Nips and Tucks

[00:00:00] The Why Curve, with Phil Dobbie and Roger Hearing.

[00:00:04] What is it we don't like about our bodies?

[00:00:07] And why are so many of us willing to spend thousands on unregulated, potentially life-threatening operations to make us look better?

[00:00:15] The surge in demand for cosmetic surgery makes it a multi-billion dollar global industry.

[00:00:21] Many of the nips and tucks can do long-term damage to your health as well as to your purse.

[00:00:26] So why the rise in body dissatisfaction?

[00:00:29] Is it all down to social media pressure for the perfect image?

[00:00:32] You'll buy big money for unscrupulous surgeons.

[00:00:35] And can we ever do enough to become what nature hasn't made us?

[00:00:40] The Why Curve

[00:00:42] This is going to be interesting, isn't it? A couple of old middle-aged men, you know, later middle-aged men.

[00:00:46] Talking about cosmetic surgery, which we haven't had.

[00:00:49] About the body beautiful. Yeah, well, I'm fine. I'll talk about that in a bit.

[00:00:53] Well, we know, I mean, the number of surgeries you've had.

[00:00:56] But why do people do it? Why do they do it?

[00:00:59] I mean, that is the question.

[00:01:00] And there must... I feel as though, if you're having it done, there's something a bit wrong with you.

[00:01:05] You know?

[00:01:06] Oh, prejudice.

[00:01:07] Well, it is prejudice, isn't it? But I just feel as though there's... I mean, it's not...

[00:01:11] And it's not necessarily your fault.

[00:01:13] And I wonder whether you're actually being sold a promise by people who are going to make a lot of money

[00:01:18] without anyone actually questioning you about, you know, your real motive and what you're aiming for.

[00:01:24] Is it actually... Are you actually going to achieve what you're aiming for?

[00:01:27] And shouldn't it be society's perceptions of beauty and what looks nice that changes rather than you having to, you know, go under the knife?

[00:01:34] It's a really backwards process.

[00:01:35] If you turned up for your day job, which you do sometimes, just for a bit of fun, I know, not for the money, obviously, at the BBC World Service.

[00:01:41] And you had these massive lips that you didn't have the week before.

[00:01:45] I mean, people would have a bit to say, wouldn't they?

[00:01:47] Well, my audience wouldn't because it's radio, so it wouldn't matter.

[00:01:50] It might make a funny noise next to the microphone.

[00:01:52] They just hear the...

[00:01:53] Yes, the...

[00:01:55] Yes.

[00:01:56] I'd just be revolting.

[00:01:57] Anyway, let's talk to someone who really knows what they're talking about on this, and that's Ruth Holliday.

[00:02:01] She's Professor of Gender and Culture at Leeds University.

[00:02:04] She also co-wrote the book Kitsch, Cultural Politics and Taste.

[00:02:08] And she joins us now.

[00:02:10] So, Ruth, the obvious question.

[00:02:11] I mean, this is very much a young people's phenomenon, isn't it?

[00:02:14] Although you do see older people.

[00:02:16] Well, I guess you look at Hollywood, you know, and they're all having jobs done.

[00:02:20] You know, maybe in Hollywood you've got that pressure because you're on screen.

[00:02:24] But, you know, everyone's at it.

[00:02:26] Why are they doing it?

[00:02:27] I think it depends who you ask.

[00:02:29] I mean, if you ask psychologists, they'll tell you that, you know, media images are circulated,

[00:02:37] that those images make people feel insecure about their bodies, that they have, you know,

[00:02:45] that creates low self-esteem and people want to emulate these kind of perfect bodies of celebrities.

[00:02:52] And I think that's sort of become the kind of the dominant narrative about cosmetic surgery.

[00:02:58] And is it a purely, I mean, is it a gendered thing?

[00:03:03] Is it something that people, that women feel under far more pressure than men about?

[00:03:08] Well, I don't know.

[00:03:09] It's happening with blokes as well, isn't it?

[00:03:10] I've always wanted to look like Peter Andre, for example.

[00:03:12] It's going to be a long haul there.

[00:03:17] So, again, you know, this is kind of a difficult question to answer completely.

[00:03:24] So, historically, of course, women have been judged far more by their appearance because, you know,

[00:03:31] when women haven't been able to earn, you know, good incomes for themselves,

[00:03:38] they were sort of at the mercy of the marriage market in many respects.

[00:03:41] And so looking good was one way of attracting a good husband and, you know, was something that you sort of offered, you know, in that context.

[00:03:55] But hopefully we are way beyond that stage now, aren't we?

[00:03:58] Where, you know, surely, you know, we're getting to the stage.

[00:04:03] I would certainly hope so for young people that women stand as good a chance as a man for getting a job.

[00:04:09] And very often they do better at school.

