Howard Jacobson asks

Thank you janeainsworth - my knowledge of various enhancements is somewhat lacking. If the results are what I have seen, then it should be regulated the same as it is for clinicians. When you think of Katie Price, Pete Burns and now this Frenchy, it's almost criminal in my mind.

Hollydaze Lip fillers are not usually provided by accredited plastic surgeons. It is a completely unregulated practice often carried out by beauty therapists who have been on a short weekend course.

Why do women trade the grace and dignity of age for a plastic look?

Because some societies don't value old and ugly but seem to idolise youth and beauty so it's hardly surprising that some women will go down that route in order not to be thrown on the scrapheap based on nothing more than physical appearance.

There is a French woman on Celebrity Big Brother - 'Frenchy' - whose mouth has been terribly distorted by too much filler

I was shocked to hear that she was only 38 - she looks much older than that and her facial alterations are probably part of the reason; shame on the clinician that did that to her, he could have (should have?) refused.

That's often the argument that's put forward penguin but why do women feel that their happiness is so tied up with the way they look, and why is there such a rigid "template" for what constitutes beauty?

The cosmetic surgery industry is reliant on fostering this dissatisfaction, and then represents people's decisions to undergo appearance-altering surgery as solely a matter of personal choice and thus "empowering". I feel that, when people feel compelled to change their appearance so as to conform to a rigid view of what is attractive, it is anything but empowering.

I think you are right penguinpaperback. In the past, I have occasionally suggested to women friends (my contemporaries - at any age) that they were wearing very high heels or a lot of make-up etc to please men, they have always retorted in surprise that they weren't doing it for men but for themselves.

Spot on, Penguinpaperback
Bags I think reputable and ethical plastic surgeons do assess their patients' psychological state before embarking on surgery, and perhaps paradoxically those who would be disappointed by the outcome dissuaded from treatment and/or offered counselling.
I also think many people don't face up to their own mortality and then when things start happening to them in later life it comes as a big shock.

I too have earned a few wrinkles this morning, just come back from a great game of tennis.

Howard J assumes the woman in his story has had surgery in order to please, keep the man. I think that's rarely the case? Women who choose to have surgery usually do it in order to feel happier about themselves.

And I'm getting my walking gear on for a tramp about. Interestingly, in a walking group I sometime join, all the women have dyed hair, except me. I'm one of the youngest and am greyer than the lot of them.

... one one side of my face, not our!

aka I always thought that poor Michael Jackson had developed a case of body dysmorphic disorder and the real tragedy was the people who preyed on him for their own financial gain. I wonder, if there is a severe case of mental ill-health, as in above, how much can be done to change that. I have no idea, I don't know. Just wondering how hard it is to make someone like that see sense (for want of a better phrase). I should imagine it is very difficult.

I was out with friends the other night and sitting at the table next to me, facing me, was a woman of about my age who had had a lot of work done. I struggled throughout my dinner not to stare . Interesting often how overdone cosmetic surgery and wearing lots of make up go hand in hand.

I don't mind my wrinkles, but I have in recent years developed brown splotches on our side of my face only (the side that faced the sun all those years I drove in a hot climate). So I've had the three largest ones "neuked" with laser, damn sore, but I'm so happy they're gone. They were bothering me.

I find it quite fascinating studying the way my face changes over time. I've never had heavy upper eyelids, yet I've noticed lately that my eyelids are beginning to head south and settle in a little fold. I can see too that I'm going to end up looking like my favourite aunt .

I haven't read the article by the way! Just jumping in

Sun's out. I'm off to work outside for a bit to earn some more wrinkles.

Ah well, there's the crux—evidence of their own mortality. My attitude? Shrug. Get real. I'm not saying that in a nasty way. It expresses exactly how I feel about it with regard to myself—simple acceptance of life's reality.

The people who are really suffering a psychological trauma (disturbance? illness?) because their self-perception is not good could perhaps do better with some psychological help to increase their self-esteem rather than surgery. It is their choice though and I'm happy with that but sad also at the excessive lengths some people go to which, in the end, don't improve their looks anyway!!

As the article points out.

And not just women. The late Michael Jackson went down the same path. I often, like HJ does in this article, asked 'why?' He was a good looking man before he ever have surgery, but like most who take this to extremes, I suspect he was looking for something he was never going to find.

I agree that women have the right to do what they want with their appearance, but it saddens me to see how their character disappears and that plastic look inhibits facial expression when they go too far. There is a French woman on Celebrity Big Brother - 'Frenchy' - whose mouth has been terribly distorted by too much filler. She has clearly been a beautiful woman in her time, but now she looks ridiculous because of the permanent swelling that should not be there.

I think HJ's article was funny and a little too close for comfort in his description of the elderly woman who could very likely have osteoporosis. I have seen so many women like this in New York and Los Angeles, extremely thin and surgically altered to the extent that their old friends must struggle to recognise them.

Morning Ffinn
Perhaps people don't like to see evidence of their own ageing because it heralds their own mortality, and reminds them of times lost that can't be regained, quite apart from the commercial and cultural pressures to conform to the cult of youth?

