- BraunS / Getty
- Plastic and cosmetic surgery have substantially grown in popularity over the last few years, with the number of procedures increasing from 14 million to 23 million globally since 2010.
- Men account for about 14% of all procedures, while women make up the rest, with over 20 million of them going under the knife every year to change their appearance.
- INSIDER spoke to four people who have had surgeries – a nose job, a tummy tuck, ear pinning, and a breast augmentation.
- Each had surgery for different reasons, but there’s one clear message: surgery should not be taken lightly, and it’s vital people visit professionals who know what they’re doing.
- Bad experiences don’t just harm individuals – they also alter the public’s perception of surgery in general by increasing misinformation, misconceptions, and stigma.
Connor* struggled with his weight his whole life. He told INSIDER he hit 266 pounds in his twenties due to the vicious cycle of being miserable about his weight, and eating more to numb the pain.
But at age 23 he thought “enough is enough,” and thanks to a new sense of motivation and a healthier diet, pound after pound fell off. Finally, in 2012, he completed the London marathon in under four hours.
This wasn’t the end of his body confidence issues, though. Connor was left with a large amount of excess skin and fat on his front which he couldn’t shift with diet and exercise. It didn’t bother him too much at first, but as time went on, it felt like part of his past kept haunting him. “I thought ‘I need to change this as it’s holding me back,'” he said. “I had spent years sorting it out … and I was just left with constant reminders of my previous body state and ill-health.”
So, when he was 30, Connor visited the MYA Cosmetic Surgery in London for a consultation about an abdominoplasty, which is a “tummy tuck” that makes the abdomen more firm, and liposuction, which removes excess fat.
The number of people getting cosmetic surgery is rising
There are about 23 million cosmetic surgeries every year worldwide. This number has risen from the 14 million total procedures in the top 25 countries in 2010. Men account for about 14% of all procedures, while women make up the rest, with over 20 million of them going under the knife every year to change their appearance.
“To me, at the time, cosmetic surgery or procedures were something people in Hollywood had, especially being a man,” Connor said. “I thought they may say there is nothing that can be done, but at least then I knew I had tried.”
People decide to have cosmetic surgery for many different reasons. Connor struggled mentally because of his weight, and the surgery helped him feel more in control. It made him realise he deserved to be happy, he said, and he found the confidence to take his shirt off on holiday, which he hadn’t done in years.
“It completely changed my life,” he said. “If anything. I wish I had done it earlier. But then again I had to go on my own personal journey and I was comfortable with that.”
Rebecca* also decided to have surgery to help her confidence. She told INSIDER she’d known she wanted to change her nose since she was 13 years old, and her decision to get a rhinoplasty, or nose job, at 21 was never influenced by anyone else.
“I had struggled for years due to low self-esteem and no confidence, and as a nurse I did not feel comfortable in a people-facing job role due to this,” she said. “Before I had the surgery, I had such a negative perception of myself.”
Rebecca tried to improve her self-confidence without resorting to surgery, but in the end it felt like the only permanent solution. She also visited the team at MYA for her procedure, who she said made sure her mind was in the right place for an adjustment as huge as changing your face.
It can sometimes go very wrong
A spokesperson for MYA told INSIDER that there are multiple steps taken with every patient to make sure they’re making the right decision throughout the whole process.
“Typically, a patient that comes to MYA has been thinking about the procedure for many years,” they said. “There can be a real nervousness to talk to people about what they are thinking of doing. We have an incredible community which massively supports people at whatever stage in the journey they’re at.”
- Sia Cooper / Instagram
Sia Cooper, an Instagram fitness influencer with 1.2 million followers, had a more difficult and traumatic experience with cosmetic surgery. She had a breast augmentation back in 2011, in her twenties, because she wanted something to boost her self-esteem. But she told INSIDER that although her new body helped her confidence initially, it became a burden on her health for the next seven years.
“Each year I became more ill and had more problems, and it went unexplained for the longest time,” she said. “I was having chest pain, hair loss, dry skin, blurry vision, and I was so tired I was sleeping up to 14 hours a day with a nap in the middle because I really could not function.”
Cooper visited doctors countless times to try and get a diagnosis, but blood tests kept coming back normal. She was showing symptoms of autoimmune disease, rheumatoid arthritis, and hypothyroidism, like swollen joints, rashes, and pain. No healthy 29-year-old should be getting these things, but there seemed to be no explanation.
It wasn’t until she heard about breast implant illness from her Instagram followers and a support group on Facebook that she thought her surgery could have caused the problem.
“Every story I read really resonated with me, it sounded exactly like what I was going through,” Cooper said. “A lot of women like myself have a hard time finding answers because doctors don’t believe us, and it’s not widely accepted just yet.”
