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Everything you didn’t know you needed to know about plastic surgery


TextSadie Bargeron

Lips fillers, butt lifts and tummy tucks, oh my!

Welcome to Beauty School, the corner of Dazed Beauty dedicated to learning. From guides to histories, this is where we shed light on past subcultural movements and educate our readers on current trends and various goings-on.

Today, tweaking and tucking is alarmingly common as the extensive range of surgeries reflects the restless beauty trends of our ever-changing popular culture. To help you understand the complex realm of cosmetic enhancements, here’s a 2019 Dazed Beauty directory:

Boobs

Boob jobs haven’t had a glamorous ride. In 1895, the idea for breast enlargement was born when German surgeon Vincenz Czerny transferred a tumour from a patient’s back to her boobs in order to level up their size. Czerny’s procedure inspired various dodgy trial and errors, including some involving paraffin injections which resulted in blindness and ulcers, while others led to breast amputation for survival. A range of experimental implants followed, from glass to ox cartilage. Then in 1961, Frank Gerow and Thomas Cronin introduced silicone implants that felt just like the real thing. The 1960s also welcomed saline (salt water) implants that felt just as real and with that, inflatable chests began to blow up.

Big boobs became an integral part of pop culture in the 1990s as the world was hypnotised by Pam Anderson and her slow mo running. It was still a risky time for a boob job, however, and after countless reports of rupturing the Food and Drug Administration (FDA) made a legal requirement of compulsory safety tests for silicone breast implants in 1991. Seven years later, British glamour model and boob job icon Jordan had the first of her eight silicone implant procedures. As the new millennium progressed so did our love for fake breasts, and with the flood of surgically enhanced celebs on mainstream TV, boob jobs rose 39% from 2000 to 2011.

However, since peaking in 2013, breast augmentations are now dwindling. In 2017, Victoria Beckham confessed to having her implants removed and even Katie Price got hers reduced two years ago. Dr Charles Durrant, consultant plastic surgeon and member of the British Association of Plastic Surgeons tells Dazed Beauty, “There is an increasing proportion of patients requesting a more modest breast enlargement. Patients are more concerned about a natural shape than an absolute increase in volume.” There’s a longing for authenticity with diversity and body positivity reigning supreme, so now huge fake boobs just conjure memories of Big Brother’s garishly plastic heyday. But who knows, maybe they’ll bounce back.

Ears

Otoplasty or ear surgery dates all the way back to 5th century BC in ancient India. Records from 1845 document the first surgery for specifically having ears pinned back, which today is the most common ear procedure. Incredibly common among kids and teenagers, this surgery is also one of the top ten cosmetic enhancements for men, gaining momentum into the 2000s when actors such as Brad Pitt and Ben Stiller were rumoured to have had theirs done. Last year, Love Island siren and surgery patron Megan Barton-Hansen spoke out about getting teased and consequently getting hers pinned back. According to statistics, however, men are now becoming less concerned: otoplasty went up 4% among women in the last year and down 0.5% for men. Dr Durrant believes this decline in male otoplasty may be due to “changing fashions and hairstyles with men having longer hair that may be more easily styled to hide protruding ears, making surgery unnecessary.”

Noses

Another surgery that originated in ancient India is rhinoplasty, or the nose job, which dates back to 6th century B.C., when noses were reshaped with flaps of skin from other body parts. The syphilis epidemic in the late 16th century triggered a surge in nose jobs as the disease left holes in the middle of peoples’ faces due to decaying. In the 1920s, returning war veterans reconstructing their wounded faces triggered the rise of the nose job, socially normalising them at just the right moment as commercial consumerism flourished.

Fast forward to the ‘90s and early 2000s, nose jobs were the must-have accessory, explaining why there’s a range of actresses who all look curiously similar in the Scary Movie/American Pie age. It was even casual practise for Jewish girls to get gifted one on their bat mitzvah.

