For many doctors and their patients, plastic surgery is about so much more than appearance. The real effects of plastic surgery and cosmetic treatments are seen every day on RealSelf, where thousands of patients share their personal stories of procedures that renew confidence, rebuild physical ability, and affirm identity. For our Beyond Beauty campaign, our community of patients, editors and doctors shows how beauty is just the starting point for so much more.
When I first considered working at RealSelf, I had a knee-jerk reaction to plastic surgery. Everything about the company seemed great, but as I scrolled the site’s very real before and after photos and read up on procedures I was surprised to learn even existed, I wasn’t sure I wanted to make aesthetic medicine my bread and butter. As a writer here, I knew I wouldn’t be able to detach my role from the industry it supports. I would think about procedures all day and create content to entice other people to think about procedures. My byline, and therefore my name when I’m Googled, would become attached to breast implants and vaginal rejuvenation.
I was already working in the beauty industry before landing at RealSelf—and not without qualms about doing so. In the midst of newly marketable and mainstream feminism, I loved working with brilliant and creative women on projects that were wholly for women too. For the first time in my life, I experienced beauty as not only a series of top-down mandates but something to be created and innovated and that was straight-up fun. At the end of the day though, I was selling people skin care and makeup they didn’t really need by convincing them that they did. It was all dependent on the long-held notion that women could not merely exist as they were but had to improve, improve, and improve some more. Even if (especially if) they enjoyed it—often under the guise of self-care and “You do you.”
Why do we willingly sign on for the endless pursuit of beauty? In Perfect Me: Beauty as an Ethical Ideal, philosopher Heather Widdows argues that our increasingly global dominant beauty ideal (the set of standards including thinness, firmness, smoothness, and youthfulness of face and body) is bound up in our moral sense of self. “It provides a shared value framework against which individuals judge themselves morally good or bad,” Widdows writes. “It is constructive of identity and provides meaning and structure, individually and collectively.”
The beauty ideal is both demanding and rewarding. Time, money, and effort are spent daily on attempts to look certain ways. A slate of popular editorial series, including Into the Gloss’ “The Top Shelf” and Glamour’s “What It Costs to Be Me”, glorify individuals’ monumental spending in the name of beauty. Aligning with beauty standards promises desirability and employability as well as, more broadly, what Widdows calls “the goods of the good life.” Beauty has long been tied up with social and economic potential under capitalism and the patriarchy, and today we see this very explicitly play out among Instagram influencers, for whom follower count and brand sponsorships—aka their social status and income—depend directly upon the quality of their selfies.
The way we reconcile with a system in which we must diet, shave, wear makeup, and blow out our hair in order to have worth is by believing those behaviors are of our choosing, perhaps even believing that we find pleasure or satisfaction in them. Choice in beauty, from lipstick color to breast size, can make us feel like we are in-control decision makers, finding ways to express our true identities—especially as brands become more transparent and align themselves with clear values (cruelty-free, vegan, green, clean). As Jia Tolentino writes in the essay “Always Be Optimizing” in Trick Mirror: Reflections on Self-Delusion, “The ideal woman always believes she came up with herself on her own.”
That choice is an illusion at best and a manipulation at worst. In the 2006 movie The Devil Wears Prada, fashion magazine editor-in-chief Miranda Priestly (Meryl Streep) excoriates personal assistant Andrea Sachs (Anne Hathaway) in front of their team for thinking she’s above the whims of the fashion industry:
“You go to your closet and you select out that lumpy blue sweater, for instance, because you’re trying to tell the world that you take yourself too seriously to care about what you put on your back, but what you don’t know is that that sweater is not just blue, it’s not turquoise, it’s not lapis—it’s actually cerulean. And you’re also blithely unaware of the fact that in 2002, Oscar de la Renta did a collection of cerulean gowns. And then it was Yves Saint Laurent who showed a collection of cerulean military jackets, and then cerulean quickly showed up in the collections of eight different designers. Then it filtered down through the department stores and then trickled on down into some tragic Casual Corner, where you no doubt fished it out of some clearance bin. However, that blue represents millions of dollars and countless jobs, and it’s sort of comical how you think that you’ve made a choice that exempts you from the fashion industry, when in fact you’re wearing the sweater that was selected for you by the people in this room.”
Beauty, like fashion, cannot simply be opted in to or out of. As sociologist Tressie McMillan Cottom explains in the essay “In the Name of Beauty” in Thick: And Other Essays, “There aren’t any ‘good’ preferences. There are only preferences that are validated by others, differently, based on social contexts. These contexts should not just be reduced to race, class, and gender, as important as those are. Institutions that legitimize the ‘right’ ideas and behaviors also matter. That’s why beauty can never be about preference. ‘I just like what I like’ is always a capitalist lie.”
