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“You’re a goofy ****. I hate goofy ****s.”
As a child with large ears and prominent teeth, I was far from immune from the threat of bullies. Bullies latch onto a person’s most obvious weakness, and physical characteristics that differ from the perceived image of perfection make for excellent targets. Facial features, body shape, hair or skin color—the more obvious, the better. It’s little wonder that many of us have grown up with lasting insecurities concerning our physical appearance. But never before have so many people sought medical intervention to address those insecurities. The cosmetic surgery industry is worth nearly $60 billion, and increasing yearly.
The reasons behind this are manifold: the steady advancement of medical techniques and the concurrent fall in the cost of procedures; a burgeoning surgical tourism industry; the ubiquity of social media (essentially visual in nature) and online porn (ditto). But we’ve also been thrust into an inescapable relationship with our own image. From Zoom meetings to photo-packed smartphones, we’re confronted with ourselves daily, and psychologists are noticing the results.
For me, what leaps out from the pieces collected below isn’t just the normalization of cosmetic surgery—with patients routinely likening it to dieting—but the normalization of extreme procedures. Getting your ribs trimmed, having your shoulders or legs broken and reshaped, or being implanted with objectively oversized testicles (seriously) may assuage that tiny voice in one’s head, but they may also leave you in a far worse situation than when you started.
Oddly enough, there’s a parallel here with the current hand-wringing over the rise of artificial intelligence. Once out of the box, it’s extremely difficult to put something back, especially when people are growing rich from the profits. Cosmetic surgery has its undeniable benefits, of course—for burn victims, for amputees, for those born with restrictive conditions—but it seems that we can’t have one end of the spectrum without the other. (AI, in fact, is set to play a large part in the cosmetic surgery industry of tomorrow.) As with the impact of AI, what the eventual landscape will or should look like is a matter of fiery debate. Do we need strong, international regulation and a limit on available uses? Will future generations not know life without augmentation? Are we simply overreacting? No matter which side of the fence you sit on, these stories provide fascinating insights into the world of extreme surgery as it stands today.
“I Was Convinced I Was Going to Die”: Meet the People Risking Their Lives for the Perfect BBL (Zoë Beaty, Glamour UK, November 2023)
Those of us of a certain age grew up with the well-worn trope of women asking their partners, “does my bum look too big in this?” Nowadays, that concern has reversed itself: large, prominent buttocks are desirable. This isn’t of itself new—in the ’90s, Jamaican women took “chicken pills” to attain the so-called “Coca-Cola bottle” shape. What’s changed is the breadth of the ideal. One obvious reason lies in the form (excuse the pun) of Kim Kardashian, whose rise to prominence mainstreamed callipygian ideals long before her 2014 Paper photo shoot introduced that woeful bit of hyperbole known as “breaking the internet.”
As we know, what constitutes the perfect body varies over time and place, and will continue to do so. Whatever the cause, big butts (and I cannot lie) remain firmly in fashion. Combine that with daily assaults on women’s self-confidence through all manner of channels, and it’s no surprise that the Brazilian Butt Lift—whereby fat from the belly, hips, lower back, or thighs is surgically transferred to the buttocks—is in great demand. Tragically, the procedure is also among the most dangerous: fatalities occur regularly.
As you’ll glean from this wonderful article, it’s not just women who seek BBLs. The number of men undergoing surgery may be considerably smaller, but is rising quickly. Financially, it makes sense for would-be recipients to travel to countries such as Turkey, which has rapidly become a cosmetic surgery hub, but with the cheaper prices come more relaxed regulations. Despite the pain, despite the fatalities, the BBL is a procedure that gains popularity year after year. Beauty cycles being what they are, at some point the “ideal” image will change and the industry will move on. Perhaps we’ll go back to ”less is more.” Whatever happens, it’s important to try to understand the individual stories and the personal motivations of those who feel compelled to risk their health, even their lives, in a quest to obtain the perfect derriere.
