Obsession with Beauty

Interview with dr. Cerna.

Magazin Elle, Juli 2007

It begins with an innocent botox injection, then comes a smaller bottom, fuller lips, tinier nose and soon, losing one’s identity. When does regular health care turn into a dangerous addiction?

How can a beautiful, intelligent woman become addicted to plastic surgery? Easily. Iva (37) knows very well. „My journey from being a healthy and attractive woman to being a pale wreck began 7 years ago. I was 30 years old, working as an editor in a magazine. Sometimes I would write on new cosmetic stuff, so I wanted to try things myself. I got curious. Soon, I got a few botox injections and my lips were stuffed with collagen,“ says Iva. In the following 7 years, Iva had undergone eye-lid surgery, another botox injection, laser skin treatment, collagen fillings... She continues: „It has cost me a fortune. I have never dared to count how much. But I know there were months when I was deciding between paying for botox or for my loan“.

Shortly after 30, Iva started to feel like her bottom got bigger; she thought it was time to have liposuction done. „I’ve never experienced a surgery, not a smallest thing. As the day was coming closer, I got nervous. Suddenly, the whole thing seemed ridiculous. I thought: ‚What if I’m gonna die on the operation table?‘ I knew that was silly but still, it crossed my mind – everybody will know I died just to look good in my swim suit!“ At the end, the liposuction turned into quite a painful and entirely useless procedure. „For a year, I was able to show off on the beaches, wearing thongues, but at the end, my bottom had gone back to where it was before.“

Perfect Looks, Perfect Life?

For Iva, to undergo cosmetic surgeries was like going shopping. She longed for a new face-lift as others want a new purse. At the same time, she felt that this eternal youth, fine forehead and full lips show the world she lives a healthy life, is full of energy and copes with everything with ease and a smile on her lips (no ‚laughing wrinkles‘, though). She wanted to convince everybody that her life is as perfect as her looks.

The desire to look perfect does not neccessarily come from within. „In our society, there is a generally accepted ideal of beauty, forcing people to try approximate to it. Cosmetic and plastic surgeries are therefore more and more sought for. People get a feeling they have to be perfect to make it in this society. But those who try to achieve perfection go down a dead end path“, explains Dr Zdeňka Sládečková (psychologist).

Feeling better?

Kristyna (35, 2 children) was determined: she will go and let the surgical knife “fix“ her bossom. Kristyna tells her story : „After my first kid, I still looked relatively O.K., but after the second run of breastfeeding, each breast was different size. There, a new hang-up, on top of my protruding ears“.  Nevertheless, the doctor recommended for her to wait one year after her breastfeeding. he decided that meanwhile, she would sort out her ears. „I wanted to get my ears fixed to be able to tie my hair back and to cut it short when I get old. If I’d known what I’d have to go through, I would wear my hair long and loose until the day I die. Two days after the operation, my head hurt so much I thought I’d jump out the window. And yet, I was so masochistic as to get the right ear fixed again a few years later.“ In one year, Kristyna left the clinic with new bossom. Although this surgery hurt far less than the ears, right after the operation she was convinced she would never go again. Except... „It’s the same as when you don’t want another child right after giving birth. Soon, you get over it, because the joy that comes is hundred times stronger than the pain. You’re not even scared of another operation. Her next ‚cut‘ was eye-lid lifting. It felt like if I don’t do it immediatelly, I’d look like a witch. So I did it. And results? My younger sister didn’t notice. My colleagues noticed a change, told me how well I looked ... probably a new hair-do. My husband thought my eyes got a bit bluer. Although he didn’t notice the big change, he was very supportive throughout this manic phase of mine. I think that if I told him I was getting lifting of the whole body, and mouth enlargment and nose reduction, he would just say: if it helps you anyhow, go for it.

