Why are so many people opting for cosmetic surgery? Psychologist Marie Murray examines why women are afraid to look their age
In the past six years the number of women who would surgically alter their appearance has doubled. From 10 per cent in 1999, research published by the Harley Medical Group this week has found that as many as 20 per cent of Irish women would consider cosmetic surgery today. What motivates women to choose the rigours and risks of anaesthetic, scalpel and other non-aesthetic procedures to alter their appearance? What do they wish to change? Why, and for whom, do they wish to change? What pressure persuades people to alter their physical and psychological lives?
For it is not just the body that is changed. There are psychological motivations and consequences to altering one's appearance. It is rarely just to change the body that people decide on cosmetic procedures. Motivation can come from obsessive perfectionism, low self-esteem, poor body image, delusions of deformity, fear of ageing, perceived coercion by one's social group, perceptions about the cultural requirements for success, or fear of partner loss through rejection and replacement by younger, firmer, more beautiful women.
Also, unrealistic media representations of womanhood - Lara Croft-type configurations of the human figure - tempt women to endure body alterations far removed from what nature either intended or can sustain in a healthy body. Pursuit of the body beautiful entails liposuction, abdominoplasty, breast augmentation, eye-bag removal, lip enlargement, uplifts and facelifts. Whatever we have, it seems we want to change it to bigger, better, smaller, firmer, younger. Soon, if our statistics on the cosmetically challenged are anything to go by, women will have no ages outside the 20-30 age range, with 10-year-olds looking like 20 and 40-year-olds looking like 30.
Research shows that the most sought-after procedure among Irish women is breast uplift or enlargement. Figure- shaping fat removal and tummy-tucks are popular in the 25-44 age bracket, and many favour wrinkle-eradicating solutions such as Botox.
Apart from cosmetic surgery, there is the fortune we spend on the paraphernalia prescribed by obsessive body- beautiful seekers: the lean, mean, machines of gym and swim and food fads that make the enjoyment of a simple doughnut an occasion of cosmetic sin.
This is not to denigrate healthy living or the normal desire for good appearance. Of course the capacity to alter post-accident injury or deformity enhances the physical and psychological quality of life for those who require it. But is the capacity for mass cosmetic alteration an individual choice or a collective pressure?
Each age group has the potential to divide into those that have or have not had cosmetic surgery, with confusing consequences. For example, while there are those who are chronologically 50 and cosmetically 40, those who naturally look younger will henceforth stand accused of secret cosmetic change. It is a no-win situation for women. For if we alter everyone, we retain everyone in a bizarre arrest of time and denial of reality.
How on earth did age-appropriate appearance become a social disease? How have we created new categories of psychological distress by this fixation on appearance? Because there are many whose requests for cosmetic surgery are psychological in origin, who may continue surgery until they acquire a visage of stretched skin devoid of personal expression. The prevalence of depression, of anorexia nervosa and bulimia and body dysmorphic disorder (BBD), are not unrelated to our obsessive preoccupation with how we look.
The search for beauty is not new, nor is the belief that if one were only more symmetrical of face, finer of feature, slighter of body, tinier of foot, more elongated, curvaceous, attractive or cute, one would live happily ever after. Women have been reared on fear of ugliness. After all, it was Cinderella, the innately elegant, tiny-toed waif who, on short acquaintance, beguiled the prince with her beauty. Only beauty could alter the beast, transmogrify frogs and outwit witches. As for Snow White, every older woman at some point empathises with the bejewelled yet jealous gorgon consulting her "mirror, mirror on the wall" in the vain hope that she has somehow managed to outwit time's ravages. Mirrors are strange things. They reflect not what they see but what we see.
Therein lies the problem - comparison. Beauty is firmly in the eye of the beholder. Different climates, cultures and epochs have different definitions of what a beautiful woman should be. Art galleries are replete with diverse definitions of human beauty. If every era has conformed to what culture dictated, ours is the only era to have had the capacity to chemically or surgically alter our physical being so completely. The Ugly Duckling becomes a Swan on reality TV as women are publicly cloned.
Our relationship with age is ambivalent. We seek to be older when we are younger and younger when we are older, and it is only in grand old age that we proudly declare just how old we are.
So as plastic surgery turns children into women and women into adult Barbies, the question is: who will succumb to surgery and who will give way to age in all its beauteous facial etchings of experience, unafraid to affirm that this life has been lived?
Marie Murray is director of psychology at St Vincent's Hospital, Fairview, Dublin