[00:04:11] So actually perhaps have a better chance.

[00:04:12] And, you know, does it really matter how they look?

[00:04:15] Well, I think that two things are sort of going on, really, that are, so, you know, on the one hand, yes,

[00:04:22] women are earning sort of about 85% of men's wages now until they have children, of course,

[00:04:28] when their incomes rapidly drop in relation to men's.

[00:04:36] But, yes, so it is a kind of, it is a slightly different context now.

[00:04:41] But I think, you know, one of the things that's really sort of overtaken that in a way is the labor market

[00:04:49] and the way that we are much more oriented now towards a service economy,

[00:04:55] towards customer service encounters and the importance of looking good

[00:04:59] and the way that, you know, in a sense, you know, organizations use people's bodies to kind of sell their,

[00:05:09] you know, whatever they're selling.

[00:05:11] And they kind of come to represent, you know, employees come to represent their organization in that way.

[00:05:17] That's really interesting.

[00:05:19] So, in a way, things are worse perhaps now than they were in that way.

[00:05:23] And do you think women particularly feel pressure to look a particular way for work rather than for their social life?

[00:05:30] So, I think absolutely it's expected that women turn out, you know, and look good for work,

[00:05:39] that they sort of look good in uniforms that are supplied and this kind of thing, you know,

[00:05:45] and lots of sales jobs, customer service encounters sort of require that.

[00:05:52] It's kind of, you know, it's almost, you know, sometimes it's written into the job description.

[00:05:57] Sometimes it's not written in, but it's an implicit requirement of the job.

[00:06:02] So, that's one big driver, I think, of people looking good.

[00:06:08] And I think also the other driver, of course, is things like internet dating and the kind of the way that in a way that our dating culture has become kind of quite marketized,

[00:06:24] which is, you know, which means that, you know, if you're just swiping through, looking at various people who are potential dates,

[00:06:35] you know, making a good impression is very important.

[00:06:39] And we only have one or we have a dominant image of how people should look,

[00:06:43] that there's no kind of sense of people, you know, lots of different looks can be appealing.

[00:06:48] You're saying it's gone together.

[00:06:50] Yeah, I wonder how much of actually, you know, people are striving for the, you know, supposed perfect look,

[00:06:55] which might be a contrived look that, you know, marketing consultants have put together or beauticians have put together,

[00:07:02] you know, which is just completely unnatural.

[00:07:04] Like the example is these massive lips that you see on TV, which just look ridiculous as far as I'm concerned.

[00:07:13] But so many people have them.

[00:07:15] And it's obviously it's a bit of a cultural thing.

[00:07:17] Yeah. So I guess, you know, I mean, it's an interesting thing.

[00:07:21] Historically, you know, there's been, you know, many, many, many philosophers have tried to work out what beauty is.

[00:07:28] And they've always really tried to find the one best model of beauty and to kind of hold that up as an ideal for everybody else to sort of aspire to, I guess.

[00:07:42] And, you know, in reality, of course, the way that we, you know, who we find beautiful is often a product of our, of how attractive they are to us,

[00:07:54] which is a much more individualized thing.

[00:07:58] But of course, you know, when we have these ideas of, you know, that there's one kind of model of beauty, I guess it makes people sort of aspire to that.

[00:08:10] Certain kinds of images of beauty often associated with upper class bodies, you know, become the ideal and people go for that.

[00:08:20] But certain things like big lips and so on are fashions, you know, so this is another kind of another complication of this of the image of beauty is that it doesn't stay the same.

[00:08:33] You know, it changes over time.

[00:08:35] But something like the lips.

[00:08:37] I mean, I haven't had it done, as you won't be surprised to know.

[00:08:41] But I mean, it's a fairly temporary thing.

[00:08:43] But what's interesting is the push towards some quite radical and expensive and dangerous surgery that actually permanently changes the way you look.

[00:08:52] I mean, that's something else, isn't it?

[00:08:54] So big bottoms is the example, isn't it?

[00:08:56] I mean, and that, again, surely is just a trend.

[00:08:58] But it's a more permanent rendition to your body, permanent adjustment.

[00:09:03] Yeah, I think, I mean, again, it depends what you're using to implant into your buttocks to make them larger.

[00:09:11] You know, as to how permanent it is.

[00:09:14] But yeah, I mean, I think there's, it's, you know, the Brazilian butt lift, the BBL has been sort of around for a while.

[00:09:23] And it's taken different, you know, different technologies, I guess, to create it.

[00:09:29] So historically, it's always been done by kind of fat transfer.

[00:09:35] Or I think, you know, originally it was probably implants.

