal was to “live fast,
die young and leave a beautiful corpse.”9 At least he achieved the
first part of his ambition, but I doubt that his corpse would currently
be described as beautiful. A far better objective might have been to “live
well, die at the right time and leave a beautiful life.”
A biblical proverb teaches us that “Charm is deceptive, and beauty
does not last; but a woman who fears the Lord will be greatly praised”
(Proverbs 31:30, NLT). This inner attitude, incorporated in a godly character
that reveals itself in caring, kindness, respect and reverence to God,
is just as
appropriate for men as women.
When all is said and done, none of the reasons for which people modify
their bodies will result in real and lasting satisfaction. That is to
be found only in a relationship with God, in a relationship that transforms
us, marks us as God’s unique and special person, and fills us with
a real and inner beauty that won’t fade—ever.
1 The actual quote is available here: http://www.scifi.com/bionics/sixmill.html
2 http://extratv.warnerbros.com/dailynews/extra/01_03/01_09c.html
3 All statistics provided by the American Society of Plastic Surgeons, see http://www.plasticsurgery.org/public_education/statistical_trends_92to01.cfm
4 The makers of Botox® are very strict about the use of the “registered” symbol. The term “medicinized” is a deliberate play on the neologism “weaponized” that surfaced in the anthrax scare last year.
5 http://www.tvacres.com/adslogans_p.htm
6 http://www.hms.harvard.edu/news/releases/599bodyimage.html
7 Also extrapolated from http://www.plasticsurgery.org/public_education/statistical_trends_92to01.cfm
8 Derived from an idea from an interview with cosmetic surgeon James Wells in an article by Mary Ellin Lerner’s, “Psychology of Plastic Surgery” (USA Weekend, May 30-June 1 2003), p.12. My personal experience in elementary school involved a boy with big ears, but it was changed here to big nose to prevent family members from thinking I was writing about them.
9 The actual source of “Live fast, die young, and leave a good-looking corpse” was spoken by John Derek in the 1949 movie Knock on Any Door, according to http://www.bbc.co.uk/dna/h2g2/alabaster/A988266
Ray Albrektson is an associate professor of New Testament at the U.S. branch of the International School of Theology, near Rancho Cucamonga, California.