Filling the self-esteem void with cosmetic surgery
Brianna Caldwell is a normal 18-year-old at heart. She spends a bit too much on food. She’s weighing up her options with university, and she tries to save a fair amount of her pay from her casual job.
But where she differs from many of her peers is that she’s not saving for a trip abroad or a first car: Brianna is saving for a nose job.
“If I get my nose done, it’s one surgery, done for the rest of my life,” Brianna says.
“And if I’m spending that sort of money, I’d rather have it for 50, 60 years, than wait until I’m halfway through my life and then pay the same amount of money and have those results for less time.”
Brianna is among the one-in-four Australians spending up to $1 billion a year on non-surgical cosmetic procedures to alter their appearance. And they are procedures that, according to The Medical Board of Australia, have no medical necessity other than to boost a patient’s self-esteem.
Dermal fillers are the latest in beauty trends that can cost anywhere from $300–$900, depending on the amount of filler injected.
It’s not cheap but also not a deterrent for Brianna and a wave of Australians chasing an ideal of beauty.
But that pursuit has many risks, according to psychologist Dr Gemma Sharp. In June this year, she wrote for the Australian Psychological Society to explain people who seek cosmetic procedures have a higher rate of dissatisfaction with their body image than the rest of the population. In most cases, cosmetic enhancement is usually sought to address a problem only that person sees.
The dissatisfaction with one’s own body image can spiral into a mental illness and in the most severe cases is diagnosed as body dysmorphic disorder (BDD) – a mental illness characterised by worrying over a perceived fault in appearance.
Dr Sharp wrote that BDD is prevalent in up to 15 per cent of people who have undergone cosmetic procedures, compared with up to three percent of the rest of the population.
Brianna first recognised a feeling dissatisfaction with her body when she was starting to hit puberty.
“The nose and the lips were something I’d had an issue with from when I was really young – early teens, 12, 13.
“I’ll be like, ‘Oh I hate my nose’ and people will say, ‘Your nose is fine! Your lips are fine!’ Everything is fine,” she scoffs. “It’s just a ‘me’ thing. All of the work I’ve gotten done, or will get done, is for me.”
This unsatisfied feeling is something practitioners have to consider, says owner of Clear Complexions Clinic Suzie Hoitink.
“Body dysmorphia is something we’re obviously very aware of with our clientele,” Ms Hotinik says.
“There is definitely a warped perception of what beauty and youth looks like. Beauty is always in the eye of the beholder, and none of us are judgmental, but we certainly want to make sure our clients understand what ‘normal’ should look like.
“A lot of people come in and say, ‘I want 50 units, because that’s what my friend had.’ And that’s completely irrelevant, because what your friend needs, and their whole anatomy, can be quite different to yours.”
While the motivation for having work done is a sensitive subject, the type of treatments available to clients also require some caution.
Dermal fillers – or lip fillers, as they are colloquially known – are injectable medications that occupy space, producing a voluminised or ‘plump’ look. Lip fillers are highly popular for the instant change they produce and the minimal downtime required post-procedure. But they are also a prescription-only medicine under the Therapeutic Goods Act 1989.
In other words, they are not to be taken lightly.
Most clients are advised to wait up to four weeks between procedures to make sure filler settles correctly. Brianna opted for a ‘natural’ look with only 2mL of filler, but she says her practitioner injected another client with 8mL of filler in subsequent months, drastically changing their appearance.
Beauty technician Emma Baxter, who is training to become a cosmetic nurse, says despite guidelines for practitioners, vulnerable patients will try to ‘game’ the system to achieve the look they want.
“It’s ethically wrong to be providing treatments to patients when they don’t necessarily need it or when they present with signs of an underlying condition or disorder,” Ms Baxter says.
“But still, patients will find a way around it if they’re unhappy with their appearance – doctor-jumping and continuously looking for more ways to enhance themselves.”
The obsession with, or desperation for, cosmetic procedures is partly driven by the pressure, particularly on young women, have a certain ‘look’. Studies have shown social media has changed our perception of ‘normal’ and ‘beautiful’. Exposure to certain ideals of beauty on the internet can exacerbate how much people criticise themselves.
And with one-in-three Australians owning an Instagram account, there are a lot of opportunities for people to see cosmetic surgery as a normal solution to body image issues.
Emma Baxter says she can see it in the motivations of many of her clients.
“The media, celebrities and influencers are very open about their injectable procedures and that gives younger people a perception that it is not only safe and socially acceptable to have these treatments, but also fashionable. says.
“Many young people look up to celebrities like Kylie Jenner and see their transformation and think that that’s ‘beautiful’ and if they have their lips done they will look like that. I think there’s definitely a lot of people in their 20s and even 30s seeking non-invasive treatments to improve their confidence and body image.”
Many plastic surgeons and practitioners now post videos of procedures and pictures of ‘transformations’ on Instagram, Facebook and Snapchat. The problem is that when consumers see these promoted procedures, they don’t always consider the potential complications, costs or long-term care requirements.
Brianna Caldwell says most people only care about the emphasis on immediate positive results..
“[On] Instagram and Facebook you just see people living their best life, living a better life than you, looking better than you, affording things you can’t. I think social media has an effect.”
For people with skewed perceptions of their own beauty, that quest rarely stops at one cosmetic treatment.
Australia’s annual spend on cosmetic surgery is among the highest in the world, according to Dr Catherine Archer from the Cosmetic Physicians College of Australasia.
“There are reduced costs for patients and advancements in medical technology – meaning procedures are less invasive with minimal-to-no downtime – helping drive uptake of these procedures.”.
While Brianna makes enough in just one week at her job to pay for another round of lip fillers, she can’t say for certain she won’t start saving all over again for something new after her nose job.
“I think it will stop there. I hope after that I’m satisfied. I don’t want to be one of those people who keep on getting more and more because they’re never satisfied. I’ll try and stop [but] I think lip fillers helped me get used to the idea of altering my face.”
The irony is not lost on her. She can’t bear the pain of blood tests but she’s happy enough to have more cosmetic injections, tattoos and piercings.
And although she spends just as much time on social media as any other 18-year-old, Brianna maintains cosmetic surgery should be for the individual.
“Don’t do it because your friends are doing it. Don’t do it because you saw someone on Instagram that looks nice. Don’t do it because you think people are going to like you better. It’s helped – but it hasn’t fixed all my self-confidence issues. I think that’s something that regardless of cosmetic injections or surgery, it’s going to be there.”
She touches her lips, almost subconsciously. “That’s something I’d have to figure out for myself.”