Ugly Beauty (25 page)

Forty years later, however, the daughters of those
Victorian wives had become lipsticked suffrage marchers who, as everyone knew,
would sooner rather than later have their way. And Helena Rubinstein, rich,
independent, self-made, eye-poppingly chic, and sheathed in a seamless shell of
creams, powders, and paints, both offered an image of what was possible and
provided the means of getting there—or at least of taking a step along the
way.

The problem, however, with products that are of a
particular moment is that they tend to date. Economically, today’s women have
never been freer. In that sense we are still living in Rubinstein’s world. But
cosmetics have moved on dramatically since Madame, in her heyday, was the
constantly visible face of Helena Rubinstein. It was Eugène Schueller’s
scientific laboratory, not Helena Rubinstein’s kitchen, that would hold the key
to the cosmetics future.

II

D
uring the
twentieth century, dreams that had for centuries been the stuff of fairy tales
one after another became reality. Airplanes gave us magic carpets; automobiles,
seven-league boots. The telephone let us speak across continents; radio and
television showed us all that was happening in the world, often at the moment it
happened. Most recently, the Internet has granted us instant, universal
knowledge. And although immortality is still beyond us, the beauty business
offers a consolation prize. What (Freud famously inquired) do women want? Madame
Rachel could have told him: to be beautiful forever. And today, beautiful
forever is, up to a point, ours. When, in 1935, a reader wrote to the author of
Skin Deep
inquiring about Helena Rubinstein’s
“Herbal Tissue” cream, retailing at $1.25 and supposed to “prevent or heal
lines, crepy eyelids and crows around the eyes,”
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the answer was: “There is, alas, no cosmetic known capable of
doing the things described.” Today, however, that is no longer true.

Skin creams are still most people’s first line of
defense. And these days, they
can
have some slight
effect. In April 2007, research carried out for the BBC television program
Horizon
, investigating the antiaging industry, found
that although most creams left wrinkles wholly unsmoothed, one did, over time,
make a slight, but measurable, difference: No. 7 Protect and Perfect Serum, a
proprietary brand of the British pharmacy chain Boots, and at £16.75 ($27) for a
30ml jar, one of the cheapest products in the survey. Within twenty-four hours
of the program being broadcast, sales jumped 2,000 percent. Customers queued
outside branches of Boots at five the next morning. In Yorkshire, there was a
near-riot when one woman bought a store’s entire stock. Within two weeks what
had been a year’s supply of the lotion was bought up, and single jars sold on
eBay for up to £100. Today, in time-honored style, the Protect and Perfect
family has expanded to include day cream, night cream, beauty serum, intense
beauty serum, and a range of products for men. Why stop at one product when
twelve will do?

The secret of Boots’ cream is a vitamin A compound
called retinol, which increases the production of two important components of
the skin, glycosaminoglycan and procollagen. Creams today also use hyaluronic
acid, or hyaluronan, a component of connective tissue that cushions and
lubricates, and their advertising heavily emphasizes scientific certainty. Thus,
L’Oréal’s Youth Code skin cream is “Inspired by the Science of Genes.” But the
scientifically active ingredients in such creams, although present, are a
vanishingly small proportion of the whole—far less than the quantity required to
produce any noticeable effect. As Liz Walker, proprietor of the House of Beauty
in Barnsley, Yorkshire, put it, “A pampering facial or a nice cream is all very
well, but it’s not going to make those wrinkles completely disappear, is
it?”
10

If the cream doesn’t do the trick, however, new and
effective resources are now available. We can either go deeper, with plastic
surgery, or iron out wrinkles with “cosmoceuticals.” In 2006, the number of
cosmetic procedures, both surgical and noninvasive, was estimated at well over
21 million worldwide. By 2015, the American Society of Plastic Surgeons expects
its members to carry out 55 million such procedures annually in the United
States alone.
11
The market, valued at nearly
$14 billion in 2007, is growing at $1 billion a year.
12
On-demand shape-shifting has become one of the passions of the
new millennium.

