Peter Frankenberg (3:04)

That must be part of it afwa, but also must be that if you are more confident in how you look and feel that that must also have some, some role too. I mean for us. I've had been lucky healthcare so far, health wise so far. But I did break my little finger a few years ago playing cricket through sheer incompetence. And when I went to have it x rayed and checked I got asked by the doctors and the wonderful people who looked after me. I must have been about 30 times whether I felt okay in myself or whether I was traumatized by the fact my little thing isn't straight anymore. And well, I wouldn't have worried about it or thought about it but because I was asked so many times how did I feel and would I like to.

Afwa Haq (3:43)

How did you feel about the change in appearance to your little finger?

Peter Frankenberg (3:47)

It would have an impact on my, on my mental health and well being in a way I'm very grateful to live in a society where people think that they would be so worried about it. I mean for me, the fact that I can stretch a tiny bit further now on the piano keyboard than I used to because it happened to break in the right kind of way, it's probably, probably quite a good thing. But the fact I was off so many times.

Afwa Haq (4:05)

This is how you relate to the story about faceless cosmetic surgery is whether you felt any trauma about a change in the appearance of your little finger. I find that very endearing. I'm glad you're okay. So today we're going to do a deep dive into deep plane facelifts and and see how its legacy is shaping the culture. Anyone who pays even the slightest bit of attention to the world of show business will have noticed that there is a new celebrity face.

Peter Frankenberg (4:43)

Hello and welcome to a new episode of Legacy. I'm Peter Frankenpern.

Afwa Haq (4:47)

I'm Afwa Haas.

Peter Frankenberg (4:48)

And this is Legacy, the show that explores the lives, events, and ideas of that have shaped our world. And asked whether they have the reputations that they truly deserve.

Afwa Haq (5:05)

This is Facelifts, episode 2. The facelift goes viral. Well, the reason I actually asked about if you had had an intervention, if you would share, is because I think one of the most interesting discussions for me is the stigmatization around these surgeries. And I think that there's a link between the more impressive these surgeries are becoming, the more destigmatized they're becoming. Because in the past, it was a source of shame. People didn't want to admit they'd had a facelift. It was seen as embarrassing. Now they're so good technically, and the results are so desirable by many people that people actually much happier to talk about what they've had done, kind of own it. And the deep plain facelift, I think, has played a big role in that. So there are a number of celebrities who have stepped out in recent years looking different, just to name a few. Lindsay Lohan, Brad Pitt. This is not all women. Christina Aguilera. And as we mentioned at the beginning of episode one, Kris Jenner. And I'm just gonna say what a beauty consultant based in New York, Alexis Page, said, everyone is talking about it. These facelifts look glowing. They look bouncy. They look vibrant. Even straight guys are asking me about facelifts. Everyone wants to know what's happening.

Peter Frankenberg (6:31)

What does that mean? Even straight guys? Why even straight guys? What's wrong with having a.

Afwa Haq (6:35)

That's Alexis Page's quote. But I think in the past, it was considered more typical of gay men to be very curious and finely attuned to what people are doing to their face. Whereas straight men, on the whole, could be kind of oblivious. And, you know, they might say things like, I don't spend much time looking in the mirror. I think. I think someone I know said that recently. I can't remember.

Peter Frankenberg (6:57)

Well, tell that to the Emperor Augustus we spoke about last episode, who had these enormous statues of himself looking ripped.

Afwa Haq (7:03)

Narcissism and vanity is different. This is a deep curiosity and. And attention paid to subtle changes in someone's appearance. And I'm not stereotyping people of any sexual orientation. Gender can do that, but typically it's been associated more with gay men than straight men. Just saying.

Peter Frankenberg (7:23)

So I guess that's really interesting that I never really thought about the gender and the sexualization of facelifts. But I mean, what is incredible is that the ways in which facelifts are being done, the new techniques are so exciting or so good that they are more or less undetectable. I mean, you can tell something has changed, but you can't see incision marks. I mean, it's kind of incredible the skill that plastic surgeons have today. But I'm still not quite clear for what actually deep plane facelifts actually are.

