Combined, they've had breast implants, cheek implants, chin implants, nose jobs, dental procedures, neck liposuction, waist liposuction and laser hair removal. One woman has had Restylane injected into her feet.

In today's New York Times, Ginia Bellafante writes:

"Addicted to Beauty" aims to be "The Office" with liposuction, the emphasis placed on staff politics rather than on patient shenanigans… Nobody looks good; everybody merely appears as desperate as [a castmember named] Gary sounds.

LA Times TV critic Mary McNamara calls Addicted To Beauty "less a reality show than an infomercial." Whether people tune in to watch a "reality" show in which people are so fake remains to be seen. But since these people clearly feed on attention, it seems kind of creepy to enable them.

Tucking, Augmenting and Office Politics [NY Times]
'Addicted to Beauty' [LA Times]

Cosmetic surgeons are seeing more and more patients — particularly women — seeking surgery to improve their looks by getting increasingly popular nose jobs or alleviate back pain by reducing their breasts. Surgeons are noticing the difference.

"Definitely we are performing more plastic surgery than before, mainly because the security situation of the country has improved," said Rida Ali, a plastic surgeon who estimates that half her patients are seeking cosmetic surgery, compared with less than a quarter a few years ago.

They include men as well as women, and most of them want nose jobs, which cost $600 to $1,000 each.

While it's good that the security situation is improving for Iraqis, I'm not sure that an uptick in plastic surgery is necessarily a development to be celebrating.

Some people think that plastic surgery is increasing in popularity because more Iraqis have access to pop culture and images of supposed physical perfection that are themselves surgically created.

The trend has been fueled largely by the arrival of satellite television, which since 2003 has beamed into Iraqi living rooms the glamorous Egyptian and Lebanese celebrities who are reputed to keep regular appointments with their cosmetic surgeons.

The results aren't always what the patient expected.

"Our patients get all their ideas from TV, then they come to us and request the operation," said Mahdi Hameed Abood, a senior surgeon at the Wasiti Center for Reconstructive Surgery.

Iraqis: they're just like us!

Many women say that they get plastic surgery to get a husband — or, in one case, to get her daughter a husband.

Marriage prospects are a major reason cited by Iraqi women for choosing to go under the knife. During the worst years of the sectarian war, matches were put on hold, and now many women feel they have to make up for lost time.

Mulook Abuid Wihhab, 49, believes she found a husband because of the nose job she had 23 years ago, and she dreamed of a similar operation for her daughter Noor, 21, a business student at Baghdad University.

She was finally able to get her daughter the nose job she always wanted to her to have recently, as doctors were less busy treating victims of violence. Who knew it would be so easy to come up with a downside to a reduction in violence in Iraq?

The New Face Of Plastic Surgery In Iraq [LA Times]

Sara Taylor is a 44-year-old divorcée who spends about $7,350 on cosmetic procedures every year just to be able to look at herself in the mirror again.

I do all my own manicures and eyebrow grooming at home, and I shave instead of waxing. That way, the money I save can be spent on the cosmetic injections.

Now, I have Botox every four months and fillers every six to nine months. To me, it's money well spent, because the benefits are clearly visible.

She has, by the way, a 15-year-old son who I'm sure has a wonderfully realistic mental portrait of what a gracefully-aging woman looks like and a sense of self-worth that isn't totally couched in his own looks and rather about his intelligence, grace, charm or kindness.

Anyway, back to the children of Jessica Bennett's article who are certainly in no way influenced by women like Taylor.

Girls today are salon vets before they enter elementary school. Forget having mom trim your bangs, fourth graders are in the market for lush $50 haircuts; by the time they hit high school, $150 highlights are standard. Five-year-olds have spa days and pedicure parties. And instead of shaving their legs the old-fashioned way-with a 99-cent drugstore razor-teens get laser hair removal, the most common cosmetic procedure of that age group.

Let's be frank though: it's not like elementary school girls have the money for $50 hair cuts or weekly mani-pedis: these little luxuries and coming straight from Mom and/or Dad's wallet.

Four years ago, a survey by the NPD Group showed that, on average, women began using beauty products at 17. Today, the average is 13-and that's got to be an overstatement. According to market-research firm Experian, 43 percent of 6- to 9-year-olds are already using lipstick or lip gloss; 38 percent use hairstyling products; and 12 percent use other cosmetics. And the level of interest is making the girls of "Toddlers & Tiaras" look ordinary.

That's nearly half of girls in 1st through 4th grade have a little lipstick in their purse — and not a bubble-gum flavored Bonne Belle either. And it's not like it's a phase for these girls, either:

Consider this: according to a Newsweek examination of the most common beauty trends, by the time your 10-year-old is 50, she'll have spent nearly $300,000 on just her hair and face.

