Anxiety-driven, painful, and sometimes even deadly: is cosmetic surgery self-harm?

Women are force-fed crap from the day they’re born, then mocked for having swallowed it.

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Neighbours described Leah Cambridge as “absolutely stunning”, while her partner said she was “a natural beauty”. This didn’t stop the 29-year-old from travelling to Turkey to undergo a “Brazilian butt lift”, a procedure that transfers body fat to the buttocks from areas such as the stomach and back. She suffered multiple heart attacks and died on the operating table.

Tragedies such as these tend to prompt one of two responses. First, there’s concern about a lack of regulation in the cosmetic surgery industry, particularly in cases where customers have travelled abroad. Then there’s dismay that women are taking these risks to begin with. Has popular culture really made them so shallow?

Writing in the Mail, Amanda Platell describes Cambridge as having been “so desperate for a perfect post-baby body that she went to Turkey for a Kim Kardashian special”. “How,” writes Platell, “does her children’s father explain to them that Mummy died because she wanted to be perfect – when she always was in their eyes?”

News of Cambridge’s death came in the same week as reports claiming that nearly a quarter of UK girls aged 14 are self-harming, with links being made to poor body image. On the surface these are quite different things. The grown woman who offers up her healthy body to the surgeon’s knife is not the same as the teenager who cuts herself in private.

Nevertheless, parallels are there, at least if we move beyond the vanity-shaming that so often accompanies our responses to women who pay someone else to stick in the knife. Can’t cosmetic surgery also be viewed as a form of self-harm? Why else would a woman undergo so much pain, surrounded by people who try to persuade her it is not worth the cost?

Leah Cambridge made a decision only she could make, for a body that was hers alone. Yet the boundary between self-harm and self-actualisation is not always a clear one.

Yes, adverts promising that a nose job or breast implants will reveal the “real you” – as though women arrive on Earth as mere lumps of clay, waiting to be sculpted into being – are obviously ludicrous. Even so, the ability to change one’s own appearance can feel like a source of power. To alter what people see when they look at us is to alter our own position in the world. Where, then, does self-expression stop and self-destruction begin? Can the two even co-exist?

From my own experience, I’d say that they can. There will always be a part of me that believes that the body I had when I was suffering from anorexia was more truly “myself” than the body I have now. Women search for a body that tells the story of who they are, but they do so in a culture that insists biological imperatives – growth, disease, death – must be dreamed, denied, sliced and staved away.

You only get one life; why live it in a body that miscommunicates with its own environment? Why shouldn’t you be seen as the person you really are? To live otherwise is painful, too. As Naomi Wolf put it in The Beauty Myth, “if you tell someone she has cancer, you cannot create in her the disease and its agony. But tell a woman persuasively enough that she is ugly, you do create the ‘disease’, and its agony is real”.

Women are not stupid. We see the celebrity magazine covers and the Sidebar of Shame. We’ve heard the way men (and women) disparage the bodies of women they do not like. We’ve noticed the creeping invisibility that sets in during our early forties, and we’re well aware of all the ways in which a woman’s appearance is used to cast doubts about her intellect.

It is hard not to conclude that it is just easier to change one’s own body than it is to change the world. This is why I find the vilification of female vanity – frequently disguised as body positivity – so utterly pointless. We’re force-fed crap from the day we’re born, then mocked for having swallowed it. Criticisms of cosmetic surgery cannot start and end with “she should have realised she looked fine as she was”. Fine for whom? Clearly not for her.

Criticisms are needed, though. How can it be that we have normalised starving away some parts of your body, sucking out others, slicing off still others, and then pumping up whatever remains with silicone, collagen and Botox? This is not just self-expression. It is anxiety-driven, painful and shot through with the knowledge that whatever we do, it will never be enough. There will always be someone more ageless and perfect, at least until one can purchase a full body transformation into human sex doll.

As long as women and girls feel they have little control over how their bodies are perceived in public, the right to do harm in the name of regaining possession – setting fire to the territory to deny the occupier – will exert a powerful draw. It doesn’t matter whether what we are doing is generally interpreted as making the body more or less valuable to others. The slicing of skin, the removal of flesh, the inflation of breasts – all of it becomes a way of trying to find an authentic physical self. Liberation from these damaging rituals will require more than pep talks.

“Soon,” argued Wolf in 1990, “not even a loving partner will be able to save many women’s sexuality from the knife. Today a woman must ignore her reflection in the eyes of her lover, since he might admire her, and seek it in the gaze of the God of Beauty, in whose perception she is never complete.”

What drives women and girl to self-harm is not so much distorted self-perception, as a hyper-awareness of our place in the world. There’s no procedure on offer that will give us thicker skin. Change needs to come from outside our own selves.

You can find information, help and advice about anorexia at Beat. You can find more information, help and advice about self-harm at Mind.

Glosswitch is a feminist mother of three who works in publishing.