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Beauty Junkies: Under the Skin of the Cosmetic Surgery Industry
by Alex Kuczynski
Vermilion ₤7.99, 304 pages
FT bookshop price: ₤6.39

”Looks are the new feminism, an activism of aesthetics. As vulgar and shallow as it sounds, looks matter more than they ever have - especially for women.” Such superficiality is depressing. It’s a contemporary obsession Alex Kuczynski elucidates in Beauty Junkies.

Looks matter so much that the global cosmetic industry is worth about $20bn, reports Kuczynski; in 2005 the US cosmetic industry ”constituted $13bn to $15bn a year” (the book is very US-centric). So just what drives this apparent right to beauty that so many of us now feel we have? What are our entitlement issues when it comes to a wrinkle-free existence, with pert breasts that bear only tiny scars to show how we came by them? Why, in 2004, did 478,251 Americans feel the need to have liposuction, now the most popular treatment (the figure is up from 372,831 two years previously), 334,052 to have breast augmentation (up from 248,641 in 2002) and 166,187 to have nose jobs (no prior figure given)?

Kuczynski does a fine job of trying to explain this. She is thorough, and takes the reader from cosmetic surgeons’ offices to plastic-surgery conventions. Her writing is vivid and often amusing. At one conference, she recalls a sales rep explaining that women prefer the breast implants that look the most rounded, the most unrealistic: ”’I don’t know why, but they like the fake shape,’ the salesman says, bouncing a breast implant in his hand. It makes gentle thwack-thwack noises as it lands, bonds briefly with his sweaty palm, and lifts up with a slight sucking noise.”

Kuczynski explains how Botox works, the different kinds of face lifts that are available and looks seriously at the industry - from the difficulties with regulation to surgical fatalities (including the case of Olivia Goldsmith, author of The First Wives Club, who died from complications arising during chin-tuck surgery). She even describes a former cosmetic surgeon’s quest for the mathematical formula for beauty. This same former surgeon studies Kuczynski’s face, which the jacket picture shows is nothing to be worried about, and hilariously says: ”But I gotta tell you, your eyebrows aren’t doing you any favours.” Incredibly, she takes the comment to heart.

This is an important point about the author, and one that she does not make clear until close to the end of the book: she was, herself, a cosmetic-surgery junkie. She worked her way up from Botox to liposuction to eyelid-fat removal and the injection of Restylane (at the time a substance that ”had not been approved for any human use by the Food and Drug Administration. Doctors simply bucked FDA restrictions and had the drug shipped from abroad”). That last procedure caused what she calls an ”exploding” lip. And yet her tone is never jarring. It helps make sense of her complex subject: an industry that merges surgery with salesmanship.

In a chapter entitled ”The Breast”, Kuczynski sums up the quest for surgical enhancement, particularly in this area, thus: ”In the end, it all comes down to sex.” Later she expands: ”We are looking for love. And we will accept lust.” In part she blames the rise of pornography: ”On MTV’s Real Life: Plastic Surgery, girls want to look like Pamela Anderson, not Kate Moss: this is porn talking.” I am sure she has a point. But I wish she’d explored the possibility that reproduction could also be a factor. Do women want to look younger so they look more capable of childbearing and, thereby, more appealing as a mate?

And what effect has the loss of religion - the triumph of the here and now over the hereafter - had on our self-obsessions? Though she touches on the increase in the ageing population, I wonder about the effect that rising life expectancy has on our perceptions of age. I stopped caring about wrinkles when my father died, but friends who are 20 years older, but who still have their parents, happily obsess about those physical markers that signpost the route to death. I look at the ravages of time with interest - they are the visible terrain of our lives; they are, effectively, our memories.

Regardless, Kuczynski writes about a driving superficiality of modern life with depth and consideration; she is now a cosmetic-surgery abstainer.

Edwina Ings-Chambers is the FT’s deputy fashion editor.

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