That's quite the college education you and her might have been able to pay for (or pay back to Sallie Mae).

Eight- to 12-year-olds in this country already spend more than $40 million a month on beauty products, and teens spend another $100 million, according the NPD Group. This trend seems unaffected by the tanking economy: cosmetic surgery procedures dipped slightly last year, but cosmetics sales have increased between 1 and 46 percent, depending on the product, according to the Nielsen Co.

That means the parents (mostly) of children in the 3rd through 7th grades spend half a billion every year on inculcating their daughters with the idea that they are only pretty, presentable or socially acceptable when they are sprayed out and made up. If you add in teen girls, the Beauty Industrial Complex then reaps $1.7 billion from underage consumers every single year.

And, naturally, it doesn't stop with make-up and hairspray.

New statistics from the American Society for Aesthetic Plastic Surgery show that cosmetic- surgery procedures performed on those 18 and younger have nearly doubled over the past decade. Dr. Alan Gold, the society's president, says that nearly 14 percent of Botox injections are given in the 19 to 34 age group-and while his trade group doesn't break down those ages any more specifically, he's seen a significant increase in the younger end of that group, seeking treatments as preventative.

Once again, most 19-year-olds are probably not going to have lying around the $1,300 Taylor spends yearly on Botox alone — at least some goodly portion of those women have got to be getting their Botox funds from their parents.

I'm not alone in thinking that this is probably not the best thing in the world.

In Susie Orbach's new book, "Bodies," the former therapist to Princess Diana argues that good looks and peak fitness are no longer a biological gift, but a ceaseless pursuit. And obsession at an early age, she says, fosters a belief that these are essential components of who we are-not, as she puts it, "lovely add-ons." "It primes little girls to think they should diet and dream about the cosmetic-surgery options available to them, and it makes body the primary place for self-identity."

In other words, girls begin to value themselves more for their own supposed attractiveness, believe that others do the same, and see less value in the other things they might otherwise contribute to the world.

But in between the statistics about what some girls and woman will be spending on beauty treatments over their lifetimes, there's one essential fact that is missing from the articles. Companies are creating a lifetime market for themselves by marketing to girls. By creating consumers as such a young age, companies are ensuring that they'll have those consumers — and their money — for life. It's also the only available market into which these companies can expand. It's a hard sell to convince a 31-year-old feminist-y blogger type in the midst of ongoing media massacres that I need to wax my legs, wrap my nails, coat my face in chemicals before I leave the house and keep my highlights up to date, partly because I'm a little too old to care that much and because I never got in the habit of it, thanks to my mother's no-make-up rule and my penchant for sleeping as late as humanly possible. But if, like Bennett, the Beauty Industrial Complex can sell you a "$130 Crème de La Mer face cream I use so sparingly it defeats the purpose of having it" at 27, they figure they'll have less trouble selling you on Botox or laser skin resurfacing for your recessionary job interview in 10 more years. It's straight up-selling — only they're just starting young enough that you don't notice.

Generation Diva [Newsweek]
Botox Has Given Me The Confidence To Look In The Mirror: How Much Does It Cost To Run Your Body? [Daily Mail]
The Beauty Breakdown [Newsweek]
How to Market Nips and Tucks in a Recession [NY Times]

Earlier: Little Lolitas: The UK's Narcissistic Pre-Teens
How Many 8-Year-Olds Have To Get Bikini Waxes Before We All Agree The Terrorists Have Won?
If A Girl Gets A Spa Treatment And No One Films It, Did It Really Happen?

Although it sounds sort of obvious - who wouldn't be depressed upon figuring out that she can no longer move her eyebrows? - lead researcher Dr Judith Grub believes that her study on Botox reveals a deeper link between freedom of facial motion and negative feelings. In the study, 30 people were shown a series of disturbing and gruesome images. Some of the participants were asked to keep a blank face while examining the photos, while others were allowed to express their natural reactions. Results showed that subjects who were unable to show their emotions perceived the world as a worse place, and held onto their negative feelings for longer. Grub said: "Suppressing negative emotions is something we do every day to be polite. However, my research shows that paralysing muscles that help you to express emotion leads to internalising these feelings."

Unsurprisingly, Botox doctors dispute Grub's findings. "Botox shouldn't paralyse the face and you should still be able to make facial expressions," said Dr. Patrick Bowler.

But maybe cosmetic treatment experts like Bowler should worry. Another kind of depression has lead to a significant decrease in the number of cosmetic procedures performed in 2008. The Times of London reports that the decline in procedures in the last few months of 2008 was so steep that it could force 15% of surgeons in Britain to close shop. Dr Hamish Laing explains: "There has been a significant drop across the country because cosmetic surgery is a lifestyle choice. When times are hard, people considering cosmetic surgery may decide to put it off." This fact, coupled with the rising cost of insurance premiums, has made it increasingly difficult for doctors to stay in business.