Even if the surgery goes ahead without complication, British patients travelling can suffer multiple complications. “The biological time for a wound to heal is six weeks,” Dr Stefano Cortufo, who runs a clinic in Harley Street, tells me. Patients are expected to wear a body compression suit—or faja—for at least that amount of time, if not longer, and cannot sit or apply any pressure to the site of surgery for at least two weeks.
“That is the minimum time that doctors and patients need to be together. If I operate on you, you need to see me every week for six weeks.” Sitting on a plane for hours, days after an op can put a patient at risk, he says. Indeed, a quick search on TikTok and YouTube shows women going straight to A&E in the UK, suitcase in hand, after stepping off the plane. One was admitted with sepsis, a life-threatening infection. “The NHS is full of people coming back with infections,” Cortufo says.
Designer Parts (Melanie Berliet, The Atlantic, April 2012)
There are two types of FGCS (female genital cosmetic surgery, not to be confused with gender confirmation surgery): vaginoplasty (tightening tissue for enhanced sexual pleasure) and labiaplasty (reshaping labia purely for aesthetic reasons). The author of this frank and, at times, cringingly humorous piece, Melanie Berliet, understandably focuses on the latter, asking why many women are willing to pay thousands of dollars to reshape an area that is hardly ever on display. To try and answer this question, Berliet takes the admirably brave step of exposing herself (literally) before one of the many surgeons who offer this procedure. As a heterosexual man, I can honestly say that I do not have, nor have ever had, any concept of what the ideal female genitalia should look like. Sadly, there are men out there who do fixate on such things. Perhaps the more interesting question is why? Berliet posits a link to the ubiquity of online pornography, a connection that feels as disturbing as it is obvious.
“Fifty-nine hundred bucks for a tighter vagina,” I muse. Internally, I consider what else I might buy with that kind of disposable income if I actually had it. Fifty hour-long hot stone massages! A dozen tickets to The Book of Mormon! A lifetime supply of Bazooka gum!
“Well, if you do the vaginoplasty and labiaplasty simultaneously, we charge $9,900 for what we call vaginal rejuvenation.”
Would a Turkish Hair Transplant Change My Life? (Rudi Zygadlo, The Guardian, October 2023)
As a 2023 paper in the Journal of the American Psychoanalytic Association unsurprisingly revealed, “[h]air loss causes many men significant psychological distress.” After all, male baldness has been associated with lower social status as far back as the 17th century. The first-ever hair transplant was undertaken in 1952, but surgical intervention dates back much further: in the 19th century, surgeons used a technique known as the “scalp flap,” which doubtless was as grim as it sounds.
By the age of 50, 30-50 percent of men will have experienced some degree of balding. (As I write this, I am steadfastly refusing to look in the mirror.) I can empathize all the more, then, with Rudi Zygadlo, the author of this piece, whose hair loss began at the age of 18, and who has taken the increasingly common step of traveling to Turkey for treatment. It’s a booming industry but, like any invasive surgery, should not be taken lightly. Zygadlo writes with an endearing honesty and narrative panache, revealing insecurities most of us would rather not share. Nor does he shy away from providing gruesome details—eight hours under the knife, with plenty of gouging and scraping, plus 50 injections directly into the scalp. Happily, for Zygaldo, the pain was worth it.
Obviously I’ve known about hair transplants for years, but I thought the window had long passed for me; I’m too far gone, I can’t afford it. I have also avoided Googling all things hair-related because I know how quickly one’s algorithm turns into an obstacle course of triggering adverts.
But, six months ago, a good and fellow-afflicted friend encouraged me to have a WhatsApp consultation with an outfit in Istanbul that he visited for a third of the price of UK equivalents. I know Jamie has done boatloads of research; unlike me, he has tackled the problem head-on and now flaunts a resplendent mop. I trust him. I have the consultation and, assured my situation is salvageable, I get a quote and mull it over. It’s now or never. Hiding is exhausting. Either embrace what I have or take a punt with the Turks. I book.
