In Fiji, the percentage of girls who felt ashamed of their bodies rose from 10% to 30% after the first television arrived in 1995 and one in every ten began forcing herself to vomit. In the developed world, more than half of men and women report feeling sad about their weight, and 2.5 million Americans will die from eating disorders in the next 20 years. Studies show that looking at gorgeous women makes women feel disappointed with their looks and men disappointed with their lives.
What would make you happier: winning the lottery or losing your arms and legs? In the short term, certainly, lottery winners are delighted and paraplegics become suicidally sad, but a landmark US study found that after just one year lottery winners were as miserable as they were before they won, and paraplegics were as cheerful as they were when able-bodied. The implications of this are massive – most people spend their lives trying to be happy, but if these dramatic events don’t make much difference, what does? The answer, for some, may be cosmetic surgery.
A series of studies have found that the majority of people who have cosmetic surgery don’t just feel happy about their treatment, they stay happier for years. It may be because “beautiful people” are simply happier: in 2011, a study of 25,000 North Americans and Europeans claimed that those the researchers rated “highly attractive” were 1o percent happier than those found to be “ugly.” But the link between beauty and mental health is complicated: for people suffering from Body Dysmorphic Disorder, cosmetic surgery will often run into an unending series of unsatisfying procedures, and four separate studies have found that women who get breast implants are much likelier to commit suicide than those who don’t.
Undeterred, the world’s appetite for cosmetic surgery continues to grow. Over 17 million operations took place in 2010 (five times as many as 15 years ago) at a combined cost of US$30–40 billion. Society’s sense of human beauty is likely to change accordingly. Around the world, ideals of attractiveness vary, and body modification can easily become the norm, as it has for the Suri women in Ethiopia (who wear large clay plates inside their pierced lower lips), or women in Mauritania who are force-fed to fatten them up. If you don’t want to go under the knife, you may be better off just finding a place where your face fits in.
“In LA, if you want to be pretty, you can be pretty”
Charlene Case, psychologist, Los Angeles, California, USA
Charlene Case works as a psychologist in Los Angeles, California, a city often described as the world capital of plastic surgery. Three million cosmetic procedures are carried out every year in the USA – more than in any other country in the world. Nine out of ten of those operations are performed on women.
“When I was growing up in the 1960s, classic Swedish blondes were what was considered beautiful, but I’m one-quarter oriental and had oriental eyes. I cried on my mom’s shoulder to let me get plastic surgery. My parents didn’t have much money, but in the end she paid for it, and in the process of fooling around with the facelift, the surgeon cut a nerve and paralyzed the left side of my face.
“I couldn’t close my eye for a year. It was very, very painful. I had to cover it with this thick, oozy stuff every night to keep it protected while I slept. In three years the nerves grew back, but my left eye still doesn’t blink much. All that vanity. There I was dissatisfied with my looks, and suddenly all I wanted to do was close my eye.
“Here in LA, if you want to be pretty you can be pretty, and I think that’s fine. Everyone’s doing it, so why not? Some people go overboard with perfection and will never be satisfied, but I think anything that makes people accept themselves more is great. As a psychologist, I tell my patients they can change their brain’s biochemistry by accepting themselves. Accepting who they are raises their serotonin, and anxiety will flood them with protezone.
“I’ve been married five times. I’m an idealist – maybe too much of an idealist and not enough of a realist. I always felt that marriage has to be perfect, but if life gives you lemons you better learn how to make lemonade. You can’t change the cards that are dealt you, just play them the best you can. Sometimes I wish I had had children, but if I did my life over again I’d do it the same. I wouldn’t change anything.”
What should you change?
The “facial feedback hypothesis” argues that emotions are strongly influenced by facial expressions. In a 2006 US study, 10 women with untreatable long-term clinical depression had Botox injected into their foreheads, making it physically impossible to frown. Two months later, nine were no longer depressed, and the tenth had much improved.
Three out of four women who have cosmetic surgery say that their overall quality of life is higher afterwards, and this quality of life is most improved for those who have breast augmentations. One study followed 25 women undergoing psychiatric treatment before their operations; afterwards, all but three stopped therapy.
Tummy-tuck patients report an increase in their happiness second only to those who have breast augmentations. Have liposuction with it, however (known as a “lipo-tuck”), and you face the risk of post-liposuction depression – a recognized condition about which cosmetic surgeons warn their patients. No one knows why it happens.
Two-thirds of men suffer substantial hair loss before the age of 35, and balding, particularly in its early stages, is a major cause of depression. Hair implants transplant hair from the legs and back to the head, and prices are calculated on a per-follicle basis.
With over 60,000 procedures a year, Iran is the nose-job capital of the world. Costing 18 million rials (US$1,500) on average, the procedure carries status, and post-surgery bandages may be worn for months like a badge of honor. Some even wear the bandages without undergoing the surgery.
One in 4,000 people feel that they are trapped in a body of the wrong sex. Gender dysphoric people are especially vulnerable to depression, and a 2010 US survey of 7,000 transsexuals found that 41 percent had attempted suicide. Following gender-reassignment surgery, former emotional problems are found to be drastically reduced.