Plastic Surgery: Six things I learned about this emotionally loaded, spiritually conflicted choice

Plastic Surgery: Six things I learned about this emotionally loaded, spiritually conflicted choice

Illustrations by Karine Leger (

My friend Wendy has always been the envy of our group of women friends. Willowy-tall, she has legs that go on forever, naturally blond hair, and a face like a model’s. Yet when she turned 50, she began to notice those little flaws that vex every woman of a certain age. In her case, droopy eyelids became the focus of intense dissatisfaction.

“Look how this lid makes it hard to open my eye all the way,” she said a few years ago, as I drew close. “I’m thinking of getting surgery to correct it.”

I was taken aback. Wendy was gifted with so many physical charms, and to risk going under the knife for one tiny imperfection seemed vain. Why meddle with nature’s course?

And yet soon after, I felt the sting of judgment myself in the office of my dermatologist, an opinionated, hilarious man. For 15 years we had bonded over my precancerous sunspots. But on this particular day, he looked into my face and frowned. “You know, I can take care of those crow’s feet,” he said. “And you might want to consider some lipo for your tummy.”

Indignant, I replied: “Why would I want to do that?”

He smiled: “Um, so you could get a date? And look less matronly?” He hugged me as if to say, just kidding! But his words stung. As I passed through his posh waiting room, I stared at the perfect beauties waiting for their next Botox fix with a bit of scorn ... and a hint of jealousy. And in turn, they seemed to look at me with curiosity. Look—a woman of 60 who’s had no work done! Doesn’t she care how she looks?

Welcome to the Great Plastic Surgery Debate—between women who do and women who don’t, and between the pressure to look 25 no matter the cost and our desire to be true to ourselves and lead authentic lives. It is a quiet, undeclared war, in which we sit at the table facing each other, judging, woefully self-critical, and contorting ourselves to fit into a culture where youth rules and age makes you invisible.

Only a few decades ago, plastic surgery was limited to socialites and other women with money and a big stake in looking perpetually 25. Now it’s positively mainstream. Even in enlightened circles—at yoga and meditation classes, and at ashrams and Buddhist temples—you can see the strangely tight faces, the too-pouty lips, the breasts that defy gravity. If plastic surgery has confounded me in general, the indulgence in it by those following a spiritual path—a path that emphasizes transcendence of the ego—leaves me flummoxed.

No fewer than 14.6 million cosmetic plastic surgery procedures—both minimally invasive and surgical—were performed in this country in 2012. In order of popularity: breast augmentations, nose jobs, liposuctions, eyelid surgeries, facelifts, and tummy tucks.

Yet some indicators hint that a backlash has begun. In Hollywood, Isabella Rossellini has referred to cosmetic surgery as “the new foot binding”; Salma Hayek blasted it as “the uniform of a generation”; Halle Berry calls its proliferation “really insane, and I feel sad that that’s what society is doing to women.” And Emma Thompson, Rachel Weisz, and Kate Winslet have formed what they have dubbed the “British Anti-Plastic Surgery League.”

Other signposts are popping up. Sixtyish model Cindy Joseph has created a cosmetics line, Boom, aimed at women of a certain age, and business is (ahem) booming.

“I feel like we’ve reached a tipping point, and women are waking up,” she says. “It’s exciting to see how many women are beginning to see the beauty of aging and wearing it with style. We love our wrinkles and wear them proudly.”

And Mireille Guiliano, the author of books including the best-selling French Women Don’t Get Fat, is bracing for controversy when her new book, French Women Don’t Get Facelifts, is released this Christmas.

“Sex and seduction are not reserved for the young in France. French women see aging as a stage of life, and wrinkles come with it and are an expression of who we are,” she says. “We also like a natural look and think it’s disconcerting to see a stretched face without any expression or life.”

Yet plastic surgery also has its staunch defenders. Women get a nip or tuck for many reasons that have less to do with vanity than with surviving in a tough world with their sense of self-worth intact. Making the decision to cut or not to cut even more agonizing is the fear that they will be judged if they choose the surgical route to youth.

All of these thoughts on the controversy set me on a path to examine the phenomenon of plastic surgery through a lens of spiritual exploration. In the course of my journey, I’ve learned six key lessons from the Great Plastic Surgery Debate.

Lesson 1: We avoid the present moment.

