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The Substance, a recently released horror movie, takes aim at Hollywood’s glaring obsession with youth. It stars Demi Moore as a 50-year-old celebrity who uses a black-market drug to create a younger, better version of herself. It is extreme, over-the-top, gory and appears to be set in another world. But while the plotline might stretch credulity, the movie’s bleak commentary on society’s warped and unattainable beauty standards rings alarmingly true.
Twenty years ago, cosmetic augmentation was strictly the preserve of celebrities and the ultra-wealthy. Today, teachers, entrepreneurs and teenagers are as likely to avail of what are cutesily called “tweakments” as the rich and famous. The past decade has seen an explosion in the market for lip filler, Botox and cosmetic dentistry as our obsession with looking younger, smoother and tighter grows. Irish people spend what some conservatively estimate to be €200 million a year on injectable beauty. Overfilled lips, cartoon lashes and teeth-like rows of piano keys have become so commonplace that a generation raised on an endless carousel of filtered social media images and reality TV view them as desirable and normal.
Society’s pressure on women to look younger is not a new phenomenon: Cleopatra supposedly took daily baths in donkey milk to preserve the youthful appearance of her skin. But it was in the latter half of the 20th century that the marketing of “youth” as a product took off, with cosmetic companies pushing a barrage of lotions and potions that promise to turn back the hands of time. Men, for the most part, used to be exempt from the sales pitch, but today, this double standard has all but disappeared. Not because women have freed themselves from the tyranny of impossible beauty standards, but because cosmetics companies, spotting an untapped market from which they could profit, began focusing their marketing efforts on men.
These days, male grooming is booming and a recent survey found that beauty spending among UK men has increased 77 per cent year on year. Men are also spending more on procedures such as cosmetic dentistry and hair transplants. The global hair transplant market was valued by one research agency at $8.05 billion in 2023 and is expected to reach $16.62 billion by 2032.
In Ireland, celebrities and sports stars acting as “brand ambassadors” for hair-restoration clinics have helped lift the stigma previously associated with male grooming habits. Advocates claim to have overcome embarrassment about their receding hairlines and developed a newfound confidence in the aftermath of transplants. Improved self-esteem is undoubtedly a positive, but there’s another side to it: the promotion of hair restoration helps reinforce the notion that baldness – like wrinkles or thinner lips – is a disease that needs to be cured and not a normal part of the ageing process.
As we have grown accustomed to new aesthetic norms – fuller lips, veneers, or a thick head of hair – the associated costs with keeping up with them are proving a significant financial burden. As a result, patients are seeking out cheaper treatments abroad, sold on the idea of combining beauty enhancements with a sun holiday. Tens of thousands of Irish people travel for surgical procedures every year, many of them to Turkey, which has become known as the hair transplant capital of the world. The country is also a popular destination for cosmetic dentistry and rhinoplasty. With the cost for such procedures up to 75 per cent less than a similar treatment in Ireland, it’s easy to see its appeal.
Booking cosmetic surgery in Turkey is now as easy as ordering a food delivery from Tesco. A quick Google search turns up dozens of packages, including flights, treatment and a stay in a five-star hotel. Wrapped in the veneer of a luxurious holiday, packages for serious medical treatments are sold under enticing monikers such as “the mummy makeover” or “the sapphire hair transplant all inclusive”. Many packages offer chauffeur-driven cars, dinner at exclusive restaurants and steep discounts if a patient avails of multiple treatments. On social media, influencers showcase glamorous trips to sun-drenched beaches where they take a few hours out of their holiday to avail of cosmetic improvements before returning home relaxed, tanned and supposedly better looking.
But while there are many safe, regulated surgeries in Turkey, there are also many unscrupulous and unchecked clinics that pose serious risks to patients. What the influencer videos don’t show are the scalp infections, reopen wounds and agonising tooth pain, all of which are reported complications suffered by patients who have travelled abroad for treatment. Irish doctors warn there has been an increase in the number of patients presenting in hospitals having returned from clinics where they received seemingly innocuous procedures, only to later experience negative side effects. In a recently published study, doctors from Connolly Hospital examined the records of 30 mostly female patients presenting with complications related to aesthetic procedures performed outside Ireland between September 2021 and December 2022. Abdominoplasty – or a tummy tuck – was the most common procedure, and 70 per cent had travelled to Turkey. “Wound dehiscence” – when the wound reopens – accounted for the majority of complications. “The bacterial etiology is varied, and antimicrobial resistance poses significant challenges,” the doctors noted.
Patients aren’t always warned of the risks involved and don’t always receive the level of detailed consultation before a treatment that would be required in an Irish-regulated clinic. Language barriers pose further risks as patients may not fully understand exactly what treatments they are agreeing to or what the required aftercare steps are. At least nine Irish people have died since 2020 because of cosmetic and medical treatments they received in Turkey, according to media reports, highlighting the acute dangers associated with this type of travel. The Irish Department of Foreign Affairs now features the following warning in its travel guidance on Turkey: “the [department] is aware of citizens who have experienced complications in the course of their treatment in [Turkey], and a number who have died.”
Yet despite these warnings, people continue to travel in their droves. The shifting perception of what we view as normal coupled with a relentless feed of filtered messaging, is driving people to make drastic enhancements to their appearance even when the potential risks outweigh the rewards. And that’s a reality scarier than any horror movie.
Elaine Maguire O’Connor is a writer and consultant working in fashion law
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