172cm, 48kg and 3mm of fat

The question whether or not plastic surgery can help is usually essential for surgeons themselves. Dr Zuzana Černá from the Laderma Clinic in Prague explains: „If I’m not sure that I can help the patient, be it esthetically or mentally, I do not operate on her. Every doctor ought to have his or her own ethics and responsibility to the patient and operate only in clearly indicated cases. Although mostly, it is dificult to see the patient’s motivation. Do they want to get rid of a particular defect or are they looking for a band aid for their personal problems? When I see a client who is young, 172 cm tll, 48 kilos and 3 mm of extra fat around her belly button, I know something isn’t right. More often though, you can’t tell because the client really does have a bigger nose or saggy breasts, I can’t ask her: ‚Are you happy with your life?‘.“

Mirror, Mirror on the wall, better say nothing at all

The borderline between a usual desire to be beautiful and an unhealthy obsession can be rather thin. You think you’ll be happier having new breasts. But then you get a good idea to get rid of the small folds on your hips and also of the bags below eyes. It’s the same as other things in life – we set our hearts on certain dreams: when I’m done studying, I’ll meet my Prince Charming; when my house is built, when the kids are older and I go back to work, when it’s spring, summer...

Is it possible to achieve happiness, considering the body does age? Kristýna admits that it is quite easy to get addicted to plastic surgery. „I don’t want to just watch myself age. Now I’m content but I’m already considering whether I should get my neck or arms done. It’s depressing when I look at young girls, thinking I used to be that beautiful. The only justice is that in a few years, they will also look like me today. We are all getting older, „ she’s comforting herself.

In general, the happier we are on the inside, the easier it is to accept our looks. That is not the case of Tereza (26) who spends way too much time in front of a mirror. Every time she walks by, she checks it out, she would never miss out on her own reflection in a glass. She usually runs to work last minute, because she can’t make herself leave the house on time. When she’s stressed, she plucks her eyebrow so that not one little hair is sticking out; when she’s depressed, she stands in front of the mirror, pinching her belly, assuring herself that being so fat, she can’t go out. Mostly she ends up crying, thinking of liposuction, in worse scenario about suicide. And yet, Tereza is a very attractive woman who is just pedantically making sure she looks perfect.

Psychologists call this obsession dysmorphic disorder (BDD). A woman is obsessed with her looks but at the same time, she hates herself because she wants to look different -- younger, slimmer, she wants a firmer bosom or bigger lips. Even when she has gotten all this, she cannot be satisfied. Just as Tereza who is commited to fight everything that bothers her. „I had my teeth whitened, my hair extended and I wear colour contact lenses. Recently, I have had my lips enlarged and got the mimic wrinkles ‚dealt with‘ using botox.“ This year, she is planning a breast surgery. „Although they are quite big, I want them to be perfect“, she reasons.

This never ending round of cosmetic procedures is not the only consequence of BDD. It can also bring along depression, eating disorders such as anorexia and bulimia, fitness or shopping obsessions. And just as you can’t explain to an anorexic woman that she is too skinny, it is hard to convince a woman addicted to plastic surgery that before she was also beautiful and that she doesn’t need any operation. It is rather a therapist’s job.

Imperfect or edgy?

The trap of any obsession is that once you learn to find faults, you always find one. Even where nobody else would find it. However, things might come to breaking point where you stop and think. The money runs out, the operation does not turn out well, the body loses patience and the immunity system revolts. Or you start doubting your actions. Besides her breasts, Tereza wanted to get her cheek bones fixed. She is slowly waking up: „I’ve felt awkward since the last operation. Although it was done perfectly and the change is so small, suddenly I don’t recognize myself in the mirror. I start doubting how I’d feel after the next operation. Plus, that would be quite an essential change. Suddenly I’m not sure what’s better: not to be perfect or not to feel like yourself?“

It is important to distinguish the two kinds of aesthetic procedures. There are those giving you something beautiful you once had that changes with aging (wrinkles or sagging breasts). The other procedure change something you’ve had since you were born (big nose, thin lips, small breasts). With the latter, everybody should really think twice about why they want such change and whether it would really help. Of course it’s good to undergo a procedure that changes your self-evaluation and soothes your hang-ups; but not an operation that wipes out your personality.