What happened to Rosa Travers, after she’d been skinned (carbolic acid and phenol), had her nose snipped, received paraffin injections in her breasts and was irradiated to remove undesirable body hair? That would have been the first part of her prize. When all was done, she had an opera audition. Rosa Travers was a sweatshop worker who in 1924 had the distinction of winning the New York Daily Mirror’s competition to find the ‘homeliest girl in New York’:
A plastic surgeon has offered to take the homeliest girl in the biggest city in the country and to make a beauty of her. All you have to do is to send your photograph with name and address to Homeliest Girl Contest Editor. We will not print names, and the photographs will be ‘masked’. Our art department will paint the masks on the photographs to obviate identification. Here is the chance for New York’s homeliest girl. Her misfortune may make a fortune right away.
Somewhere in the archives of the Mirror, a masked Rosa Travers gazes out in muted triumph. Some time later, the new-model Rosa would, I suppose, have been unveiled. Unless the carbolic acid caused a third-degree burn, the scalpel slipped, the paraffin migrated or she developed paraffinoma or ‘wax cancer’. In which case, there would, presumably, have been no ‘after’ picture. Worryingly, in her history of cosmetic surgery, Elizabeth Haiken ends the paragraph on Rosa Travers with a parenthesis: ‘what happened afterwards was not reported.’ At the very least, it suggests that Rosa’s misfortune did not make a fortune for her after all. Or shall we cheer ourselves up by assuming that the face-lift did wonders for her vocal chords and she lived happily ever after under the name of Kirsten Flagstad?
We don’t know whether it was homely Rosa or a friend with her interests at heart who sent in her picture and immortalised her as the phantom of the face-lift. If it was Rosa herself, she wouldn’t have been the only or the last woman to have been caught between the pressures of self-improvement and the puritan values of America. What’s a girl without congenital wealth to do if she hasn’t been blessed with some class-effacing talent or exceptional looks, when she knows that success in life is the result of an individual’s effort? Grasp the opportunity; go for surgery – which, it would seem from the association of beauty with an opera audition, is likely to take care of both. And what’s a girl to do if it all goes unpleasantly wrong on the operating table? Expect to be dropped like a burnt potato by her sponsors and informed by her friends that vanity reaps its own rewards.
If that strikes some as unfair, it probably wouldn’t surprise Rosa and her sisters. What’s fair about being born plain, flat-chested, or bandy-legged in a world where appearances are very nearly everything? Even talent in Rosa’s day didn’t quite compensate for an unsatisfactory face. Fanny Brice was the first famous woman to announce publicly – in 1923 – that she had had cosmetic surgery. She didn’t lack ability or appreciation as a comic actress, but she had a large, irregular nose and felt that her hankering to play Nora in The Doll’s House would never be fulfilled without recourse to surgery. Dorothy Parker sniffed that she had cut off her nose to spite her race, but Brice was just trying to enlarge her repertoire. Things may be thought different now: Barbra Streisand has climbed the heights of Hollywood stardom without a nose job. Her big movie break, however, was playing an unreconstructed Fanny Brice in Funny Girl.
We might blame Rosa and Fanny Brice’s predicament on popular democracy and the mass media; go back to ancient Egypt and the correlation of beauty with power would probably not have caused any young woman to lift an eyebrow, let alone to dream of collagen implants. Monumental images were limited (no movie screens or giant billboards) and controlled (no nubile lovelies cavorting on the TV in the living-room), so that beauty could become one of the innate attributes, if not the prerogative, of members of the deified royal family. Their god-given royalty, indeed, defined beauty. No point in a common girl eating her heart out in the Nile delta if she didn’t look like Nefertiti – she wasn’t supposed to. Much as she might admire Princesses Meretaten and Meketaten their sloe eyes, full lips and massively, pathologically, elongated bald skulls, she couldn’t hope to look like them. And, though the chances are she wouldn’t know it, they didn’t even look like themselves. The depictions of the royal women of Amarna were conceptual rather than realistic, Dorothea Arnold explains, quoting Edna Russmann, who dismisses the search by other scholars for a pathological explanation of the egg-headed princesses. Such views are, she says, based on false premises. ‘They arise from modern perceptions and preoccupations – from scientifically oriented curiosity and from our irresistible tendency to assume that distinctive features must, like a photograph, mirror an actual appearance. Akhenaten’s concerns, of course, were entirely different. In departing radically from the styles of all earlier royal representations ... the ... representations of Akhenaten at Karnak are deliberately unrealistic.’ In other words, the extraordinary features were metaphors for the extraordinary, otherly nature of the royal family. Not that this would be very different from the way Hollywood depicted Gloria Swanson, Greta Garbo or Clara Bow, who were, in addition, called stars to suggest that they were out of this world. It’s perfectly possible that Clara Bow’s sweetheart lips would have struck an ancient Egyptian scholar as pathological rather than an image of other-worldly perfection, but our common girl from the Nile delta would not be burdened with Rosa Travers’s democratically induced belief that it was only sheer bad luck that she herself lacked such perfection, nor with the scratchy feeling that if she could do something about it, she ought to. In 20th-century America anyone could come from anywhere and turn out to be Greta Garbo; indeed Fifties-pretty Elizabeth Taylor became Cleopatra and even married her Antony a good few times.