[00:09:39] But now I think, you know, one of the sort of real dangers is the sort of direct injection of sort of loose silicon that you can use in very small quantities in lips, for instance,

[00:09:53] is being used to do something like, you know, like a whole bottom, which means, you know, sort of hundreds of inject injection sites and liters of silicon, you know,

[00:10:08] which is, you know, very different kind of thing.

[00:10:12] You know, it's, you know, it is, it's silicon moves.

[00:10:19] It doesn't necessarily stay where it is.

[00:10:21] You know, having multiple injections is, you know, always a risk for infection entering the body.

[00:10:29] You know, if you inject in the wrong place, you can end up injecting something into someone's bloodstream, for instance.

[00:10:37] So, yeah, these are very risky procedures.

[00:10:40] I mean, it'd be not done under medical supervision by what we gather.

[00:10:44] It's pretty unregulated, in fact.

[00:10:46] I think.

[00:10:47] OK, so there's always been a sort of tension between doctors, you know, right from the very beginning,

[00:10:54] there was a sort of tension between plastic surgeons and what were dismissed as beauty doctors or just beauticians.

[00:11:01] So, you know, there's this sort of three categories of people that are involved in this stuff.

[00:11:08] I think that, you know, certainly a BBL would have historically been done or sort of in the recent,

[00:11:15] in our recent history would have been done by a fully qualified, you know, cosmetic surgeon.

[00:11:22] And I think if you're going to get sort of a major procedure like that, getting it done by a beautician in a hotel room is obviously, you know, not the correct thing to be doing.

[00:11:36] On the other hand, this whole industry is very poorly regulated.

[00:11:41] And is that the case around the world that there's very little in the way of regulation?

[00:11:44] Or are we behind the eight ball a bit on this?

[00:11:47] You know, there are countries where it's a bit more regulated.

[00:11:52] But, you know, so for instance, I think Belgium has very strong regulation on cosmetic surgery,

[00:11:58] but then that only applies to Belgian citizens.

[00:12:00] So if you went to Belgium for cosmetic surgery, then their rules wouldn't apply to you if you were from the UK.

[00:12:08] So it's very, very complex and uneven and difficult to work out.

[00:12:15] And certainly trying to get any kind of recompense across national borders is very difficult too.

[00:12:21] And given the surge, there seems to be in demand for this kind of thing and more radical surgery involving actual,

[00:12:27] you know, putting people under sedation and altering them with scalpels or what have you.

[00:12:33] There seems to be a much more demand for that than there used to be, Ruth.

[00:12:37] Do you think that's true?

[00:12:38] Again, that's quite difficult to say because obviously the people that are involved in the industry will always talk it up

[00:12:45] and they will always, you know, use statistics that make it seem bigger than it is.

[00:12:52] It is growing, but it's so difficult to tell because, you know, only certain procedures are recorded by certain bodies.

[00:13:01] There's certainly growth in things like lip fillers and facial fillers and Botox and those kinds of much more minor procedures.

[00:13:11] Whether there's a massive growth in actual surgery, I think it's hard to tell, you know.

[00:13:20] These surgeries have been quite popular for quite a long time now, really.

[00:13:26] And are sort of, you know, in some places, like you mentioned, LA or whatever, are becoming the norm, you know,

[00:13:32] for lots of people now, particularly around anti-aging and for both women and for men.

[00:13:39] And so, you know, there are different kinds of, you know, again, certain kinds of surgeries come in and out of fashion.

[00:13:47] Certainly more young people are having procedures.

[00:13:53] But lots of those procedures, my impression is that lots of those procedures are becoming less surgical.

[00:14:00] And, you know, sort of the interventions are kind of becoming, you know, less invasive, I guess.

[00:14:07] So it always surprises me about Hollywood, how, you know, so many people in Hollywood are having all of this done.

[00:14:12] And you'd be thinking, actually, he must be really difficult to act if you can't move your face.

[00:14:16] You know, you see them there at the Oscars.

[00:14:18] You don't know whether they're happy to have won or not.

[00:14:20] Quite a lot of actors have never moved their faces very much.

[00:14:23] True.

[00:14:24] Maybe Roger Moore was an early example, perhaps.

[00:14:26] Maybe he had something done.

[00:14:27] But, look, do you know, I have actually had cosmetic surgery done.

[00:14:31] It might surprise you to learn.

[00:14:32] I don't even know, Roger.

[00:14:34] I mean, technically it was cosmetic surgery.

[00:14:36] You're talking about your eyes now.

[00:14:37] Yeah, I had my eyes.

[00:14:38] I had the lenses sucked out of my eyes and had new lenses put in because I was just a bit sick of wearing glasses.

[00:14:44] Now, I could say, you know, I mean, the argument internally in my mind was that I was just sick of wearing glasses.

[00:14:50] It was nothing to do with, you know, how I looked with glasses.

[00:14:53] In fact, my wife has said she actually preferred me with glasses because it framed my face better.