And it looks like the same thing is happening on this side of the pond. According to a report released by the American Society for Aesthetic Plastic Surgery, almost every procedure is down 10-12%, and total procedures are down 12.3%. Botox is still the most popular nonsurgical treatment for both men and women, but boob jobs have replaced liposuction as the most popular surgical procedure. The Aesthetic Society president, Alan Gold, attributs this change to "changes in fashion, i.e. décolletage baring styles." I'm not sure when décolletage baring tops were out of style with the boob job set, but this explanation makes just about as much sense as the recession justification.

Botox Injections Could Make People Depressed, Study Suggests [Telegraph]
Liposuction No Longer The Most Popular Surgical Procedure According to New Statistics [The American Society for Aesthetic Plastic Surgery]
Cosmetic Surgeons Suffer As The Vain Learn To Live With Imperfection In Straitened Times [Times]
Report: Laser skin resurfacing is recession-proof [Cosmetic MD Nation]

Related: When The Going Gets Tough, The Tough Get Implants

So, according to the Sun, British plastic surgeons have seen an upswing in certain procedures, like "people wanting to get rid of thread veins and redness around the nose and cheeks." Men's procedures, like man-boob-reduction and hair implants, are also going strong, with male brow lifts alone up by 60% this year in Britain. Says a spokeswoman for one plastic surgeon,

We've been in business for 30 years and we have found that recessions are times when people still want to look and feel good, especially in a competitive work place...People want to look good and are willing to make cut backs on going out, shopping and luxuries like holidays in order to look good every day of the year.

One doctor explains that the redness around the nose can make a job candidate look "drunk," while a hair transplant surgeon tells the LA Times, "If you have two people coming in for a job, and one of them is partly bald, you'll think that the one with hair has more youth and vitality." The perceived benefits of implants are, I suppose, apparent.

It's not hard to see that, as in many things plastic surgical, the actual issue here is one of confidence, and I'm guessing most of these people would probably have made surgery a priority in any case. As such, it seems unfair for these doctors to play upon their insecurities to such a degree. On the other hand, anyone dwelling on perceived faults probably is hurting themselves in a job search ...and, of course, the cosmetic surgery market's hurting, so no one's shocked that the docs are playing up the angle. But much as "The Economy" has given some people an excuse to drop gym memberships or cross cousins off wedding guest lists, surely it's serving as a rationale for a few people who might have otherwise denied themselves...which goes to show that a) you can justify anything and b) at the end of the day, you really don't have to.

To Get A Job – Get A Boob Job [The Sun]

In A Hairy Market, Can Transplants Aid The Balding? [LA Times]

• Sad face: Mickey Rourke's 18-year-old chihuahua, Loki, has died. Rourke called Loki "the love of his life." And famously thanked his all his dogs in his Golden Globes speech. RIP little dude! [E!, TMZ]