So I suppose the concept of perfection is what is being discussed, and how that influences the individual. I think there are some people who are psychologically disturbed by their appearance which hasn't been caused by illness/trauma, but I think there are many more who want to indulge in the perfection-fantasy that much of the media peddles, which I think is a pity.

Yes, a complex issue.

What irritates me is that the external signs of ageing is becoming something that needs to be held in check. Particularly for women. Why for heaven's sake?

Morning Bags
I don't disagree with you and Eloethan, and I think that the pressure on young women to have Botox etc is particularly bad. Incidentally in fairness I don't think the pressure comes from plastic surgeons - more from silly magazines and the celebrity culture.
But where do ideals of beauty come in? Haven't these always been portrayed in classical Art?
Perhaps some people (I don't think it's just women, men can also be very concerned about their appearance) have always been made miserable about their appearance - a too large nose, a prominent chin or teeth - and the difference in modern times, thanks to the work of Sir Archibald McIndoe with horrifically injured airmen after WW2, they can. If someone genuinely feels their face is prematurely aged - and smoking is very ageing - is that essentially different?
I suppose it's like many examples of progress - some of the uses are adapted in ways that the originator didn't intend. I doubt whether when the Internet was developed, anyone envisaged that young people would be driven to suicide by harassment in social media.

I agree with your point, jane, but eloethan's point that people, especially women, are made to feel bad about their looks is the real one, I feel. There is something rotten at the heart of a society that puts SO much importance on appearance and which doesn't appear to value ordinary, plain, healthy looks. As far as I'm concerned those are the looks that are really beautiful, wrinkles and slight imperfections included. We do not have to be perfect!!!!! and there shouldn't be so much pressure for us to try to be perfect.

I think he was pondering on why so many women are unhappy about their appearance and feel they have to undergo unpleasant and sometimes very painful procedures.

At one time (not quite so often now) there were several TV programmes where people had complete "make overs" - face lifts, eye lifts, nose jobs, dental work, etc., etc. It seemed to me to be normalising behaviour which, in my view, is really not quite normal but which, of course, makes a lot of money for cosmetic surgeons. Some people (and increasing numbers of young people and men) seem to eventually become almost "addicted" to these procedures. I think it's very sad.

Bags The NHS recognises the importance of psychological well-being with respect to personal appearance, in its provision of various things from orthodontics to reconstruction after mastectomy.

Whether something is provided or not is a joint decision between the patient and the clinician, bearing in mind the biological and financial costs versus the perceived benefits and how satisfactory the outcome is likely to be.

HD may have intended his article as a humorous piss-take, but if you scratch beneath the surface, this is a complex subject. I personally think that anyone who resorts to facelifts is probably rather insecure -and HD was (perhaps unintentionally) quite cruel.

I think we draw the line where something looks ridiculous. Who decides what looks ridiculous? We all do, all the time. We all make judgments based on appearances. Sometimes we make wrong judgments this way but in a general way it's a useful and necessary skill. Why do I think that?—because it's the same skill that we use in face recognition for, as the name suggests, recognising people whom we know.

I use skin cream too, not to prevent wrinkles, because I don't believe anything does that, but because the skin on my face feels dry (tight) after I've washed it (using water only). Likewise I moisturise my hands not to prevent wrinkles (I've always liked wrinkled hands; used to gaze at them when I was a kid) but because my hands get chapped very easily. So my beautification, such as it is, is for comfort.

I suppose one could extend that from physical comfort to psychological comfort in which case janea has a point about where to draw the line. However, I think this is just a humorous piss-take about excess caused by the demands of fashion so I don't think it's cruel or misogynistic.

We have all seen people like the ones Jacobson describes, but his attitude is misogynistic verging on misanthropic. And if this is his customary literary style, I am glad I have never got round to reading his books

Sorry a superfluous 'whether' before HJ

Ffinn
The patient who needs facial reconstruction because of cancer or trauma has basically the same problem as someone who has plastic surgery to combat the ageing process - they are unhappy with their appearance.

I don't see them as separate matters - they are part of a spectrum of necessity. We may think a woman who has plastic cosmetic surgery deluded, but her problem is real. What you or I may consider unnecessary intervention will not be considered in the same way by someone who is dreadfully unhappy with their appearance. Whether HJ had no way of knowing the woman's(if she was real or a figment of his imagination doesn't really matter) state of mind before or after her surgery and no right to judge her.

I do dislike the pressure that some women, particularly young ones, seem to be under to conform to imposed standards, but as one who dyes my hair and applies various creams in a probably vain attempt to slow down the appearance of wrinkles, I wonder where you draw the line of what is acceptable and what is not - surely it's an individual decision for each woman?
Now I've thought about it properly, I'm just off to 'unlike' the article on Facebook

Janeain. I understand your view about HJ being judgemental, yet would disagree that having plastic surgery following trauma/cancer is essentially the same as willingly choosing to do so.

Plastic surgery has developed wonderfully over the years, and I admire the skill and dedication it takes to transform lives.

I see the need to have bigger boobs, sexier lips, more youthful skin and the attempts to hold back the natural ageing process through plastics as quite a different matter.