[00:14:57] And can I get reverse surgery?

[00:15:00] But when I got it done, part of me was thinking, what if this goes wrong?

[00:15:05] What is the recourse I've gotten?

[00:15:07] You know, sure, maybe I could sue the company.

[00:15:09] But I'm sure, you know, given that there were, I don't know, 24 pages of very small print that I signed, I'm sure they've covered off that eventuality.

[00:15:16] And I would be left high and dry in a position where I'm worse off than when I started.

[00:15:20] So it was a very considered decision.

[00:15:22] But I'm wondering whether some of these people are making, you know, their decisions with much less thinking, much less thought behind it.

[00:15:30] And it is, in their case, you know, just the way they look rather than, you know, the convenience of or getting rid of the inconvenience of ageing, which is what I was doing.

[00:15:38] Yeah, I think risk is something, you know, it's not the same for all people.

[00:15:46] So, you know, risk is a kind of perspective and it depends where you're coming from.

[00:15:51] If you're sort of part of a social group where lots of people are getting boob jobs in that group, then you're going to consider the risks of getting breast augmentation as very low.

[00:16:06] You know, if everybody you know is doing it, it doesn't seem like a risky thing.

[00:16:10] If you don't know many people that are having a procedure and, you know, if you think about risk all the time in other ways in terms of, you know, staying fit and eating the right kinds of food and, you know, making sure you put on sun cream and those kinds of things, then, you know, you're going to be, you're probably going to consider, you know, the risks of cosmetic procedures a bit more.

[00:16:39] So I think, you know, risk is quite, varies according to, you know, perception of risk varies according to social class quite a lot.

[00:16:48] Yeah, well, that was, I was going to ask about class because it does seem like, you know, it is very much a class driven thing, isn't it?

[00:16:54] I think, well, some things are and some things aren't.

[00:16:58] So, of course, you know, some of the more fashionable things, I think, are more class driven.

[00:17:05] Anti-aging technologies are kind of less class driven, I think, and less gendered.

[00:17:12] You know, the reasons that people have cosmetic surgery from a sort of sociological point of view are quite varied.

[00:17:21] So, for instance, have it, you know, lots of people have the perception, for instance, that people are having breast augmentations because they want to look more sexy.

[00:17:30] But in fact, you know, many of the women that we've spoken to in our research, for instance, say they just want to look more like a woman and that they worry that being very flat.

[00:17:40] That's a really interesting term, though, that is looking more like a woman.

[00:17:45] Yeah.

[00:17:46] I mean, how do you how do you process that?

[00:17:49] I mean, they are I presume they are a woman.

[00:17:51] They they look like a woman because that's what women look like.

[00:17:54] They just don't have big boobs.

[00:17:55] So surely then and in between them thinking that and them going to see a surgeon, surely there's got to be some sort of counseling or something that's going to teach them.

[00:18:05] Well, actually, you don't need it.

[00:18:07] You do look like a woman.

[00:18:08] And, you know, what your perception of what you're trying to achieve is, you know, the end game that you're going for is going to amount to nothing at all.

[00:18:17] I mean, surely there's and obviously the the industry is not going to do that because they're making a quid out of it all.

[00:18:22] So does the government need to step in in some way?

[00:18:25] Do you need to have NHS approval or, you know, and then we become a nanny state?

[00:18:31] Don't we?

[00:18:32] Is it even wrong, though?

[00:18:33] I mean, Ruth, do you have any issues with people having that sort of surgery?

[00:18:37] They don't think they look like a woman.

[00:18:38] Does it matter?

[00:18:39] It's their choice.

[00:18:40] So I think, you know, those are the arguments that you've both that you've both made there.

[00:18:48] You know, choice, free choice on the one hand or, you know, these sort of poor victimized people that don't know their own mind on the other.

[00:18:56] And I think that actually what really, you know, I sort of started off by saying, you know, self-esteem is something that psychologists might use to talk about this.

[00:19:07] But I think sociologists would talk about this more in terms of value.

[00:19:11] And, you know, what we would say is that certain images of beauty circulate in the media and they become the kind of images that people aspire to.

[00:19:24] And basically, you know, having the breast augmentation, you know, that is a way of kind of saying, you know, I'm somebody who's worth investing in.

[00:19:37] I have a body that's worth investing in.

[00:19:40] You know, I am a valuable person.

[00:19:41] So it kind of marks value as well as adds value to the body.

[00:19:46] It's a body worth investing in and a body that has been added to and made more like, you know, the images that we value that circulate.

[00:19:58] That is a very strange rationale, though, isn't it?

[00:20:01] Because, I mean, you could just as easily say, well, it's a body that wasn't good enough.

[00:20:05] So it needed improving, I guess.

