Leith, William (28 page)

I said I'd read an article in the Daily Mail which described two Vogue models as 'ugly' and `skinny'; I said I thought this use of language demonstrated that the cult of thin was absolutely in the ascendancy.

I said, 'I mean, a state of body has to be extremely powerful in today's PC world when you can call it ugly. You can't say fat people are ugly. You can't even say they're a bit dumpy. Surely the cult of thin has won.'

`Watch this space.'

`Do you think a change is possible?'

,Well it is. I'm around teenage girls, and they're sticking their bellies out, and wearing these crop tops, and they're not at all skinny. So there is a zeitgeist change about to happen.'

Orbach said she thought the change might be brought about by fashion designers and high-street stores and magazines; things could be different if these people would only change their ways, make clothes in bigger sizes, use bigger models.

`I'm hopeful,' she said.

I told her I'd had trouble with overeating, overconsumption in general. I said I needed help. She said she would not give me therapy.

But she could recommend somebody who would.

In Disguise

I'm sitting on the bench, drinking my coffee, and thinking that diets don't work because diets are about being fat and wanting to be slim. Diets, in other words, are about being one type of thing, and wanting to look like another type of thing.

And if your main motivation is to look slim, you will almost certainly fail, now or sometime soon. Mostly, fat people are fat because they're troubled, and if they lose weight, they become troubled slim people, and then they just start overeating again, and become fat people who are even more troubled than they were before.

I've laid out all sorts of statistics, but here's the most Important one 95 per cent of the people who lose weight

find themselves back where they started, or somewhere even worse.

That's the problem with the whole of the diet industry. The diet industry says to millions of troubled people, 'You don't have to look into the reasons why you're troubled.'

The diet industry says, 'Just follow these simple steps, and you can avoid any of the difficult stuff.'

The diet industry says, 'You have problems, and you don't want to talk about them, and, guess what you don't have

to.

If it's successful, a diet merely makes you temporarily look like a person who doesn't have your problems. You might lose weight, but the problems, which made you overeat in the first place, are still there. So you'll overeat again. Or, like me, you'll do something else you'll use drink or drugs or whatever, and then you'll probably start to overeat again

anyway.

So diets don't work. Diets are like facelifts, which aspire to making you resemble a different type of person, but which can never turn you into a different person.

To diet is to believe in the supremacy of the image; dieters are like people who believe they are more real in photographs than in person.

At best, diets, like facelifts, enable you to walk around in

disguise.

No Trouble

I met a woman who wanted to walk around in disguise. To me, Anne's face looked fine. Certainly, there were some crow's-feet around the eyes and some lines between the nose

and the mouth. Her brow was slightly wrinkled. She also had something of a double chin. But Anne was fifty-three. Her facial expressions, made from the movements of the lines, wrinkles and muscles of her face, had an air of integrity. They were the outward manifestations of the thoughts of a woman in her early fifties.

To me, Anne's facial lines were part of why her face looked fine. But I was not Anne. Anne did not want to look like a woman in her fifties. She wanted to look like something which, to her, was significantly different a woman in her forties. She wanted, superficially, to pass for someone who was born, not in the era of Glenn Miller, but around the time when Elvis was beginning to make an impression. She wanted to have the appearance of a younger version of herself. Looking less old, she believed, would improve her life.

Anne was due to have a facelift, and some liposuction, the next day. The operation would last nearly four hours. She invited me to watch it.

`It should take five or ten years away,' Anne explained. She told me what would happen to her. It frightened me. Just the idea of it frightened me. She would be anaesthetized. The skin around her ear would be cut with a scalpel. Not pricked, or jabbed, but sliced. Next, her cheek would be separated from the flesh of her face. Her facial muscles would be rearranged. Her skin would be stretched. Excess skin would be cut off. Then she would be stitched up. The whole process, of course, would be repeated on the other side. Then her eyelids would be cut open with a laser beam. Fat would be removed from

the eyelids.

Looking Younger, Anne said, would improve her `confi—

dence'. She was already relishing the thought of looking in the mirror and seeing the difference.

She said, 'You may think: Small problem, silly woman. But it's about what you feel like inside.'

Anne's husband, Derek, who was fifty, said, 'I'm passionately in favour. If it doesn't do any harm, then it's got to be good for everybody.' He himself had had fat sucked from under his chin.