Inside the Secretive World of Penile Enlargement (Ava Kofman, ProPublica, June 2023)
It should come as no surprise that the penile enlargement industry is experiencing sustained growth. (Fill in your own joke here; I’ve already written and deleted a half-dozen of them.) Historically, women’s looks have come under far more scrutiny than men’s, and they’ve been subject to higher levels of insecurity as a result, but if there’s one area in which men are particularly susceptible to self-doubt, it’s the size of their genitals. Recent studies suggest that just under half are dissatisfied with the length of their penis.
Here, in a ProPublica investigation co-published with The New Yorker, Ava Kofman brings sensitivity and tact to the true tale of “Mick,” one of an increasing number of men going under the knife in search of extra inches. It’s a gruesome story, and one which advocates caution. One of the surprising revelations is the woeful lack of regulation when it comes to genital implants. That said, there are many questions we could ask of Mick, whose lack of preparation and research might seem astonishing, but Kofman is never judgemental, instead teasing out the humanity and emotion with which we can all empathize. Indeed, it’s impossible not to feel for him. Be warned, though; the graphic descriptions are not for the faint of heart.
The basic operation would cost $15,000—roughly half of Mick’s life savings—though he added in a pair of discounted testicular implants, at seven grand more. He put down a deposit, told his long-distance boyfriend that he was taking a work trip and, on a sunny morning in September, arrived at Elist’s office, in Beverly Hills. A framed copy of the GQ story—cover line: “We Have Huge News About Your Manhood”—hung on the wall of the exam room. Elist strode in, directed Mick to drop his pants and rolled Mick’s scrotal sac appraisingly between his fingers, as though it were a piece of fruit at a market stall.
How Many Bones Would You Break to Get Laid? (Alice Hines, The Cut, May 2019)
You may have never heard of “gymceling,” “jelqing,” or “mewing,” but chances are you might soon. As if women didn’t already have enough reason to fear men, the rise of the incel (involuntarily celibate) movement surely represents one of the most disheartening and dangerous subcultures to have sprung from the internet’s rotten skull. If you haven’t heard of them, I advise you to read up—but just a little, lest you lose all hope for humanity. The incels’ basic premise is that attractive women are cruel and shallow creatures who will only tolerate “ugly” men when they themselves are old and used up. Therefore the incel, who is not conventionally attractive, finds himself at a distinct disadvantage, which is solely the fault of said beautiful women. (The incel’s double standard in only desiring conventionally attractive partners is neatly sidestepped in such thinking.)
For a fascinating and disturbing cinematic tale on this subject, watch John Frankenheimer’s 1966 cult classic, Seconds, starring John Randolph as Arthur Hamilton, a middle-aged man who longs for a new life, and the great Rock Hudson as the man he becomes. Fair warning: Seconds contains one of the most brutal endings ever committed to celluloid.
One sector the incel phenomenon has been good for is cosmetic surgery, with an increasing number embracing face and body altering surgical techniques to transform themselves from “beta” males to “alphas” or “Chads.” Those with such a mindset are all too easily entrapped by grandiose promises of physical enhancement, and can find both brotherhood and easy enticement on TikToks and online forums that amplify and bolster their opinions. If your entire worldview, your whole sense of self-worth, revolves solely around your looks, set in relation to Hollywood hunks, the chance of transforming yourself into the latter must seem far too good an opportunity to pass up. Here, we have another tale of a surgeon who is literally operating without moral responsibility. This article presents a compelling account of what happens when these two worlds meet.
Eppley’s not sure exactly why a patient would want testicles of dinosaur-egg size. But that’s true of many of his procedures, which he tends to design in response to patients’ requests. If his practice had a slogan, it would be “We don’t care why you want it,’’ he tells me. “And I suspect patients seek me out because they know I won’t ask them. I don’t see it as my job to cast a judgment.”
Chris Wheatley is a writer and journalist based in Oxford, UK. He has too many guitars, too many records, and not enough cats.
Editor: Peter Rubin
Copyeditor: Krista Stevens
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