Cosmetic surgery is in the news again. After six facelifts, an eyebrow lift, neck lift and a lip lift, reality star Katie Price has new 'butterfly lips', made with tape and filler that make the lips larger and curled upwards. Price may have had more aesthetic surgeries than most, but she's not the only one going under the knife. Last year there were 35 million such treatments worldwide. Facial surgeries - eyelid corrections, nose jobs, lip fillers - will increase by 20% in 2023. Whatever else is going on - pandemics, economic and political crises, wars, human rights abuses - we cling to the belief that if we improve our appearance, we can improve our lives.
It's an understandable - if solipsistic - belief, given the attention paid to beautiful people; they're the ones who seem to get the jobs, the relationships, and the Oscars. We are much more likely to trust, forgive, and believe people who look good. And if we can get a piece of that, why wouldn't we, even though we know that some treatments end in tragedy? Last week, Alice Webb, a 33-year-old mother of five, died from complications following a non-surgical 'Brazilian butt lift'.
Our quick-fix culture prioritizes appearance over everything else, including mental health. Social media and artificial intelligence are reinforcing this trend. One in three women look at Instagram influencers and think they need to do some work after comparing their faces unfavorably to those of AI. The more algorithms define "beauty," the more they lead people to those unattainable versions. It's a spiral of doom.
Not all treatments are influenced by fashion or fear of aging. About 100 million people in the world live with a facial scar, blemish or disease that creates "visible difference," the term used by advocacy groups. 'Deformity' sounds more pejorative, but it is a surgical term and a protected characteristic under the Equality Act 2010.
Surprisingly, people with serious facial injuries do not necessarily experience more psychological problems than people concerned about thin lips or acne scars. Low self-esteem linked to facial differences is completely subjective, and mental health conditions such as body dysmorphia are on the rise. Surgical solutions are often offered as a shortcut to healing. But there are no quick fixes and no evidence that cosmetic surgery makes us happier. On the contrary, the more treatments we have, the more we pursue; that 'new you' is always around the corner. For Price, it's her butt: 'I've lost weight. So... that's the next thing to fill. A kind, brave one [ sic] chubby, plum ass."
The misconception that being prettier or more beautiful will make us happier underlies this phenomenon Another mannow on US release. The film, directed by Aaron Schimberg, stars Sebastian Stan, Renate Reinsve and Adam Pearson. Pearson has neurofibromatosis type 1, a genetic condition that leaves his face covered in benign tumors, and he is a strong advocate for people with visible differences. He previously contributed to my Interface project, which explores the emotional history of the human face, from cosmetic surgery to facial transplants. We meet at King's College Gordon Museum of Pathology in London, where, surrounded by wax models of facial injuries, we talk about Another man and what it might reveal about our makeover culture.
Stan plays Edward, a man with neurofibromatosis, the same condition as Pearson. Edward leads an unfulfilling existence - he 'plods along', says Pearson; "He's not unhappy, but he's not happy either." Living in a cramped New York apartment, he seems awkward and shy, especially around his new neighbor Ingrid (Reinsve), a wannabe screenwriter who thinks she might be writing a play about Edward. But before that can happen, "Edward becomes involved in a medical trial that 'cures' him." Edward becomes a conventionally handsome man (played by Stan without his prosthetic mask). After laying down his old life and killing Edward, Guy rises from the ashes. He reinvents himself as a real estate agent and uses his appearance to sell the dream of a new life.
However, nothing has changed inside; Guy remains clumsy and insecure. When he meets Ingrid and discovers that she has written a play about Edward, he auditions, using a prosthetic mask. He is suitable for the role because, he tells Ingrid, one of his best friends has a facial difference. But it's a role he's never been able to play, as he realizes when Oswald appears, played by Pearson. In the film, as in real life, Pearson is charming and gregarious, fun to be around. He bursts with energy and confidence, unlike Guy, who even in his beautiful state moves pompously, as if afraid to take up space. Oswald takes over the play and shows how things should be done, and Guy begins to unravel. As Pearson puts it, "He sees echoes of the past, or the past he could have had but couldn't bring himself to. And a real descent into madness ensues for Edward.