• Sarah Jessica Parker's been talking about the Sex And The City sequel. She wants the new movie to be a "massive romp." And she's worried about the consumerism: "How do we address these economic times in a franchise that has a lot to do with luxury and labels? You know, there is a lot that we have to think about because times are very different." Indeed. [UPI]
• Lindsay Lohan was seen having a fabulous time in New York while Sam Ronson was in San Diego, what does it mean??!?! [Page Six]
• The lone Asian dude in Miley Cyrus's "goofy" photo has been identified; his name is Chuck Willis, and he is a model/actor/photographer. Who hangs out with Hannah Montana. [ONTD]
• The Guardian's Hadley Freeman spends five minutes with "the surprisingly tall" Justin Timberlake and promptly falls "a little bit in love." [Guardian]
• Oscar producers want M.I.A. to be on the show so badly — even though she just gave birth — that they're willing to let her perform her track from Slumdog Millionaire from a "large bed" on stage. Or she could appear via hologram. The bed idea sounds kind of awesome, but only if there are dancing orderlies. [NY Mag, MSNBC Scoop]
• More Oscar gossip: Hugh Jackman is hosting, but he'll be joined on stage by Beyoncé, Zac Efron and Vanessa Hudgens and Mamma Mia's Amanda Seyfried for a big song and dance number, directed by Moulin Rouge's Baz Luhrmann. If they do "Dancing Queen," it just might be the gayest thing on TV since Charles Nelson Riley. [Yahoo News via E!]
• John Mayer will be attending the Oscars, and says: "It's my first Oscars. And it's my first being an Oscar boyfriend. After that night I have a deal almost signed in blood that says I must go into the studio and finish this record. So after Oscar Sunday, Monday morning I'm invisible." [PopSugar]
• Bookies who deal with Oscar bets says Heath Ledger is "such an absolute certainty you've got to feel a bit sorry for the fellow nominees. They have no absolutely no chance whatsoever of winning." [Mirror]
• An L.A. Superior Court judge has ruled that Roman Polanski will have to come to the U.S. and face a judge before his 1977 child sex case can be dismissed. Of course, if Polanski arrives in the States, he faces immediate arrest, as he is a fugitive. [Variety]
• Hayden Panettiere, 19, fresh off of her breakup from Milo Ventimiglia, 31, was seen flirting with Gerard Butler, 39. Can you blame her? He's hot! [MSNBC Scoop]
• Seth Rogen will appear on the cover of Playboy, only the 9th time a dude's been on the cover in 56 years. But will he be clothed? [Page Six]
• Rachel Bilson and Hayden Christensen are engaged, by the by. [Page Six]
• Kanye West looks morose on the new cover of Details and inside says the kind of stuff you expect Kanyeezy to say. Like: "Put this in the magazine: There's nothing more to be said about music. I'm the fucking end-all, be-all of music." And! "People ask me a lot about my drive," he says. "I think it comes from, like, having a sexual addiction at a really young age. Look at the drive that people have to get sex-to dress like this and get a haircut and be in the club in the freezing cold at 3 a.m., the places they go to pick up a girl. If you can focus the energy into something valuable, put that into work ethic..." [Yahoo News via E!]
• Also, when Kanye was 12, he produced a video game: "My game was very sexual. The main character was, like, a giant penis. It was like Mario Brothers, but the ghosts were, like, vaginas. Mind you, I'm 12 years old, and this is stuff 30-year-olds are programming. You'd have to draw in and program every little step-it literally took me all night to do a step, 'cause the penis, y'know, had little feet and eyes." [Yahoo News via E!]
• Michael Phelps is so afraid of people snapping his picture, he's had the windows of his home tinted and he's been hiding out in strip clubs, where photographs are not allowed. No, really, that's the only reason. [Page Six]
• Has Kylie Minogue had cosmetic surgery? The latest edition of the UK's Grazia magazine asks on its cover: "What has Kylie done to her face?" A surgeon who does not treat her has the answer: "Kylie's brows look a little higher than usual, which suggests she's having regular Botox to lift them. One of Kylie's brows is slightly more arched and higher than the other, which is often a telltale sign." [News.com.au]
• Boo-hoo: Eva Longoria Parker is sad that Nicolette Sheridan is leaving Desperate Housewives. "I love her so much as a person, and I love the character of Edie Britt, that I can't imagine the show without her," Eva says. [Mirror]
• Here's a video of Benicio Del Toro talking about playing Che Guevara and doing some really good stuff with his expressive eyebrows. [Guardian]
• Kid Rock is making Kid Rock Beer, which is expected to create 394 new jobs in Michigan. Those without jobs will at least have something to drink? [Detroit Free Press]
• Ashton Kutcher is in negotiations to star in a flick called Traded, about a superstar NFL quarterback and a 12-year-old middle school geek who magically trade bodies. Sort of Freaky Friday Night Lights. [Variety]
• Bob Barker "relaxes in retirement with dog and bottle of tequila." He doesn't watch Price Is Right. [ABC News]
• Set your DVR; A&E has ordered 11 episodes of Hammertime, a show which tracks the life of MC Hammer and his family. Can't touch this? [Variety]
• Luther Campbell from 2 Live Crew was arrested for contempt of court last night; he owes $10,233.36 and he'd better pay up. [TMZ]
• Morrissey, who turns 50 in May, says of the chance that he'll still be in the music biz at age 55: "I think it's incredibly slim. For heaven's sake!" [Daily Express]
• Blind items! 1. Which movie producer is finding out bad habits die hard? Despite being married, he asked a gorgeous, dark-haired woman back to his hotel for a "late-night private audition" after a dinner at the Berlin Film Festival. As the actress accepted, look for her to appear in his upcoming pictures. 2. Which kooky fashion figure asked for illegal substances on her contract rider? She said in order for her to appear at a fashion show, she needs two bottles of Cristal and "cocaine - a lot of it." [Page Six]
• Blind item: "Which F-list celeb had an abortion six months ago? We hear she's still not sure who the father was." Wait, why do we care about this? [Gatecrasher]
• "God, I might pass out. Your heart pounds really hard, and just that moment…wow. My grandmother is coming. My mom and my grandmother. Three generations. " — Taraji P. Henson, on being a nominee at the Oscars. [Washington Post]
• "My mother, she was like, 'I don't know if Mama wants to come because she had a knee replacement surgery and she's been going to the doctor and it's a long evening.' I said: 'Mom, you know what? Why don't we just let Grandma make the decision? Let's call her and let her say no.' We called her on a three-way and I said, 'Hey, Grandma, we got an extra ticket for the Oscars, you wanna come?' 'I sure do, baby!' She did not hesitate, do you understand? Grandma is not going to miss it for the world, do you hear me? She didn't want to hear about how long it was going to be. She didn't want to hear about that, she'd moved on to what she was going to wear. She was like, 'Well, I have this outfit and these shoes.' I was like, 'Bring it, Grandma.'" — Taraji P. Henson. [WaPo]
• "It's just something for your eyes to look at. It's just a change from the norm, innit? The problem is, I never buy a piece of art. I don't see the point in buying something because I know my eyes will get bored of it eventually. You know, a lot of museums keep the stuff, they rotate it, because people get sick of looking at it. They shift the art around, don't they? People go, 'I'm sick of that now.' They move it around the world, let someone else's eyes look at it." — Ricky Gervais, on art. [Guardian]
• "I really believe I'm on the very tail end of television as a big money-making business. I think there will always be a certain number of people who make a lot of money, like American Idol or NFL football, but I just think that in 10 years when people have good Internet connections, there are going to be a thousand channels. People will be making money, they just won't be making a lot of money. Even successful shows or programming will bring in small amounts of money." — Jimmy Kimmel. [Broadcasting & Cable]
• "Oh my God, I'm one of the greatest rappers in the world. I'll get on a track and completely ee-nihilate that track, I'll eat it and rip it in half. I wouldn't have to think of it. […] I have, like, nuclear power, like a superhero, like Cyclops when he puts his glasses on." — Kanye West. [Yahoo News via E!]
• "The next chapter of your life has begun. The toughest decisions you will ever have to make lie in front of you. You have shifted the cultural paradigm of America, but now you have to live up to the ideal that fostered the shift and ensure that the paradigm doesn't shift back. You must deliver." — LL Cool J, in an (open, unsolicited) letter to Barack Obama. [Mirror]
• "I am her biggest fan and I can't get enough of her. But wearing my fashion hat, I want to say to Meryl Streep, 'You need to accept responsibility for what you are wearing. I don't know that you do.' The message she's sending is, 'I'm too smart for this and it doesn't matter to me what I'm wearing.' I want to say to her that it should matter to you." — Tim Gunn. [MSNBC Scoop]

