Cosmetic surgery goes in and out of the closet

Staying true, but looking good
“There’s more pressure to look good and there’s also more pressure to stay true to yourself,” says Krystal Schwegel, who chose not to go public with her nose job at the time but says she doesn’t mind talking about it now. “There are definitely mixed messages out there, which is why I kept [my surgery] on the down low.”

Some of those messages have to do with assumptions about a person’s self-esteem, says Liz Rankin, a 27-year-old Seattle teacher who plans to keep her forthcoming hair transplants hush-hush (she says she’s willing to talk with msnbc.com because she wants to shed light on the condition — which looks to be alopecia — and let other women know there are new options available).

“I think a lot of people assume if you have work done that you don’t have any self-esteem, that you hate yourself,” she says. “And I don’t agree with that.”

Of course, if you get surgery on the sly, it had better be darn good surgery. Otherwise, you might end up being ridiculed by friends and family the same way starlets and celebrities are pilloried in supermarket tabloids and sites like Awfulplasticsurgery.com (Who wants to be known as the girl with “Cyclops breasts” or “slug lips”?).

Which brings in another aspect to the fear, shame and guilt society brings to the surgical table: the bigger the procedure, the harsher the judgment.

“It’s very complex,” says Sundaram. “We make moral judgments about people if we consider them vain. And if you’re willing to have a drastic invasive procedure, how vain must you be?”

The stigma of being labeled superficial is so powerful, in fact, even those who are up front about their work can question their decision.

“I’m totally comfortable with sharing the information that I’ve had a tummy tuck,” says Stephanie Abdullah, a 38-year-old entertainment PR specialist from Hollywood, Calif. “I'm happy about it and I’m not in no closet. But I just mentioned it to a guy I’ve been seeing and he looked really stunned. Now I’m wondering, did my telling him make him feel any differently about me? Am I now a fake? A phony?”

Lying is getting easier
Recent trends in cosmetic work may be putting a lot of these issues to bed. Plastic surgeries that used to require weeks or months of recuperation are being replaced by less invasive procedures that carry less downtime — and, apparently, less social stigma.

“Many of my patients are more comfortable talking about the minimally invasive stuff than they are talking about the cold hard surgery,” says Sundaram. “By and large, if they’re having ‘little’ procedures done — Restylane and Perlane and Botox — there’s more openness.”

Ironically, this openness may be something of a moot point.  Not because we’re finally at peace with our eternal quest for youth and beauty, but because aesthetic plastic surgeons and dermatologists are now better able to give us that stealth we so desperately seek.

“These days, it’s all about smaller changes, subtle changes,” says Dr. Hirsch. “You don’t have to make up a story if you go to a really good cosmetic dermatologist. I’m Spanx, I’m why the dress fits well. I’m the best vacation you never took.”

Diane Mapes is a Seattle freelance writer and author of "How to Date in a Post-Dating World."

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