From hormone replacement pills to Viagra to yoga poses that promise better skin, it has never been easier to avoid the signs of aging. But that raises the question: why should we want to?

“I’ll never forget getting an email from a vendor who wanted to sell me an ‘antiaging’ element for my cosmetic line,” says Joseph, who calls Boom a “pro-age” line. “I replied to him and said, ‘I’m sorry, but you’re kind of missing the point. Age is to be celebrated, not hated.’”

I know that in my own life, aging has offered me some fantastic benefits: from excellent friendships to time to read, from a greater understanding of the human heart to an appreciation of Shakespeare. But savoring those things requires slowing down life’s frantic pace and embracing the present moment, seeing the beauty of the age I am, rather than pining for a younger version of me.

The media theorist Douglas Rushkoff, author of Present Shock, makes the argument that our culture is stuck in what he calls “the short forever.”

“Fighting time is not only impossible but counterproductive,” he says. “When people try to freeze time, they lose access to the living moment.”

His take on shows like The Real Housewives of Beverly Hills, in which the superwealthy bicker and bond over Botox and boob jobs: “They are trapped in another version of the short forever—one in which a particular stage of one’s life is deemed to be better than the rest, and so everything before and after is remade in its image.”

Lesson 2: We can’t deal with impermanence.

“This is definitely a youth-obsessed culture,” says the Buddhist teacher Lewis Richmond, author of Aging as a Spiritual Practice. “It’s almost impossible for us to grasp the idea that nothing is permanent and everything is in flux, including our identity and including us.”

Our own cells embody this truth—every day, our physical form is changing, aging, marching toward the day it will give out and disappear, he says. “I write in my book that ‘everything changes’ is the first truth of Buddhism and thus of human life. From a spiritual perspective, you have to begin with recognizing that loss is written into the fabric of existence.”

Yet accepting that impermanence can also bring great joy. “The evanescence of things is the reason you enjoy your life,” he says. “A plastic flower might look pretty at first glance and will be around forever, but only a real flower, which will wilt and drop its leaves soon after blossoming, is truly beautiful.”

How does this relate to women who strive to never change? “When you cling to what you know you will lose, you suffer needlessly,” Richmond says. “But embracing impermanence is opening the door to joy.”

Lesson 3: Older women feel invisible.

Not surprisingly, the largest demographic getting face-lifts comprises women pushing 50.

“Men buy Ferraris; women buy face-lifts because they want to feel that they are still wanted, valued, and desirable,” says Lynn Forbes, cofounder of the Whoa Network, an online community for women at midlife and beyond. “Women feel less powerful, less seen and heard as they age.” Old is deemed bad and young is good in our culture, says Forbes, which is why so many women this age suffer from a lack of self-esteem.

I’ll never forget the night I was flirting with an old boyfriend at a party—until I realized he was actually looking at a beautiful girl standing behind me.

“It feels like there is nothing more humiliating than being a middle-aged or old woman in this American culture,” says Nicole, 57, a Los Angeles writer and professor who had a full face-lift. “I’d suddenly become invisible, and for someone who was used to being heard, it was unacceptable. So I did something about it.”

Stubbornly quixotic women like Joseph, though, believe that no one can take your power and self-esteem unless you let them. “This generation has reinvented every decade it’s been in. I see this as a great opportunity for boomers to model a whole new way of living our later years. The shift is definitely happening. When we change our perception of ourselves, when we refuse to be invisible, the world will change its impression of us.”

For Carole Simone, a Northern California spiritual coach and healer, women’s reasons for seeking a nip or tuck all boil down to one thing: “I see clients all day long who are having procedures done, and they’re confused about it,” she says. “They’re concerned about how lovable they are. I don’t have any judgments about [surgery], but if I can help them see themselves as strong and beautiful, then they can make a solid decision about it. But I have compassion for any woman who questions whether she is worthy of love, as should we all.”

Lesson 4: We judge others and are judged.

Compassion is what I most certainly lacked a few years ago when I challenged Wendy about her decision to have her eyes done, and it came back to haunt me. When I approached her about letting me interview her for this story, her first question was whether I was going to judge her again.

“You gave me a bit of a hard time,” she recalled. “You had your opinion. It was OK because I did it anyway. I still loved you as a friend.”

But clearly my judgment had hurt her feelings: where I’d forgotten completely about my careless comments, she had not. I was ashamed of myself in hindsight; if my former self had viewed her choice as unspiritual, I know now that my own rush to judge her was that and more.

