In plastic we trust: America's love of cosmetic surgery and credit cards

By Laurie Essig
Friday, January 7, 2011; 8:30 PM

It's only a week or so into January, and I already feel fat and broke. I've tripped over all my resolutions and self-improvement plans for the year ahead. No refined sugar? Out the door with that Jan. 2 avalanche of dark-chocolate-covered cherries. I haven't been to the gym yet. And as for spending less and paying off my credit cards? I can't even think about it until the post-holiday sales are over.

This doesn't mean I will give up. Nor will everyone else who finds that when it comes to resolutions, willpower falls short. Instead, we must remember the sage advice that Mr. McGuire gave to young Ben Braddock, played by Dustin Hoffman, in "The Graduate": "I just want to say one word to you. Just one word. . . . Are you listening? . . . Plastics."

In our case, two varieties of plastic are coming together to give us hope - plastic credit cards and plastic surgery. These plastics feed our insecurities even as they dazzle us with promises. If there's one thing we Americans are brilliant at, it is deluding ourselves into thinking that we can make the future better than the present. And credit and plastic surgery offer tantalizing shortcuts.

Nineteenth-century sociologist Max Weber traced this American obsession with self-improvement to a "Protestant ethic" that became the motivating force of capitalism. Bettering ourselves, increasing our wealth and well-being, is the most sacred and American of acts.

But that was then; this is now. Today, we imagine our wealth as a result not of hard work, but of good luck and good looks. And we imagine that the best way to achieve a more beautiful self is not through the eternally elusive discipline and self-control, but through surgery.

According to the American Society for Aesthetic Plastic Surgery, Americans are still turning to cosmetic procedures despite the economic downturn. Indeed, 2009 saw only a 2 percent decrease in the number of cosmetic procedures in the United States compared with the year before - and a look at the past 13 years shows an increase of 147 percent. (Liposuction remained the most popular procedure for men and the second most popular for women, right behind breast augmentation.)

In researching this subject over the past few years, I spoke with 137 people considering cosmetic surgery. Most of these patients were female, white and middle-aged, matching the general trends for cosmetic procedures. But what surprised me - and what runs counter to the "Real Housewives" parading on our television screens, freshly eye-lifted - is that these women were not rich, not even close.

They were nurses and cops, schoolteachers and real estate agents. According to a 2005 survey, almost 30 percent of cosmetic surgery patients earned less than $30,000 a year, and an additional 41 percent earned between $31,000 and $60,000.

And like 85 percent of all cosmetic surgery patients, the people I spoke to were paying for their procedures with debt, often specialized medical debt available through physicians' offices with interest rates as high as 30 percent. Americans already put about $45 billion in medical procedures on our credit cards, and that amount is expected to triple by 2015.

And it isn't vanity or the delusion that they will become extraordinarily beautiful that pushes ordinary Americans to take on debt and undergo major surgery. It is insecurity - insecurity in the job market and insecurity in the love market. As the vast majority of Americans became worse off financially, they also became less secure in their relationships. And Americans are now almost as likely to be unmarried than married.

As Toni, a 55-year-old beautician, told me, she was considering a face-lift and a second round of breast implants because "by the time you're 50, you might as well be dead. If I was married, then nah, I wouldn't be doing this. If my husband loved me the way I was - but that's not reality, is it?"

By contrast, I spoke with a doctor in his 30s who was considering getting hair implants - but decided against it because he was married.

Even if you don't spend a lot of time with people who get cosmetic surgery, you probably have seen the phenomenon on TV. Watching boob jobs on the boob tube, we can see the desperation that a lot of Americans feel to enhance, improve, upgrade. Take a look at "Bridalplasty," the newest cosmetic surgery reality show. It pits young brides against one another to win nose jobs, lipo and, for the last Frankenbride standing, a glitzy "dream wedding."

These women really believe that a perfect body and a perfect wedding will lead to a better future, a way out of their economic and emotional ruin, their dead-end jobs or their chronic unemployment. Just like the women I interviewed. You can feel smug about their desperation, laugh at them for being so shallow, but in fact, cosmetic surgery is as American as apple pie.

In a sense, they've hit upon a sad, sobering truth. They can't - not on their own, anyway - force the sort of structural changes that can create equal access to education, livable wages and secure retirements. But they can pay for new breasts with their credit cards, finding a plastic fix for one specific insecurity in a moment of insecurity everywhere.

Laurie Essig is a professor of sociology at Middlebury College and the author of "American Plastic: Boob Jobs, Credit Cards, and Our Quest for Perfection."

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