In the past twenty years, the face of the quintessential plastic surgery patient has changed dramatically. Women are more likely than ever to seek cosmetic procedures at an increasingly younger age, and, much like trends in fashion, these procedures fall in and out of style with the passing of time. However, in the past several decades of our national plastic surgery narrative, one emerging theme is clear: Cosmetic operations are becoming more and more integrated into the everyday lives of Americans. A major catalyst of this movement is the medical spa, an institution that represents the intersection of three main motivators of the plastic surgery’s pervasiveness: increased accessibility, social normalization, and manipulative marketing schemes. The medical spa offers an insightful model through which to explore the changing face of plastic surgery and its distressing cultural consequences.
Today, it is easy to envision the perfect cosmetically-crafted face. Features like dramatic Kylie-esque lips, sculpted cheekbones, and filler-defined jawlines dominate the celebrity sphere. This image is far more familiar than the frozen and over-Botoxed faces once associated with older clientele of an earlier era. Many plastic surgeons agree that a shift has occurred in the cosmetic surgery landscape—increasing numbers of young women are opting for alterations that have little to do with turning back the biological clock. Many of these younger patients often seek non-invasive procedures such as injectable fillers as a regular part of a beauty routine, existing in the same vein as a weekly face mask or hair treatment. Furthermore, many of these women want their faces altered noticeably rather than naturally, making an impossibly full pout or outrageously defined bone structure into a material symbol of elite. This reality has some very dystopian connotations; it isn’t difficult to envision a future where wealth can be gauged immediately upon assessment of individual beauty.
This is an ultimately detrimental cultural trajectory. The prevalence of plastic surgery not only holds the potential to create visible beauty-based schisms between socioeconomic classes but also increases national utilization costs for unnecessary services. From 1997 to 2017, the number of total cosmetic procedures performed more than doubled, and in 2016, Americans spent over 16 billion dollars on plastic surgery, an absurd statistic; this value is more than the federal government’s spending budget for food and agriculture. Based on these values, it may come as a surprise that only 4% of Americans have undergone a cosmetic operation themselves—however, in adjusting for the economic luxury that is plastic surgery, a different trend emerges. 31% of Americans whose household income is over $75,000 know a family member or close friend who has elected to surgically alter their face or body. These procedures are a powerful, growing presence in American culture, particularly in wealthy spheres where they are more monetarily feasible.
Medical spas in particular increase the accessibility of plastic surgery for those who can pay, with typical treatments ranging from several hundred dollars to values in the thousands. A hybridization of day spas and procedural clinics, these organizations offer traditional spa treatments such as facials and seaweed wraps as well as treatments previously limited to plastic surgery clinics, like Botox, hyaluronic acid fillers, and chemical peels. These injectables and skin rejuvenation procedures are highly desirable to clientele, as they are non-invasive and require little to no downtime. Recent advancements in medical technology and changes within the plastic surgery industry itself foster a landscape ripe for the development of many of these new, non-surgical treatments that are more logistically accessible women. Many of the treatments offered by medical spas require no days off from work and carry few side effects or unintentional cosmetic consequences, like the scarring, loss of sensation, and implant failure risked by surgical procedure patients.
The marketing of cosmetic procedures is also a key element in accelerating their normalization. It is an increasingly common advertising tactic of surgical centers to portray operations as a feel-good practice of self-reward, much like a full body massage. Healthcare consulting firms suggest clinicians frame procedures in a “positive light” and focus on “aspirational messaging” and confidence-building as a major motivator. Rather paradoxically, many plastic surgeons look to align their services with our current cultural moment fixated on self-care and body positivity. This phenomenon reflects the economic motivations behind the concept of medical spas. They compound changing cultural trends and attitudes into a profitable system by acting as a bridge between what is already socially acceptable and what still remains controversial. These spas break down the already-declining taboo of cosmetic procedures by making them available in an established environment of personal care and self-love.
Increased exposure to beauty standards through social media is also a hypothesized agent of rising individual dissatisfaction with facial features. Some studies posit that photo-editing apps like FaceTune as well as the filtering capacities of Snapchat and Instagram all normalize facial alteration and make “perfection” tantalizingly achievable in the digital world. These apps publicize photoshop in a way that allows for the propagation of beauty standards by social peers rather than by distant celebrities. The desire to assimilate with peers is a powerful motivating force, which bleeds into the conceptualization of medical spas as a social environment. Traditional spas are themselves a social environment—women often seek treatments in the form of “spa days” with their mothers, sisters, and friends; medical spas capitalize on this tendency by offering “girls night out” packages, or reduced-price offers to encourage parties of women to carry this trend into the context of cosmetic procedures. It is increasingly common for women to seek out injectables as well as more invasive surgeries with their social peers and female family. Medical spas are an important factor factor in integrating plastic surgery into the normal social sphere and creating a space where women go under the knife together as a bonding experience.
The rise of the medical spa is the best representation of this societal shift in the technological capability, commercial promotion, and social perception of plastic surgery. American culture looks upon cosmetic procedures with a fascination that borders on obsession. Some social critics predict the full adoption of plastic surgery as a normal part of life for the majority of wealthier Americans, and many arguments exist regarding the morality of this future—but we are not yet there. For now, plastic surgery gone wrong is still the most popular fill-in on the Google search bar.
Photo: “Plastic Doll“