We discussed the reasons for Anne's facelift. Finally, she said, 'Men mature, whereas women age. Men look quite good when they look older.'

I said, 'Why is that?'

`I don't know. I don't know why. But it's true. For instance, grey hair looks nice on a man. Not on a woman. It's very, very hard to say why, but it's a fact.'

I drank the champagne Anne poured for me. Having entered the final twenty-four hours before the operation, Anne was not allowed to drink.

`Are you worried?'

She said, `Oh, yes, I'm anxious. I'd be abnormal if I wasn't.'

Anne's facelift was to be performed in a small private clinic in Highgate in north London. As I approached the clinic the next day, feeling hollow and nauseous, I realized that I had mixed feelings about cosmetic surgery. I couldn't shake off a feeling of discomfort. But why is it wrong? If it is ageist, so is jogging. So is yoga. If it is a superficial change masquerading as a more significant one, so is wearing a suit. Did I believe that beauty was divinely ordained, or that there should be only so much of it around? My misgivings were elusive, but

persistent.

The clinic was a former Edwardian house in a residential street. Anne was watching television in an upstairs room. She was quiet. She looked nervous. I was terrified. She had opted not to have a 'pre-med', an injection to quell her nerves. The television rumbled away. We did not say much to each other.

To attend the operation, I had to wear 'scrubs' a blue, square-necked T-shirt, blue cotton pyjama-like trousers, a blue elasticated paper cap, and white slip-on sandals with, for some reason, a little heel.

The administration of the anaesthetic was a shock for which I had not prepared myself. Anne was wheeled into the room on a trolley. She was lying on her back. Dr Chang, the anaesthetist, who had himself had cosmetic surgery on his eyelids and his ears, stuck a needle into Anne's hand. The needle was joined to an open socket. Chang was whistling. Anne said, 'I'm very calm, actually. Yes. Just a slight apprehension in the last few minutes, but nothing dreadful.'

Chang said, 'Anne, have a nice sleep.' Then he took five syringes and, with practised ease, pumped their contents, one after the other, into the socket in Anne's hand. There was a muscle relaxant, the anaesthetic itself (which is white and soya-based), a painkiller, a steroid to ease swelling and an anti-sickness drug. (Later, Chang would tell me there is still some medical mystery about how the anaesthetic

works.)

For a tiny moment, Anne concentrated on her hand. Then, horribly, all expression on her face collapsed. It was like watching the moment of death. The eyes rolled in their sockets and the head, suddenly heavy, slumped down on the pillow. I had an overwhelming sensation of disgust. (It's

gone wrong! They've killed her!) While Anne's face was being injected with adrenaline, to reduce blood flow, I slipped out of the room, and, breathing deeply, took a seat in a room next door where a surgeon was eating a turkey sandwich. 'I'm having lunch between faces,' he told me.

A trolley was wheeled in. A nurse said, to a patient, 'Come on, Julia. Julia! Time for you to wake up. Keep waking up! That's better. Listen! Stay awake for me.' The patient's face was heavily bandaged. She was gently moaning.

Superficially calm, I walked into the operating theatre. It struck me that my misgivings about cosmetic surgery might simply be a fear of blood and unnecessary violence. Also, the more people who do it, the more chance there is that, one day, it will be my turn to feel the pressure. Anne had talked of the influence of older film stars who looked good because they'd had facelifts. Julie Christie, Joan Rivers, Burt Reynolds: their nips and tucks have crept into the culture.

Anne was on her back, on a trolley. She looked like a corpse. She looked like a dead old bloke. She had tubes coming out of her mouth; a machine was breathing for her. Mr Prakash, the surgeon, was standing by the side of the trolley, in scrubs. Two thick magnifying lenses were protruding from his glasses like frog's eyes.

The first thing Mr Prakash did was to make a hole under Anne's chin, and insert a cannula, which looked like a thick needle. This was for liposuction, or, as cosmetic surgeons prefer to say, `liposculpture'. The cannula was attached to a clear plastic tube. Mr Prakash jabbed the cannula under the skin of Anne's neck. After a moment or two, a bubbly pink substance, like strawberry milkshake, was sucked back

through the plastic tube. This was the fat. This was the double chin.