Afwa Haq (7:51)

So we talked in the last episode about the old school wind tunnel facelift, where you just stretch back the skin and then the evolution of the SMAS technique, which is manipulating the muscle tissue underneath the skin and actually architecturally rearranging the muscles underneath to lift the face. Rather than just stretch the skin, the deep plane facelift elevates the mid facial soft tissues in the plane beneath the SMAs. So it's like each of these new generations of facelift is going one layer deeper. This technique emerged in the 1980s and 90s and it was basically trying to address the sagging structures and deep nasal labial folds that you get here. If you're watching, I'm pointing and it's often attributed to a Texas plastic based surgeon named Sam. And Peter's doing a bit of face mask.

Peter Frankenberg (8:42)

I'm checking what I need to have done. Yeah. Okay.

Afwa Haq (8:45)

It's often attributed to a Texas based plastic surgeon named Sam Hamra. Hamra found that the SMAS lift helped with the jowls at the chin and the sagging necks, but it was less effective at correcting sunken under eye patches and hollow cheeks. God, it's kind of disarming doing this because you start to diagnose these problems.

Peter Frankenberg (9:05)

Honestly, as you're reading it, I'm touching all the different parts. I mean, instinctively. Okay. But that's, I guess that's where the aging shows. Yeah.

Afwa Haq (9:12)

With his new method, Hamra cut into the face under the SMAS layer, actually freeing that muscle layer from the ligaments that connect it to the deeper face muscles below. This is a super complex procedure because you're not only manipulating the muscles underneath the skin, but you're dissecting underneath that muscle layer. And that's where facial nerves are located. So some doctors are worried about deep plane facelifts because they do carry a higher risk of nerve damage, which can be quite serious and potentially permanent. So people are doing it anyway. And the reason for that is because the results are so impressive. So you can lift up a patient's entire cheek and then re drape it back on their cheekbone, but make it plush and rosy. So it's like you're literally undoing the effects that gravity had in pulling it down.

Peter Frankenberg (10:06)

So I love it Afra when you send me emails and whatsapps, but when you sent me a image from the World Journal of Otorinngology Head and Neck Surgery 2016, it didn't help me with my breakfast because you show the deep. It's a picture of the deep Blaine technique. And this is quite dangerous as well.

Afwa Haq (10:25)

There is that risk of nerve damage and if you think about the kind of people who can afford these procedures because the cost is astronomical, they are not people that doctors want to cause permanent nerve damage to. You can imagine how much that would cost in damage.

Peter Frankenberg (10:39)

Legal cover?

Afwa Haq (10:40)

Yeah, basically a normal facelift, the old school stretching the skin tight will set you back around 10 to 20,000 pounds. Some surgeons for deep plain face lifts are charging more than £100,000. So this is not the kind of procedure that the ordinary person can afford. But people, even those who aren't super rich are trying to save up and do it or borrow money and do it because it is considered so radical in the results it has. And I have to say, Peter, I am really, really squeamish. I was not destined to become any kind of medic. I am not good with blood. I can't watch anything that involves dissecting any part, not just the human body, but an animal body either. And I find even the diagrams that I sent you for this episode quite hard to look at. But I was reading an article by a journalist who basically embedded with one of the most successful, successful deep plane facial surgeons. And it was so crazy to read because she describes quite nonchalantly how she just passed out in the operating room and had to be revived by a nurse. And that wasn't even kind of the main point of the piece. But I was like the idea of having something done to my face that would make an observer pass out because it's that gory is not something that I would do lightly. I guess you're probably the person least affected because you're under an anesthesia, but it is not for the faint hearted at all.

Peter Frankenberg (12:07)

And you mentioned Kris Jenner, but we think probably on balance that she didn't have this intervention because her surgeon reportedly doesn't do deep plane facelifts. There's a bit of ambiguity with the plastic surgeon surgery community about whether deep plane facelifts, are they really very common? Are they really dangerous? Is it just marketing hype? Do they actually really get done? To many people, but some of that's to do with social media expectations and the way in which people want to jump on a new fad. But I mean, how do we tell who's had one? It doesn't matter if it's this expensive, whether people really do well.

