Chapter 24: Skin Deep

Is plastic fantastic?

“She got her looks from her father – he’s a plastic surgeon.”
—Groucho Marx

Anyone who’s a fan of award ceremonies, particularly the red carpet segments, is treated regularly to parades not just of celebrity but of cosmetic science. Probably at no time in history have so many people who’ve availed themselves of so much plastic surgery been so available for public examination. Face lifts, eye jobs, nose jobs, neck jobs, breast and buttock augmentations, filler, Botox, collagen injections, laser peels: it’s all on ample display. On display, too, are the relative extremes of the cosmetic continuum, from Joan Rivers at one end (the question isn’t what she’s had done but what she hasn’t) to Meryl Streep at the other (if she’s had any work done, it’s impossible to tell). The common motive for most of this “work” done by and to celebrities is clear: to defeat age. And the impulse isn’t restricted to Tinseltown. Today, non-celebrity Zoomers are turning to the same procedures in record numbers, too.

My first reaction is: “Why not?” If we can avail ourselves of better vision and hearing because of the miracles of modern medicine, why not improved looks and body parts and the benefits they bring? What’s the difference between mechanical enhancements and esthetic ones, especially if both add to our quality of life? Why are the former applauded and the latter condemned?

At the same time, I have some serious reservations. First is the cost of cosmetic procedures. The subject is relevant only if – and it’s a large if – a person can afford the work. And a significant percentage of our gang cannot. In this case, a hierarchy of relative importance quickly becomes apparent: quality of life is not life itself; plastic surgery is not heart surgery. While such procedures might not be trivial to the people who want them and indeed might be helpful to a person’s self-confidence and psychological well-being, they will inevitably be regarded as a luxury or extravagance to the people who can’t afford them.

Second, there’s the philosophical issue: the possibility that “Anti-Aging” cosmetic surgery can be interpreted as one more kind of age discrimination: a delegitimization of the aging person and older age as meaningful institutions in themselves. The bottom line for me, and the philosophy this space espouses, is that the natural face is the truest face, and natural beauty the truest beauty. The acceptance and celebration of age is a virtue, not a surrender or a delusion.

That said, assuming a person can afford a procedure and the procedure is undertaken tastefully and with a sense of proportion, I see nothing wrong with a nip or tuck to make someone feel better about themselves. To judge otherwise would be to be guilty of a different kind of discrimination.

It’s eye-opening to examine just how popular cosmetic procedures have become among our demographic. Between 2005 and 2010, according to the American Society for Aesthetic Plastic Surgery, the number of overall cosmetic surgeries in the United States fell by 17 per cent, but for those over 65 rose almost 30 per cent. This translated to a 2010 tally of 27,000 face lifts, 25,000 eyelid operations, 6,500 liposuctions, 4,000 forehead lifts, 6,000 breast reductions, 3,500 breast lifts and 2,500 breast augmentations for that cohort. Exact statistics are hard to come by in Canada, but anecdotal evidence gathered from cosmetic surgery clinics suggests that our increase is similar, and our figures proportional to the Americans by population – about a tenth as large. (One hard statistic we do have is the number of Canadians who feel “people should age without cosmetic enhancement” – a mere 19 per cent.) The oldest known breast augmentation patient on the planet is Marie Kolstad, 84, of Orange County, Calif., who last July had her breast size surgically increased from 36B to an eye-popping 38D.  “I would love to find a new man,” said Ms. Kolstad, a widow, “but all the men my age want women 20 years younger. I thought I’d better take action so I can compete.”

In fact, doctors and researchers in the field identify several reasons for the growth in later-year cosmetic work; everything from older people in the workplace needing to compete with younger colleagues in appearance-sensitive fields to a simple but powerful dissatisfaction with what we see in the mirror as we age.

