Don’t blame Instagram for the popularity of plastic surgery; blame those who profit

From Botox to fillers, every time a new beauty treatment arrives on the market it seems to wash through society.

If cosmetic medical procedures were a solution to ugliness, you would think that supermodels and actors would be the last people to “get work done”. And yet it is considered newsworthy when a group of people defined by their beauty choose not to artificially enhance it.

Women’s magazines periodically run stories about middle-aged women (always women) who publicly eschew cosmetic interventions, sometimes at a cost to their professional success. “When you see everybody around you doing it,” mused the actress Halle Berry at the age of 48, “you have those moments when you think, ‘To stay alive in this business, do I need to do the same thing?’ I won’t lie and tell you that those things don’t cross my mind, because somebody is always suggesting it to me.”

You could bounce a penny off Berry’s perfectly taut skin, and yet she is apparently fearful of being outdone by her even tauter peers. You know that look that rich women all seem to share nowadays, a plumped and pouting, cat-eyed effect? That is a result of the dermal fillers they’ve had injected into their faces.

Male celebrities are now more openly getting in on the game, including by injecting fillers into their jawlines. “The trends are shifting in such a way that men are finally catching up to where women have been for decades,” one Beverly Hills cosmetic dermatologist told Fox News. Some of these interventions are subtle enough to offer plausible deniability. Some of them, however, are not (Simon Cowell once described getting so much work done that he looked “like something out of a horror film”).

Occasionally, cosmetic procedures go incredibly wrong. In 2015 the Canadian model Linda Evangelista – one of the most famous women in the world during the 1990s – retreated from public life. Last year, she revealed why. She had undergone a fat removal process called cryolipolysis that was supposed to use extreme cold to break down fat cells, further slimming her already sleek figure. But she suffered a side effect called paradoxical adipose hyperplasia, which affects less than 1 per cent of cryolipolysis patients. In layman’s terms, her fat cells expanded, producing hardened “bulges” in her flesh.

Evangelista described herself as “permanently deformed” and “brutally disfigured”. “I loved being up on the catwalk. Now I dread running into someone I know,” Evangelista told one interviewer through tears. In August Evangelista appeared on her first British Vogue cover since the procedure, wearing a hat and scarf to conceal its unwanted effects. Under these coverings, Evangelista’s skin was apparently expertly taped, and the photographs were retouched. In the final images, the 52-year-old supermodel looked much the same as she did when she first appeared on the cover of British Vogue in 1989. Even without the hats and Photoshop, in paparazzi snaps taken after her procedure, Evangelista looks fine. You wouldn’t look twice if you passed her in Tesco.

Except, of course, that supermodels need to look an awful lot better than the average supermarket customer if they are to continue working. Evangelista’s beauty is her livelihood, which is part of the reason she’s so devastated to find herself looking as ordinary as the rest of us. Such is the brutality of her industry.

In recent decades, this brutality has started to seep into the rest of society. It is becoming increasingly common for normal men and women (mostly the latter) to spend large sums on procedures that carry serious risks. The Brazilian butt lift (or BBL), for instance, is one of the fastest growing cosmetic surgeries in the world – and also among the most dangerous. A paper published in 2017 found that one in 3,000 BBLs carried out worldwide resulted in death.

At the less extreme end of the market, dermal fillers and Botox can cost only a few hundred pounds per treated area. It’s no wonder, therefore, that the filler “look” has become commonplace on Instagram.

More harmful, though, than artificial-looking results is the downstream effect when these interventions are done well. When a customer is left looking prettier and younger, but with no obvious signs of having undergone anything unnatural, it can only increase others’ insecurity.

Many commentators blame the prevalence of cosmetic surgery on social media, or even on Zoom. The theory is that, as we spend more time looking at our own digitised faces, as well as other people’s, the urge for aesthetic self-improvement becomes irresistible. I’m not so sure. My suspicion is that it is the inventors, rather than the consumers, leading the way; we find ourselves in the midst of an arms race. Every time an effective new beauty treatment arrives on the market – whether Botox or cryolipolysis – it washes through society, first hitting the celebrity class and then reaching us mere mortals as it becomes more affordable.

If almost every woman is wearing concealer, barefaced women start to look blemished by comparison; if almost every woman has had Botox, natural ageing starts to look strange. The only winners, in the end, are those making money from a beauty game that is inherently competitive. It is inevitable that the next cosmetics treatment will further raise the stakes, encouraging more effort, more money and more risk from players desperate to win.