The crisis at the heart of the film is that Stan's character is uncomfortable in any of his social masks. He couldn't thrive as Edward because he expected others to reject him, or because he had already rejected himself. Nor could he flourish as Guy, as the change was only superficial. Eventually the handicap kicks in The other person is how society treats Edward, and how he treats himself.
This is consistent with what appearance psychologists know about the challenges of facial differences. It is easy to internalize the abuse others suffer, and people with visible differences are routinely bullied and harassed, mocked and abused. Last week it was reported that Oliver Bromley, who also has neurofibromatosis type 1, was asked to leave a south London restaurant because he was "scaring customers".
Those with visible differences are not helped by our historically entrenched focus on beauty and the use of facial differences as shorthand for evil. Think Golden Eye, Airfall, Casino Royal And joker; or Darth Vader; Freddie Krueger and Voldemort. There have been films specifically about visible differences - Freaks (1932), The elephant man (1980), Open your eyes (1997) - very little from the perspective of the individual involved, and virtually nothing in the last twenty years. Why these films are made and who is involved matters. "Is it because they've had experience," Pearson wonders, "or is there some kind of fascination with the whole thing; are they trying to make the audience more compassionate and empathetic, or are they going for shock value?
Pearson is open about the abuse he experienced. When we met in King's Cross, he had been dealing with trolls on social media all morning. Nowadays, with so much emphasis on cosmetic enhancements, people expect Pearson to be able to physically transform just like Edward. That would be impossible even if he wanted to: "All these tumors are wrapped around blood vessels and nerves, and I don't think people realize that. People are like, 'just go get surgery,' and I'm like, 'Bruh, this is it after surgery.'"
There is more than one way to be socially marginalized. AI, which promises so much in the field of medical diagnosis and treatment, is not good for people with visible differences. "The bane of my bloody life," says Pearson. "You just read my passport, you do it online and it says, 'This is a bad photo,' and you say, no, this is a beautiful photo, but your software doesn't appreciate it. I have problems with the automated booths at airports; I have to unlock my iPhone with a PIN because it doesn't recognize my face."
Oliver Bromley, who has neurofibromatosis type 1, was told to leave a London restaurant because he was 'scaring customers'.
Pearson shouldn't be this resilient, but he is. Likewise, his character Oswald turns the viewer's suspicions upside down with his apparent disregard for his condition. Unaware that he may feel socially inadequate, Oswald goes out into the world expecting to be accepted and liked. And That ', say appearance psychologists, is the only way to be - because when you are down or awkward, when you exhibit the timid gestures that Edward does, you invite awkwardness in others. It's true that confusing expectations cause people to act differently; Often people avoid looking at people who are visibly different because they are unsure how to act.
The uncomfortable thing about this approach is that all the work is placed on the person with visible differences. It requires individuals like Oswald - and by extension Pearson - to be an example to the "face-different community." It's a role Pearson has taken on gracefully, though not always of his own choosing. "When you are labeled 'role model', and that is imposed on you, people sometimes think that you speak for everyone. And I can only speak for myself. For me it's about advocacy. While other people might be, "It's not my job to explain it to you." But who owns it? Who is better equipped to do this than me? So when I talk about it to nausea until I get bored, and that means it comes easier to someone like me, and it makes the world a better place, than rock and roll. It's not just about me," laughs Pearson. "That should be the case, but it isn't."
Critics have applauded the film's refusal to give viewers a simple answer to the issue of facial differences. I'm interested in how far we can go beyond it, to see a person as a whole. If Pearson is in a film where there are no visible differences, we have evolved as a society. As I walk him to his taxi, Pearson is repeatedly stared at, and I'm not sure if this is because of his fame or his appearance. He tells me that when he first met Stan, and Stan wanted to be in the role, he told him, "I could talk to you for ages, until the cows come home, about a deformity and you'll never more...get it someday. But what you do understand is what it's like to be known and thus lose your privacy. I've always said there are two ways to lose your anonymity in society: disfigure yourself or become famous. So I kind of let myself down on both counts. The public still thinks they own you, or that you owe them something."
Dr. Fay Bound Alberti is Professor of Modern History at King's College London, where she is Director of Interface and the Center for Technology and the Body. Her new book Face Value: A Cultural History of Being Human is published by Allen Lane in 2025
