Recently, there have been a host of TV programmes on the topic of cosmetic surgery. ‘The more extreme, the better’ seems to be the mantra of these popular shows, which include Extreme Makeover, the Swan, Botched and 10 Years Younger. The radical transformation of ageing women’s bodies into younger, sometimes unrecognisable versions of their former selves is beguiling to watch, and the viewer is often drawn into such programmes with mixed feelings of disgust, empathy and awe.
But as entertaining as these programmes may be, underlying them is the troubling reality that cosmetic surgery is becoming increasingly commonplace. This may not be immediately apparent– not every patient has the time, money, or TV endorsement to have the full works done. Yet the statistics of the ASAPS* reveal the rise in procedures being carried out each year, including a 427% increase in the number of women having surgery in 2014 since 1997.
One of the most popular treatments on this list is breast augmentation. This is somewhat surprising, given the ongoing recalls of breast implants – only in 2012 the French PIP devices were deemed unsafe. The dangers of faulty implants and other complications such as capsular contracture (a painful side effect in which scar tissue forms around the prosthesis, causing the breast to harden) have been well known to the public for some time. Why, then, are women still choosing to have surgery, and to pay good money (around £5,000) for it?
Breast augmentation, as we know it today, has only been around these last few decades. The first silicone implants were invented in 1963, but the practise only became commonplace with the commercialisation of cosmetic surgery in the 1980s. Raised awareness of breast cancer also contributed to the increased use of implants in reconstructive procedures. Yet the majority of operations (around 80%) were carried out on otherwise healthy breasts.
When breast augmentation was first marketed to the public in the 1980s, the procedure attracted much attention and excitement. A buoyant economy along with women’s increased participation in the workplace meant implanted breasts were seen as a status symbol. Underneath their shoulder padded suits, London’s power women boasted spectacular breasts to match, their femininity protruding proudly in an otherwise masculine environment. The surgery was widely endorsed by women’s magazines, with Cosmopolitan claiming that augmented breasts ‘had a better contour than the real thing!’ The release of the Wonderbra in the early 1990s only perpetuated the gravity defying look of artificial breasts.
Yet after what became known as the ‘silicone scandal’, the enthusiasm for augmentation began to wane. In the early 1990s, reports began to emerge of women suffering from autoimmune diseases, and there were fears over a possible link between implants and breast cancer. In the ensuing court cases, it became apparent that the medical devices had not been sufficiently tested, and in 1992, the American Food and Drug Administration withdrew silicone implants from the market. Although the devices were never banned in Britain, the high publicity of the scandal had its recumbent effects, and the popularity of the operation dropped.
Nonetheless soon implants rose once more, becoming ubiquitous with a particular client in Britain – the glamour model. Anyone who has ever looked at page 3 of a 1990s run of The Sun will know that ‘bigger, the better’ operates as the general rule. In a press interview, Jodie Marsh was quite open in her competitiveness to go bigger than her model rivals by having her chest augmented to a 32 GG. In a strange continuation of the logic of the 1980s, women were furthering their careers by going to work on their bodies.
Still, the association of implants with glamour modelling – as opposed to the high flying ‘power women’ of the previous generation – led to a revision of breast aesthetics. Surgeons and implant manufacturers didn’t want their market restricted to the sex industry alone, or associated only with borderline sex work. In order to appeal to other consumers, advertisers began to promote a more ‘natural’ look. This culminated in the introduction of the teardrop shaped implant in 2007, around the same time the FDA lifted its ban on implants in America.
Since then, the industry has bounced back with surprising alacrity. This is partly due to the variety of implants now available – which stress consumer choice. With shapes ranging from the ‘natural’ to the ‘burlesque’, there is something for everyone. But is there really much choice involved here?
Returning to the TV programmes of Extreme Makeover et al, these work on the premise that the viewer can place themselves at a distance from the contestant. She (or sometimes he) always begins the programme looking much older or worse off than they ought for their age. As viewers, we gain satisfaction in feeling we haven’t reached the same state as to require radical surgical intervention. But as media scholar Meredith Jones argues, these shows serve to regulate and normalise the practise of cosmetic surgery. There is an element of shame in having surgery, but it is acceptable as long as any changes are carried out discreetly. These days young girls can have something ‘fixed’ without garnering too much gossip or negativity from the people surrounding them. Though it may be noticeable or even discussed by curious friends and neighbours, nobody would get ostracised or questioned anymore.
So look around you – more people have probably had surgery than you’d suspect. It’s all in the figures.
*American Society of Aesthetic Plastic Surgeons