Afwa Haq (12:42)

The point is the more expensive and the more skillful really the procedure is, the more undetectable it is. And actually when we talked about people paying more than a hundred thousand pounds for a facelift, what they're paying for is actually this undetectability. They're paying to look younger without looking like they had a facelift to make them look younger. And you're right, Peter, that's not necessarily through deep plane. And actually from what I've read and the surgeons that I've heard speaking about it, it seems like developments in the SMAS technique are maybe the bigger thing in really changing the game for facelifts. A lot of the people you might think had deep plane facelifts just had really effective and really natural looking SMAS facelifts. And that this deep plane is being thrown around just because it sounds kind of impressive, it sounds kind of like space techy and that it's being used as a marketing term. Just this kind of shock and awe at the incredible things that surgeons are able to achieve, which is fueling this desirability for the whole industry. And it's also, I think, and we'll get into this after the break, it's destigmatizing the facelift. It's making it something people are talking about in excitement, in awe, they're impressed by. It's no longer this kind of dark secret. And it's become genuinely an area of innovation in science that even if it's not accessible in cost, it's very accessible in terms of the visibility of it, that people's favorite celebrities are all doing it, they're all talking about it. And the way it looks is something that doesn't alienate people because it just almost has this magical effect of taking the person, you know, they still look like the person. You know, they don't have this unrecognizable stretched look like people used to have with facelifts. They look like the person that you were looking at, only younger, glowier, bouncier. And you know, for my skepticism about our anti aging culture, it's undeniably attractive to see somebody look themselves only bouncier, fresher and springier.

Peter Frankenberg (14:39)

So young, glowy and bouncy is a, is a great look. I mean, you know, I, you know, having Been listening Afro. You know, it makes me think that there's only so far that lots of coffee can do. That could certainly give you the bounce and even the globe. I don't think it does much for the younger bit, but it's, it's bound up with wellness and with other ideas, not just about physical beauty. It's about how you need to try and live a long life and be teetotal or be vegetarian and how you need to be more thoughtful about the world around you. And yet there's this price tag on the top. Whatever kind of intervention and surgery you have, unless you need it for medical reasons or reconstructive after, after surgery for underlying health conditions, it's something you do because you've got the disposable wealth. Or maybe you're even borrowing money to prioritize your physical appearance. But what I really want to talk to you about, afwit, is about culture and particularly about celebrity culture and beauty culture. So let's do that. When we come back,

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Afwa Haq (17:04)

The name plastic surgery has a lot to answer for when we think about how it's been positioned in the culture, in my opinion, because if you think about plastic surgery, and you know, I definitely thought this when I first heard the term probably as a child, you're imagining something Connected to plastic. Right. And this is also an era where people are putting silicon and other kind of artificial substances in their boobs. So there was this sense that it's all kind of fake and that if you get a facelift, it's. You're kind of fake ifying your face. Actually, that's always been a bit of a misnomer, because plastic in plastic surgery isn't coming from plastics. It's coming from the Greek word plasticos, which means to mold. And I think in a way, plastic surgery is becoming less and less plastic in the contemporary sense because it used to be associated with the superficiality, fakeness, but now I think it's becoming much more culturally embedded in deeper ideas about beauty and youth, which I think are problematic, as I've said before, but also longevity. And it's quite difficult to work out where one of those begins and the other ends. And I hope we're going to unpick that in this episode, Peter.

Peter Frankenberg (18:16)

Well, I know that we started episode one talking about the Kardashians. Since we did that, I've now informed myself much better about the Kardashians and the family setup. I suppose as a family, they're the kind of most famous example of people in the public eye, enormous followings. I mean, the picture of Kim Kardashian with a bottle of champagne on her backside is one of the most viewed images in human history, if not the most viewed image of all sorts of reasons. That celebrity Kardashian, I don't think I've

Afwa Haq (18:44)

seen that, and I don't want to Google it, but I'll take you away.

Peter Frankenberg (18:46)

I'm not going to share that on the social media profile of this show. I guess because we live in a globalized world and we have these celebrities who are famous everywhere, kind of with followers in their tens. We've had hundreds of millions of people. What you look like and how you living your life are hugely significant. They drive your revenues. And so therefore looking good all the time and not being afraid to tweak and twist and make sure that you've got the light in the right place, that you're standing in the right pose. But I guess also how you modify your face and your body become really important. But tell us a bit about the Kardashians and Kylie Jenner in particular.

Afwa Haq (19:20)

Well, one of the things that's really changed is the level of transparency that people, especially high profile women, are willing to offer about what they've had done. So as we were saying, it used to be quite stigmatized People wanted people to think they naturally looked like this. Now, I think the cosmetic procedures are in themselves so aspirational. People are boasting about them. And, you know, I think Kylie Jenner, who's one of the younger ones, if you're a bit of a Kardashian ignoramus like me, did something quite interesting when she basically was being asked on TikTok whether she'd had a boob job. And there was all this speculation. And instead of kind of denying it or ignoring it, she leaned in and wrote exactly what the specifications of her boob job were, which surgeon performed it, and exactly where it was positioned.