[00:20:06] I mean, you know, I suppose for people that work in professions like ours, you know, we feel like getting qualifications is very important.

[00:20:16] You know, that's what helps us in our jobs, you know, and what gets us promotion.

[00:20:21] But if you're working in the service economy, you know, and what you look like really matters, then investing in your body is a good way to do well in those occupations and to get on.

[00:20:35] But aren't we going backwards on this?

[00:20:37] Because in a way, if you're working in a service economy and how people expect you to look, that's where the education needs to be and that people should expect to look at people as people.

[00:20:47] I mean, it's the customer that's the problem.

[00:20:50] But you can sort of see that, you know, if they've got nothing else, if they're thinking, well, OK, you know, how do I make my life different?

[00:20:57] And there's nothing immediate, then I guess you do look internally.

[00:21:01] And how can I how can I change myself?

[00:21:03] And you could change yourself by saying, well, OK, I'll go to college and I'll educate myself a bit more.

[00:21:09] But maybe they haven't got that capability or they're not interested in doing that.

[00:21:12] So they just look at themselves physically, I guess.

[00:21:15] I mean, one of the one of the interviews that I did, I'll never forget with with a woman that I was interviewing for a project.

[00:21:24] And she sort of said, you know, well, she broke her nose when she was young.

[00:21:29] So she had surgery to correct her nose.

[00:21:31] And then she had her children.

[00:21:34] And after she finished breastfeeding, you know, her sort of breasts shrunk right back down again and had been much fuller when she was pregnant and breastfeeding.

[00:21:46] And so she decided to go to travel abroad and have surgery, have a breast augmentation.

[00:21:53] So she said, well, you know, I had my nose fixed.

[00:21:56] I've got my boobs done.

[00:21:59] And, you know, when I can, I'm going to go back to college because it's all about money at the end of the day, isn't it?

[00:22:06] You've got to pay your mortgage.

[00:22:08] So, you know, for her getting qualifications and investing in your body is, you know, they're equivalent things.

[00:22:16] So it's not that she wasn't capable of doing it.

[00:22:19] It's just it was, you know, on the list of things to do later as I kind of, you know, we live in a society that tells us all the time that we should make the best of ourselves.

[00:22:30] You know, and how we, you know, how we present ourselves and our appearance is obviously a big part of that.

[00:22:37] And I guess more so for women.

[00:22:39] But that's all down to expectations again, isn't it?

[00:22:42] It's if society's expectations are not that you have to look a particular way, that simply wouldn't be an issue.

[00:22:49] Whereas I suppose qualifications are a universal idea that actually, you know, you've improved your mind in some way.

[00:22:55] Yeah, but I guess, you know, this is the, you know, the issue is power, isn't it?

[00:22:59] I guess.

[00:23:00] And who has the, you know, when employers are sort of deciding between candidates, you know, that's a time when they have a lot of power over their lives of potential employees.

[00:23:12] And I think people are aware of that.

[00:23:14] And so, you know, they're fashioning themselves into the kind of person that employers want, you know, is, you know, part of it.

[00:23:25] But are they getting that right, though?

[00:23:27] Is it?

[00:23:27] Are they the type?

[00:23:28] I mean, is that just in their own mind?

[00:23:30] This is what employers want.

[00:23:32] So an example, if you watch an episode of Love Island, I think there's two people, two types of people who watch Love Island.

[00:23:38] And, well, three, there's the ones who are seriously bored, which is me if I ever find myself confronted with it.

[00:23:44] Those who think, well, all these are magnificent specimens and they're watching it for the bodies.

[00:23:48] And those who think that those bodies are freak shows that have just gone too far.

[00:23:54] And I mean, if I was a boss, I'd be, you know, I'd be thinking, well, hang on a second.

[00:23:58] You're not a real person.

[00:23:59] Why would I be employing you because you've spent so much time creating a body, which is your idea of perfection, that it just shows that, you know, you are not genuine.

[00:24:09] Beneath all of that, you are not a genuine person.

[00:24:11] So why would I want you to be in my company?

[00:24:14] Yeah.

[00:24:14] So, again, these things are very classed.

[00:24:18] So for sort of middle class people who have cosmetic surgery, what they want more than anything else is to look natural.

[00:24:26] So it's not that they're not having cosmetic surgery.

[00:24:29] It's just that they don't want anyone to know that they've had it.

[00:24:32] It's just done better.

[00:24:34] Okay.

[00:24:34] More expensively.

[00:24:36] Yes, probably more expensive.

[00:24:38] So do you think there's a lot of people out there that we just don't know?

[00:24:40] So we're drawing a conclusion.

[00:24:41] We're doing a very male thing of making an assumption that it's obvious.

[00:24:46] The people who we see, it's just obvious.

[00:24:48] But there's a whole load of people out there who have had it, you know, had some sort of surgery and it's just not obvious to us.