However, as beauty standards are evolving and diversity is becoming more widely celebrated we’ve seen a decline in nose jobs. The rise of fillers has also affected the nose industry. The “lunchtime nose job” is a 15 minute procedure developed by Dr Alexander Rivkin where temporary fillers are injected into the nose to smooth out bumps or adjust the size, and can last for years. Less intimidating and expensive, and with no recovery time, these procedures have seen an increase of 29% over the past year.

Lips

The earliest lip fillers arrived in the late ‘70s and were made of ox collagen: Zyderm and Zplast. However, as Goldie Hawn demonstrated in First Wives Club, the swelling was ridiculous and they didn’t last very long. In 2003, an alternative of human collagen was introduced – Cosmoplast and Cosmoderm – which lasted a bit longer, however, it was hydraulic acid coming a few years later that changed lips forever. As a natural, human bodily substance, HA fillers are a lot longer-lasting and safer than collagen although they still only last about four to six months. Being temporary is not necessarily a flaw, however, Dr Durrant says. “It gives a sense of security that, if fashions change or they simply prefer a different look, then their result will have diminished in a relatively short time allowing them to ‘start over’. The psychological decision to make a ‘permanent’ change is often more difficult than a temporary solution.”

Pop culture’s always had a thing about big lips: from Angelina Jolie’s natural, pillowy pout breaking hearts worldwide to the Rolling Stones’ iconic juicy logo. Since 2000, lip augmentation has increased 60% and injected lips have become a twisted millennial trademark. However, in 2014 super-influencer Kylie posted a selfie on Instagram that triggered an international obsession with lip fillers. After months of speculation and denials, in May 2015, Kylie admitted that she had her lips done on an episode of Keeping Up With The Kardashians. That same month google searches for lip fillers rose 57%. Despite Kylie recently telling a fan on Insta that she has removed her fillers, sparking end-of-a-trend-debates, Dr Paun says: “Fillers are still as popular as ever.”

Eyes

Eyelid reshaping surgery or blepharoplasty first appeared in Germany in the 1800s. Although initially developed to repair cancer disfigurements, in as early as the 1900s, surgeons began removing the upper eyelid for aesthetic reasons; a phenomenon that has grown to become one of the top five procedures in the US today. It’s also widely prevalent in Korea where the naturally hooded eyes are altered to suit the enhanced, cartoon aesthetics of famous Korean stars.

Explaining the most common reason for eye surgery in the UK, Dr Durrant says, “patients usually complain of looking tired or do not like the hooded appearance of their eyes. In severe cases, the excess skin may even impinge on the eyelashes and may even affect peripheral vision.”

Although eyelid surgery has been in the top five most popular procedures over the past two years, overall the procedure has seen a decrease of 36% since 2000. This is likely due to the rise of tear trough fillers which less intrusively enhance the eyes and rid dark under eyes and puffiness, suiting the no-rest-for-the-wicked 21st-century grind. Since tear trough filler launched in 1996, there has been over nine million procedures in over 70 countries.

Stomachs

The tummy tuck is over 100 years old, originating in the 1890s when a French surgeon noticed how sleek his patients looked after removing excess skin to get to herniated tissue, and it soon became another cosmetic phenomenon. But in 1988, liposuction changed the game. Creating the two-way procedure of a tummy tuck combined with liposuction meant that surgeons could give a range of body types the toned physique of a gym bunny without any protein shakes... or exercise.

“The most common reason for a tummy tuck,” Dr Durrant says, “is the post-pregnancy tummy with loose skin and parted tummy muscles that no amount of gym work will address.” The procedure is not without its dangers, however. In 2007, mother of Kanye, Donda West, died shortly after having the surgery.

With airbrushed pics still flooding mainstream media and advertising, it’s no shock that people are idolising flawless appearances, and since 2000, tummy tucks have soared 107%.