Well, she asked the plastic surgeon for his opinion, as part of an exposé for Vanity Fair. Since Americans spent $13 billion on 11.7 million cosmetic procedures (both surgical and nonsurgical) in 2007, and it seems that patients getting elective cosmetic surgery are younger and younger. Berliet actually visited three physicians for her article, asking them what she "needed" and, as the piece notes, "The answers were as different as the doctors themselves." Berliet writes:

When I began this project, I was relatively certain that I didn't need plastic surgery. I also suspected that plastic surgeons might tell me otherwise. To test my hypothesis, I went undercover. In the process, I hoped to learn something about what happens inside examination rooms across New York City and, by extension, the United States. Are teenybopper idols and those who emulate them freely choosing plastic surgery? Or is plastic surgery choosing them?

The first surgeon, Dr. Rapaport, wanted to lipo Berliet's "waist wads," even though they were "borderline." (He said: "I've done supermodels with much less than this. To them it was important. To each his own.") He also wanted to suck the fat out of her outer thighs and "banana rolls" — that is, the part of her butt that peeks out of her underwear. ("As a Caucasian woman, you probably…would want this brought down," he explained.) Add a C-cup, some Restylane, and a nose job, and you've got $33,000 worth of procedures. Dr. Rapaport also suggested Berliet do something with her hair.

The next two doctors Berliet visited weren't nearly as aggressive. "Botox? You don't need it. You look good," Dr. Heller insisted. Dr. Racanelli was more even-handed: "The way it works is: you tell me if something specifically bothers you, and I'll tell you if I can address it. But I'm not here to sell you services or goods."

But one has to wonder if the eager Dr. Rapaport is the exception or the rule. Are cosmetic surgeons more salesmen than doctors? Remember the 26 year old who was told she needs Botox? Or what about the doctor who suggested Tracie get lipo on her vagina? And what are the chances that a young woman or teenage girl is going to see a Dr. Racanelli type instead of a Dr. Rapaport type?

Plastic Surgery Confidential [Vanity Fair]
Earlier: New York Doctors Tell 26-Year-Old She Needs Botox
Pimp My Vadge
Paying Someone To Cut You Is Growing In Popularity

Orbach, author of Fat Is a Feminist Issue, writes in New Scientist,

Until very recently, we took our bodies for granted. We hoped we would be blessed with good health and, especially if we are female, good looks. Those who saw their body as their temple, or became magnificent athletes or iconic beauties, were the exception: we didn't expect to be like them.