Peter Frankenberg (20:06)

So you're going to tell, you're going to tell us, of course, in case people are listening. And by the way, are we, are we on, Are we on a commission? If someone goes to this surgeon, do we get a little bit of a shout out? Maybe, you know, maybe you can fix my cricket injury and maybe we could

Afwa Haq (20:18)

get proceeds donated to a fund that help people with body acceptance.

Peter Frankenberg (20:21)

So what did Kyla Jenner, what did she have done?

Afwa Haq (20:24)

Kylie Jenner had 445cc, moderate profile, half under the muscle. Silicon surgeon Garth Fisher. Hope this helps. Lol. So that was actually widely praised by a lot of people. This is what Harper's Bazaar said. We're entering a new era of aesthetics. It's no longer enough to know if someone went under the knife. We now want to know what they did and who did it. Fueling this change is the ongoing dialogue on TikTok, an app where authenticity about beauty treatments and treatments is currency. It's refreshing, likable even, to see Jenna jump into the comment section to deliver this intel rather than making it an orchestrated PR move. Jenna's mom, Chris, deserves some kudos here too. Her rep recently confirmed that her new lifted look, this is the facelift we were talking about earlier. Peter can be credited to New York City based plastic surgeon Steven Levine. I've had more than one family member ask me if I can help them make an appointment with him for a facelift. I can't. This is the Harper's Bazaar journalist, not me, speaking there. But no, I definitely think if you're going to do these kind of procedures, the more transparency, the better because it helps people have realistic expectations. And, you know, one of the things I've been very critical about the Kardashian score is the way that they have spent an unattainable amount of money changing their bodies physically and then using it to create this new beauty norm that makes young women Think that's how you're supposed to look, even though it's not natural. They weren't born like that and it cost them a lot of money to look like that. And you know, it creates this gap between how people are realistically going to look and how they think they should. And in that gap is a lot of self loathing, a lot of insecurity, a lot of people feeling really bad about their bodies and, and wanting to instead of invest in how they can remedy that, spend it on a few elite plastic surgeons who can do actually quite dangerous procedures to change their bodies into something that is also unattainable for most people, thereby fueling the cycle. And, you know, again, not judging people who do it, but if you just take a step back, I'm not sure that's a very healthy culture for us as a collective.

Peter Frankenberg (22:37)

I'm still thinking about tweakments, which is my new word of the day. I'm going to suggest that to students in their essays that, you know, you could maybe do if you have a, a few tweakments to improve it. But just listening afro to that, you know, I wonder because, you know, because of your work on decolonizing the body, whether this is a new form of celebrity colonialism, whether the kind of it's a dominant look that you have to conform to and if you choose to do things your own way, there are pushbacks. I mean, is this, is this a different era? I mean, it's obviously done in a slightly different way, but is this a new form of digital colonization?

Afwa Haq (23:09)

I think that it is an endless cycle and there's a digital AI element to it. There's a kind of medical industrial complex element to it. So, you know, earlier we were talking about old school facelifts, how long they last. A SMAS facelift lasts basically 8 to 12 years. So once you get one, you now need to be basically repeating it. And this is costing you tens of thousands, maybe a hundred thousand pounds every decade basically to keep up the appearance. Once you've expanded experience what it looks like to be kind of cosmetically de aged, it's going to be really hard to go back to how you actually look naturally as you're aging. Add to that other medical innovations like Ozempic and all these GLP1 drugs, they have fueled a huge rise in cosmetic interventions because they make you lose weight. And as I can personally attest, whenever I lose weight, the first place I lose it is not that, maybe on my hips or thighs where I wouldn't mind losing A bit. But on my face, it's the first place it goes. And as they say, fat is natural Botox. So as you lose weight, places you want to be plump and dewy begin to sag. Your face, your butt, a zempic butt, is a real thing. And so people are now in this cycle where they do one medical intervention, which then changes their appearance and makes them need another medical intervention. And I can't help but thinking that who's benefiting is big pharma is elite surgeons, is drug companies that offer medicalized solutions to these things. And it's one of the reasons I wrote Decolonizing My Body, because I thought, in the big scheme of things, what would it be like if we learned to actually be happy with the bodies we have? And not just as a abstract proposition, but to think our bodies come from somewhere? So, you know, back to Mosul in Iraq being the cosmetic capital of the world and lots of Arab women wanting nose jobs, I was thinking about how your nose is actually part of your ancestry. You know, you inherited your nose from someone. The model Bella Haddad, whose father is Palestinian, had a nose job when she was 15. And she wrote quite candidly. And I think it was brave of her that she now, as I think she's now maybe 30, regrets that because she now looks back and realizes that her nose was her ancestral Palestinian nose. And by changing it, she was trying to conform. You know, as a. As a young girl growing up in Hollywood and a very attractive young girl, she was trying to conform to the beauty standard that, you know, she was exposed to. But now she realizes that was actually a gift that meant something and connected her to a community and a lineage that she had changed. So I'm not saying people shouldn't do these things. I always advocating that we should just think carefully before we do them so we make informed choices. And instead of thinking, I want to look like the people on TikTok, also think about what our ancestors look like, what our other family members look like, what people who've achieved things that have changed our lives historically look like. Is the cosmetic intervention going to make your life more meaningful or going to allow you to have more impact, or is it just going to get you on a spiral where there are always more things that you can tweak?

