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

And emotions may indeed carve themselves on a face. John Greden, M.D., chairman of psychiatry at the University of Michigan Medical School, has found that key vertical frown lines linked by a horizontal curve are actually a good indicator of emotional agitation and clinical depression. Facial shape and lines help us read and assess others. Plastic surgery may alter that animated map, occasionally smoothing it out so that it is less expressive. But perhaps, in the case of a person with genetically programmed jowls, surgery alters a "false" indicator, allowing the face to more precisely fit the inner personality. When writer Joan Gage gave a detailed, two-part, stitch-by-stitch account of her first face-lift in Vogue magazine, she wrote, "I am delighted with the result. I think I look approximately my age but more like the real me."

Psychologists like Kenneth Gergen question whether there is a core self in today's society: "Because of technology we have many different audiences, many more types of people we have to appeal to. We have an audience in our home, our community, friendships all over the world, people in the business setting, people that we know on television or through our media. All these different groups have different senses of the ideal person, so we have a lot more criteria to meet. We end up being fragmented and emptying out the notion of any kind of core being."

Gergen believes that the current fad of body-piercing is actually a rebellion against these overwhelming standards. The body is indeed the site of the battle, but it is an act of defiance against standards of perfection. "If you live in a world where you've got to measure up in so many ways, you can't do it. One response is to challenge the standards in the most horrific way possible, by mutilating the body as a mode of social rebellion."

Non-Person To Person

No one will ever be able to untangle the cause and effect of body and self. The two are as intertwined as the double helix of DNA itself. "Often plastic surgery modifies the body image, and that modifies behavior," notes Cincinnati's Kearney-Cooke. "There's a lot of evidence to show that plastic surgery changes patients' perception of themselves." People who are beautiful draw others to them," explains Berkeley's Then. "People want to be with other good-looking people, because they hope the benefit will rub off on them. And so when people say they're getting surgery ,just for themselves, it's hard to separate out what is 'self.'"

That was brought home to me when Betty, a 62-year-old Georgia businesswoman, called me the day after I interviewed her. At first she told me she'd gotten a face-lift for pragmatic reasons, to "look like I did when I was younger. I own a business and call on customers. It's very important to look good if you're in competition with people who are young and look good."

But when she called back, her tone had changed from ebullient to somber. "I didn't tell you the most important thing," she said. "When you get to be my age, people stop noticing you. That's everybody, anywhere. You become a nonperson. After my facelift, people noticed me again. They noticed me being alive. I became a person again."

Perhaps the most interesting aspect of plastic surgery is that, as pragmatic as it seems, it reveals us as we really are. It's not just about nip and tuck, it's about life and death in America. Harold Brodkey, an eminent writer who has been chronicling his death from AIDS in The New Yorker, said it marvelously: "It is the basis of America—the forward-looking thing. We will create a nation, and we will have gardens and swimming pools and corrective surgery. America is defined by what it does next."

In short, you cannot meet the future if you look like the past.