Another phenomenon that’s been spiking disproportionally among the over 45 is one that seems to go hand in glove with the growing demand for cosmetic enhancement: and that is divorce.  In Canada, “Grey Divorce”  – a label that Maclean’s writer Anne Kingston says is “itself awaiting a youthful makeover” –  is now the only kind of divorce on the rise. Between 1993 and 2003, the overall Canadian divorce rate declined 11 per cent; among people 50 to 65, it rose almost 40 per cent. The same “surge” is evident in the U.S. (one New York family attorney, Peter Bienstock, says his waiting room sometimes looks like a “geriatric unit”). Britain, Italy, even France – in all these countries, women are surprisingly the predominant seekers of marital dissolution, possibly because it’s women who are most anxious to reconnect with the romantic and relational sides of their lives after their child-rearing responsibilities recede.

For many of these women, the nonsurgical procedures, which involve injections of Botox and fillers and are less costly (with no downtime), have become extremely popular. But these procedures, meant to recreate the volume and smoothness of the youthful face, have also created a new look characterized by a puffy, round face. Even more disturbing is the growing popularity of fillers and Botox with younger women, who can end up resembling, bizarrely, older people trying to look younger. The result is a strange, nebulous middle ground where everyone, regardless of actual age, looks the same – and just as unnatural.  (In New York recently, paparazzi apparently mistook the 25-year-old actress Lindsay Lohan for the 66-year-old singer Deborah Harry, a result of the cosmetic work Lohan has evidently undergone.) The new motive behind all these trends, which appears to be to erase any signs of natural aging at whatever age, is most baffling of all. Especially among younger people, the historical prejudice when it came to looks was strongly toward maturity and sophistication; teenagers didn’t want to be regarded as “just kids” or, worse, to be told how young they looked. When did we all become terrified of age at every stage of life?  If the natural face is the truest face, when did we become so afraid of the truth?

Women, older and younger, happen to be in the pronounced majority – actually, 95 per cent – when it comes to having cosmetic work done. But men are just as capable of going too far. When this happens – whether you see it on the red carpet or at a retirement party – the result is someone who has become a caricature of themselves. Sometimes, this is the result of the relative skill of the surgeon (which is to say a lack of); sometimes, it’s obsession on the part of the individual. We’ve all seen the results: faces that seem perpetually surprised or frightened; eyes too wide, head and cheeks so taut, so smooth as to be blank; the end of visible emotion.

Another pitfall of an excessive desire to look young is the surgery. In an era when nonsurgical options continue to proliferate, surgery is the serious option and potentially even more so for candidates in their 70s and 80s.  There are, granted, 77-year-olds like Mary Graham, a restaurant owner in Thomasville, Ga., who received a face lift and breast implants last year and commented, “I work seven days a week, and the only time I go to the doctor is for plastic surgery.”  But there are also plastic surgeons who point out that general anesthesia is statistically riskier for people over 75, that older patients may take longer to heal and that the results of the surgery may disappear sooner than with younger patients. Marie Kolstad, the 84-year-old with the renovated bosom, notes that her daughter was against her getting implants because of the potential danger for someone her age.

Another paradox of cosmetic surgery is that in wanting to look more like ourselves, we risk ending up looking like someone else. In one famous joke, a 55-year-old woman has a heart attack, is rushed to the hospital and, while on the operating table, sees God. “Is my time up?” she asks him. “No,” God says, “you have another 43 years, two months and eight days to live.” The woman recovers and, to celebrate, decides to stay in the hospital for a face lift, breast implants and a tummy tuck. Released from the hospital when it’s done, she crosses the street and promptly gets flattened by a speeding ambulance. She arrives in heaven, this time none too pleased. “I thought you said I had another 40 years,” she says to God. “Why didn’t you pull me out of the way of the ambulance?”  “Didn’t recognize you,” says God.

That’s one funny side of the argument. The other side belongs to Marie Kolstad:

“In my day, no one ever thought about breast enhancement. But nowadays women go out and never get a second look if they show their age. I find that you have to keep up your appearance physically, even if you just want a companion or someone to ask you to dinner. That’s not going to happen if you don’t have a figure that these geezers are looking for.”

Welcome to the new-old ageism.

Moses’ Zoomer Philosophy — which launched in ZOOMER Magazine in October 2009 — is a series of monthly essays on age and aging, and the secrets and the science to living better, longer, healthier and happier lives. The first volume of his collection is now available in e-book format on the Kobo Books website.  Click here for more information.