Peter Frankenberg (26:17)

Well, I think one of the questions before we think about the legacy of facelift is going to be thinking about the future, too. You know, in a world where we're stepping into the world of the metaverse, where avatars, where digital tools can change what we look like on screens. You know, there are going to be all sorts of ways in which we present and think about our bodies in different kinds of ways. And we've already seen that because of the Instagram generation and the ways in which you always need to present your best self in the best possible physical light and the best surroundings. I mean, it could be that this is all on the point of a different way in which we think about our own bodies and those of other people, because we're going to have different versions of ourselves that you could present in different kind of environments. I mean, literally digitally. So these ideas about how we look and for who, and is it for our own self esteem? Is it for our peer group? You know, there's the kind of mar a Lago look that's been incredibly popular since Trump got re elected, where, you know, if you want to be part of the court of Trump, there is a particular kind of look for both men and for women across different age groups about what part of the ruling elite looks like. And as a historian, those feel very familiar to me. I mean, it's not something new in the 21st century, but I do think that the digital revolutions we're going through are going to change these kinds of things where you can make yourself look however you like without an intervention, because of the way in which we're going to use avatars and, like I said, go through the metaverse.

Afwa Haq (27:40)

Well, I think that's an optimistic. Well, maybe it's an optimistic reading, but as we're recording this, there's just been a new generation of AI apps released that allow you to create unprecedented reconstructions of scenes in dramas. You're able to take your favorite actors and create new scenes from your favorite movies. You're able to mash them together. There's real fear in Hollywood, especially, especially about AI actors beginning to replace real actors, which is one of the reasons there was a big strike in Hollywood a couple of years ago. Now it's becoming real. And based on what's happened in the past, my fear is that as AI becomes a viable alternative to human models, actors, people are going to feel under more pressure to match the perfection AI achieves. Because obviously it's not real and you can mold it. And who is programming AI, you'll find that it's mainly white men in America who are kind of creating this technology or at least commercializing it. And there's no reason to think that they have an agenda to help us get back to a more pluralized world of beauty. Standards or reconnect to ancestral norms and reject this kind of Eurocentric single narrative about what's attractive. If anything, it looks like it's going to deepen that shrinking of what's considered beautiful. And it's very unattainable. And the more people feel that they won't be able to survive professionally or commercially, the more they're going to try and fit it. And you know, that I think is really dangerous, I think about girls, young girls. Now, if they're seeing all these avatars and that's presented to them as what someone should look like, they are going to feel that they should try and make their real life bodies conform to that.

Peter Frankenberg (29:24)

Well, that's one part of it. But you know, we've already seen the late great Carrie Fisher appear in Star wars sequels. Reasonably rudimentary AI but sort of perfectly passable. And this will all get better. And you know, you can make Carrie Fisher as Princess Leia be any age you want, any weight you want, any height you want. So anybody who's recognizable, you can stretch, widen, improve, turn to be older, younger, you know, in the same, and also in the same film too. So it's, that's going to do lots of different things to celebrity and celebrity culture. But my guess will be young people will become, they already are quite distrustful of what they can see online. If I had a conversation with our children at the weekend and they said the single most obvious deep fake that they'd ever see would be a picture of Donald Trump holding a book because Donald Trump doesn't read. So. So working out how do you tell what's real from what's not is going to be a real skill set that the next generations will have that we weren't brought up with.

