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Implant or Animal?

From nose jobs to liposuction, perfection awaits.

Apr 23, 2007, Vol. 12, No. 30 • By RACHEL DICARLO
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Beauty Junkies

Inside Our $15 Billion Obsession with Cosmetic Surgery

by Alex Kuczynski

Doubleday, 290 pp., $24.95

In the decade since she turned 28, Alex Kuczynski has had an eyelift, Botox, collagen treatments, liposuction on her thighs, and a disastrous Restylane injection that inflated her upper lip to the size of a large yam. After the lip-swelling experience, Kuczynski, a reporter for the New York Times, abandoned cosmetic surgery for good and wrote Beauty Junkies, a droll examination of the modern obsession with cosmetic surgery, its cultural implications, and the horrifying surgical procedures and upkeep some endure in the quest for perfection.

There's the Upper East Side podiatrist, known as New York's "foot face-lift" doctor, who shortens her clients' toes so their feet fit into ultra-skinny Jimmy Choo heels, and injects collagen into their soles so their feet can withstand the brutal pounding of high heels on cement. The podiatrist explains her practice to Kuczynski: "We live in a 15-second culture. That's how long it takes for a man to look at you and decide if he will be in love with you. That's it. And if you're wearing stiletto sandals and your feet look like hell, he's not even going to give you the time of day."

One of Kuczynski's creepiest subjects is Mrs. X in Los Angeles, the wife of an entertainment mogul, whose upkeep "encompasses all her interests: It is her profession, her hobby, passion, and primary relationship." She is a member of the Restylane frequent-user awards program, has her porcelain veneers changed yearly, slathers her skin daily with cow-brain extract, and finds something to be nipped, tucked, or remolded once a year. Among her friends she's considered the norm. She won't give up her age to Kuczynski, but on a good day she might pass for 30--although she has a 33-year-old child from her first marriage.

Some have died on the operating table, including, in a fatal twist of New York irony, novelist Olivia Goldsmith. Goldsmith's book The First Wives Club (later made into a movie) exalts a trio of middle-aged women who, Ivana Trump-style, don't get mad but get everything, and derides as vapid and shallow the younger women for whom their husbands leave them. In real life, Goldsmith entered the prestigious Manhattan Eye, Ear, and Throat Hospital for a chin tuck and went into cardiac arrest after receiving the anesthetic. She died instantly.

Then there's the nonsurgical Botox, a purified crystalline form of poison found in spoiled sausage which, when injected into the face, eliminates lines by paralyzing the surrounding muscles. Botox became something of a household word in 2004 when John Kerry was rumored to have used the stuff to smooth out his furrowed brow. Since then, sales have risen $200 million a year. Since 1997, they've increased by 2,446 percent. American women used to host Tupperware parties for their friends or have the Mary Kay lady come by to show them how to put on their makeup in five minutes or less. Now they have "pumping parties" at which a doctor arrives with a bag full of needles and Botox to inject the host and her friends while they sip vodka and gin tonics or some other calorie-free cocktail.

A whole new lexicon has emerged to describe the world of the improvement-obsessed. There's the "carb face," for those faces that show evidence of ingesting bread and sweets; "trout pout," for overfilled lips; and "Kabuki mask," for an over-Botoxed face incapable of showing expression.

Cosmetic surgery is no longer the exclusive privilege and distraction of the wealthy or famous. Radio shock jocks promote contests in which young, female listeners write raunchy letters describing why they deserve breast augmentation. College girls save their money for cheap liposuction. There are cyber-begging websites like on which women pose topless in hopes that a benefactor will donate a large sum to their cause. The public adores TV makeover shows and dramas about plastic surgery such as The Swan, Extreme Makeover, and Nip/Tuck.

Here are some facts presented by Kuczynski: In 2004, 290,343 Americans had excess fat trimmed from their eyelids--up from 229,092 two years before that. (Evidence that women now reject old glamour in the form of the droopy "bedroom eyes" look Marlene Dietrich and Tallulah Bankhead helped bring into vogue.) Liposuction is Americans' favorite procedure. In 2004, 478,251 Americans had fat vacuumed from their bodies--up 111 percent from 1997. Tummy tucks are up 144 percent.