[00:24:53] So we're not seeing it.

[00:24:54] Yeah, I guess people might look at you and not know that you've had surgery on your eyes.

[00:25:01] Yeah.

[00:25:01] So, you know, I mean, this is the thing is that when you sort of start to talk about it, lots of people start to confess the procedures that they've had, whether that's, you know, eye surgery or they've had a scar removed or a nasty looking mole removed.

[00:25:18] You know, and so it goes on.

[00:25:21] You know, there's not really people who have surgery and people don't have surgery.

[00:25:26] It's a continuum, really, I guess.

[00:25:29] And where's the boundary between, you know, what's done privately and what the NHS will do?

[00:25:33] Because the NHS obviously does do some cosmetic surgery.

[00:25:35] If you're involved in a nasty accident, for example, they'll try and do what they can to, you know, to turn you back to looking, you know, close to how you were before.

[00:25:43] But what's the boundary there?

[00:25:47] Well, the NHS tends to, I mean, the NHS barely does any cosmetic surgery now because, you know, it's under so much pressure.

[00:26:00] So, you know, I think there was a time in which if you could sort of show that you had, you were sort of suffering sufficient mental distress, you know, that that might entitle you to have surgery.

[00:26:14] For instance, if you had a completely flat chest and you were worried or actually much more likely if you're a man and you have got, you know, what are colloquially called moobs, that's a man boob.

[00:26:31] You know, that actually you can still get that done on the NHS.

[00:26:36] Can you?

[00:26:36] But that's half the population over 50.

[00:26:39] Yeah, that's very interesting.

[00:26:40] I'm just wanting to know if there's a website and go to.

[00:26:42] Yeah.

[00:26:42] Immediately interested, yes.

[00:26:43] I think especially young men find it, you know, they're very self-conscious about that.

[00:26:48] But if you're a woman with a completely flat chest, it would be, it's much harder to justify getting a breast augmentation in that situation.

[00:26:59] And yet if the NHS, I know it costs more money, but, you know, someone's ultimately got to pay.

[00:27:03] But if that is a psychological condition that needs to be overcome and the only way actually is to have some sort of surgery, then why shouldn't the NHS pay for it?

[00:27:14] Yeah.

[00:27:14] If it was someone who had a hideous mark on their face, which basically meant they couldn't interact socially because of our values and our perceptions, that might be a valid reason to have plastic surgery on the...

[00:27:27] Well, that means that, you know, it is monitored.

[00:27:29] It is, you know, we're not in the situation where we have these unscrupulous surgeons who are making lots of money out of it all.

[00:27:37] I mean, that would be a good result, wouldn't it?

[00:27:39] Of course, you know, it means we've got to pay more to the NHS.

[00:27:42] So that's problematic in itself.

[00:27:44] But, I mean, if we were looking for the ideal results, surely that would be the best outcome.

[00:27:47] And then also you'd get to a situation where you'd go through some sort of process where, you know, there is a bit of cancelling to find out whether it's actually necessary or whether it's all in your mind and you're better off not doing it.

[00:27:56] And I guess the difficulty is if you sort of know that it's free on the NHS, if you can show that you're psychologically upset about it enough, then, you know, lots of people can perform being upset.

[00:28:12] Yeah, just a few acting clothes.

[00:28:14] I think if these things were easy, they would have been settled a long time ago.

[00:28:19] But the difference, you know, we talk about the kind of the boundary between plastic surgery, sorry, reconstructive and aesthetic surgery.

[00:28:29] And that boundary is incredibly hard to draw.

[00:28:33] And it depends on all sorts of things.

[00:28:35] So if the NHS is a bit more buoyant, you know, it might perform a few more breast augmentations on women and breast reductions on men.

[00:28:46] But if it's if things are really tight, then they could only afford to sort of look at cancer surgeries, for instance.

[00:28:56] You know, so, you know, it's never you can never sort of like scientifically say right here is the dividing line.

[00:29:04] It sort of depends on the context in which that decision is being made, I think.

[00:29:09] So, Ruth, we kind of need to draw this conclusion.

[00:29:12] But I mean, in the interest of confession and Phil has confessed to having something that could be called cosmetic surgery.

[00:29:18] What are you going to tell us about, Jim?

[00:29:19] I can confess that I've never had anything of that coin.

[00:29:22] Ruth, I mean, very indelicate question.

[00:29:25] Have you, would you ever consider it?

[00:29:27] Oh, well, so I haven't so far.

[00:29:30] But I guess, you know, part of the reason that I keep researching on this topic is probably because I wonder if I ever would.

[00:29:39] Really?

[00:29:39] How interesting.

[00:29:42] And have you drawn any conclusions?

[00:29:44] I mean, of course, you know.