When Mr Prakash took the cannula out of Anne's neck, it slurped, as if it were a straw sucking the last drops of the milkshake from a glass. He had, he told me, performed this operation seventy times. He replaced the cannula, and jabbed away, with a great deal more vigour than I would have expected.

There was more fat on the left side of her face than the right. The fat bubbled back through the tube. Mr Prakash smoothed his gloved hand over the flesh, as if moulding putty.

He said, 'See how the bulkiness has gone?'

It was when Mr Prakash picked up a tiny scalpel that I started to feel sick. The blood left my head. My legs felt hollow at the sight of a man, with a blade, preparing to insert it into the face of another human being. I found a chair and sat, head in hands, swallowing saliva. I needed a few moments.

One of the reasons often cited by the opponents of cosmetic surgery is that it is a simple, painless process. You go into the operating theatre unbeautiful, and, hours later, emerge, beautiful. All you have done is paid; somebody else has done the work. (I've heard people take the same tone with fake suntans: you don't have to work for them, so, in some way, You have taken an unfair advantage.) Looking at Anne, though, whose grey, open-mouthed, open-eyed face resembled that of an old man hovering between life and death, I dismissed

11inissed this idea. In the end, she might look younger, or

better; she might have fewer wrinkles and a taut neck. But, on some level physical, mental, spiritual she looked like she Was paying for it.

Mr Prakash told me that, to combat my nausea, I could try bending over Anne's face and concentrating on small details. It worked. Mr Prakash sliced into Anne's flesh. He went around her ear with his scalpel. The wound did not spurt with blood. There was a slight welling. The adrenaline injections had done their job. Mr Prakash said to the nurse standing on the other side of the trolley, 'Have you seen the breast girl?' He was referring to his next patient.

Mr Prakash said, 'Pull the ear, please!'

Dr Chang said, 'Now comes the interesting bit.' And, with a pair of tweezers, Mr Prakash began to peel Anne's skin away from her cheek. Or was it that he was peeling her face away from her head? He started behind the ear and moved around to the front of the ear. Underneath, the flesh was pink and slightly runny, like raw veal. As he pulled the skin away, he cut the membrane joining it to the layer of muscle underneath. You can see why some people who have had facelifts lose sensation in their faces for a while. Their nerves have been cut.

Every now and again, there was a sizzle, and a smell of cooking. Mr Prakash was cauterising those blood vessels which were still seeping. When Mr Prakash had cut the side of Anne's face, as it seemed, free of the muscles underneath, all the way down to the corner of her mouth, a clamp was inserted, tenting the cheek.

Now, there was a cavernous space, inside which were stalactites of fat, and glands, which resembled sweetbreads, and the flesh itself, stringy and bright red and gently oozing. With tweezers, Mr Prakash inserted a cloth to mop up the blood. Then he placed the cloth on a tray.

Into the hole in Anne's face, Mr Prakash inserted a needle—

contraption. thread

d aption. He put a stitch in each of the facial an—

muscles and pulled them upwards, holding on to the thread, his gloved hands dextrous, twirling. It took ages. The stitches, he said, would dissolve in 120 days.

`Ear, please.' While the nurse held Anne's ear, Mr Prakash gently pulled on her skin. And the skin, stretched, fit over the bottom half of the ear, as if it were a rubber mask. Mr Prakash cut the excess away with a pair of scissors. He went around the ear, cutting little triangles of fleshy skin. He placed the skin on the tray. One bit had hair on a triangle of scalp. Again, the blood left my head.

Ninety minutes passed. Mr Prakash repeated the procedure on the other side of the patient's face. When Anne was stitched up, he slid metal eyeball-guards underneath her eyelids, which he would slice open with a laser gun. Anne looked like an android. We put on goggles, to protect our own eyes from stray laser beams.

Using the laser contraption, which looked like a dentist's drill, Mr Prakash cut across each eyelid. As soon as the beam touched, the flesh seemed to spring apart. Then, with a pair of tweezers, he pulled out the fat. It came out in worms, and looked like bloody snot. Finally, he ran the laser along some of Anne's facial lines. His smock was smeared with blood. Next door, through a glass panel, I could see a man lying on a trolley. He was writhing and bucking. Minutes later, a young woman walked towards the Operating theatre with a trolley by her side. 'I'm walking in,' she said. It was the breast girl.