But now "the notion of the empowered consumer, along with the workings of the diet, pharmaceutical, food, cosametic surgery and style industries, and the affordability and availability of their products have made us view our bodies as something we can and should perfect." Orbach cites extreme makeover shows, cosmetic surgery, baby heels, and amputee fetishes as examples of this new obsession with perfection. We agree that baby heels are a sign of the apocalypse, but amputee fetishism is really more about sexuality than beauty. And while boob jobs haven't been around forever, tattooing, piercing, and more severe modifications like neck lengthening are quite old.

So are standards of beauty. While it's always been easier for rich people to conform to these standards — in part because they frequently set them — far from true that average people have historically ignored their attractiveness. Makeup, for instance, is as old as the Ice Age, and enjoyed widespread, cross-class popularity in Regency England as well as post-WWI America.

Casting our obsession with beauty as a recent phenomenon muddles the issue — it pathologizes the age-old human interest in adornment. But Orbach does identify a more serious problem: "the homogeneous visual culture promoted by industries that depend on the breeding of body insecurity." Before the advent of mass culture, your tribe or city-state or kingdom might have been ideal of beauty, which might be constricting its own way, but now multinationals like Unilever can promote a worldwide ideal of bodily perfection that's arguably more damaging. Not only does the global-beauty complex reduce "body variety" and privilege one racial and ethnic makeup over others — it's also far more pervasive than anything present in the Ice Age. Luckily, women also have more education and economic power than at any other time in history, and thus more ability to fight back against standards of beauty we don't like. The problem isn't that women never used to care about beauty — or even that we shouldn't. It's that, as messages about beauty get more numerous, standards of beauty get narrower — and we don't have to stand for it.

Why do we need bras for babies? [New Scientist]

Douvall, a "glamour model" famous in Britain for having kissed and told about various celeb boyfriends, has had 15 boob jobs, facelifts, and repeated operations to change the shape of her face. Doctors in the UK will no longer treat her, so Douvall comes to the States for surgery and lies about her medical history. She says she has been known to walk into a surgeon's office without a clear idea of the procedure she wants, as long as she gets something. She tells the Independent, "Imagine playing Russian roulette with your life,t hat's what I'm doing. It's out of control, and has cost me more than £1m. Before I decided to come to Malibu, I'd accepted that I was going to carry on with it until I was either bankrupt or dead...I've had so many operations that I can't feel my stomach, my left breast, or anything under my right arm."

Douvall's a pretty clear case of body dysmorphic disorder, and it's heartening to know she's treating her addiction. Why she's doing it on a celeb rehab reality show is another matter, but we'll take the charitable approach and hope the example helps others with cosmetic surgery addictions. And if exposure is the only way certain celebrities can be induced to get help, well then, so much the better. The nature of the treatment is somewhat controversial, focusing as it does on "curing" addictions rather than adhering to the time-tested AA-style approach that addiction can only be managed. Douvall found the round of experts and intensive therapy so draining that she describes breaking down numerous times per day (which we would sort of assume is standard in rehab) and after the show wrapped, she stayed on an additional two weeks. Has it worked? Well, Douvall recently canceled an appointment for an upcoming "toe facelift," so we can only hope.

Alicia Douvall: Addicted To Cosmetic Surgery [Independent]

We knew the implant industry had taken a hit, but brace yourself: according to the New York Times, Botox, which analysts thought could weather any storm, is down. "The company reported that sales of Botox - both for wrinkle-smoothing and for medical problems like eyelid spasms - fell about 3 percent, to about $329 million in the fourth quarter, compared with the corresponding quarter in 2007." Also hurting: the face-plumping racket (which, in fairness, probably the same industry.)

As such, Allergan, the maker of Botox, is bring forced to lay off five percent of its workforce and use all sorts of incentives to entice people. "These include a $50 coupon on a Botox treatment and a $100 rebate if a customer buys two syringes of Juvéderm, a facial filler. The company has also just introduced Latisse, a $120 eyelash growth drug, which could help drive cosmetic consumers into doctors' offices." And sales are only expected to drop further.

What we'll be curious to see is how the industry rebounds. Sure, any hardcore Botox junkies aren't going to deny themselves, and as the Times points out, the bulk of Allergan's revenue comes from insurance-funded medical procedures. But as we know, cosmetic procedures can be addictive: what will happen to those people who have been forced to abstain from Botox and other such procedures and are forced to deal with their faces in their natural form, perhaps for the first time in years? Will they be appalled by the normal affects of living and time? Or will they, perhaps, come to deal with it - and even like it? We're hoping the latter. The Times calls this drop "Vanity's Downturn," but we're guessing the Seven Deadlies don't go that easy. More realistically, we're anticipating a major upswing in the "surgery-alternative" cream market.

