A gory photograph has been my “look at this freak” party piece for most of the
summer. It's of a glassy-eyed woman, drugged up on Xanax and morphine, with
eyeballs that appear to be weeping bloody tears, her skin red, oozing and
bruised, and her eyelids glossy and raw like tuna tartare. When I showed it
to my dad, with a jocular, “Look at this, euw, gross out, tee-hee,” he was
visibly disturbed. He is a surgeon, used to sicko operating-room comedy, but
he did not find this funny. “I can imagine some silly actress doing this,
but not my daughter,” he said.
When, in the name of research for a television documentary, I allowed myself
to dip a toe into the murky waters of cosmetic surgery, I thought I would
barely get my feet wet. We decided to go to America, as it is a culture
broadly more accepting, open and enthusiastic about cosmetic enhancement
than over here. I thought I might have a bit of Botox, make my excuses and
leave. Actually, in the course of interviewing some of the country's top
practitioners, I got wet right up to my eyeballs, quite literally.
Previously, I had found cosmetic surgery curious, fascinating, not for me.
Instinct told me it formed the deepest, darkest recesses of the misogynistic
capitalist system that is the beauty industry. I dye and remove my hair; I
have pedicures; someone else plucks my eyebrows. Slicing yourself up:
ethically wrong, economically crippling and likely to make you look weird.
“Cosmetic medicine” is the best, if contradictory, catch-all term to describe
the vast range of treatments available today, including lasers, peels,
injectables, legally and scientifically dubious embryonic stem-cell work and
hormone therapy, as well as the scalpel.
The noninvasive procedure - anything that is knife-free - is where the market
is heading. In America, cosmetic-surgery procedures have increased by 140%
in the past 10 years and noninvasive procedures by 740%. In the UK, the
market more than tripled in the space of five years, and the vast majority
of procedures are noninvasive.
These are entry-level procedures and they're unintimidating. They can can perk
up your face and are reassuringly temporary - costing as little as £120; a
decent face-lift is £8,000, and if you don't like it, you're stuffed. Having
some cringingly raw photos of my unmade-up, 38-year-old, lived-in face
presented to a panel of beauty-industry critics, who pointed out what made
me look ugly/old/ordinary, brought me a little closer to the culture of what
I can only call extreme self-improvement.
By the time I arrived in New York, I was interested, wondering what I could do
to myself. In such a high-risk game, you only want the big-name
dermatologists or esteemed aesthetic surgeons working on your face - and I
had access to all of them. Clearly, my personal quasi-feminist standpoint,
my moral objection to it all, was careful avoidance. I wasn't principled - I
had just swerved the issue for cultural and financial reasons.
We nailed an appointment with Dr Fredric Brandt. Brandt is Madonna's guy -
he's hot. They also call him the “baron of Botox” - he buys more Botox than
any other person in the world. Him, the “don of needles”, he would work on
my face.
But, like a kid in a sweet shop, I couldn't wait. While I was interviewing a
Park Avenue cosmetic podiatrist, I got chatting to her colleague, a
radiologist called Dr Everett Lautin. “Diagnosing” all the flab, sag,
wonkiness and hollows in my face, he prescribed some needlework. As a
radiologist, he is not qualified to work with a knife, but he can stick as
many needles in it as he likes. Any qualified doctor can administer
injectables in America, even a radiologist. (In the UK, the regulations are
even looser - anyone can inject Botox provided they are “overseen” by
someone authorised to prescribe it. Soon, if the government has its way,
anyone will be able to administer non-surgical lasers: doctors, nurses, nail
technicians, window cleaners - anyone.) The point being, Lautin is no
Brandt. But he had a knowingly buffoonish air, which was a refreshing change
from the smooth-talking charm-meisters, with the photos of their
shock-and-awed, “all my own work” wives on their desks.
As we talked, Lautin was totally comfortable lampooning the Botox junkies, the
women who aren't happy unless their faces are in permanent rictus. They say
you choose your cosmetic doctor based on empathy - Lautin talked like James
Stewart. As we chatted about the importance of keeping it subtle - the
“European look” - I decided he was just the kind of guy I wanted injecting
poisons and volumising materials into my face.
Impatient, I asked him if he could do me now. Checking his watch, he said
things were tight, as he had a cocktail party to go to, but he would squeeze
me in.
Forty minutes, £1,250 and 50 injections of Botox and Sculptra later, he dashed
off. I went home for a much-needed medicinal gin. Anyone who describes
injectables as painless may have had a little light Botox around the eyes.
What I had was rough and painful.
The following morning, as I lay in the chair of “Madonna's guy”, I felt
bruised. Brandt is jaw-dropping evidence of what happens when cosmetic
dermatologists get high on their own supply - less 59-year-old man, more
freaky porcelain doll in appearance. Did it put me off? Did it hell.
I told him I'd seen Lautin (he spat to his PR, “Why didn't anyone tell me
she'd let a radiologist loose on her face?”), and then waited for him to
refuse me. Did it put him off? Did it hell.
Another 20 injections. Being injected so repeatedly is like being stung by a
swarm of wasps. This time it was Botox into my jawline and Restylane into my
top lip; the latter hurt a lot. What was I thinking? Every time the needle
penetrates your skin, you feel stupid, vulnerable and assailed, but,
underneath, there is the corollary to the suffering: the prospect of looking
good. Even though I looked an absolute wreck - bruised everywhere, swollen,
green around the gills - I was riding high, looking forward to seeing the
effects and buzzing off pain-induced adrenaline.
