SPECIAL REPORT

Posted Sunday, March 5, 2006; 12.33GMT

	Cesar Lucas Abreu / Cover for TIME remodeled Thinner after surgery, Pozas is mistaken for her boyfriend’s new woman

That's precisely the subtext of many makeover programs broadcast on European TV channels. The absence of beauty, they suggest, precludes a normal existence. In the past, cosmetic surgeons had to rely upon before-and-after shots of clients: you've seen the dowdy mugshot followed by the coiffed glamour-puss look. The genius of the reality television shows was to develop this emotive narrative into multipart series. Their names resonate with promise: The Swan, 10 Years Younger, Make Me Perfect. Poland's first-ever locally produced surgery show, Make Me Beautiful, attracted 100,000 applicants in its first season.

One of the most successful examples of the transformation genre, Extreme Makeover, devised in the U.S., has been sold to broadcasters in 30 European territories; the format has also been licensed to homegrown versions in six European countries. Each episode introduces participants at their lowest ebb, discusses their "defects" and emphasizes their unhappiness in voiceover. Then comes the transformation scene: a surgical makeover, usually involving multiple procedures, new teeth and wardrobe, and industrial quantities of makeup. Finally we arrive at the "reveal," the climax when the transfigured patient is unveiled, à la Dinoire, to the applause of friends and family.

It's a great moment. But Wendy Lewis worries the TV shows have raised unrealistic expectations. "We've created a culture of people who can't afford surgery or aren't stable enough for it. We've made it seem a little too accessible. Having your boobs done won't mean you meet the man of your dreams." Moreover, she challenges the idea that surgery is an option for everyone. "This is a luxury and an elective item. If you can't afford the fee, if you start going into financing, then there's so much riding on the outcome of that surgery that it puts too much pressure on you."

Besides, sometimes surgery doesn't do the trick. Gérard Le Gouès, a Paris-based psychoanalyst and author of a book about cosmetic surgery, Un Désir dans la Peau (A Desire in the Skin), believes that many successful surgical operations are "failures, psychologically speaking — I would estimate about 35-40%. Surgeons aren't psychological specialists."

And sometimes it's more than the psyche that's damaged. In France, Muriel Bessis, 62, has undergone five breast operations, six facial procedures and 11 years of tribulation to achieve her current look. And she says frankly, "I do not recognize myself." In 1985, Bessis, a Parisian speech therapist then in her early 40s, decided her breasts would benefit from a little work. The operation was not a success. She eventually consulted a second surgeon who offered to fix her breasts and to give her an eye-lift. "After the surgery I was unable to close my eyes for almost a year. I looked inhuman. My husband had to put drops in my eyes constantly and I had to sleep with my eyes open. The stitches were put in in such a way that I also lost all my hair." Bessis founded a support group for fellow sufferers and discovered she was far from alone in her experience. But "women were not speaking out because they felt guilty. Why did they feel guilty? Because they had willingly been operated on when there is nothing technically wrong with their bodies."

Bessis does not oppose cosmetic surgery; she just wants the discipline to be as well-regulated as other branches of medicine. Le Gouès, the psychoanalyst, stresses that cosmetic surgery can bring about substantial benefits. "Take, for example, a young woman whose breasts are too large. She can't do sports; she has trouble knowing how to dress well; she has trouble with boys. In other words, it's a sort of handicap for her." A breast reduction, he suggests, will not only solve the practical problems. "There's something more; suddenly her chest is something she's pleased with, that she finds beautiful." Hold that nice thought and add one twist to it. In Europe today, increasingly, that "she" opting for breast reduction is a "he."

The Deadly Male
"We've had a very good january — a phenomenally good January — so I thought, 'I'm going to treat myself,'" says Mark Jennings, who works in the London M&A division of one of Europe's leading banks. A trip to Verbier? A new Porsche? Nah. Jennings, 41, invested part of his bonus in stomach liposuction at London's Harley Medical Group. "I work very long hours — it comes with the territory — but I've been fit all my life so it shocked me when I started to get a midlife belly," he explains. Gym visits did little to beat the small bulge. "So I looked into cosmetic surgery."

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