There is a crease between my eyebrows. It measures about two centimetres but I think about it so much that it might as well be the entire length of the M4. The monstrous self-scrutiny of the compulsory Zoom has, of course, only made this worse. It’s embarrassing to admit but I’ve started googling “Botox near me”.
[Read original Times article here]
I’ve never considered myself the kind of person to go in for this, but then I’ve never been made so miserable by my own face before now. I’m certainly not alone: the last year has seen a surge in demand for injectables and fillers. Clinics have also reported a boom in work on the bits you can’t see on camera. It makes sense: if you’ve been considering a boob job or liposuction but always been deterred by the recovery time, lockdown is the perfect opportunity to get it done.
The way we talk about cosmetic interventions is so breezy — a “tweakment”, a “nip and tuck”. Once treated with secrecy and suspicion, plastic surgery is no longer something to hide. Influencers share the story of their nose job on social media. Your trusty dentist probably offers a sideline in lip-plumping and jowl-lifting. Ask a well-preserved acquaintance for her secret and she won’t give you some flannel about face cream: she’ll just slip you her aesthetician’s number.
This is all normal now, which means it feels safe. The places that promise to erase my crease (technical name: glabellar line) shine with white-coated medical trustworthiness. Why wouldn’t I put my face in their hands? It seems obvious that anywhere offering injectables would be tightly regulated and subject to the most stringent checks. You can’t just go around putting things inside people without the government taking a robust interest, surely.
Presumably the women who had breast implants manufactured by the French company Poly Implant Prothèse (PIP) believed something similar. Only after they’d had the devices sewn inside their chests did the women learn that they contained industrial-grade silicone intended for mattresses, rather than the appropriate medical kind. PIP implants are also more likely to rupture or disintegrate, leaking into the body, causing swelling and pain.
Last week, more than ten years after concerns were raised about their safety, women with PIP implants finally heard that they may receive compensation. Why did it take so long to get to this point? Partly because one of the problems with plastic surgery is working out who’s responsible when it goes wrong. In this case, blame has finally settled on the German company that certified the implants as safe.
For the PIP women, it’s been ten years of anxiety and unhappiness, spiked with self-reproach. One of them, Alifie Jones, told the BBC: “I feel guilty that I messed about with my body and I put them in in the first place.” But the painful truth is that plastic surgery clients are, by definition, vulnerable and deserve protection. Nobody puts themselves forward for cosmetic interventions because they feel completely great about themselves.
Unscrupulous people in the industry take advantage of this. When PIP’s boss (who has since died) was on trial in 2013, he accused women of inventing their symptoms: the same contempt that made it seem acceptable to fill women with mattress stuffing presumably made it seem acceptable to disparage them as fantasists.
Yet this is just the most blatant, Hollywood-villain version of the industry’s disdain for the people it profits from. The 2016 Keogh review, set up in response to the PIP scandal, painted a horrifying picture of underqualified surgeons with inadequate insurance, pressure-selling clinics and an unregulated injectables market. Five years on, some of its recommendations have been implemented — for example, there’s now a registry of implants so patients can be easily notified when faults emerge — but the industry is still woefully under-legislated.
It’s still the case that anyone can administer injectables. There are responsible clinics but it’s up to the client to work out who they are. A bill that would ban giving injectables to under-18s has just gone to committee stage in the Lords. That means that, as things currently stand, it’s legal to perform Botox or fillers on someone aged 17 or younger, who won’t even be fully grown, never mind showing signs of ageing.
Surgery tourism — clients travelling abroad for cut-price operations — has made the situation even murkier. When things go wrong, it often turns out that the company that did the work isn’t insured to cover the damage and the NHS is left to pick up the pieces. As new procedures are invented, so are new dangers and new victims. The next big thing for medical malpractice in plastic surgery is likely to be buttock implants, say lawyers in the field.
And still, a bit of me would take my chances to do something about my crease. Perhaps you disagree that it’s the state’s job to save me from the rashness of my narcissism. To take that position is to take the side of the most exploitative portion of the plastic surgery industry: those for whom self-loathing is just a resource to be rinsed for income.
People who seek cosmetic interventions may be vulnerable but they’re not stupid. These procedures exist because women in particular know that they count for less as youth and beauty fade. When the law won’t give them overdue protection, it too is judging them as worthless.