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In life, we are often taught that if we don’t like something, fix it. When it comes to our bodies, this holds true. Instead of fixing ourselves physically, why don’t we ever stop to think about fixing our mentality first, instead? It all starts in the mind. Removing my breast implants has truly taught me self love. The day I had my explant was the day I threw my security blanket out the door. It felt weird going in reverse in a society that pushes us to continually alter ourselves. But I couldn’t go on preaching self love when I was still plagued with thoughts of wanting to change more about myself. So here I am. Scars and all. But I don’t mind the scars.. they tell an amazing story, I think. On a side note, it should be illegal to place these plastic bags over your heart and lungs. If you’re new to my page, I spent years going to doctors and having various tests without any answers. I had multiple autoimmune symptoms (fibromyalgia, lupus, rheumatoid arthritis, thyroid disease, and more) without a single diagnos. Nothing made sense until I found out about @breast_implant_illness. Now almost 6 weeks after surgery, almost every symptom has improved or resolved itself. It makes sense though.. they never tell you what silicone is made up of for a reason. It would shock you to your core. Now, you see women removing their implants everywhere and the truth is being heard. The FDA will be held accountable and I can’t wait for that day to come. Thank you all for your continued support. This journey has been just as much mental as it’s been physical. I feel like an odd trainer out sometimes, but I have to remind myself that it’s okay to be different and to stand out from a crowd. Just because a majority is doing something doesn’t make it right. I want my daughter and son to grow up seeing my scars knowing the price I had paid for false beauty. I want this to be a lesson to you all. The grass isn’t always healthier on the other side.. it’s where you water it. I encourage you to spend some time “watering” and nurturing your mental health. This is the true key to loving and accepting yourselves. It’s ok to go backward in order to go forward. ????
The evidence for breast implant illness is anecdotal for now, but just this week, a public hearing held by the US Food and Drug Administration agreed that patients should be better informed about the risks and benefits of breast implants.
The panel heard stories like Cooper’s, where women had suffered rare lymphoma, autoimmune problems, or connective-tissue disease after breast implant surgery.
Cooper said she was never warned that she could experience such pain and discomfort, and it was only when her implants were removed that she realised what a burden they had been.
“Immediately within the next couple of days after the explant I felt like I could breathe better, I felt lighter, I just felt an immediate sense of relief,” she said.
“Over the next few weeks, I lost 10 pounds, and my face completely changed … I can lift weights again, my knees don’t hurt, my acne has improved, and I’m not as tired. It’s incredible.”
She said her body was expending so much effort trying to fight off her implants – which weighed a pound each – but in the end started attacking itself.
The risks of popular procedures are often downplayed
Cooper thinks that because breast enlargement surgery is so common, people tend to assume it’s routine and they will always be fine. It is currently the world’s most popular cosmetic procedure, with 1,677,320 breast augmentations being performed in 2017, according to the International Society of of Aesthetic Plastic Surgery.
It’s not that Cooper believes cosmetic surgery is all bad, but she said people should be aware that it’s a decision that shouldn’t be taken lightly. All the necessary information about what people are getting themselves into should be transparent, she said, especially if the solution to breast implant illness is going under the knife again.
- Sia Cooper / Instagram
At MYA, only 10% of patients who come in for an initial consultation proceed to have the surgery, because of the diligent checks the team has in place to assess their mental health and pre-existing conditions.
“If any of the experts involved feel the patient’s long-term health and wellbeing will not benefit, the risk is that the patient will return unhappy shortly after surgery and that is not a good situation for anyone,” the spokesperson said.
“If a partner has heavily influenced the decision, the prospective patient is indecisive or a recent ‘trauma’ has taken place – there are different pathways that will be taken with a high likelihood that surgery will not take place, or certainly not at that time.”
Still, plastic surgery is good business
Harley Street Aesthetics cosmetic surgeon Dr Dirk Kremer hinted to INSIDER that surgeons don’t always operate this way, though. After all, it’s good business if someone keeps coming back to get more work done. The average annual salary for a cosmetic surgeon in the US is around $150,000, but some make over half a million dollars a year.
A really good surgeon, however, realizes “less is more,” Dr Kremer said, which means seeing the “real beauty” in individuals, and noticing how the smallest tweaks could vastly change someone’s face.
“Really it’s something that the harmony is missing, that there’s one thing in the face that’s maybe has to be repaired, let’s say,” he said.
“There’s the classic beauty, like Grace Kelly, but it’s like saying everyone who doesn’t look like her is not beautiful, and that’s not true … There are an endless amount of women, they are all beautiful but they all look different.”
Social media makes people feel imperfect
Dr Kremer said when some people go in for surgery, it can be like opening Pandora’s box, because they are never happy with the results. Cooper agreed, saying even when she had her implants, she still had low self esteem. She thought about going back to the surgeon with everything else she wasn’t happy with, from her thighs to her nose.
