Look closely: some people are not real

Fed up with the wave of anti-Europeanism sweeping Washington, I took myself off to a Saturday night party: it was what Washingtonians like to call an "A-list" event, of the kind where you have to search desperately for a face you do not recognise. But, scanning those faces, an inescapable truth suddenly struck me. A large proportion of the people not only looked unreal, but were unreal: their faces and bodies had been chiselled and moulded to the extent that some looked, literally, artificial.

Women who appeared, from a distance, as though they could be in their twenties turned out to be 60 or beyond, their facial skin tightened so much that they were completely unable to frown; and at least some of the men, too, looked suspiciously as though they were not as nature intended.

Yes, America's 76 million baby boomers are turning out to be just as narcissistic and looks-obsessed as legend always had it. The oldest are now drawing perilously near to their seventh decade, but are refusing to accept that they are ageing just like the rest of us. The result has been an explosion in cosmetic surgery: last year, 7.4 million Americans (one in six of them men) put themselves under the surgeon's knife in a vain effort to look eternally youthful.

Many millions more have started using Botox, a neurotoxic drug derived from the Clostridium botulinum bacterium, and which is likely to be approved by the US Food and Drug Administration for anti-wrinkle use this year. Botox "relaxes" (or, more accurately, paralyses) the muscles around the eyes and forehead, keeping the skin smooth if reinjected in just the right quantity every few months.

In America it all starts, naturally enough, with Hollywood. From the disturbingly unreal face of Michael Jackson to the ultra-taut skin of Joan Rivers, the entertainment industry heralded the trend. The earliest known such case, in fact, was when an ageing music-hall star, Fanny Brice, underwent cosmetic surgery in a hotel room in 1923. (The American Society of Plastic Surgeons dates back to 1921, the surgeons having originally learnt their skills reconstructing the faces of young men injured in the First World War.)

In 1937, Popular Science Monthly featured a photo spread under the headline "New noses in 40 minutes". In the past two decades, it has became virtually incumbent on television anchormen and women to have their faces surgically "enhanced" - though few will admit it publicly.

There are rare exceptions, however. One is a black national ABC News anchorwoman called Carole Simpson, who freely admits to having what she calls a "chin liposuction and eyebrow lift". It was, she says, a painful process. This year, a 47-year-old CNN legal pundit called Greta Van Susteren was poached, for $900,000 a year, by the Fox News Channel; in the month when she was off the screens, she underwent a startling change in appearance after facial surgery including blepharoplasty, a process that involves removing fat from the upper and lower eyelids. Before, she looked a reassuringly normal woman with large, inquisitive eyes and prominent teeth. When she reappeared on 4 February, she looked like a clone of countless unreal, bland and only superficially attractive television anchorwomen.

This being such a conformist society, Americans flock to imitate the images they see in the media. Thus that vaudeville star in 1923 and Greta Van Susteren in 2002 set trends. The difference now is that the cosmetic transformations are being beamed into practically every American living room. The result is that, in the past decade, breast "augmentation" and "lifts" rose by 472 and 476 per cent, respectively; buttock "lifts" by 366 per cent; eyelid surgery by 190 per cent; liposuction by 386 per cent. Facelifts, already in vogue by 1992, increased only 77 per cent.

Back in Hollywood, Martin Scorsese, the film director, complains that it is hard to find an actor these days who has the ability to scowl. The reply of the cosmetic surgery industry - in this case, of a famous New York dermatologist called Patricia Wexler: "A scowl is a totally unnecessary expression." With such attitudes being pushed via Hollywood and then the nation's television screens, it is not surprising to find a survey showing that 89 per cent of American women are now unhappy with their bodies and want to lose weight.

Most of those 7.4 million Americans who offered themselves to the cosmetic surgeons' knives last year were still largely confined to social and economic elites - but the trend is rapidly widening. Surprisingly, in proportion to the population, the heaviest concentration of cosmetic surgeons is not in LA but here, around DC. Hence all the supposedly beautiful people at my Saturday night party - whose appearance, in some strangely primeval way, I found peculiarly upsetting. Was it because real substance, literally and figuratively, had been replaced by fragile artificiality actually intended to deceive? Or because so many of my fellow guests were, literally, not entirely real?

The answer is a combination of both, I suspect. Physical perfection and desirability are unreachable goals. The quest for them, in this current American craze, causes much pain, and often takes weeks of recuperation, hiding away until the bruising fades and the stitches are removed. There is also a disturbing sense that, in this culture, people are increasingly assessing one another on how they look, rather than on who they are or the qualities they possess.

Look past that drum-tight skin into those uplifted eyes, and all you see is a desperate, frantic unhappiness.