Tweak of nature
Cosmetic surgery? Never! But fillers, sprinkles, discreet facial treatments? Polly Vernon is hooked.
“You’re holding up OK,” she says. “Your cheekbones are good. Your eyes are good. I’ll just tweak. I like to start from the upper face and work down. So, what I’d suggest is a little filler here [she presses on the side of my face below my temples], and here and here [she touches two further spots], which will lift your cheeks and sharpen your cheekbones, draw attention to your eyes. Then I’ll inject along the jawline and into the chin. There’s so much focus on the upper face. The lower face often gets forgotten. And then, a little on your lips? But nothing dramatic. I don’t do Barbie lips. We don’t like Barbie. Any questions?”
No, I say, and lie back on her medical couch with wild abandon, more than ready to submit to her aesthetic attentions. “Well, you should have questions,” she says. “I’m injecting into your skin, your muscle. You should want to know exactly what and where. It will swell and hurt. You may hate me in a few minutes. You will definitely hate me tomorrow. But by the day after, you will love me. Ready?”
I’d never have any “work”. Would you? In the cosmetic sense? Never actually, you know… go under the knife. Nor would I submit to Botox — not in the traditional sense of the procedure, anyway, where the end result is a forehead frozen to a hard carapace, eyebrows poised in a demi-arch of surprise, face rendered so immobile by overuse of the product (derived from botulinum toxin, the world’s most lethal neurotoxic agent, if you don’t mind), it begins to wrinkle in odd configurations in the only places it still can achieve movement: in whisker- like formations that emanate from beneath the tear ducts. As for filler? Cheeks so overladen with foreign substance they puff out like a chipmunk’s? Lips stuffed to a grotesque parody of a pout, in such a way as to inspire both derision and sympathy in all that behold them? Absolutely not!
But would I get “tweakments”? Would I submit to the softly-softly approach of a new wave of doctors, dermatologists, aestheticians; the subtle, minuscule, ongoing adjustments of a facial structure and complexion otherwise somewhat besieged by age? Would I do that? I would. I am. “Ready?” the doctor asks as she slips the first needle into my skin.
Over the past three years, the aesthetics industry has had a dramatic makeover. Where once it was considered an extreme, desperate and rather shaming business, the preserve of the fatally vain, it has become something more people do. The yummy-mummy school-gate community, which shares doctors’ details like it shares nannies. Personal trainers trying to “grow their brand” on Instagram, brides-to-be and their bridesmaids, for whom a trip to the Botox doc is now a part of the pre-wedding build-up. The recently divorced, seeking a “refresh” before launching themselves on Tinder. “Plastic positive” 20-somethings who celebrate their right to adjust their faces as an expression of empowerment. My younger sister, a lawyer, who replied to my text asking her what she wanted for her 36th birthday with a link to vouchers for a local aesthetician.
The first time I — or anyone, really — heard of Botox was in my late 20s. One of my editors called to ask what I knew about it; I genuinely thought she was asking what I knew about “buttocks”. I spent my 30s supremely confident I’d never submit to it. Botox seemed like something other women did; women less assured of their innate personal worth, more consumed by how youthful they appeared.
I assumed one’s first trip to the Botox doc signalled a failure of nerve, character and feminism, but also a crossing of the Rubicon that could only possibly lead to a spiralling obsession with one’s looks, an increasingly frantic internal dialogue of self-hatred, and the aforementioned frozen forehead. I knew I’d never do that. Not me. No way.
But then I hit 40. I started realising that, in addition to the wrinkles I’d developed along my forehead and at the corners of my eyes — lines I’d embraced as indicators of a life jollily but also thoughtfully lived — came deeper, more severe, downward-reaching furrows between my brows that made me look cross and tired, when I wasn’t. “The elevens”, aestheticians call them. I did not like them. Also: was that a faint suspicion of a drooping around my jaw? The first hint of a jowl? Did my eye sockets seem hollow? Were the corners of my lips sloping down? Was I less inclined to scrape up the protective curtain of my hair into a ponytail?
Instagram’s culture of self-portraiture hit simultaneously. I fought off the compulsion to post selfies, but eventually submitted, because… Who knows why? Haven’t we all? As soon as I did, I realised the standards we impose upon digital images of our face are far more stringent than those we impose on our reflections in the mirror, not least because digital stills encourage us to poke and splay, to prod at pictures of our faces with thumb and forefinger, enlarging them into unforgiving close-up, so we might analyse every inch of our ageing mush.
In 2015, I published a book that became, briefly, controversial, provoking criticism of me not just as a writer, but also as a person. Because my face was on the cover of the book, I quickly came to associate my appearance with the judgment and aggression of others. Around the same time, I heard the actress Robin Wright — a beautiful woman with a few years on me — admit that she had “the tiniest sprinkling of Botox, twice a year — to take the edge off”, a turn of phrase I liked. It made me think Botox might be a means to a subtle, gentle diminishing of the rigours of age, rather than a ghastly mask that obliterated all signs of it — and normality.
And so, in my early 40s, I booked my first tweakment. I started with mesotherapy, in which a concoction of vitamins and amino acids are injected all over the face. The intended result being a reinvigoration of collagen, the main structural protein of the skin and its connective tissue, which operates like tiny balloons, propping up the face, until age diminishes it and your face begins to droop and hollow. I loved it. It hurt — when people stick needles into your face, it tends to. The difference was subtle. I looked not younger, but certainly gently renewed. I wanted more.