[00:29:45] Has it lured you closer towards it?

[00:29:46] I have a certain, you know, there are certain things that make me less likely to do it in that I'm an academic.

[00:29:53] And, you know, the more sort of disheveled I look, the cleverer or the better I have a job I'm just going to be.

[00:30:00] Now, there's another value judgment, isn't it?

[00:30:02] Yeah.

[00:30:02] That's why Roger's seen as an accomplished broadcaster for precisely that same reason.

[00:30:06] On radio, which makes it even easier.

[00:30:08] Yeah.

[00:30:09] But it is a bit, I mean, and I think, I guess it's fair enough if people want to do it.

[00:30:14] I mean, maybe, you know, maybe they should be able to do it.

[00:30:16] But I do worry about the, you know, the fad thing.

[00:30:19] So like my wife, who hasn't had anything to tell you, she spends a fortune on skincare, mind you.

[00:30:24] But that's fine because she looks good as a result of that.

[00:30:26] And that's how, you know, that's as far as she wants to go.

[00:30:29] But it does cost a lot.

[00:30:31] So I guess it's not cosmetic surgery, but it's spending money on yourself.

[00:30:34] And, you know, we all like to do a little bit of that, don't we?

[00:30:37] So we look our best without necessarily involving a knife or a scalpel.

[00:30:41] But, you know, we want to get the kitchen done and we're looking at colours, you know,

[00:30:44] and the whole thing is, well, is this colour going to be out of fashion in four years?

[00:30:48] Well, you know, what happens if, you know, these Brazilian bums are just completely out of fashion in four years?

[00:30:54] Everyone's walking around, you know, it's pretty hard to get rid of.

[00:30:57] Yes.

[00:30:57] I mean, you know, so this has also happened with breast augmentations is that there was a fad sort of 10, 15 years ago for quite large breast implants.

[00:31:09] And, you know, since then, there's been a trend towards smaller ones.

[00:31:15] You know, so, you know, the people often, you know, I suppose it's easy with a breast implant because you can just remove the implants and put in a smaller one.

[00:31:25] You know, it's still serious surgery, but it's not the same.

[00:31:28] I mean, how you would undo injections of silicon, you know, just sort of loose injections of silicon.

[00:31:36] I don't know.

[00:31:36] I think these, you know, something that people should think very, very serious.

[00:31:41] It does sound very grim.

[00:31:43] Are these surgeons genuine, do you think?

[00:31:46] Are they or are they just out for the money?

[00:31:48] I mean, in this case, in this case, it wasn't even a surgeon, was it?

[00:31:53] I think it was a beautician that undertook the surgery in a hotel room.

[00:32:00] And we've seen this a few times over the years.

[00:32:04] But, you know, I think surgeons on the whole, I mean, I've spoken to a lot of surgeons.

[00:32:11] They're sort of, they're not people who are sort of figuring out how they can, you know, make the most money or certainly not, you know, in the countries that we've looked at.

[00:32:23] And, you know, they do have a sort of strong sense on the whole of professional responsibility.

[00:32:29] And, you know, there's a certain way in which, you know, they have to be careful because so much business for surgeons comes from word of mouth.

[00:32:39] So, and also even online patients spend years sometimes looking at particular surgeons, watching patients go through the process of thinking about surgery, having surgery, recovering from surgery, looking for any information about something that's gone wrong.

[00:33:00] They scan all this before they make the decision to have surgery themselves.

[00:33:05] So surgeons, they need to be, you know, they need to be doing their best or they're going to end up with sort of bad reviews online, you know, scandal online, which other patients will pick up.

[00:33:17] But ideally, they'd be better regulated.

[00:33:20] Okay, I know we're going a bit over time now, but I just want to ask this one final question then.

[00:33:23] So if you were to draw a Venn diagram of people who've had surgery and people who go to the gym, now there would be in the middle there, you'd get the people who go to the gym just to show how good they look without necessarily doing any exercise.

[00:33:36] And then you have the, you know, then there'd be other people outside that middle bit who are going to the gym thinking, well, you never want to look good.

[00:33:43] I just need to exercise a great deal.

[00:33:45] How big do you think the overlap is between those two cultures?

[00:33:47] Because they are both trying to achieve the same thing, aren't they?

[00:33:50] Which is basically look better.

[00:33:51] Yeah, and I think there's probably quite a lot of overlap.

[00:33:55] And particularly, I think people who have spent a lot of time in the gym when they're younger and that's worked for them, they get to a certain age and things just start to drop and sag anyway.

[00:34:07] It's a lot of hard work, I tell you.

[00:34:09] Yeah.

[00:34:10] And it's at that point.

[00:34:10] I think we know which part of the Venn diagram, Phil, is it?

[00:34:13] Or maybe I should go to the middle.

