On Culture

Plastic Surgery's Allure Cuts Both Ways

Beauty's only skin deep, but that's good enough for many: Dr. Terry J. Dubrow preps a woman for surgery on Fox's reality show
Beauty's only skin deep, but that's good enough for many: Dr. Terry J. Dubrow preps a woman for surgery on Fox's reality show "The Swan." (By Robert Voets -- Fox)
By Robin Givhan
Washington Post Staff Writer
Sunday, November 18, 2007

The death of hip-hop artist Kanye West's mother following plastic surgery has once again unleashed our demons -- at least the ones that focus on our dysfunctional relationship with beauty.

Surgeon Jan Adams has said he performed a tummy tuck and breast reduction on Donda West, who died last week. What followed was an avalanche of gossipy speculation, a media scavenger hunt for court documents, arrest records and unhappy patients, and a seamy display of coldheartedness in the face of one family's tragedy.

As the public conversation moved from the specifics of West's death to a more general dialogue, the underlying message became that indulging in plastic surgery is inherently selfish and narcissistic. In short, we seem to believe, the patient is courting tragedy by her unwillingness to age gracefully, lose weight through diet and exercise or get a grip on her self-confidence issues through therapy. This is a culture that craves so-called easy answers and then assails those who take them.

As plastic surgery has become more accessible, even to those of modest means, it has become both a way of combating cultural prejudices, as well as exacerbating them. Giving in to youth culture has its rewards -- job opportunities, financial gain, flattery. But it also makes the emphasis on youth even more inescapable.

With all of Hollywood nipped and tucked into ageless perfection, "perfection" has become the standard. Who wouldn't be speed-dialing a plastic surgeon in a panic?

The Internet is clogged with derisive commentary about which celebrities are looking old or unappealing. But it is also filled with speculation about which celebrities have had work done -- and how terrible it is. Celebrities are trapped: mocked if they look bad, mocked for trying desperately to look good.

Increasingly, that standard applies elsewhere, too: in the boardroom, in politics, in suburban neighborhoods.

In the last week, plastic surgeons have cranked their public relations machines into high gear explaining the risks of cosmetic procedures while also touting their safety. One medical expert helpfully noted that despite the widespread availability of cosmetic surgery, it was probably not a good idea to sign up for major surgery at a mall.

Yet despite the popularity of cosmetic surgery, West remained, on the surface, an unlikely candidate. She had not developed a reputation for partying with her famous offspring or of being more enamored of the loot that her son could bring home than with his well-being. She did not appear to be a stage mother living vicariously through her son's success. She was, instead, a former English professor at Chicago State University. Academia comes with its own set of stereotypes, of course, not the least of which is the assumption that its acolytes are completely uninterested in anything pertaining to fashion or style.

And there is also the issue of ethnicity. Of the 11.5 million cosmetic surgery procedures performed last year on men and women, only 6 percent of the patients were African American, according to the American Society for Aesthetic Plastic Surgery. Black women are less likely than whites to compare themselves with the Hollywood, fashion magazine, air-brushed standard of beauty.

So how is it that this black academic, who left the university life in 2004 to run her son's literacy foundation, decided to have cosmetic surgery?

There's no way to know what was going through West's mind. But her death makes one marvel at the way in which popular culture pushes, pushes, pushes people toward an ideal. And then tut-tuts when they take the bait.

No matter that the most conscientious surgeons emphasize that cosmetic surgery cannot transform a patient's life, the promise remains. With a snip and a tug, faces can be made younger and more attractive. The patients believe they will not only look better but also feel better, which will lead to greater confidence, which will strengthen their cultural currency.

Audiences like nothing more than a beauty makeover. The ugly duckling turns into a swan. Cinderella got a fairy godmother of a stylist and won the heart of the prince. It was beauty that charmed the beast -- not the young woman with the scintillating personality.

But beauty makes folks envious. They want to be assured that others work hard to maintain their appearance (even if they're looking for the easiest ways to maintain their own). Consider the notion of aging gracefully. What does that mean, really? Folks are demanding that the enduring beauty of matrons and dowagers be earned. They want them to maintain a six-day-a-week workout schedule that includes walking on a treadmill to nowhere and a life that is devoid of meat, dairy, alcohol, sunshine, sugar and anything else remotely pleasurable. Is that natural? Is that grace?

There are virtually no women who have the genetic good fortune to arrive at age 60 looking like a Catherine Deneuve, Sophia Loren or Diahann Carroll without a surgeon's expertise. Most people in the public sphere do something, Botox to boot camp, to fend off the effects of time. They are encouraged and expected to take action. If they don't, they will be judged harshly. But they must take care not to let the effort show -- don't reveal any hairline scars or improbable perkiness. Otherwise, our judgment will be even harsher.

© 2007 The Washington Post Company