Plastic surgery is not new. As long ago as 2000
B.C.
, doctors in India repaired noses
disfigured by disease or punishment. But until antiseptics and anesthesia made
operations relatively painless and safe, it was used only in extreme cases.
Toward the end of the nineteenth century, it gained ground: plastic surgery was
one of the treatments Helena Rubinstein investigated on her whirlwind tour of
European skin specialists in 1905, along with chemical skin peels and other such
scientific innovations. But these treatments were expensive and often risky. In
1921, the American heiress Gladys Deacon, whom the press dubbed the world’s
loveliest woman, and who was certainly one of the richest, had paraffin wax
injected into her face to correct a small indentation at the bridge of her nose.
She hoped to achieve the profile of a Greek statue, but unfortunately for her
the wax slipped, leaving her with an incipient horn on her forehead and a
swollen neck where the wax had run down under the skin. It was a catastrophe
from which neither she nor paraffin-wax treatments ever recovered.

As so often, military requirements nudged the
science forward. Wars destroy many faces, and doctors such as Jacques Joseph in
Germany during World War I and Archibald McIndoe in Britain during World War II
were both made famous by their pioneering techniques in reconstructive surgery.
Inevitably, these were soon co-opted by the beauty business. After World War I,
another pioneering plastic surgeon, Sir Harold Gillies, wondered if it might be
possible to make a living out of private plastic surgery. The answer, as he soon
found, was yes. He neatly summed up the difference between his new field and his
old: “Reconstructive surgery is an attempt to return to normal; cosmetic
surgery is an attempt to surpass the normal.”
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But while comparatively few people, at least in peacetime, need reconstructive
surgery, almost everybody would like to look better than they do, and many are
happy to pay for the privilege.

Today, surpassing the normal has become so
run-of-the-mill that to age unretouched seems almost a form of obstinacy. The
website of one London cosmetic-surgery practice offers a body map: click on the
appropriate part to choose your preferred procedure. Face, ears, arms, hands,
breasts, abdomen, genitalia, hips, legs, skin—all can be altered, and,
hopefully, improved. You can indulge in medical tourism: see Prague (or Warsaw,
or Rio) and get your tummy tucked while you’re there. The
New York Times
even published a restaurant-type guide to Rio
doctors, giving prices, specialties, booking advice, and handy hints: “Dr.
Müller is known for, among other things, sculpturing beautifully shaped breasts
and performing body liposuction. If you’re looking for an aggressive makeover
this is not the place for you: Dr. Müller specializes in the natural look.
. . .”
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Doctors tout themselves
online, publishing testimonials from grateful patients and employing media
consultants to promote their public image—not only in America, where this kind
of thing has always been allowed, but in Britain, where it very much has not. An
old-school plastic and cosmetic surgeon I spoke to—he didn’t want to be named,
I’ll call him Peter—thought advertising for cosmetic surgery “the pits: you used
to get struck off by the General Medical Council for that kind of thing.”
However, even where there is a prohibition, doctors get around it: all they need
do is belong to a clinic, which does the advertising for them.

So fundamental, indeed, has body altering become to
our lives, and so fascinating are the possibilities, that watching it in action
has become a component of prime-time television. In programs such as
Extreme Makeover, Nip/Tuck
, and
Ten Years Younger
, unreconstructed subjects undergo transformation
by a team of experts—the dentist, the hairdresser, the boob man, the nose man,
the stylist-cum-cheerleader—into another person altogether. The original
subject—the clay, so to speak—exists only as raw material: the Before. The
wizards do their stuff, and—shazam!—a new woman or man is born, all their own
work. Pygmalion and Frankenstein live!

