On last night's premiere of the new season of Joan & Melissa, Joan Rivers got some more plastic surgery. Naturally, this required her to arrive at her surgeon's office sans makeup, and she allowed the reality cameras to capture what she really looks like. She's the first to admit it's not pretty.

For years, Rivers has been the butt of jokes about being a plastic surgery addict, going under the knife so often that she's barely recognizable from her former self. This time around she wanted to get loose skin beneath her chin removed, citing that it was visible on camera of her E! show Fashion Police. Rivers insists throughout the episode that it's "show business" that requires physical perfection from her. But does it? Let's be real: Joan Rivers' success as a comedian has never been hinged upon her beauty or youth—her career didn't even really get going until she was in her late '30s.

And while it's revolutionary that a 78-year-old female celebrity would allow herself to appear on a television show with no makeup (and in terrible, overhead lighting) it's also kind of weird, too, considering that the reason she did it was to achieve some kind of (unattainable) facial perfection for a different television show. Hollywood really fucks with women's heads—and faces.