Is the Stigma of Plastic Surgery Vanishing? (And Is That a Good Thing?)

Iggy Azalea has talked openly about her breast enhancement and a nose job. Photo: Getty Images

Earlier this month during an interview with the New York Times, Kylie Jenner gave a shout-out to the doctor who has been injecting her lips with Juvéderm. “I go to Dr. Ourian in Beverly Hills. He’s the best, and he’s super natural about it,” she raved. “I was going to somebody before, and it was just looking crazy.” Jenner certainly isn’t alone in her candor. In the past few weeks, actress Ariel Winter opened up to Glamour about her breast reduction, while rapper Iggy Azalea talked frankly to Seventeen about her breast implants and nose job. “I’m not denying it,” Azalea said of her procedures. “Denying it is lame.”

What a change from even a decade ago, when celebrities would suddenly appear noticeably younger or different (or scarier) but would stay silent on their transformation. In the ’80s and ’90s, “Have you ever gone under the knife?” was the dreaded question celebrities faced in interviews thanks to the popularity of face-lifts. However, after Botox was launched in 2002, they could truthfully tell the media, “I’ve never had surgery,” while not admitting to injectables or lasers. For years, beyond Kathy Griffin, Cher, Joan Rivers, and a bunch of Real Housewives, very few celebrities copped to having procedures done. But with a new crop of young stars who are willing to talk, TV shows and media spotlighting different procedures, and less-invasive options that someone can have done over their lunch break, the stigma is vanishing. The question is whether that’s a good thing.

Plastic surgeon Anthony Youn, MD, has noticed the shift happening for a while now: “I think this has been a gradual change. It started with Extreme Makeover on ABC in the late ’90s, early 2000s. That was the first thing that really brought plastic surgery into the mainstream.” Having a generation grow up with the idea that if you are unhappy with something you can change it is leading to a new openness and rebranding of plastic surgery. It’s gone from something to keep secret to something seen as easy, accessible, and even empowering. Jennifer Berger, executive director of About Face, a nonprofit that aims to improve self-esteem and body image of girls in relation to media, has seen firsthand the impact that seeing celebrities talk about their procedures has had on teens. “It’s a ‘They did it, so we can do it too’ attitude,” says Berger. “All they really are concerned about is, ‘Could I afford it if I wanted to do it?’ Or, ‘Will my mom let me do it?’” says Berger of the teens she works with. “I think it is becoming much more normalized with kids stating that they see it as a way to solve the ‘problem’ of their appearance.”

Youn is also noticing younger and younger patients wanting work done — and it’s not a trend he’s happy about. “It’s a very troublesome phenomenon as a physician, because I question whether people under 18 truly understand the ramifications. Even under 22 I am cautious. Can they deal with the changes and the risks?” He points to Kylie Jenner as an example of a celebrity making a procedure seem like no big deal, when there’s a lot that can go wrong. “If the [lip] injection is accidentally injected into a blood vessel, part of your nose or lip can turn black and fall off.” It’s terrifying to even think about. There are also the physical risks — irreversible changes that make you look worse, not better — infections, even death. Then there are major psychological concerns too. Some people may not be able to handle having a new body or new face that they can’t change back. With plastic surgery, the fact is you don’t always look better. Sometimes you just look different — and that can be traumatic for certain people.

Before-and-after tummy tuck photos. (Photo: MacKenzie Walker)

Despite his caution with younger patients, Youn recently performed a tummy tuck on MacKenzie Walker, age 15. “She is one of the only exceptions I’ve ever made for operating on a minor,” says Youn, and it’s clear why he felt she stood out. Walker lost more than 100 pounds in a year through diet and exercise alone, leaving her with a ton of excess skin on her stomach. “You think as soon as you lose all this weight you are going to have abs and look like a fitness model. I had a lot of excess skin on my stomach, and it was very discouraging,” admits Walker. Her doctor told her she would never be able to get rid of it through exercise, and despite his warnings, she set out to prove him wrong — but a year later it was still there. “I had always had a lot of issues in the summertime; wearing certain clothes, you could see it. It would get sticky and smelly. I was getting pain in my back too, because it was heavy,” Walker reveals.