It’s easier to believe you’re developing and representing yourself in your beauty preferences because choosing not to choose isn’t really an option. Even if you decide not to adhere to standards of the beauty ideal, the society around you will. Your opposition can only be defined in relation to the standards you’re rejecting, giving them power regardless. The costs of not conforming land squarely on the individual. Depending on your genetic starting point, life may go along swimmingly or you may be passed over for a job (per the well-studied attractiveness bias) and have your profile swiped left on Tinder.
Contemporary women’s media would have us believe that beauty standards are being overturned left and right. We do see pimples, wrinkles, body hair, stretch marks, cellulite, and belly rolls now, but it’s difficult to feel too optimistic when the applause goes to brands for showing these real body features in their marketing campaigns. Knowing that, in a post-Fenty Beauty world, a brand will get publicly condemned for releasing a narrow range of foundation shades, the cynic in me can’t help but see expansive releases from otherwise unprogressive brands as a mere attempt to shore up profits. It’s not that these changes shouldn’t be happening, but we should acknowledge that they are the commodification of inclusivity rather than inclusivity itself. The boundary lines of the beauty ideal are broadening because there’s money to be made. As McMillan Cottom writes, “Our so-called counternarratives about beauty and what they demand of us cannot be divorced from the fact that beauty is contingent upon capitalism. Even our resistance becomes a means to commodify.”
Because our culture is so visual, the images we’re surrounded by influence our perception of the world. Like with the blue sweater, if you’re subliminally fed enough of a trend, that trend can blend seamlessly into your own taste. While in India with ReSurge International, a nonprofit that provides reconstructive surgical care in developing countries, on behalf of RealSelf, I disturbingly caught a Western body-positive advertising trend dictating my aesthetic understanding. A teen boy’s burn scar manifested as a striking pattern of hypopigmentation on his neck, from chest to chin, the area he was injured now a mottled pink against his otherwise deep-brown skin. Having seen models with similar-looking vitiligo increasingly featured across the promotional emails and social media campaigns of more than a handful of direct-to-consumer lifestyle brands (whose Instagram grids can play like body positivity Bingo), my eye had been trained to find this contrast beautiful, particularly since I was working as photographer for the trip. My first urge was to snap his photo, my second to listen to his story. His body was another in line for consumption. Meanwhile, he lived his life in high-collared shirts to hide his affected skin and was seeking treatment for the traumatic injury.
While focusing on cases where something has gone wrong, the E! reality series Botched actually captures a wide range of motivations for plastic surgery. On any given episode, sure, you’ll see over-the-top obsessives seeking a totally fake look (their own words often include “cartoon” or “Barbie doll”), but you’ll also see people whose lives are held back by something they’re uncomfortable with on their bodies, whether due to genetics, an accident, or an ill-advised decision. There are social and economic implications to not being able to live life fully, to being fixated on one physical feature to the point where you see nothing else or perceive yourself as nothing more than the sum of your features. Under the beauty ideal as an ethical ideal, failed beauty is shameful, reflecting you as a failed person. Stating this circumstance is not condoning it; rather, by acknowledging it, we can begin to understand it and undermine it.
The personal stories individuals post to RealSelf have completely reframed my perception of plastic surgery. Surgical procedures and aesthetic treatments are restorative and transformative in the lives of patients, whether pursued as cosmetic or reconstructive. Theory and criticism, while helpful for contextualization (and my own comfort), are inconsequential to the lived experiences of patients if, unable to extricate themselves from the beauty ideal’s powers, they must shoulder its burdens personally. Because I fall in line with the general standards of the ideal, contemplating beauty can be an intellectual exercise. I have the privilege of thinking abstractly: As a 28-year-old, decently fit, able-bodied white woman, I’m someone whose body has never been policed as “other” or has yet to change much with age, childbirth, illness, or accident. My body and face still feel like my own, still feel like me. But I read RealSelf member reviews from people who either dissociate their bodies from their personhood or feel like a less valuable person because of their appearance. A common refrain post-procedure is “I finally feel like myself,” sometimes with “again” or stated as if for the first time. You cannot tell a person they do not deserve that. A fulfilled sense of self isn’t vanity.
“The beauty ideal is self-defeating over time—ultimately we all sag, wrinkle, and die—but nonetheless the ideal, like other ideals, provides meaning and identity,” writes Widdows. “It gives life goals to strive for and daily practices by which to structure our lives.” I’ve chosen to structure 40 hours a week of my professional life around the cultural pursuit of beauty, not to mention the countless personal hours dedicated to my own pursuit, because I’d rather continue to critically examine—and try to push toward change—the persisting beauty ideal than hopelessly disengage. Blind participation is reductive and limiting, but so is absolute dismissal. Belief in the possibility of better is belief in continuation, expansion, and evolution. I like to think it’s a form of love. For all the individuals who’ve spent lifetimes improving in its name—that is, all of us—it’s beauty that can be better.
