"What is REAL?..."

"Real isn't how you are made..."

"It's a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you...”

"Does it hurt?..."

"Sometimes…"

"When you are Real you don't mind being hurt..."

"It doesn't happen all at once… You become. It takes a long time. That's why it doesn't often happen to people who break easily, or have sharp edges, or have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don't matter at all, because once you are Real you can't be ugly, except to people who don't understand."

~Margery Williams

I have always loved segments from the above paragraph taken from the well-known child’s story, The Velveteen Rabbit. It epitomizes one of the genuine benefits of aging. If one has lived life as a Sage, incorporating all of life’s experiences well, by implication, by the time one is old, “ you can't be ugly, except to people who don't understand.”

But to paraphrase Bob Dylan’s song, “the times they are a-changin’.” Now we have Fox’s reality show The Swan, ABC’s Extreme Makeover, MTV’s I Want a Famous Face and other plastic surgery shows to tell us that once ugly ducklings - or at least self-perceived ugly ducklings - can easily morph into swans replete with magazine model good looks. With the deft slice of a surgical knife, the implication is that external beauty can save faltering marriages, jobs can miraculously improve and one’s perception of outer beauty may magically transform and reflect one’s concomitant new radiant self. I am all for doing what works in order to feel and look one’s best. I admit it’s a dose of vanity as well as my need to soothe my soul that keeps me watching my weight, meditating, participating in yoga and Pilates classes and taking part in other health and spiritual-oriented activities. So effort towards additional self-improvement is not a foreign concept to me. However, as a psychologist, I am also concerned about the impact on those who only improve their external selves without paying attention to internal integration, and I worry even more about those who may feel inadequate in today’s society because they either don’t have the finances to spend on external self-improvement or who genuinely want to (S)age as nature intended with wrinkles and sagging skin, character lines reflective of years of experience and of living longer.

According to the American Society for Aesthetic Plastic Surgery, plastic surgeons conducted a record 11.9 million procedures last year. These included non-invasive approaches such as Botox and Restylane, as well as surgical procedures such as eye and brow lifts, tummy tucks, liposuction, breast reduction or augmentation, and chin implants and neck tucks for both men and women. Studies seem to suggest positive outcomes for those who hold realistic expectations about results, including greater comfort with body image, lifestyle and general psychosocial functioning. However, for those who may be plastic surgery “junkies” or who hold unrealistic expectations of outcomes and/or those who have histories of emotional issues, merely changing oneself from the outside may result in anger, greater feelings of doubt and inadequacy, and even self destructive behavior. Who you are on the inside ultimately matters most. And internal emotional health does not happen overnight. Sometimes it requires a lifetime of living.

Does cosmetic surgery help individuals feel better? Sometimes. As with any self-improvement decision, it depends upon one’s goals. In our society, looking good, especially as one becomes fifty and furthermore, has some advantages. People who are considered physically attractive often receive more preferential treatment and are perceived by others in a better light. However, if one is emotionally distraught or unstable or has unrealistic expectations about outcomes, a cosmetic procedure can cause greater risk of unhappiness, anger, depression or even suicide. As with all things in life, moderation and attitude matter. Some individuals undergoing a cosmetic change can get a boost. For those who expect an external change to save a failing marriage, get them a desired promotion or even help them feel more comfortable in their own skin, the results may be disastrous.

When seeking a competent surgeon, he or she should always evaluate the motivations of their patient. If an individual is totally preoccupied by appearance and as a result continually changes some offending body part to the point where alteration becomes an obsession, a surgeon would be wise to refer that client to their spiritual advisor, therapist or a support group to get help. The problem is like an internal “itch” that cannot be “scratched” by external means. It is vital to understand your own motivation for change. Are you doing it for you, someone else, a romantic partner? External attractiveness can be an added enhancement. However, internal beauty is more often reflected in ways that everyone can see and feel.

We live in a time when what is real is up for grabs. Whatever one may choose to do or not do to improve their external sense of beauty, internal beauty lasts forever. And when one has confronted life’s challenges long enough to have developed a sense of true self, when one is real, I believe one "can't be ugly, except to people who don't understand."

 
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