Vanity's Downturn [New York Times]

Yesterday the Cosmetic Physicians Society of Australasia (CPSA) urged its members not to administer Botox to pregnant women following reports linking a woman's use of the toxin during her pregnancy in 2005 to her child being born deaf and blind. The woman did not use Botox, but a rival botulinum type A toxin called Dysport during her first trimester according to information obtained through Freedom of Information laws. The birth defect was among 46 different adverse reactions to the toxin reported to Australian authorities since 1994. The CPSA said that though "botulinum toxin has a long history of efficacy and a robust safety profile," it should not be administered during pregnancy and breastfeeding, or when the patient has glaucoma or neuromuscular disease. [The Sydney Morning Herald]

Today's New York Times reports that the bad economy is having little effect on the number of teens getting plastic surgery, and in fact, the number of people age 18 or younger who had cosmetic surgery more than tripled in the past 10 years, to 205,119 in 2007 from 59,890 in 1997. Liposuctions and breast augmentations are much more popular than they were a decade ago — remember Amanda from an episode of the View last July? —  and have increased more than sixfold.

Teens are often motivated to get plastic surgery because they believe their natural looks are inadequate. “Unlike adults who may elect cosmetic surgery for that ‘wow’ factor to stand out in a crowd, to be rejuvenated and get noticed, kids have a different mantra. They do it to fit in,” said Dr. Frederick Lukash, a New York plastic surgeon who specializes in adolescents. Dr. Lukash is especially familiar with why teens want to change their appearance because he has performed rhinoplasty on two of his three daughters, at the ages of 16 and 17.

All teens want to fit in, and the reality is that kids will often be teased for "abnormalities" such as ears that stick out "too far", or a crooked nose. But studies show that today, most kids think there is something wrong with the way they look naturally. 7 in 10 girls said they believed that when it came to beauty and body image they did not measure up, and only 10 percent thought they were "pretty enough," according to a recent survey of 1,000 American girls sponsored by the Dove Self-Esteeem Fund. “Our children are barraged with images of ideal women and men that aren’t even real, but computer composites,” said Jean Kilbourne, co-author of So Sexy, So Soon, a book on adolescents. “These girls and boys can’t compete. The truth is, no one can. And it leaves teens feeling more inadequate than ever and a lot of parents unsure as to the right thing to do.”

Often the parents and doctors who allow a child to get plastic surgery just want to spare them pain and increase their self esteem. Some even justify the plastic surgery by saying it will prevent other destructive behaviors like eating disorders, bullying, and self-mutilation. But while most doctors say they can judge how developed a teen's body is and if they are getting a procedure done for the "right" reasons, the long term effects are hard to predict. It's natural for teens to have issues with their looks because their bodies are changing so much and they're trying to figure out how to define themselves as adults. But accepting how you look is part of maturing, and if perceived imperfections are taken care of with a knife, teens may not be learning mentally how to be comfortable with their appearance.

Seeking Self-Esteem Through Surgery [The New York Times]
A Surgeon Finds Teenage Clients In His Own Family [The New York Times]

Earlier: Teen Girl Gets Lipo To "Prevent" Eating Disorder

• Johannes Mehserle, the Bay Area police officer who shot a restrained, unarmed man in the back, has finally been arrested (on a murder warrant) as part of the investigation into the horrific New Year's Day shooting that left 22-year-old Oscar Grant dead. • Despite popular belief that pheromones play an important role in our sex lives, scientists say that no pheromones have ever been identified in humans, and that we simply may not have them. • A new study suggests that self-help groups are the most effective way to treat survivors of sexual trauma. • Micheal S. Smith, 44, has been named the official White House decorator. In a statement released yesterday, Michelle Obama said: "Michael shares my vision for creating a family-friendly feel to our new home and incorporating some new perspectives from some of America's greatest artists and designers." • A flier reading "Why I hate Black History Month" was sent home with St. Louis-area schoolchildren, much to the dismay of their parents. The flier, which was designed to promote Black History Month, has since been changed. • Recent changes in Iraqi law have weakened the quota of seats set aside for women. • A report released by The American Academy of Cosmetic Surgery indicates that the cosmetic surgery industry has been negatively effected by the economic downturn. • A newspaper in North Carolina notes that a record number of obituaries have mentioned pets as the surviving relatives of the deceased. • Breaking News: Girls like to play video games, too! Unfortunately, this means more companies are coming out with games like "Party Babyz." • Unboxing videos are the newest craze in "geek porn." Oddly enough, this is exactly what it sounds like: videos of people taking shiny, expensive items out of boxes. • A new study has found that race and gender are two factors that can influence the way politicians speak. • A new bill introduced by state Senator Denis Damon may make Maine the third state to legalize same-sex marriage. • The Afghan girls who were attacked with acid two months ago while walking to school say they refuse to be intimidated out of an education. •  Prolific (and young)  16-year-old Australian author Alexandra Adornetto has announced plans to release a fourth novel before she turns 18. • Research released last spring that connected eating cereal to the likelihood of giving birth to a baby boy has just been disproved. • A task force created to investigate the problem of online sexual solicitation of minors claims that there is not actually a significant problem. • Wendy Brown, the 34-year-old Wisconsin woman who stole her teenaged daughter's identity to try out for high school cheerleading, may spend up to three years in a mental institution. • Tampa Bay residents be warned: a feces-throwing monkey is on the loose! He may be armed, but is "not considered dangerous." •

