Change of Face...Change of Fate

Is our national obsession with appearance a new sickness or a perennial human concern?

By Jill Neimark, published on May 01, 1994 - last reviewed on March 27, 2006

Surgeons notice that patients now come in as informed customers, having analyzed their "flaws," with a sense of the changes they want. "What would you change about my face?" I asked Pober. "I won't tell you what to do. I'll discuss what you want," he replied. He showed me photos of patients whom he felt had made aesthetically incorrect decisions: a woman who had asked to liposuction only her hips and not her thighs; a man who had a nose job and did not strengthen a receding chin with an implant. The doctor did what they asked. (The man came back 10 years later for the chin implant.)

"Women used to come in with their husbands," says Sanders. "Now they come alone. And they are younger; they come in their late thirties and early forties. I get a lot of single women in their fifties and sixties, who are divorced and working." More men are coming, too. "From the moment a young girl pierces her ears and puts on fingernail polish, she's changing her appearance. It's accepted among women. For a long time it was not accepted among men, but now they are coming in for their eyes, or for peels and skin care. I get men who say, 'Gee, my wife had this done, and I really liked how it looked on her.'"

Ordinary People

The doctors I spoke with pointed out that their patients were generally not actors or stars—the vain and the rich, as the media portrays them—but most often working professionals who wanted to look good in order to remain competitive in the workplace. This was especially true of middle-aged women. In fact, the influence of a two-career society on plastic surgery was a frequent theme. "Women in their fifties and sixties need to look energetic to maintain that competitive edge," said Los Angeles's Sanders.

Men, too, "are turning to plastic surgery, particularly with the tighter job market and age discrimination," explains Debbie Then, Ph.D., a social psychologist in Berkeley who lectures at Stanford, and whose work has focused on body image. "More men are interested in collagen, eye-lifts, and face-lifts because they're starting to experience appearance-related discrimination in the workforce. They're competing with younger men and with women."

Most surgeons also noted the obvious: We're a society that fears and despises age. "In today's society, looking old is not accepted," says Sanders. "It's a stigma, it's associated with a lack of energy and a dwindling of the mental faculties. I don't think anybody wants to appear old to anybody else. Our society over the last 20 years has become absolutely obsessed with youth."

Toby Mayer concurs: "At 55 someone looks in the mirror and they don't recognize what's looking back. Their face sags, there are bags under their eyes, they look tired, depressed, and angry. They don't want to look 20, they want to look good for their age."

Are the doctors just caught in their own house of mirrors? I don't think so. At 36, I find myself reacting with pleasure when asked if I'm in my twenties. Why the hell should it matter? The other day a 19-year-old who was flirting with me asked my age and when I told him, said, "I thought you were about 31. But I knew you weren't in your twenties." I asked how he knew. "I looked at your hands," he said simply. I felt uneasy, almost violated. My age indicated, I suppose, a loss of sexual power on my part.

I remember a gesture—poignant, fleeting, and unforgettable— made by a woman in her fifties when she introduced me to a male friend. He smiled at me, and for the brief moment that his eyes lingered on me she lifted her chin and stroked the faint wattle of flesh under it. It was a gesture of fear, and concealment.

What Babies Know

"Most people think looks shouldn't be important, but unfortunately they are," says Elaine Hatfield, Ph.D., professor of psychology at the University of Hawaii, and coauthor of Mirror, Mirror: The Importance of Looks in Everyday Life. "One study found that if you show two pictures to people and tell them you'll pay them if they guess correctly about the personalities of the people in the photographs, they will guess the good-looking people are kind, nurturing, patient, and happy."

In fact, according to Debbie Then, "studies of children as young as 18 months show that they prefer to look at a more attractive face." Then also cites a recent study conducted at the University of Western Michigan, where girls in kindergarten perceive thin friends to be nicer, neater, more popular, and smarter than chubby friends.

"The problem," says Then, "is that our society is conflicted about appearance. On the one hand, everyone knows that looks matter a lot. On the other hand, there is a real taboo about trying to improve one's appearance. People who get plastic surgery are considered vain, self-absorbed, and conceited. Here you have to look good, yet you're not supposed to do anything about it. If we could be more upfront about 'looksism' and the prevalence of plastic surgery, it might relieve some of the pressure."

Plastic surgery's appeal may in part be due to the chaos in gender roles today, according to Ann Kearney-Cooke, Ph.D., a psychologist specializing in body-image disorders in Cincinnati. "There has been so much change occurring in the sex roles that some people are holding on to body shapes as a way to say, I'm a man, I'm a woman. Plastic surgery helps emphasize the feminine and masculine, allowing the body to become a symbolic attempt to figure out what masculine and feminine are today."