Cooper says social media has played a huge role in people thinking they’re not “perfect” enough.
- Harley St Aesthetics
“A lot of people do look through their newsfeeds and bring pictures to the plastic surgeon and say ‘I want to look like this girl, I want boobs just like that,'” she said.
“I think social media can be a great tool but it can also be very bad. So my advice is to unfollow anyone who makes you feel bad about yourself.”
The most dramatic shift Dr Kremer has seen in his career is the rise “non-invasive” procedures like fillers and Botox – the number of women in the US aged between 19 and 34 getting these procedures has risen by 41% since 2011, for example.
He also attributes this to the rise in social media, and how admitting you’ve had lip fillers is seen as acceptable. For instance, we’ve seen celebrities who’ll admit they’ve had lip fillers, but won’t come clean about their facial reconstruction or Brazilian butt lift.
Dr Kremer said patients come in to see him with unrealistic expectations for what these procedures can do. For instance, they might like how they look on their Snapchat filter, with bigger eyes and a more defined jaw, but it’s not a realistic goal.
“People think ‘wow, filler can do that,'” Dr Kremer said. “It’s an impossible standard.”
He added that it doesn’t make sense for someone to say they’ve only had their lips done, but for their whole face to look different.
“It’s like lip fillers you can admit, but if she said she had her whole face broken and pulled forward with screws or whatever, they say that’s crazy.”
There’s little regulation around fillers
If young women think fillers can change their face, they may also visit backstreet beauticians for the procedure, which Kremer said can be dangerous. If done incorrectly, filler can block nerves, leaving patients with severe skin necrosis, or even blindness.
Kremer said that just because a procedure is labelled as “non-invasive,” it shouldn’t be seen as such. Someone is still injecting your face with a foreign substance, and cheaper products mean worse – and potentially dangerous – results.
“Botulinum toxin injections, dermal fillers and other ‘minimally invasive’ cosmetic treatments can be administered by anyone, regardless of their qualifications,” reads an article on the site for Save Face, a national register of Accredited practitioners.
“In addition to their lack of qualifications, untrained practitioners often purchase cheap, unlicensed products over the internet and the implications of this can be dire.”
Fillers and Botox have become so popular among younger women that the average age someone goes in for a cosmetic procedure is the lowest it has ever been at 39 years old, according to research by plastic surgeon Dr Julian De Silva.
“It used to be only older people who would have facelifts and necklifts, so people aged 40 to 50, and the change is really obvious,” Dr Kremer said. “But now you’re having people who have a young, fresh face, and that’s exactly what you should see, but they want more – fuller cheeks, fuller cheekbones, chiseled jawline, a thinner nose … these are the facial procedures young people want.”
They already have the benefit of having youth, he said, which is what older patients are longing to have.
“They have it but they don’t appreciate it,” he said. “They do these treatments and they create a new type of woman that is ageless. Basically between 20 and late 40s even, they can all look the same.”
People fear the social stigma
Dr Kremer was recently interviewed on the BBC with Megan Barton Hanson, a contestant on the reality show Love Island who is famously upfront about having various procedures like lip fillers and a breast enlargement. But she regularly receives a slew of negative attention online for her honesty.
“I can’t believe everyone is up in arms that I’ve had surgery,” she said. “I don’t know why it’s targeted to girls my age to go and get surgery … but then when you get it you’re penalized for getting it.”
- BBC / YouTube
Barton Hanson hits on a point that is a concern for many people who want surgery – the stigma.
Connor, for instance, initially felt a lot of guilt about spending the money on himself, especially as he had just become a dad.
“I also felt rather embarrassed, again because it was to do with my weight,” he said. “I was worried people wouldn’t understand and also they may just think it was the ‘lazy way’ of getting myself in shape as I hadn’t really opened up to many people about my journey and how I felt as I found it difficult.”
Rebecca said she has never regretted her rhinoplasty, but she’s aware cosmetic surgery in general is given a bad name, and is often associated with vanity.
“I did not get my surgery so I could find myself a modeling contract or take better selfies,” she said. “I got it so I could feel comfortable going to do my food shopping and go to work without this dark cloud of low self-esteem hanging over me.”
Another 26-year-old woman, Ana,* got her ears pinned back when she was just 10 years old. She said her ears never really bothered her, but her mother would comment on them often and made her and her sister get the procedure before they were even aware they could be bullied.
“Honestly, I’m not sure how I feel about the decision now,” she told INSIDER. “Since growing up I was never insecure about my ears, I often wonder if I would have grown to eventually develop that insecurity later.”
Ana said she often felt more insecure about the fact she’d had surgery than she did about her ears, because she didn’t want to seem vain. Being an objectively attractive person, she still sometimes worries that people will think unkindly of her for getting work done.
