A visit to the body shop: just cut ‘n go

Going under the knife is quicker, cheaper and more accessible then ever: supermarket surgery will soon make it as easy to remodel your face as it is to redesign a product.

New year, new you. How about it? Joined a health club yet? Started a diet? There’s nothing like an embarrassing photograph from the office Christmas party to make people reconsider their presentation, not to mention their capacity for alcohol. But the promises we make, like the pints we consume, ultimately end up in the toilet.

So what’s the solution? If you really want a new you, you could consider cosmetic surgery. It still needs willpower and a fair bit of cash, but you won’t have to join other hopeless cases down at the gym. You will, however, be joining a crowd of a different type. As well-off baby boomers approach middle age, more and more people are prepared to go under the knife. Cosmetic surgery is set for its own boom, and the only bust in sight is the one with implants in it.

Technology is rendering cosmetic surgery quicker, safer and less painful, and means more procedures are affordable to the average consumer. The repertoire of same-day surgery procedures is growing. With the aid of tools such as software packages that enable patients to create a blueprint for their new look on-screen before going into surgery, we are learning to redesign ourselves. As attitudes to cosmetic surgery relax, more people will want it.

The British Association of Plastic Surgeons recently argued that there was demand in Britain for up to three times as many consultants as presently exist by showing that referral rates are higher in areas where plastic surgery was easily accessible. GPs and doctors, the BAPS said, recognised the value of specialist local surgical services. These services would mainly meet the needs of patients recovering from trauma such as burns or breast cancer, but would also make cosmetic surgery dramatically more available to the population.

But it is in the US where attitudes to cosmetic surgery are more advanced, and the market there is years ahead of anywhere else in the world. The American Society of Plastic and Reconstructive Surgeons claims that the number of Americans who approve of cosmetic surgery has risen by 50 per cent over the past decade; it says 65 per cent of people having cosmetic surgery are from families with incomes of under 35 000.

Nothing illustrates more graphically the way cosmetic surgery is taken for granted in the US than a conversation I had with one of New York’s leading surgeons. Dr Sherrell Aston has a clinic on Park Avenue and operates at the Manhattan Eye, Ear & Throat Hospital. He spoke to me, as a matter of course, carrying out a facelift while wearing a telephone headset. In the background, I could hear the clanking of metal on metal and, at one point, a loud squelching noise.

“I’m talking to you from Room One in the world’s largest cosmetic surgery hospital,” he says. “We have eight or nine operating rooms doing purely cosmetic surgery every day. I’m starting my ninth operation of the day [it was about 3pm]. In New York, there’s a tremendous amount of cosmetic surgery being performed, and all over the US. It has increased significantly in the last ten years and it will continue to increase.” He explains that much of the increase is driven by the fact that techniques have been perfected: they are now predictable and reliable, and the complication rate has reduced substantially. “We do these things over and over again,” says Aston, “so we know what’s going to happen.”

The anaesthetic regimen is also much improved- there are intravenous drugs and combinations which didn’t exist five years ago, so people can have wake up much faster after their operation. “We now do ambulatory procedures with the idea that patients can leave the hospital about three hours after their operation. Eyelid surgery, nasal surgery, breast augmentation, chemical peels of the face, laser peels of the face, liposuction of small areas…

“For bigger procedures, such as facelifts, people stay overnight – they need time to prepare for surgery, and time for the drugs to wear off afterwards. It’s not like having your hair done and being able to walk out straight away. You do need a little recovery time. But if you think about it, being able to leave hospital three hours after having your nose or eyelids done shows we’re moving along fairly rapidly.”

OK, so it isn’t quite like going to the hairdressers. But it doesn’t seem so far-fetched that in ten years, clinics offering an expanding range of quickie outpatient services will have popped up all over Britain too. Customers will be able to choose from a wide array of procedures and, stage by stage, subject to some counselling and preparation, redesign their face and body.

New techniques are being pioneered all the time in the US. Endoscopic, or keyhole, surgery is becoming popular as a way of inserting breast implants or removing damaged tissue, for example, with a minimum of scarring and pain. Research is being carried out by NASA’s Jet Propulsion Laboratory, among others, on whether these high-precision operations could one day be carried out by robotic arms, directed remotely by a surgeon, the advantage being that the arm of a robot is not prone to the shakes or trembles that can sometimes affect human hands.

Sick of your tattoo, birthmark or wart? Have it removed by laser. Want rid of those wrinkles around the eyes? Have a chemical peel. Bored with putting on make-up every day? Have it surgically injected in the form of permanent pigmentation. There are all new developments in human tissue engineering. And just announced by US company Reprogenesis is its breakthrough in cultivating living human tissue in the lab. Its aim is to grow replica nipples and whole breasts for transplants: say hello to the test tube tit. Chemists in Spain and Brazil, meanwhile, have successfully grown artificial muscle in the laboratory.

With advances in liposuction techniques and bone implantation, there is scope now to completely rebuild your face – though Aston and all other legitimate surgeons will still turn away the kooks who turn up saying they want to look like Bruce Willis or Cindy Crawford.

But, who knows, in 20 or 30 years’ time the term “identity consultant” might be taken over by someone who helps clients develop their personal identity: designing not new logos but new faces. They would do this by manipulating digital photographs of their clients, on-screen, much as designers now do with products and packaging. “Morphing” is used already, but is seen as a bit of a marketing gimmick that sets up unrealistic expectations. With more development, it may gain credibility.

And with advances in behavioural engineering and mood-enhancing drugs, the identity consultant may even help people redesign their personality. Designers have been able to turn their hand to new skills and client groups in the past: why not the human body? It’s a frightening thought, of course. But the audience’s appetite has been whetted by the numerous makeovers of ordinary-looking men and women performed on breakfast TV by heavily-coiffed salon-owners and goateed wardrobe experts. The potential market is enormous.

Aston, busy sewing up someone’s face as he speaks, would like the job of advising on more permanent makeovers left to qualified personnel. “There are people in the US who are trying do that already: be personal consultants, advising people on what cosmetic surgery they need. But all they do is get people into trouble. They have little knowledge of what’s technically possible… They can tell people whatever they want, but then when the person sees a legitimate cosmetic surgeon they find out it’s all bogus.” With a slurping sound in the background, he is gone, and I am glad he can concentrate on the job in hand. He’s right: better leave this sort of thing to the professionals.

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