Many women have had similar experiences.

“I was at a pub one night where I liked to sing karaoke with my friends, about six weeks after having breast implants,” says Michelle, 55, of Nevada. “There was a group of very competitive ‘mean girls’ who would come in. When I got up to sing, one of them said, ‘Whoa! How do you spell plastic surgery?’”

Wendy is philosophical. “I think it’s just human nature to judge—but the judger might want to pause and reflect on what it is they have contempt for, and why.” As I wrote once, ‘Whatever I have contempt for, I’m might just as well set a place for it at my table, because it is either in my life already, or coming.’”

Simone agrees. “Judgment is all about fear, and under fear there is a lot of projection. You may think you know someone well, but you don’t know their deepest story. People have to find that place inside themselves that is big and inclusive.”

Richmond, the Buddhist teacher, evolved in his perspective toward cosmetic surgery after hearing poignant personal stories from women. “Ageism threatens their livelihood and their sense of who they are. People do what they need to do. How does it help to criticize them?”

Lesson 5: We need to know what we’re getting into.

In interviewing several women who have had “work” done, each one advised thinking carefully before deciding to go through with it or not.

In addition to the potential for emotional and spiritual side effects, cosmetic procedures do carry some health risks—from the (fortunately rare) horror stories of badly botched surgeries, to more common complications that can lead to a difficult recovery or long-term pain.

“Research your doctor carefully,” says Michelle. “Ask yourself why you’re doing it, and if you’re expecting your life to change as a result. If you are, I’d venture to guess you have some interior work to do first.”

Adds Jacquie, “Make sure that the only person you’re trying to please is yourself, and double-check those reasons.”

Gale, a filmmaker, had gone as far as booking herself into the surgeon’s schedule to take care of a droopy jawline, only to cancel at the last minute. “I felt like doing this would mean apologizing for being the age I am, and I don’t have anything to apologize for. I would have been haunted long after by the sense that I am vain.”

If you’re contemplating taking this step yourself, Simone suggests a meditative exercise. “I encourage anyone considering this to go inside themselves and ask one question of the wise-woman part of them. Ask that wise woman, What are you trying to tell me? And listen to that. And then ask the wise woman if this is the highest good.”

She advocates a thoughtful, cautious approach. “When you quiet down and get away from your fear, ask yourself, What are you afraid of? And if you can work with that part that is afraid, then you can make a good decision. I just always try to remind people that you can always be more beautiful, but it won’t bring more joy into your life.”

Lesson 6: Everyone can win the Great Plastic Surgery Debate.

The first step in evolving past the knee-jerk stage of the controversy is to support other women in making whatever decision is right for them. Everyone has her own story, her own path.

Try slowing down long enough to be fully in the moment and at home with your true self. Embrace the impermanent (and imperfect) nature of our world and our bodies. You’ll be less judgmental of yourself.

Embrace your authentic self—whether that means getting that boob job or celebrating your crow’s-feet and gray mane. See what makes you happy in this bold experiment called life. And proceed with caution and think things through before getting a dragon tattoo or face-lift.

Reconsider the concept of beauty. “We need to change the whole notion of what true beauty is,” says Joseph. “When a woman feels good in her skin, when she’s happy and joyful and finds her true purpose and passions, she shines from the inside out.”

Cultivate inner happiness by giving of yourself. Volunteer at a senior center, organize a book club, audition for community theater. Doing for others keeps you from obsessing about those crow’s feet.

Buck the cultural impediments to visibility. Walk tall, refuse to take a table by the kitchen, make your opinions known. Change the way you look at yourself, and the world will change too.

Turn over a new leaf. “Reinvention is huge for women at this age,” says Forbes. “They call it the fuck-you 50s for a reason. We’re finally at a point where we have the courage to be ourselves, do what we want, surround ourselves with the people we want to be with. We get adventurous and start businesses, or go back to work after years of staying home, or focus on a passion, our creativity, or causes we believe in. I find this time amazing.

“But,” she adds, laughing, “I still don’t like the crow’s-feet.”

The author of Naked on the Page and editor of the acclaimed anthology Single Woman of a Certain Age, San Francisco-based Jane Ganahl wrote about environmental outreach at San Quentin State Prison in the May/June issue of Spirituality & Health.

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