Change yourself if you can’t change the world

My face is my fortune, sir, she said
Cosmetic surgery and allied procedures were less hard hit by the great global crash than many other businesses. Women saw their faces and bodies as assets needing investment to help them in a tough market
Laurie Essig said in spring 2007 that the United States was on the verge of a major crisis, during a conference call from Middlebury College, Vermont. Her level of economic expertise barely allows her to sort out her coffee break bill, but her area of sociological research – cosmetic surgery – perfectly positions her to observe “the subprime mortgage crisis of the body” (1).
People in the US pay for 85% of cosmetic procedures (surgery, laser and injections) by borrowing. There is no minimum downpayment, as is required in every other country except Mexico and Australia.

This is the result of measures Ronald Reagan introduced after he became president in 1981: the authorisation of medical advertising and credit deregulation. The institutions that specialise in financing medical procedures – the largest is CareCredit, a subsidiary of General Electric – approve loans widely and easily. Interest rates can reach 28%, and double if a debtor misses a single monthly payment (2). Cosmetic surgery was once only available to the wealthy, but has become an enormous industry producing “a much more widespread standardisation of Americans’ faces and bodies”. A practitioner said it now attracts “everyone from hairdressers to Walmart executives’ wives”. Patients are 90% female and 80% white, and between 2000 and 2010, spent almost $12.5bn annually.

Sector growth, at 465% over the past decade, has kept up with the widening of the gap between the rich and poor. Essig believes that it is the result of an attempt to resolve the contradiction between grandiose dreams, intensified by media depictions of the way of life of a privileged class, and decreasing real incomes. It also fits with the neoliberal vision of a malleable subject, free from predetermined traits and expected to work continuously towards personal perfection. It is based on the conviction that responsibility for everything – problems as well as solutions, failure as well as success – lies with the individual, rather than society.
The industry did not suffer much from the great financial crisis. Essig noticed that in fact people became more determined to change their appearance, even if that meant a second mortgage on their home. She thought they viewed their bodies as assets that had to be managed in order to grow in value on the market (love or labour), to have any chance of fulfilling the American dream. Upgrading the body seemed a sensible investment. A friend of Essig’s is self-employed and, although penniless – or rather, because she’s penniless – has spent $800 on injections to fill in the nasolabial folds (between the nose and the corners of the mouth). “I thought maybe if I didn’t look so old, so tired, I’d get more clients,” she said. The procedure was her only possible response to her insecurity and lack of external control.

Younger you
The French aren’t impervious to all this, as a recent “Younger You Special” in Elle magazine attests. “Chloé, 36”, among others, was given a dermatologist’s feedback: “In the future, it’s not hyaluronic acid she’ll need for the lines on her forehead, but Botox. As for keeping her perfect oval face, it’s now she needs to start looking after it. At 50, if it’s really lost its firmness, you need a facelift to fix it” (3).

Essig reminds us that neoliberal ideology relies on the belief in freedom of choice, but her interviewees seem helpless and say things like: “Appearance is all that counts in our society” or “The job always goes to the one who looks youngest”. She says facelifts and Botox seem to them as inevitable as death and taxes. In fact, the interviewees create a reality over which they claim to have no control, and thereby constantly escalate demands – foreheads must be ever smoother, features ever more frozen and breasts ever larger. The ubiquitous images of models’ and celebrities’ smooth, shiny, artificial faces and bodies set a precedent, and feed anxiety, contempt and hatred of the real body.
What about the cosmetic surgery practitioners? Most began by wanting to do something else, something better, especially reconstructive or reparative surgery; but they ended up doing breast implants and liposuction because they had loans (often for medical education) to repay. Some claim that their work is pro-feminist, as it allows women to “gain more self-esteem”. Laurie Essig points out that cosmetic surgery has always been an attempt at normalisation that is as much racial as sexual: it aimed to erase marks of “non-whiteness”, and deliver patients from their inferior bodies; it was also meant to accentuate the difference between the sexes. In the early days “Jewish or Irish noses” were corrected; now an Iranian surgeon says: “Disney made the Persian nose a problem.”
“To be more feminine”, “to increase self-confidence”: in France, such objectives are at the heart of the “makeover days” organised by the French job centre Pôle Emploi for women who have been unemployed long-term. The centre works in partnership with the Ereel Fund, a charity that has on its board two deputy mayors from the wealthy 16th arrondissement of Paris, the Hôtel Matignon’s chef de cuisine, and the philosopher Cynthia Fleury; its informal patron is the British-born wife of the French prime minister, Penelope Fillon. The project has provoked bad reactions – the satirical weekly Le Canard Enchainé wrote: “On the website of the makeover studio responsible for this warpainting of unemployed women, every model who arrived with a frizzy mop left a few hours later with her hair straightened or more formally curled” (4).
At the January launch of the makeovers, which got a lot of media coverage (5), the actress Marie-Anne Chazel said she believed “girly tricks” could overcome mass unemployment. Fillon was seen in the press photos, wearing black and grey: maybe she should have been in warmer tones, with a lower neckline and scarlet lipstick? Bernard Debré, an MP, honorary president of the Ereel Fund and a regular contributor to the weekly magazine Valeurs actuelles, where he discusses “the paradox of egalitarianism” (6), said of the guinea pigs: “For months, and sometimes even longer, they’ve been out of the habit of getting up, doing their hair, putting on makeup.” Will there soon be a special facelift fund for those on social welfare?
Mona Chollet is a journalist, essayist and
publisher, and a member of Le Monde
diplomatique’s editorial team
( 1) This and other references unless
otherwise stated are from Laurie Essig,
American Plastic: Boob Jobs, Credit Cards,
and Our Quest for Perfection, Beacon
Press, Boston, 2011.
( 2) In August 2010, the New York State
public prosecutor launched an enquiry
into CareCredit and other medical credit
institutions accused of deceiving their
customers.
( 3) “Spécial Rajeunir”, Elle, Paris,
4 February 2011.
( 4) “Penelope ‘soigne son look’ à Pôle
Emploi”, Le Canard Enchaîné, Paris,
26 January 2011.
( 5) “ Opération relooking pour des
chômeuses ”, 11 January 2011.
( 6) Valeurs actuelles, Paris, 16 December
2011.