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Peter Frankenberg (30:54)

Let's finish off Applebee by thinking about the legacy of facelifts and how to think about these kinds of interventions in the round.

Afwa Haq (31:01)

I think facelifts are a symptom and cause of a really big question which is about mortality and aging. And it's not new and it's not unique to kind of 20th century American driven capitalism. As we were saying, ancient Egyptians were experimenting with some form of facelifts with, with ancient gold threads under the skin. And there's definitely a preoccupation with aging stretching back thousands of years. But I do think that the pressure to stay young and youthful is on steroids in our era, and not just in terms of appearance, but also in longevity. I mean, we've talked about this before, but I follow quite a few longevity influences, and their aspirations are nuts. And part of it's very, very relatable and very much common sense. It's how do you grow old? Well, so that you can enjoy old age. You can still be fit and. And agile and able to live a good quality of life. I think everyone wants that as they age. But there's another part of it which is a little bit more sinister to me, which is about extending your life for as long as possible. It's about kind of trying to artificially or through very contrived means, kind of stop the aging process, not just externally, but in your organs, et cetera. And that often involves basically living as little as possible. You know, no coffee for you in the morning, Peter. Also no sugar, no carbohydrates, no alcohol ever. Obviously being in bed by 9pm and, you know, up to meditate for two hours at dawn. And I think there's nothing wrong with any of those things on their own. But doing it in pursuit of some ideal of youth seems a little bit toxic to me because you're kind of exchanging being present in your actual life and embracing the natural changes to your body for this, attaining this really, really extreme ideal that requires you to sacrifice the life you have left to doing something that's basically not very fun or really that meaningful. So, you know, facelifts for me are a symptom of that. We have that tendency. You know, we're scared of death. Mortality is a big preoccupation and so fundamental to the human condition. And it's hard, it's always been, for every generation of humanity, hard to make sense of. And so it makes sense that we try to delay it. And I think wanting our faces to look young is a very, very deep manifestation of that fear and anxiety. And so if it's rooted in fear and anxiety, could it ever really be a good thing?

Peter Frankenberg (33:19)

And what about the, the. The changing fashions? I mean, it used to be that it was all about plumping and injecting with collagen or hyaluronic acid or with filler. Now all the trend is gone about something different. It's about deflation. Tell us about it, about deflation, what that is.

Afwa Haq (33:34)

Yes, your fashion forecast is deflation. So exactly as you were saying, Peter, where it's fillers and hyaluronic acid and plumping. Now it is deflating so that you look more natural, that you're not pumped up with collagen or filler, and that you look, as we're saying, undetectable. And you know, this is a subtle thing because as I was saying, because of the zempic and, and now the trend back to skinniness, people are finding themselves with hollowed out features. And that's not what they want either. They want something in between where they look kind of lithe and they don't want to look too juicy, but they also want to look young and they want it to look natural. And this is the thing we're trying to ask more and more of our faces. You know, we want to look young, but we don't want to look like we're trying to look young. And we also don't want to look too plump. And you know, the best way to look young is to have as much fat as possible in your face. As I said earlier, fat is the natural Botox. But we don't want that because we want to be thin. So we're kind of asking the impossible. And you know, we have a good track record as a species of making scientific innovation that allows us to achieve the things we thought are impossible. But my question is, just because we can do it and we found a technique to do it, is it good?

Peter Frankenberg (34:56)

Look, I think that elites have always tried to create visual forms that make them stand out and look different. In today's world, you know, the rich you are, the thinner you are. That's the kind of metric, partly because of the kinds of foods we eat and the sugars and the, and the processed foods.

Afwa Haq (35:11)

So there's, that's today because about five years ago, if we had this conversation, we would have been talking about body positivity, about the stigma of being, having a bigger body being removed and people really owning that some people are plus size. And now as we're recording this, it's completely changed, mainly because of GLP1s and now it's thinness.

