Society has always valued beauty. In literature, ­attractiveness often symbolizes an admirable protagonist, while ugliness indicates the abominable antagonist. As children we are taught, without even realizing it, to prize beauty. People of every race and culture have gone to extremes in the name of beauty – from foot-binding in China, to dangerously constricting corsets in Victorian times, to nose jobs in 800 B.C. India. While plastic surgery has been around since ancient times, it has only recently become accepted by the masses.

Television programs that promote plastic surgery – “I Want a Famous Face” on MTV, “The Swan” on Fox, “Extreme Makeover” on ABC, “Nip/ Tuck” on FX, and “Dr. 90210” on E – expose the public to a business once kept under wraps. Reality television embraces the topic due to its shock ­value – however, the public is becoming more and more accustomed to the idea of plastic surgery.

Not only have these programs created a generation that isn’t fazed by images of blood, Botox, or bandages. Sometime during the process of beautifying average humans, they have implanted something besides silicone: the belief that cosmetic surgery will improve lives. Now, not only do people accept plastic surgery, they embrace it as a solution to personal and professional problems. While appearance has always been important, mainstream acceptance of plastic surgery has created a society that values appearance over ability.

According to Drs. Iva Sorta-Bilajac and Amir Muzur, rhinoplasty developed in ancient India due to the practice of nose mutilation as a form of public punishment for immoral conduct. Therefore, the connection between an unattractive nose and an immoral being was deeply rooted in this society. While the nose is not a vital ­organ, it is exposed to everyone’s view and has ­become a symbol of integrity as well as an important ­aspect of ­human beauty.

Only a couple of decades ago it was considered taboo to admit having “work” done, and it was not ­unusual for patients to take extreme measures – sneaking into doctors’ offices through the back door, or using fake names – to hide the fact. As noted in the New York Times article “The Doctor Will See You, and Your Party, Now” by Anna Bahney, more patients became interested in procedures after seeing them on TV and researching them online. Currently, plastic ­surgery is so commonplace that instead of scheduling secretive meetings, ­patients often bring parents, siblings, spouses, or friends to consultations.

According to the American Society for Aesthetic Plastic Surgery, nearly 11.5 million cosmetic surgical and nonsurgical procedures were performed in the U.S. in 2005. On the website The Medical Tourism Guide, readers are told, “Plastic or cosmetic surgery can help to boost confidence and vitality. In the case of cosmetic surgery, think of this procedure as an overhaul, much like you’d add that new roof or coat of paint to a car.” Some of the appeal lies in the way it is promoted, like statements that market surgery as a confidence-booster.

Our reality television shows are modern fairy tales. They all use a common formula: take an average, unhappy individual, alter her appearance, and after a surgical transformation she is magically a success. While the message is the same, there is one difference: these aren’t fictional characters, they’re real people.

The confidence that comes from a new nose, fake breasts, or liposuction is only temporary – physically (many procedures are not permanent and need to be repeated) as well as emotionally. Often, patients’ insecurities about their appearance are symptoms of underlying psychological issues, such as depression, and may be temporarily alleviated by surgery. But this temporary confidence is nothing in comparison to the confidence one can obtain by excelling in sports, academics, or a hobby. Marketing cosmetic surgery as a confidence-booster increases profits, but it also gives people unrealistic expectations. They believe that their life will change and are disappointed when it doesn’t.

After undergoing plastic surgery, many people finally feel accepted. By transforming into an ideal beauty, they earn the approval of others and receive positive attention. Some people even have “coming-out parties.” But while plastic surgery may appear to increase confidence, it’s often an illusion –
even to the patients themselves, who might confuse real self-esteem with the joy of feeling as though others approve of their appearance.

Psychologist David Sarwer believes the acceptance of plastic surgery goes beyond vanity: “We’ve become ­increasingly accepting of ways of changing our bodies. We’re much more comfortable with our bodies as malleable.” People have always altered their bodies, mainly through diet or ­exercise, so it’s no surprise that many view themselves as changeable. But what causes someone to want to alter his or her body? We all seek approval – from parents, spouses, children, coworkers, and friends. Even if it’s a subconscious desire, everyone wants to be deemed acceptable. Plastic surgery can gain the approval of others, but why should you care about the opinion of people who don’t see you for who you are on the inside?

Parents often pressure their children to do well academically, but with plastic surgery becoming so accepted, some parents are pressuring their children to have cosmetic work. Children as young as six are undergoing minor procedures, and 13-year-olds are having nose jobs. Doctors and parents who support these surgeries claim that the child understands. However, it’s more probable that she realizes her parents want her to change, and is willing to comply.

Some people feel pressured by their spouse to remain youthful or become more ­attractive. According to Donna Henderson-King, author of “Acceptance of cosmetic surgery: scale development and validation,” many women “desire to meet social expectations of beauty. Women are socialized to see themselves as objects to be looked at, and consequently view themselves from the perspective of others.” In this study, King found that the more shame women felt about not having met socially defined standards of beauty, the more likely they were to accept cosmetic surgery.

Plastic surgery constantly appears in pop culture. Many celebrities have had cosmetic surgery, and the American public is constantly exposed to images of these altered humans. In a Mike Williams cartoon, two women scrutinizing Rembrandt’s self portrait say, “You’d think that if he’d been that successful he would have had his nose fixed.” This is a perfect example of society’s belief that attractiveness is a necessary part of success. Rembrandt is a renowned artist, but the women in the cartoon are not discussing his artistic ability; they’re critiquing his appearance. Our society blatantly values appearance over ability.

This acceptance of plastic surgery, as well as the value of appearance over ability, affects youth. From a young age, children play with toys like Barbie dolls and burly action figures, with bodies that are physically impossible to achieve. Exposure to these “ideals” is damaging to the self-esteem of youths.

People have always wanted to look like society’s ideal. In the late 19th century, Irish immigrants in New York got “English” noses to transform themselves into Americans. The ideal ­appearance in society is always based on the appearance of the dominant group.

With so much importance placed on appearance, other attributes often come second. Young people are learning that they should aim to be beautiful instead of intelligent. It’s even a common practice for parents to reward high school graduates with nose jobs, breast ­implants, or liposuction. But is cos­metic surgery an appropriate reward for years of hard work and academic achievement?

In American culture, the mold of an “attractive” person is getting smaller and less forgiving of any differences. “The assembly-line look ultimately damages the notion of personal identity. We are in danger of doing something unthinkable, which is making beauty boring,” according to Dr. Nancy Etcoff. In a cartoon by Dave Carpenter, two men tell a stranger, “No, we’re not related. We just have the same plastic surgeon.” This pokes fun at the tendency for plastic surgery patients to appear generic afterward. However, there is some truth to this. On reality makeover shows, the subjects come out looking eerily alike.

Cosmetic surgery is no longer limited to the wealthy; banks offer loans for it. As plastic surgery becomes more mainstream, it’s interesting to ponder whether the value of beauty will ­decrease as it becomes something that anyone can buy.

Vanity in our culture has increased and become more acceptable. People are more open about their desire to be attractive, and plastic surgery no longer has a negative connotation. However, America is also the most medicated ­nation on earth. Ten percent of our population take antidepressants. It’s obvious that these surgeries are not ­really making us happier. Rather, they delay the process of some individuals seeking the necessary psychological help. Even the young aren’t immune to depression. More children than ever are developing eating disorders and poor self-esteem.

Happiness can be achieved, but not through surgery. People need to ­embrace their differences instead of trying to erase them. Only when we are at peace with ourselves will we be ­truly radiant.