The early stages of European portraiture began, the late David Piper suggested in his 1992 study, The English Face, with tomb-effigies in the 12th century. Neither beauty nor individuality were the point of these monuments in death to rank, wealth and piety. None of these portraits in stone looks like anyone I have ever met. In England, it was not until Chaucer’s portrait in Occleve’s manuscript (c.1412) that likeness began to matter. ‘I have had the likeness made here to the end, in truth, that those who have least thought and memory of him may recall him by this painting,’ Occleve said. And, indeed, minus the smock and draped hat, he does look remarkably like my next-door neighbour. It wasn’t until Cromwell’s notion of warts and all that veracity played much of a part in portraiture. For those who wanted their quality – their power, their wealth, their talent – to shine through their face to posterity, court painters functioned in much the same way as 20th-century cosmetic surgeons. The images of Henry VIII and Elizabeth I were controlled by the sitters – Henry trusting Holbein to have the good sense, or sufficient self-preservation, to show him as awesome, though with a nicely turned ankle, rather than a fat, self-indulgent tyrant; Elizabeth not trusting anyone. In 1563 William Cecil drafted a decree demanding that she
be content that some special cunning painter might be permitted by access to her Majesty to take the natural representation of her Majesty whereof she hath always been of her own will and disposition very unwilling, but also to prohibit all manner of other persons to draw paint grave or portrait her Majesty’s personage or visage for a time until by some perfect pattern and example the same may be by others followed.
Elizabeth, for reasons of state, held back the years in her images, just as Cher, for reasons of occupation, goes under the knife; both being realistic working women. Vanity is in the eye of the beholder; women have always known the material value of looking good.
The scalpels used in cosmetic surgery, however, have largely been in the hands of men, and the profession was developed in the land of opportunity and private medicine, though it began straightforwardly enough in Europe, with reconstructive surgery on the faces of soldiers wounded in World War One. Maxillofacial treatment progressed not just for humanitarian reasons, but also because it was clear that severely disfigured ex-servicemen were less likely to get work in the postwar world. The urgency was to return the soldiers to economic independence; even then, it was agreed that looks counted when it came to applying for a job. But once the war was over, the plastic surgeons wishing to form a specialty of their own had fewer and fewer of what they thought of as legitimate customers, while they watched opportunists cashing in on their pioneering work to offer benefits to women who were neither disfigured, family breadwinners nor, in any obvious sense, ill. The quacks were raking it in. By 1939 the Ladies’ Home Journal was trilling about the surgical possibilities of ‘widening the eyes, changing them from round to oval, shortening the eyelids, lengthening or shortening the mouth or varying the width of the lips’. The original surgeons, worried by their Hippocratic commitment, felt obliged to treat only those who were diseased, not those who were dissatisfied. The solution came with the popularisation in the Twenties of Adler’s formulation of the inferiority complex. The now properly constituted organisation of plastic surgeons could justify performing the cosmetic operations they had previously despised. Mental health became an issue, and to back it up, the economic effects of poor mental health could be cited if a patient was deemed to be at risk. Market forces clearly had applied to movie stars who wanted to be more glamorous or appear younger for the sake of getting work; now middle-class housewives with noses that made them too self-conscious to be good hostesses for their husbands, or who risked losing their breadwinners to more youthful-looking women, could be helped. By 1941, the first diplomas in plastic surgery were awarded and plastic surgeons had incorporated cosmetic surgery into their practices.
There is a parallel here with the abortion on demand debate. Women had to present themselves as, and be deemed by their surgeon to be, at risk of mental illness if their ageing process was to be remedied: they weren’t free to make a personal choice about their appearance. Moreover, men were not just in charge of the surgery, they also provided motivation as husbands or bosses: a woman who wanted to keep her looks to keep her man or her job was considered by the surgeons to have a good case. It appears that the progressive popularity of cosmetic surgery had as much to do with what Haiken calls ‘tyrannical reality’ as it did with fantasies of perfection. According to Haiken, postwar American women found themselves middle-aged and invisible in an increasingly youth-biased culture:
At this crucial juncture, plastic surgeons found that the social and psychological justification for cosmetic surgery ... gave ageing a whole new look, while many middle-class Americans ... found it easier to alter their own faces than to alter the cultural norms and expectations about ageing that confronted them. Together, surgeons and their patients forged a new image of the face-lift as a sensible, practical and relatively simple solution to the social problem of ageing.