The truth is, expensive face creams can't change the way you look, but surgery
and injections can. Morally, ethically, financially, there is something
dangerous and fun about playing with your appearance. It's un-PC and it's
body modification - but so is a tattoo, ear piercing, leg waxing, hair
dyeing. They like to sell this stuff as personal style. Where this
burgeoning industry comes from, however, is a sad and unhealthy place. Many
of the doctors I met are serving career women, for whom looking fresher and
younger is not about vanity and a terror of ageing, but more about
professional necessity.
Dr Daniel Sister, a cosmetic doctor near my home in west London, says: “I deal
with everyone from lawyers and accountants to bankers and prostitutes. Most
of my clients work. Women in their thirties start worrying that younger
women will steal their jobs.”
This is terrible and depressing. But it's incredibly uplifting, getting out of
bed and going bleary-eyed to the mirror and seeing - “What's this?!” - a
picture of health staring back. It's a pleasant surprise, daily. There is
research to suggest that Botox injections can treat depression: if you can't
make miserable expressions, you cannot experience the emotions so intensely.
Things only got weirder after we moved on from playing with needles in NY, to
LA, where we flirted with knives and lasers. I was on the rollercoaster, it
was a thrilling ride and, my, there was a hell of a lot more of it to go
before I was going to get off.
It was pathetic how quickly I went from someone determined to embrace ageing
with some grace, to someone who was willing to let a fairly inexperienced
doctor remove some fat from my backside, take it to a lab, separate out the
stem cells and then inject it back into my ageing, sunken cheeks, up through
the inside of my mouth, while also, seeing as he is up there and has got me
under a general anaesthetic, getting the knife out and “redraping” the
sagging skin under my eyes like a pair of old curtains.
The fat transfer didn't happen. A chance phone call at the last minute,
telling me that nobody should work on me following the Sculptra injections,
made me call off the procedure that could have left me looking ridiculous.
Looking like a freak, I always thought, would keep me away from cosmetic
enhancement, but in America, you meet countless women who look weird, yet
think they look great. I reckon it's easy to join them. Perhaps I already
have.
When you monkey about with what nature intended, things do go wrong. The
Restylane in my top lip has slipped - there's a funny lump that shouldn't be
there. Since the Fraxel laser therapy on my eyes (performed in LA by Dr
Persky), the aforementioned tuna tatare has faded and, certainly, my eyes
look less baggy, but, still, seven weeks on, they are a weird brown colour.
My forehead is glassy and does not move. A glassy brow is not considered
good Botox, but I now like this egg-like badge of self-inflicted paralysis.
I may go back for more.
People have commented, constantly, on how well I look, and it started the
moment I walked out of Brandt's office, when the sound man told me: “You're
a real Manhattan girl now. You look awesome.” Even Anna Davies, the serious,
Oxbridge-educated, bluestocking director, liked my lips. My best mate, P,
who I had thought would be mildly disgusted, said: “You look great. I
haven't seen you like this since the mid-1990s.”
Once you are inside, it's hard to get out. At a certain point, the Botox won't
be effective enough, and it will be time for an eye-lift, a neck-lift, a
face-lift and so on. If you want to be dramatic about it, you could say that
injectables are the weed to surgery's heroin. More pragmatically, if you're
going to play the self-improvement game, you had better accept you're in it
for life. Boob jobs last only 10 years; eye jobs require volumising
materials to be injected regularly into the under-eye area to stop you
looking hollow.
I'm already nervous about the moment, in a month or so, when my face starts to
drop, and it'll be back to saggy old me, or, more to the point, back to the
doctor's chair for another few shots of happy in my face, or another
knuckle-bitingly painful procedure. I know, deep down, it's wrong. But,
damn, I look good at the moment.
The Ugly Face of Beauty will be on Channel 4 on August 24
What I had done
Botox: I had about 50 injections from forehead to jaw to iron out
wrinkles and sharpen definition of a sagging jawline. Mild bruising
persisted for a week. Will last a few months. Cost: £1,000.
Sculptra: A dermal filler developed to make Aids sufferers less gaunt.
I had about 12 injections in my cheek and lower-eye area to replace youthful
shape and volume. My face was swollen for several days, and I had deep
bruising on my cheeks for more than a week. Three or four subsequent
treatments are required for optimum results; will last two years. Cost: £400.
Restylane: A dermal filler. I had about 10 injections in my top lip to
straighten it out and add volume. My lips were tender and sore for a day and
the beads of filler made me constantly lick my lips in confusion over the
alien substance. Cost: £400.
Fraxel Re:pair: A laser over my entire eye area to remove excess skin,
refine appearance and stimulate collagen production. Seriously damaged for
two days, I sat in a darkened room, smothered in Vaseline, wiping my eyes
every three hours (even through the night) with vinegar water. It never
really hurt, however. Subsequently, tenderness and soreness for two weeks,
then for three months I must never allow my eyes to make contact with the
sun unprotected. Could last 10 years. Cost: £750.
What I didn't have done
Fat stem-cell transfer: Injections of your own adipose stem cells into
the cheek and lower eye area to replace lost volume and stimulate the
natural production of collagen. It is painful, you cannot fly for a week and
you must quietly sit in a room taking lots of pills.
Lower-eye blepharoplasty: Surgical removal and rearrangement of skin,
so that bags and wrinkles are erased. Again, it involves no flying and
quietly sitting in a darkened room. Minimal scarring. For best aesthetic
results, a maintenance programme is required to fill out hollows under eyes.
Cost (with fat transfer): about £4,500.