Cheek, Chin And Jaw

Malarplasty is the enhancement of the cheeks and jaw by implant augmentation or reshaping, originally used to correct birth deformities or injury damage. But with people getting implants for razor-sharp cheekbones and defined jawlines, contouring is going beyond Kim K palettes. The lower jaw implant involves an incision with sutures that dissolve within a week and the whole thing takes roughly two hours. Cheek and chin implants are hour-long procedures and, along with jaw implants, are entirely reversible. The ASPS statistics show that cheek implants increased 37% from 2000 to 2017 but chin augmentation has decreased 40%, despite it being the fastest growing surgery in 2011; this could be due to chin surgery inconveniently leaving up to six weeks of bruising. Dr Durrant explains: “More people are opting for lipofilling or dermal fillers instead.” Using the same substance as lip fillers, dermal chin injections don’t require any recovery time at all. Clients are able to quickly get their jawline, cheeks or chin done with hyaluronic acid injections which last about 4-6 months; then, they can move onto implants afterwards if they want a more permanent result. Although this might sound simple, consider the late Pete Burns’ horror story of his fillers escaping and swimming around his face; unregulated fillers are a worldwide problem.

The heavyweight procedure of jaw corrective surgery or orthognathic treatment is used in the UK mainly for medical reasons but is one of the most popular cosmetic procedures in South Korea; it can take six months to heal and is a painful process as the jaw must be wired together for six weeks. In 2014, South Korean presenter Won Jayhun was trolled online after drastically reshaping her jaw, modelling the radical South Asian ideal of a heart-shaped chin. As the plastic surgery capital of the world, South Korea is worryingly notorious for basing beauty standards on cosmetic enhancements.

Legs

In 1951, Russian professor Gavriil Ilizarov created a leg-lengthening surgery freakishly akin to medieval torture. The drastic procedure involves breaking a patient’s leg and then putting it back together with a rod inside the cartilage, which then takes roughly three months to heal and around five months for the client to walk again. Initially created for people with dwarfism and other conditions, in recent decades it’s been added to the list of aesthetic surgeries, popular in countries with low average heights like China and Korea. Fortunately, Dr Durrant says it is not winning over the UK: “It’s an orthopedic procedure. It is painful, dangerous and extremely time-consuming for limited gains so it is very rarely undertaken in this country. It is certainly not offered by any members of the BAAPS.”

Thigh lifts are another leg trend. Invented in 1957, the procedure involves removing skin and excess fat and has been a 21st century hit, increasing 65% between 2000 and 2018. Dr Durrant explains, “Thigh reduction is a common procedure and, like all procedures associated with weight gain or following weight loss, is gaining in popularity.” A 2017 development from this, popular in Hollywood, is thigh lighting which involves contouring of the entire leg with liposuction. Clients are known to bring in photos of Kendall or Gigi, when asking for the procedure.

Butts

Psychologists say our love for big bums is innate because they signal fertility, but fake ones are a decidedly modern craze with implants only being introduced in 1969 when Dr. RJ Bartels attempted to use Cronin and Gerow’s silicone breast inserts, before quickly realising that rounded balloon buttocks weren’t that convincing. A year later, Mario Gonzalez-Ulloa tried out a prosthetic specifically for the gluteus maximus, inserting it in-between the skin and outermost muscle layer but they restricted all movement of the cheeks. When Brazilian Butt Lifts arrived in 1971, they overtook implants with their natural effect of transferring fat, giving people everywhere a South American booty.

In 2018, the internet’s cartoon curve ideals have put Kardashian asses centre stage. “There’s been an exponential rise in requests for BBL,” Dr Durrant says, “mainly driven by social media stars and a shift in modern beauty ideals towards a larger derrière.” Since 2000, according to the American Society of Plastic Surgeons, a Brazilian Butt Lift is the fastest growing cosmetic surgery procedure of all, having increased 254% from 2000 to 2017, more than doubling in the last five years. However, Dr Durrant explains: “This demand seems to have flattened somewhat, perhaps due to a change in perception of the media stars themselves following allegations of photo manipulation, but also due to media coverage of significant complications and fatalities from this surgery, particularly when undertaken abroad.”

It’s a global phenomenon, but deathly: Brazilian Butt Lifts have the highest mortality rate of all aesthetic procedures, mainly due to damaging gluteal blood vessels.

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