Alison Dowd was one of the 22 women chosen from 16,000 desperate applicants to take part in the first series of Extreme Makeover UK, Living TV's version of the American nip-and-tuck reality show. The prize was having her features so radically tweaked that when she was introduced to a long-standing colleague on her return to work as the new girl, he shook her hand and asked her name. "I said, 'It's me, Ray! It's Alison!'" But not the quiet, serious, plain Alison who never wore lipstick or a skirt, who chauffeured her girlfriends into Birmingham for a night out and came home alone before returning to collect them. She had no plans for a 40th-birthday party until her new "self" emerged to throw a celebratory barbecue, wearing a cowboy hat and surrounded by her fellow "madeovers". Her triumphant gathering in her back garden was filmed by the programme makers as the centrepiece for a reunion show. No problem: the women were minor celebrities, interviewed and approached in supermarkets. One of them couldn't talk to me because she had signed a contract with a weekly magazine — such are the concerns of women who felt invisible this time last year.
Like most of these women, Alison saw the original US version of the show and applied for the UK edition, made the required three-minute video putting her case, travelled to London for her psychological assessment. Having been cleared of suffering from clinical depression or an eating disorder, she underwent a month of treatments and recuperation. "When I saw the programme it made me stop and realise how crap I felt about myself. If I hadn't been selected, I was going to make some changes myself. I was drifting, years were passing by and I was missing out on things."
Sipping tea in her Stourbridge kitchen, I try not to stare at her perfect ski-slope nose, its tip gently uptilted, and matched by a newly implanted chin to correct the receding profile that had her nicknamed Puffin and Chinless Wonder at school. One can barely believe that just over a year ago she "felt like a man" if she wore a dress. Her makeover shopping list included nose, teeth, chin and liposuction, costing roughly £40,000. "But inside my head I still see the person I have been for 39 years, not the new person. I catch myself in the mirror and think, 'Hang on, I look nice!' I used to be moody and angry; now I haven't got a care in the world."
The women have kept in touch, most keen to relive their surgical epiphany, in the same way that victims of accidents forge lasting bonds despite having nothing else in common. None of them — even Sandra Erridge with her phobia about the dentist and 56 hours in the chair to endure — seemed nervous about their surgery. "The wanting and longing takes over from the nerves," she says. "It takes over everything."
No small part of the success of the experience is the network of close, new friendships for women whose low self-esteem limited their social lives. Alison and Helen Hobbs from Derby have become best friends; Sandra spent new year with Jennifer Craighead in Perth, whose little boy was teased because of his mummy's "Bugs Bunny" front teeth, but no longer. They all talk easily about each other as old friends do — indulgent and admiring as they laugh at how one member of the gang ditched her partner after surgery and found a toy boy. "She came back a bombshell and buggered off. Good for her!"
They are all united on why they applied for the makeover: nothing to do with wanting to look like movie stars, just the need to be normal, functioning women, able to smile and kiss and talk without putting a hand over their face, and sit in a car at a junction without worrying how their nose looked to traffic approaching from the side. Who can blame them? Female beauty is a prime determinant of life chances: beauties have a nicer time, better jobs, even babies prefer them. The unattractive, by contrast, must develop wit and empathy, make personality count; but with these women the opposite had happened. Plainness had withered them, kept them prisoners of an intractable self-doubt. Some wanted their polish restored after gruelling life events — donating a kidney to save a gravely ill daughter's life, in Beverley Margison's case — but many were trying to escape a self-loathing that had stalked them since childhood. There was Helen Hobbs, who daren't face her groom as they made their wedding vows lest the congregation see her profile; Charmaine Rose, who was once asked in the street if she was a man or a woman, and who cried with relief and happiness for two hours when she saw her new nose.
In the run-up to the makeover, they spoke of getting a second chance. The message is clear: ugliness — imagined or objective — and happiness do not co-exist, and if we cannot shape our destiny we can at least entrust it to the hands of a doctor (a Michelangelo of rhinoplasty, if we are lucky) who will repair our looks, amend our future. Should entirely elective surgery, with all its risks, be mainstream entertainment? Children as young as seven are being treated for anorexia in Great Ormond Street hospital, and body dysmorphic disorder — where the sufferer believes wrongly that they are hideous — is increasing; meanwhile the makeover industry profiteers through a society in which milder forms of body obsession are becoming the norm. Every passing year after 40 now screams out for a tweak, a shot of Botox for the frown-line, a syringe of Restylane to fill the Shirley Temple dimple that somehow mutated into a crevice.
Charmaine, a 52-year-old mother of two teenage daughters, seems to have traded in her personality with her old face. At home in Hampshire as she shows me the scrapbooks of her big adventure, I notice how carefully her frosted eye shadow has been applied, how naturally she flicks and tosses the thick blonde hair. It is as if the former estate agent cannot stop laughing and smiling at life; fetching a lifesize cutout of her old self (a gift to all the women from the programme makers), she frowns and asks: "Who's she?" To say that Charmaine has changed is comic understatement: the breast augmentation, face-lift, brow-lift, eye-lift and nose job have made her literally unrecognisable. After nine years on her own, she has a boyfriend. "Men are terribly shallow: before the makeover they wouldn't look at me. Now, wherever I go, I get stared at. My boyfriend, No‘l, says he's going to sell me to the Arabs. But also, I have 10 times as much personality as I had before." So much, in fact, that she was invited to star in the "mini-reveal" at Extreme Makeover's press launch. "I had to burst though a paper screen. I took to it like a duck to water — such a scream!"
For years after her husband left her, life was devoted to her daughters. Her evenings were spent ferrying them around, grooming and riding horses, watching TV. Now she is a born-again femme fatale, a glamourpuss who whips out a new satin evening gown with diamante clasp at the bust, perfect for the clubs and casinos she and No‘l enjoy on their London weekends.
Maybe her head was turned when her face was fixed — but who cares, when her enthusiasm for the future is so infectious? "I want to get into television. I love it. I want to present." When we met she had entered a competition to become "The face of Revlon Age Defying Makeup", and clearly thought she had a chance. And why not? She looks great, like an older version of Penny Lancaster. Even the negative effects of the change make her laugh. "My sister said to my daughter that she thought I'd changed horribly. We always used to go to nightclubs, and she won't do that with me nowÉ" Charmaine fears her youngest daughter has inherited her flat chest, but that will be solved. "As soon as she is 18 I'll buy her boobs, because I don't want her to suffer like I did."
Is it all too easy? It is certainly simpler to suction off litres of yellow, blood-streaked fat than to banish them with diet and exercise, making makeovers a perfect option for the narcissistic, lazy and superficial. And one that increases the burden of self-doubt on everyone else, especially teenagers who compare themselves with those so naturally blessed that their features become the gold standard of aesthetic improvement. (Nicole Kidman's nose and J.Lo's cheeks are hot sellers.) On TV the gruesome slash-and-burn of the operating theatre is divested of its infected stitches, drooping eyelids, weeping wounds, allergies like the one to anaesthetic that saw Alison rushed to an NHS hospital when she collapsed a week after surgery.
The number of Cinderella TV formats whose business is making the dowdy drop-dead gorgeous is proliferating: from America's The Swan, in which ugly ducklings are turned into button-nosed Barbies and then compete against each other in beauty pageants, to Five's controversial Cosmetic Surgery Live, and the most grotesque monster of the genre, MTV's I Want a Famous Face, in which — to take a random example — a 26-year-old transsexual porn star attempts to become Pamela Anderson.