After getting a procedure, people usually ask "When can I get back to yoga?" And: "Patients are mad when they can’t get back to the office in five days," one surgeon says. "But if you say they can’t have sex for two weeks, they are like, 'Thank God, put it in writing!' People have other agendas now." Or! Some rich women just don't want to fuck their husbands. And get this:

Sylvia R. Karasu, clinical associate professor of psychiatry at New York-Presbyterian/Weill Cornell Medical Center, points out that even with surgeries designed to make patients feel sexier, having more sex isn’t the objective. “It’s such a totally self-oriented procedure most of the time,” she says. “It’s not necessarily related to the other people in their lives.”

Plastic surgery? Selfish? How shocking. But seriously: What's the point of transforming yourself into a perfect, wrinkle-free human specimen if you don't partake in some pleasures of the flesh?

Sex After Surgery [W]

"Alongside beauty, clothing and diet advice, women's magazines present cosmetic surgery as a normal practice for enhancing or maintaining beauty, becoming more attractive to men and improving emotional health," says Andrea Polonijo, who conducted the research at UBC as an undergraduate honours thesis in the Dept. of Sociology.

We took a look at a few January issues, to see what kinds of advice was being dispensed. Cosmo announces that brides are giving their bridesmaids Botox: It's almost like a suggestion, although if a "friend" did this to you, wouldn't you find it extremely underminer-y?

Marie Claire's "I Want Fuller Cleavage" story might gloss over emotional impact, but certainly doesn't neglect the physical feelings of Ning Chao, who is convinced her breasts are asymmetrical. She mentions something to her (now ex) boyfriend, who says, "Yeah, your left boob is slightly bigger, but it's no big deal." Chao deals with her "freakish secret" by wearing padded bras and then going to a doctor for Macrolane, a hyaluronic-acid filler for breasts. Even though 60% of women have asymmetrical breasts, Chao opts for the $6000 procedure, which goes like this:

[The doctor] injects the local anesthesia into my right breast using an instrument the size of a knitting needle. The pain is brutal. I can feel every push and prod, especially under the nipple, which feels like it's being sawed off.

Post-surgery, Chao's in so much pain, she writes, "I wonder if I've made a huge mistake." Now? "With my clothes on, I look the same — albeit without padding or pushup — but that's the point." Little is said about the emotional effect going from "lopsided" to symmetrical — or the fact that she'll have to do it all again in 12 months, when the acid gets absorbed into her body.

The December issue of Elle has fun, light-hearted story by Holly Millea about the new MiXto skin-resufacing laser. Millea offers up Beauty Director Emily Dougherty as a guinea pig for the procedure, which uses a "uniform layer of microdots" to burn off a layer of skin and renders Emily's face "awesomely grotesque." Emily gets hooked on Vicodin, so Millea decides she herself should try the laser, too — and drags her friend Liesl along. After a month, all three women all had sun-sensitive, marbled-red skin; after four months, one says, "I still have some brown spots, but they're fading." Liesl claims to look four years younger. Her proof? A guy tried to pick her up in Home Depot. Millea admits healing was "a long haul."

Never do any of these women stop and think: Do I really need to "fix" myself? If I'm so unhappy with myself, should I spend the cash on some therapy instead? Isn't it more important to be beautiful on the inside?

According to the study, "Magazines routinely present two "ideal" cosmetic surgery candidates… an unhappy, insecure, lonely woman looking to boost low self-confidence and self-esteem, and a successful, attractive, confident woman with high self-esteem who seeks cosmetic surgery to maintain perfection." The idea is that women view themselves as somewhere in between. But while the study found that only 18% of articles suggest cosmetic surgery may be detrimental to emotional well-being, none of the pieces we looked at even hinted at anything but happy ending. Oh, and here's an actual pull quote from the Elle story:

These women suffer for you, dear readers.

Women's Magazines Downplay Emotional Health Risks Of Cosmetic Surgery: UBC Study [EurekAlert]