I asked Peter if he felt like a sculptor when
remolding people’s faces and bodies. He said he did. A lot of his colleagues, he
said, are (as he is) painters or sculptors in their spare time—that was often
what first attracted them to this branch of surgery. Indeed, he feels artistic
skills so necessary to plastic surgeons that he set up a course called
“Sculpture for Surgeons.” In it, seven or eight plastic surgeons are given a
ball of clay and told to model the head of a sitter—something they do not, at
first, find easy even though, or perhaps because, they are so familiar with
facial anatomy. One typical participant produced, in the words of Luke Shepherd,
the sculptor who teaches the course, “what turned out to be an anatomical model,
very hollow-looking, more like a skull. He said he didn’t know how to fill in
the soft tissue around the bone structure.” That is, the shape of the end of the
nose, or the eyelids—the details, in fact, that concern potential patients. “We
try to give them a basic grounding in the language of form—what symmetry is, how
the eye balances things,” Shepherd said. “It’s training the eye to ask questions
of the form so when they come to surgery the eye is able to make those sort of
decisions.” He aims to teach the surgeons on his course to “see 3-D.” It is also
important that they see each patient as an individual problem. Plastic surgeons
get known for a particular specialty, but with facial work this specialization
can be dangerous: patients don’t want a “signature” job, they want the nose, or
chin, they themselves feel they need.

Plastic surgery is still not cheap. But easy terms
are available, and the customers are happy to pay up. Fifty-four percent of the
interviewees in the
Grazia
survey intended to have
cosmetic surgery, expecting to spend on average $5,650 (£3,500). If they didn’t
have the necessary money available, they were happy to spend less on clothes and
going out. If necessary they would take out a loan—many practices offer
low-interest financing to their customers. And the market is not confined to
women: a 2007 survey by the market-reseach organization YouGov found that a
quarter of all men in the United Kingdom. would consider cosmetic
intervention.

However, the great majority of cosmetic procedures
these days do not involve surgery. On the contrary, the American Society of
Plastic Surgeons predicts that 88 percent of the 55 million procedures
anticipated in 2015 will be noninvasive. “You can do a lot of things with a
needle now—you can compete with a knife,” said Dr. Lucy Glancey, a specialist in
cosmetic and antiaging treatments.
15
You can
either plump out your face with collagen fillers, “redistributing volume,” as
Dr. Glancey put it, so that firmness returns without the deadly “windswept” look
that can result from a face-lift; or you can simply smooth those wrinkles away
with Botox, the registered name for an injectable solution of the botulinum
toxin, which blocks the signals telling your muscles to contract. If you eat
meat containing this poison, it attacks the muscles in your chest: you can’t
breathe and it kills you. But if a small amount is injected into your face, the
facial muscles can’t move—and so, can’t wrinkle.

First used medicinally in the 1970s to relieve
uncontrollable muscle spasms, Botox’s possible cosmetic application was first
recognized in 1987. Since then, its popularity has increased exponentially. In
2000, about 800,000 Americans had Botox injections, while nearly 2 million had
cosmetic surgery; in 2008, 5.5 million chose Botox (one in eleven of whom were
men), and 1.7 million surgery. L’Oréal, already part of the injectables market
through its part ownership of the pharmaceuticals firm Sanofi-Aventis and its
share of Galderma, a joint venture with Nestlé, in 2009 introduced its own
botulinum toxin treatment, to be marketed under the name Azzalure in Europe, and
Reloxin in the States. The market for these treatments, worth $1.2 billion in
2009, is expected to grow by 13 percent per year between 2009 and 2012—a
tempting prospect, especially given that both 2008 and 2009 saw L’Oréal’s
profits fall: in 2008 by 27 percent, in 2009 by a further 3.2 percent.

Injections of Botox (as the treatment has become
generically known, though in fact the name is a proprietary trademark owned by
Allergan) are quick and virtually painless. The effects are almost instantaneous
and involve no ugly scarring. And if you don’t like the result, no problem: it
wears off. Since it works because of its paralyzing effect, it makes your face
less mobile, producing a curious masklike look. But some users actively prefer
this. Just as in eighteenth-century France, the cosmetic mask represents
something so desirable—membership in the king’s set, the defeat of time—that its
very artificiality becomes a mark of status. “As the Botox wears off towards the
end of three months, the movement returns to my face and I get really impatient
for my next fix,” said Jay Nicholls, a thirty-two-year-old model and
dancer.
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Jay has her Botox renewed every
three months at £500 (about $700) a time. That’s the financial equivalent of a
face-lift every two years, on and on, into the foreseeable future.