Women with large noses and small breasts (and lately men with puny pecs and slight penises) wanted to be what was perceived as normal. The surgeons colluded mightily with this. They were performing a service in maintaining the status quo. In 1965 a surgeon gave Esquire an example of what he considered to be a bad outcome of cosmetic surgery:
I had a woman patient recently; a very smart, chic, well-dressed woman. Middle-aged. She wanted a face-lift. She was married to a very responsible man in an upper-income bracket, and she wanted to look better for her husband. It sounded okay ... Later on I heard she absolutely ran amok – divorced her husband, ran off to Mexico, took a 25-year-old boy as a lover – the whole route. It was dreadful.
If the cheering has died down, I’ll continue. Contrast this with a case reported to Haiken by the surgeon Donald Moynihan:
The prospective patient was a young black woman whose cornrowed hair and black studies major in college suggested to Moynihan that she was ‘really into the heritage thing’, as did her request that he put a bone through her nose. ‘I respected the deep pride she had in her race,’ Moynihan recalled, ‘but the way I see it, no matter what, a bone through the nose is an unreasonable request. I turned her down.’
Difference became deformity. A dental surgeon explains how a child who was considered ‘bucktoothed’ in the Forties, would have had orthodontic braces in the Fifties and Sixties, but is now considered to have a ‘dentofacial deformity, the treatment for which is maxillofacial surgery’. The negative effects of racial difference from the presumed Caucasian norm were thoroughly understood by sympathetic surgeons. In 1926 a Japanese man called Shima Kito wishing to marry an all-American girl had his Oriental eyes Occidentalised and changed his name to William White. In the Fifties a Kansas woman called Gretchen Algren, who had always been teased about her large nose and learnt not to mind, finally had a nose job at 35 because she was lately being mistaken for a Jew and worried that it would hold back her husband’s career. In the Eighties, Michael Jackson wanted and rather tragically got a pert ski-jump of a nose rather than his own broad African-American one (to say nothing of whiter skin, thinner lips, carved cheekbones and permanent eyeliner).
The other side of all this is the pleasure we take and have always and everywhere taken in artifice. Wander round the National Portrait Gallery and witness mile-high or drooping powdered wigs, chalk-white cheeks, plucked eyebrows, whiskers, uplifted bouncy bosoms, hopefully huge codpieces – and that’s just European artifice. For a decade or so, it has been common for men and women to sculpt their bodies, shaping discrete muscles in gyms with specialist machines. In France, the performance artist Orlan takes herself to the operating theatre and films her surgeons reshaping her face into a facsimile of the Mona Lisa. The only change is that new techniques have permitted alterations to be carved out of or pumped into the flesh. Once women suffered the adverse effects of outlining their eyes with antimony: now silicone injections deform and disease. The pioneering plastic surgeon Jacques Maliniak understood this in 1933: if there is any ‘striking difference’ between the old and the new ways of enhancing beauty, he said, ‘it is that on the whole the old were safer’. But perhaps the enhancing of beauty is not just the self-mutilation by proxy of politically subjugated women (and increasingly men), or a striving for social dominance, but a way of keeping us interested in ourselves. Growing old is also an interesting process, but it proceeds incrementally and without real drama. We should not underestimate the role of theatrical pleasure in the fast, thrilling transformations plastic surgery offers. Most of us know the gratification of seeing ourselves in a new outfit; perhaps it’s not so different getting a new body or face.
It is true however, that there is no record of women asking their cosmetic surgeons to transform their youthful faces into wrinkled age (though I once asked a hairdresser to dye my hair grey, before the Lord had done it for me, and was shown the door). On the contrary, an LA surgeon has recently offered injections of botulinum toxin to prevent wrinkles by causing localised paralysis, taking us back to the turn of the century when a practitioner advocated that facial muscles be cut early in life as a preventive measure against wrinkled middle age. Smiling and animation are a real problem: ‘The constantly enforced and exaggerated smile in vogue today  is a major offender in causing wrinkles about the commissure of the mouth, the nasolabial fold and the eyes.’ In 1977, serenity was advised: ‘Profound, uncontrolled emotion leaves its imprint on our faces for all the world to see.’ And I remember a worrying beauty hint from a contemporary beautician who explained that she kept a roll of sellotape in the car and stuck a piece between her eyebrows to prevent dangerous frowning while driving. Our mothers put on clean knickers whenever they went out in case they happened to be in an accident: imagine the humiliation of being caught by paramedics with sellotape between the eyes.
To Germaine Greer’s question ‘if a woman never lets herself go, how will she ever know how far she might have gone?’ the answer might be that she could make a pretty good guess and that there’s no bus back from that terminus. And to the male surgeon who considered ‘a woman of forty years of age, or more, ought to be ashamed to have a face without wrinkles,’ we would now reply that we decide what to be ashamed of these days. Haiken rather disapproves of the fact that people try to take control of their bodies in a world that is uncontrollable. But reality is tyrannical, and we might see the refusal to conform to nature as some kind of guerrilla warfare, of the individual doing at least what can be done. Finally, it is death, of course, that is immutable, and cosmetic surgery is yet another brave though futile challenge to its visible advance.
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