Peter Frankenberg (35:30)

Well, I think, I think that, that, that, that that phase was about being more open, more tolerant, more democratic, saying, you know, you should look however you look. But I think it's, it's been coming for a long time that thinness and wealth is one thing and I think youth and thinness and wealth is another one, that if you can afford to have these interventions, if you can afford aged 80 to look like you're 50, then you know why you've got to spend your money on something. So I don't think it's necessarily a judgment about how people choose what they do with their bodies, with their money, but I think it's that looks and fads always exclude. They exclude people who look different. And so there's a degree to which some of this is about social pyramids and economic pyramids and about how you get to look in one way or another. So, I mean, it's no surprise, I guess, that these new semaglutide wegovies and ozempics and so on are about trying to take shortcuts to get towards that membership of a group that you can then look hollowed out to. I mean, the funny thing is we've spent two episodes talking about what people look like and not a huge amount talking about what people feel like. How does it affect your mental health? So I've spoken to some doctors about plastic surgeries and often they'll say that this makes a huge improvement to mental health, whether it's recovering from breast cancer and reconstructive surgeries or because people decide that they just want to lose a bit from their. From their waists or from their butts, backsides, or whatever it might be. So there is a point, I think it's not just about what you look like, it's what it's about how you feel on the inside. And it's probably a bit a grayer area about whether that's actually an intervention that's helpful. The pressures that you talked about, afwa, about needing to look beautiful all the time, and the expectations of your peer group and everybody around you. You've got to always look faultless. But there are obviously times too, where being able to feel good about yourself is a hugely important positive part of stories.

Afwa Haq (37:20)

I would take a level, and that's totally true, but I would take it a level deeper and ask where is the underlying idea that looking a certain way makes you feel good coming from? Because there's no question it does. The more you conform to the messaging you get from society about what's attractive, the better you feel and the more accepted you feel and the more you get rewarded. The problem is, though, if you use surgical interventions to achieve that look, that ideal is always changing. So you would have been having fillers and implants five, 10 years ago to achieve that look. Now you're having to take them out to achieve that look. And the problem is, if you link how good you feel about your body to what society tells you is attractive, you're going to keep having to change it and keep doing more and more. So if you fix your breasts, fix them to make them conform to what's considered good breasts, that then your face starts to age. You're not going to have the wellness you felt from conforming, because now there's another thing. And then if you fix that, then maybe suddenly big noses are in and you had. You have a small nose, so then you get your nose augmented and then it changes again. So I think that it's a valid point, but it's a bottomless pit if you tie how good you feel about yourself to what society tells you is attractive. And the gray space is that. I think a lot of us, you know, like talking about weight, for example, I feel like I have a healthy weight. If I gain weight on top of what I feel like is my healthy weight, I don't feel great. And so I'm not immune from, you know, the pressure of wanting to lose weight. But I try to make sure it's based on my body and where my body feels good rather than what I see models looking like, helped by the fact that I don't think my body is capable of being skinny in the way that models are. So it's not really an option for me, unless maybe I went on a weight loss drug and then maybe it would be attainable. So I think I would like us to do whatever we want to do to our bodies. Of course, that's your choice, but think about where those ideas are coming from and whether we really want to open ourselves and expose ourselves completely to conforming to them. And I'll tell you another thing that I think is a little bit disturbing. You know, in the past, facelifts were something that older people did now, and partly because of these GLP1s, that's younger people are taking and they're finding their. Their faces hollowed out from weight loss. More than a third of facelift recipients now are aged between 35 to 55. So this is something that people who haven't even really aged are beginning to do. And bear in mind they only last 8 to 12 years. If you start getting facelifts in your mid-30s, you could have 5 facelifts in your life. And each of those is a serious medical operation with potential consequences and definite risks. It's not a light undertaking, not even factoring in how much that's going to cost.

Peter Frankenberg (40:08)

You look afraid. It's been fascinating to talk about facelift. I'd like to carry on talking, but I need to go to the gym because I've been working on my six pack for a while and I'm almost there. I've got a one pack showing. So look, I think that all of that is exactly right about everybody making their own decisions. But the pressure of looking good in today's hyper connected world is something that has plus sides and minor sides. You know, those 35 year olds are more healthy than ever before because they look after themselves.

Afwa Haq (40:33)

They have.

Peter Frankenberg (40:34)

They take lots and lots of exercise and solving one problem creates a whole bunch of other ones. So anyway, you've been listening to us on Legacy Talk about Facelifts with me,

Afwa Haq (40:44)

Peter Frankenberg and me, Afra Hat, and

Peter Frankenberg (40:47)

we hope to see you here against.

Ayo Akemolere (41:08)

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