“There is definitely a taboo, and you see it most strongly in men,” she said. “They’re happy to look at and admire beautiful women but seem personally offended when they hear about plastic surgery, as if they’ve been duped.”
She said people sometimes deny that certain celebrities are attractive because they’re “fake,” which is absurd because its as if their perception of beauty changes when it comes to light they’ve had surgery.
“I think culturally we still very much value ‘natural’ beauty, and people are very put off by the idea that it might not be real,” she said. “Personally, I try not to judge. I see how much someone’s appearance can have a negative impact on their self esteem … and I can’t pretend I don’t have insecurities of my own.”
What does more harm, she believes, is pretending the surgery never happened. Having two younger sisters, Ana has become very aware of how social media posts of flawless faces and bodies affect their self esteem.
“I think sociologically speaking it does a great deal of harm for people to pretend that unrealistic beauty standards come naturally, and that has greater and more damaging repercussions,” she said.
“While I don’t have a problem with people doing all sorts of things to their bodies for their own reasons, I do have a problem with people putting on these false facades and setting unrealistic expectations for others, particularly a generation of impressionable young women.”
- Peter Cade / Getty
The desire to compete is stronger than ever
Instagram isn’t the cause of people’s body confidence issues, but in a world where everyone posts their best selves and edits out imperfections, the desire to compete with each other is stronger than ever.
Psychologist Robert Burriss told INSIDER that humans compete for partners, and because we prefer partners who are attractive, we are motivated to make ourselves look better, too. Men tend to value physical attractiveness cues more than women do, he said, which can explain why women tend to spend more time and money on enhancing their appearance.
Research has shown that facially average, feminine, and youthful women are consistently rated as more attractive, and so the most common procedures emphasize these characteristics like even and smooth skin, plump lips, and a thin nose.
“It would be very odd if someone underwent surgery in an effort to appear, for example, older,” Burriss said. “Many individuals report that they undergo cosmetic procedures, or make other appearance enhancement efforts, to make themselves feel better or to enhance self esteem. This makes sense and is certainly true in many cases.”
But we should also think about why we feel bad if we don’t look our best, he added.
“It is because evolution has shaped us to compete for partners, and prospective partners are motivated to judge us based on appearance,” he said. “We don’t have to actively be seeking a partner to be swayed by these deep-seated motivations.”
- Enes Evren / Getty
Despite this, the spokesperson for MYA said it’s a misconception that cosmetic surgery is all about attracting a partner, and it’s also untrue that the decision to go under the knife is always led by vanity.
For instance, many women choose to have breast reductions to alleviate back pain and allow them to play sports which they may not have otherwise been able to do in the years to come.
However, conditions like breast asymmetry and tubular breasts, which is where breasts sag due to minimal tissue, no longer fall under the NHS category of “congenital abnormality,” or birth defect that can be treated for free in the UK, despite the fact that they used to.
“We’re making a conscious effort to change how we represent ourselves at MYA, and are going through a process of evolution where we are more and more focused on the reasons behind why a person decides to have surgery,” the spokesperson said.
“We do find that the media still has a tendency to shine a spotlight on patients who have had extreme cosmetic surgery – which isn’t representative of most patients and focuses on a minority group of people.”
In reality, most of the cases of surgery are like Rebecca and Connor’s experiences – people who thought about the decision for a long time, and felt the benefits not just physically, but mentally. It’s just that they’re not spoken about as much as when someone is “botched” or has so much surgery that they’re unrecognizable.
Surgery has to fix the root problem to work
Things can go wrong, and surgery isn’t the best option for everyone. But arguably, more honesty and correct information about the risks, benefits, and realities of cosmetic surgery would be the best thing for anyone considering it. It would also probably reduce the chances of people making changes they regret, or being harmed in the process.
Cooper said if she had known what she knows now, she would never have had her breast augmentation.
“I would go back and tell myself to look at the root issue, and it’s all mental,” she said. “You have to fix your mental state, and your relationship with your body, instead of jumping to have someone quickly alter it.”
Rebecca, on the other hand, said during her recovery, she had “two of the blackest eyes” she’d ever seen, and she couldn’t even open them. But it was still worth it, she said, because she was told every step of the way what to expect.
“My family and boyfriend were so supportive and knew I had to do this for myself,” she said. “I have absolutely no regrets.”
Connor said he wouldn’t change a thing either, and once the wound had healed and the swelling had gone down, he was free to move forward with his life with confidence.
“What is silly and insignificant to some people can be the thing that plays on your mind every day of your life,” he said.
“I think if you know in your heart that there is something you don’t feel comfortable with about your body, there is no shame in having cosmetic surgery. It can really boost your mental and physical wellbeing, as well as your confidence, and ultimately, your life.”
*Names changed for anonymity.