[00:34:16] Now I've tasted it with my eyes.

[00:34:18] But yeah, there we are.

[00:34:20] Well, anyway, I mean, it is interesting.

[00:34:23] I have to say, though, I was surprised when I moved back to the UK about six years ago.

[00:34:27] I feel like we've got a lot more.

[00:34:28] I was living in Australia.

[00:34:29] I feel like there's a lot more of it going on here, which is interesting because you would have thought Australia would be a culture where it was all about the body beautiful.

[00:34:36] But I don't know.

[00:34:37] I see more of it here.

[00:34:38] Or it's just more obvious.

[00:34:39] Maybe the surgeons aren't quite as good.

[00:34:41] Or perhaps you're older and noticing it more.

[00:34:43] Maybe.

[00:34:43] With my new eyes.

[00:34:44] Maybe that's what it is.

[00:34:45] Yeah.

[00:34:46] Indeed.

[00:34:46] Indeed.

[00:34:46] Indeed.

[00:34:47] Ruth, thank you so much for being with us.

[00:34:49] And yes, taking us around the body beautiful and the pressures and perceptions.

[00:34:55] And you are fine just the way you are, Ruth.

[00:34:57] Don't have anything done.

[00:34:59] Thanks for coming on.

[00:35:01] Thanks, Ruth.

[00:35:02] Thank you.

[00:35:02] Take care.

[00:35:03] Thanks for doing it.

[00:35:03] Really appreciate it.

[00:35:05] That's OK.

[00:35:05] And you look lovely too, the way you are, Roger.

[00:35:07] I do.

[00:35:08] I do.

[00:35:09] No, no.

[00:35:09] Right.

[00:35:09] Now then, so has Rachel Reeves ever had anything done?

[00:35:12] I don't think so.

[00:35:13] Well, I don't think we need...

[00:35:14] That's not a rumour we need to spread, particularly who's paid for it, if she has, of course.

[00:35:17] Yes.

[00:35:18] That would be a terrible thing.

[00:35:19] That's a gift to the Labour Party.

[00:35:20] We do not want to go there.

[00:35:20] In the form of cosmetic surgery.

[00:35:22] Indeed.

[00:35:22] Indeed.

[00:35:23] Can you imagine?

[00:35:23] But she has got...

[00:35:24] So next week we are a week out from the budget, aren't we?

[00:35:26] We are.

[00:35:27] And Rachel Reeves is, I feel as though she could really be in the Tory party, the way

[00:35:33] she is behaving.

[00:35:34] No, she's got to crunch some terrible figures.

[00:35:36] She's got a big hole in the budget to fill.

[00:35:39] She's going to change some of the fiscal rules, apparently, which might help.

[00:35:43] Yeah.

[00:35:43] But what is she going to spend money on?

[00:35:45] What is she not going to spend money on?

[00:35:47] Well, all for changing the fiscal rules.

[00:35:49] And I think...

[00:35:50] So it'll be interesting to talk a little bit about that next week, because if that frees

[00:35:54] up...

[00:35:54] Because the thing about money is, right, if you're going to spend money on,

[00:35:56] you've got less of it in the country as a whole, then you suspend growth.

[00:36:00] If the government pulls back money out of the economy, then it suspends growth, because

[00:36:05] there's less...

[00:36:05] Unless money suddenly starts moving around faster, there's less money to pay for stuff,

[00:36:09] either in the public or private sector.

[00:36:11] It doesn't matter where it is, it's still money at the end of the day.

[00:36:13] So she's got to be careful that she doesn't pull money out of the economy and contract

[00:36:18] the economy.

[00:36:18] If she's looking for growth, there's got to be more money available.

[00:36:21] She needs you on the end of her phone line, doesn't she?

[00:36:24] That's what she needs.

[00:36:24] She absolutely needs me there to help her out.

[00:36:26] But she can listen to the podcast instead, which might be even better.

[00:36:29] Changing the fiscal rules, which I think is meaning, you know, well, okay, there's some

[00:36:33] things which are investments, which have got a longer payback, so we can pay for those,

[00:36:38] which I think is sensible that, you know, you basically split the budget into two, an

[00:36:43] operational budget and an investment budget.

[00:36:45] Yeah.

[00:36:45] If you want to go for growth, then, you know, allow for that investment money, because

[00:36:47] that'll get payback further down the track.

[00:36:49] This seminar brought to you by Phil Dobby on how to run a proper budget.

[00:36:53] Now, come on, let's put it all into next week's podcast when we can dissect it with someone

[00:36:59] who also knows a lot about it and what should be there.

[00:37:02] And we'll no doubt hear from you as well.

[00:37:04] That's next week on The Why Curve.

[00:37:06] Thanks for your company today.

[00:37:07] We'll see you next week.

[00:37:07] The Why Curve.