Within a year, I’d graduated to Botox — inspired by Robin Wright’s “tiny sprinkling” — and fillers, in my temples, but not in my cheeks. Over five years I’ve visited aestheticians once every six months. I’ve had filler in my tear troughs and a procedure called PRP, or platelet-rich plasma, in which my blood was taken, spun in a centrifuge to separate off my plasma, which was then heated and injected back into my face to plump it out and give it some glow (you may have heard of “the vampire facial”). I’ve had the surface of my skin treated with lasers and I’ve had my lip line very subtly plumped. I’ve had Botox every nine months and filler once a year. Recently, I had a hydration-boosting all-over injection called Profhilo. And now the doctor is giving me what amounts to an incredibly subtle facelift, wrought of fillers — no knife in sight. It’s a lot, when I list the tweakments I’ve had. I would have sworn I hadn’t had that much work done. But that’s how “tweaking” works: with its little and often attitude, with its subtlety, it allows you to indulge the lie you’re not really having anything done at all.
But if acceptance is growing, so too is the fear of having bad work done. “Oh, the horror stories,” my doctor says, as she moves her needle patiently around my face. “There are plenty of those.” Reports — and accompanying smartphone images published on websites — of terrible work, of dangerous procedures administered by underqualified people, resulting in septic swollen faces, have proliferated like modern morality tales. English actress Lesley Ash’s “trout pout”, her well-publicised botched lip implants in 2002, is still routinely invoked, despite being nearly 20 years old. And, of course, bad work is so deliciously, obviously visual. Good work, on the other hand, is not — the whole point being that if it’s good, you won’t notice it.
But what of the true morality of tweakments? Beyond the petty judgment of other women, the po-faced attitude of the kind of feminist who never really made peace with women so much as dyeing their hair; beyond what one aesthetician sees as “people feeling deceived into thinking someone is more genetically fit than they are”. How compromised are we by our evolving tweakment habit?
No matter how delighted I am to have my face bolstered and prepped against age by some of the best doctors, I do not feel completely morally comfortable with it, either. Surely I should be able just to get older? Surely I should care less and less about my face, and more and more about my inner peace, with every birthday? On a grander, less self-involved scale: what about the effective eradication of all signs of age from the faces of the women we see on our TV screens? Will we soon simply not know what it looks like to be a naturally ageing woman in her 40s, 50s, 60s, 70s? And what about the wealth divide that means some of us can afford to be expensively plumped and smoothed, while many of us cannot? Or that some of us can afford the good work while others can only hire the cowboys? Will good looks and the accompanying favours of status they bestow become the sole property of those who can afford the best doctors?
Two years ago, Dana Berkowitz, feminist academic and associate professor of sociology at Louisiana State University, published Botox Nation, a critical investigation into the rising popularity of Botox in America. Berkowitz speaks to the part of me that still worries about the implications of injecting away one’s age. In the book, she refers to the “crack-like addiction to Botox”. Now she tells me, on a call from Baton Rouge, “My 27-year-old nanny, who has flawless skin, just asked me if she should get it. I told her she’s too young… But there’s this gospel of prevention, this idea that young women should start having it before they develop wrinkles. And while there is some truth in the idea that early Botox will prevent the face moving in certain ways, which will prevent the development of some wrinkles, Botox is temporary. It’s only preventive if you keep doing it, so you’re locking in young women to a lifetime of procedures.” Berkowitz talks about it as a “cash cow” and references the increasing number of US physicians rolling it into their existing practices because it’s so lucrative. “I’m literally hearing about gynaecologists offering it,” she says, and about “medical spas that spring up in malls, in between Starbucks and a nail bar. When you take it out of a medical setting it becomes more and more casual.”
Is that so bad? “Well, it’s certainly addictive,” says Berkowitz. “Of my sample study for the book, only one woman stopped having Botox.” I pause to contemplate the possibility of stepping away from the tweakment circuit, allowing my face to wrinkle and fold naturally. I am horrified at the prospect. It would seem I am one of Berkowitz’s “addicted”.
“There is research that suggests preventing our faces from expressing certain emotions — anger, for example — will create a facial feedback that stops us experiencing anger, and certainly stops other people reading it on our faces when we feel it. From a feminist perspective, stopping women feeling and expressing anger — this is not good.” At the same time, Berkowitz thinks we shouldn’t “make heroes of women who don’t use it”. She herself has had Botox. “I have such mixed emotions about it. I have a one-year-old baby, but secretly — or maybe not so secretly — I’m looking forward to getting more once I stop nursing [while there is no clinical evidence Botox is unsafe in pregnancy, US regulatory healthcare bodies advise against it]. It is complicated.”
It is complicated sorting the legitimate concernsabout these practices, the true moral issues from baseless judgment, an amorphous sense that those who submit to tweakments are “cheating”, the sexist simultaneous damning of those women who choose to age naturally and those who do not. I talk about it a lot, with friends who tweak and friends who don’t (some of whom judge me for doing it), with my 40-something friend C, who’d like to “but no one in my circle does; I feel like I mustn’t”, and my 29-year-old hairdresser and his even younger assistants, who, a couple of years ago, responded to my excitedly/nervously telling them I was about to get Botox for the first time with utter bemusement: to them, it was as if I were gleefully anticipating something as pedestrian as a fringe. I’ve got a WhatsApp group with my friends P and V; we post photos of ourselves every time we get something new. But, “I’m worried you’ll end up with a face that doesn’t fit,” says my partner. Sometimes, honestly, so am I.
After 30 minutes of painful injecting, the doctor finishes. She hands me a mirror. I look at myself. It is exactly as she promised: a defining of my jaw, a lifting of my cheeks. My face is fresher, sharper, but, yes, definitely still natural. Definitely still me. “Happy?” the doctor asks. Sue me. I am.