Sunday, April 24, 2016

The New Guidelines To Regulate The Cosmetic Surgery Industry Misunderstand Why Young Women Get Plastic Surgery In The First Place

The debrief: plastic surgery is often touted as a cure-all for young women's body confidence issues. it's time we got to the real root of the problem.

'I felt like it was the norm to have a small, pretty nose and therefore I mustn't be attractive.’ 

Sophia is one of the increasing number of women who, for one reason or another, are turning to surgery in the hope that it will ‘fix’ their body image issues. But ‘body image issues’ seems to be an incredibly charged term, one which young women like Sophia are routinely confusing with their physical ‘imperfections.’

‘I thought that with a smaller, more "normal" nose I would become the outgoing, happy, charismatic person I wanted to be, and my surgeon agreed that this surgery would hugely improve my confidence. I just had absolutely no warning that it might not achieve what I wanted it to.’

Last week, the General Medical Council – the body that regulates private UK cosmetic clinics – brought in new measures designed to protect health and wellbeing by encouraging ‘transparency’ between clinicians and patients. The guidelines aim to ensure prospective patients aren’t ‘rushed or cajoiled’ into surgery by explicitly banning promotional sales tactics, and that they receive appropriate care at any time before or after their procedure. But how much of this legislation focuses on deeper issues surrounding women’s complicated relationships with their bodies? How much of it is designed to ensure vulnerable young women – the prime target of the beauty industry – aren’t turning to extreme measures to ‘fix’ their perceived flaws in the hope they’ll achieve body confidence?

At 19, Sophia was extremely young when she decided her image insecurities could be solved with a £4,000 nose job: ‘When I came round from the surgery, the surgeon said he'd "really struggled" with my nose but he thought I'd be happy with the result.’

Swelling is par for the course with any kind of surgery, and clinicians are usually honest about how long it will take for the results to ‘settle.’ But Sophia was left disappointed. ‘Six months down the line I still despised the way my nose looked, the swelling had gone down a little, but my face looked strange, and I was far more self conscious now then I had been before – the worst thing was, I’d spent four grand to feel this way.’

'Projects To Be Constantly Improved'

Laura Bates, founder of The Every Day Sexism Project, spoke recently at Southbank’s Women of the World festival about the heart-breaking realities of visiting primary schools to talk about body image issues. She talked about a task she routinely set – boys and girls alike – where they would draw themselves, exactly as they would hope to be if they could have anything at all. The boys, she said, were imaginative with their aspirations, drawing themselves with dragons, with expensive cars, with money raining down on them. But when it came to the girls, she saw the same drawing, over and over again. Girls as young as 8 or 9, who’s one dream was to be thinner, have bigger boobs and longer hair. 

Boys are brought up to regard their bodies as tools to master the world around them. Girls, on the other hand, are raised to think of their bodies as projects, to be constantly improved. And so it’s no surprise that women, overwhelmingly, are the leading recipients of cosmetic surgery procedures; that women are spending much, much more than men on personal grooming and clothes; and that women are consistently valued primarily for their aesthetic appeal, over intellectual, political or pretty much any other output.

Feeling bullied into conforming to idealised beauty standards is no failure on the part of the individual. ‘Pretty hurts,’ sings BeyoncĂ© – and if a woman regarded pretty much universally as the embodiment of western beauty standards is feeling the pressure, then how can us mere mortals be expected to resist impossible, outdated aesthetic ideals? Yet being demonized as ‘trivial’ or ‘bimbos’ when we pay too much mind to how we look leaves us in a catch 22 situation, creating stigmas around cosmetic surgery. One thing cosmetic surgery brands are increasingly relying on is the power of social media – particularly to reach image-obsessed millennials – to advertise, and therefore to normalise, their services. 

'Two-for-one Offers and Loyalty Points'

‘I recently got my lips done through an account I saw on Instagram,’ says Kayleigh*, who’s been having fillers in her lips since she was 20; she’s now 28. ‘It probably wasn’t the best idea. Luckily they’re okay. But this does seem to be a new a thing – there are loads of Instagram accounts offering fillers, which can go very wrong.’

She’s not wrong – two leading UK cosmetic surgery companies, who refused to comment, have been under long term pressure from the British Association of Aesthetic Plastic Surgeons (BAAPS) for their continued social media strategy and use of high profile reality stars to glamourize their services. Two-for-one offers and loyalty points cards are also not uncommon. In the eight years that Kayleigh’s been having cosmetic work, this is the first time she’s seen this scale of shameless promotional content. Consultant Plastic Surgeon and BAAPS spokesperson, Mr Charles Durrant, agrees that there are unique difficulties in confronting social media’s role in the increase in procedures among young girls.

‘It’s very difficult, because there is no regulation of the social media, really. Very young girls are using Instagram and snapchat, and there’s an immediacy to social media – there’s this peer pressure to always look your best, all of the time in any situation.’ Social media mega-stars like the Kardashians are having a huge impact on what young girls think of as the ‘ideal body’ – ‘and that is irresponsible,’ says Mr Durrant. ‘The time limited deals, the two-for-ones, the prizes: it’s very irresponsible advertising. The Cosmetic surgery industry hasn’t quite become what the glitzy glamorous cosmetic medicine industry has become [think lip-fillers and lunch-time botox]. But you see that it is heading in that direction unless regulation is effective, because it is becoming more of an industry, and less of a specialty.’

The new GMC guidelines supposedly aim to tackle exactly this kind of ‘irresponsible’ advertising, but Mr Durrant says there will always be ‘cowboy units’ willing to perform a procedure without considering the psychological implications at all. Addiction to surgery is not a new idea, and with beauty standards becoming more and more unattainable, and women facing greater pressure than ever to achieve them, it makes sense that invasive procedures are becoming thought of as simply a natural progression of the measures we’ve already been going to. ‘I sometimes wish I hadn’t started messing around [with my face], because now there will always be something,’ adds Kayleigh. ‘I've had lots of people tell me not to get stuff done, but I’ve done it anyway, to make myself look how I want to look – my idea of attractive. I think if I had more disposable income I would get lots done.’

Advertising Confidence

And this is exactly where the more sensitive issues arise. Women are repeatedly being sold the lie that money can fix body image issues, which, without the appropriate pre-operative counselling, it probably can’t. The problem is when people advertise confidence, which is exactly what Sophie experienced when she had her nose job at 19. ‘The whole point of me getting the surgery was to fix my own personal confidence issues, rather than getting it solely because I thought it would make me "prettier." Interestingly, since the surgery I've found a number of other flaws to focus on now that my nose is slightly improved. I guess I convinced myself that improving one aspect of my looks was going to bring me happiness, but now I know I'll never be completely alright with my looks.’

There is some good(ish) news, though – surgeons registered with BAAPS have consistently maintained high standards of pre- and post- operative medical and psychological care. If you’re thinking of having cosmetic work done, it’s always best to find a practitioner through them.

‘If I feel a patient is fixating on anything – and by fixating I mean that their insecurities based around a part of their anatomy is out of proportion to the cosmetic deficit that they have - I wouldn’t be operating on them in the first place,’ assures Mr Durrant, who is currently based at Spire Portsmouth Hospital. ‘Any qualified cosmetic surgeon – in fact any qualified doctor – has to be a councillor of sorts. They have to be able to sit and talk to a patient, understand their motives and be able to talk frankly about their expectations and the limitations of the surgery. Most ethically minded practitioners do the same thing. If I have any suspicion that a patient is not within my capabilities to council before surgery, then I would refer them elsewhere before operating.’

*not her real name

Marianna Manson

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