For Walker, who had been posting her weight-loss journey on Instagram, the inability to lose the hanging skin felt embarrassing. “It put me in a position that people were thinking I was kind of a joke because I wasn’t making progress,” she says. “It’s not cool to lose 100 pounds and still feel as insecure.” Walker admits that the response on social media was “maybe 30 percent” of the reason she wanted to get a tummy tuck. But it was her Instagram followers and friends who raised the $8,900 she needed for the procedure, something she couldn’t have afforded on her own. Walker says she knew the risks from speaking to her doctor and researching online. “You can type it into Google. It’s a little bit scary, but at the same time, I knew in my heart that regardless of the risks it would be worth it.”

True to life in the social media age, Walker has posted about the entire experience, sharing before pics, surgery prep close-ups, and her post-op progress. “I have always wanted to be able to share it. I know a lot of people wouldn’t put their bodies on social media, but I want to be inspiring people,” says Walker. “When I put my progress pics on Instagram, it’s basically me saying, ‘If I can do this, you can do this.’”

Getting ready for the tummy tuck with Dr. Youn. (Photo: MacKenzie Walker)

While people are being more candid about plastic surgery in general, Youn is noticing a major difference along generational lines. “I have noticed that, yes, older people are more open, but it’s nothing like the young women,” he says. While Gisele allegedly hides under a burqa to visit a plastic surgeon, the under-25 set are posting pics from their hospital beds.

The idea of talking about her eye lift on Facebook never occurred to Adriana, 46 (name has been changed). However, she was happy to tell close friends the truth (it didn’t hurt, her doctor was amazing). “I was relatively open with other women my age, because it’s in my nature to be helpful,” she explains. Still, she’s kept the experience a secret from her children for now. “I am opting to wait until they are a bit older. I don’t want them to have a skewed vision of what a woman’s beauty is. Also, they are a young, tender age where it might be frightening.”

The three women I interviewed for this article were all thrilled with their procedures, including Jo Piazza, Yahoo Travel editor and author of The Knockoff, who underwent a rhinoplasty three years ago. “I was always wildly self-conscious about it being crooked. I went on television a lot promoting my books, and I always noticed it then. But I really did it for me. It helped me feel so much more self-confident.” Confidence often comes up when people describe their reasons for having plastic surgery. However, many women also pointed to outside factors that affected their self-esteem and decision to pursue surgery as well. “I had this one boyfriend who mocked how crooked [my nose] was and pretended to twist it back into place. That guy was the worst!” laughs Piazza. Adriana, who works in the art world, mentions a re-entry into a high-profile job as a factor too. “I don’t think I felt pressure, though potentially I could being out there in the workforce and with the obvious issues there are with women and youth, especially because my face, frankly, is part of what gets me work.”

The normalization of plastic surgery brings up some complicated questions. Is the desire to combat aging, weight, and “imperfect” features part of a larger problem with our culture’s beauty expectations? Are we all pressured to look camera-ready now thanks to social media? It seems no matter what your career, or age, our society is more and more driven by very high visual expectations. “Cosmetic surgery overall is only the most serious symptom of a culture that wants women to look a certain way, and it’s a narrow, unattainable ideal until you can get cosmetic surgery to fix it,” Berger says. “The idea of changing yourself to fit into another person’s mold is only changing yourself on the outside in a risky procedure — not changing yourself on the inside. It’s, ‘I am going to change my face, and now I feel better about myself because the culture approves of me.’” Berger tries to teach young girls to focus inward before visiting a plastic surgeon. “We all have a responsibility to our own spirits to try and accept things about ourselves before we do anything really extreme.”

While some may blame celebrities talking about plastic surgeries for increasing the number of procedures being performed (case in point: a 98 percent increase in butt augmentation in 2014, which doctors credit to the Kardashians and Jennifer Lopez), others think their candor is a good thing. “It’s not fair for the common person to be held up to the standards of celebrities, yet the celebrities don’t admit they have helped their appearance,” Youn explains. However, when stars are honest about the amount of work and help it takes to look “perfect,” Youn believes that “people won’t expect that perfection out of their spouses. It’s not natural beauty — it’s partly manufactured. That’s why I think getting the word out is great. What you are seeing on the red carpet isn’t natural.”

Natural or not, Walker is thrilled with the results of her tummy tuck. “I have never been happier in my life, and I feel very confident. I am 100 percent happy,” she raves. Her next goal? Something she says she couldn’t have achieved without the surgery: to continue spreading the word about fitness and food, and to become a female bodybuilder.


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