Europe's Extraordinary Makeover

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Photograph for TIME by ALEX SARGINSON

It's what's on the inside that counts. That's a sentiment Thierry Moreau is preparing, body and soul, to endorse, if not quite in the spirit the hoary old platitude is usually intended. In half an hour, a surgeon will make an incision below Moreau's left breast and push a transparent sac of gel into the cavity. To the strains of Procol Harum's A Whiter Shade of Pale, the surgeon will prod and manipulate the material until satisfied, before repeating the procedure on Moreau's right side. When the patient, sutured and bandaged, stirs from his anesthetized slumber, he'll find one of his dreams made reality. Augmented from within, Moreau will rise from his bed, the owner of a proud new set of pectorals.

Will his enhanced physique enhance his life? The 43-year-old two-time divorcé thinks it will. A financial manager in the French Ministry of Defense, he's devoted his out-of-office hours in the last year to researching what cosmetic surgery can do for him. "I've always had a complex with regard to my chest," he muses, as he waits to be escorted to the operating room. "There were times when it didn't bother me that much, when I was married and living the normal life of a couple. But I'm single again and I suppose you could say there is always that desire to seduce." Cherchez la femme. When a man behaves, well, oddly, there's bound to be a woman — or women — involved. Why else would Moreau travel 600 km from his home in Bordeaux to a clinic in a Paris suburb to risk an unnecessary medical procedure and the potential jibes of friends and colleagues — and shell out €3,900 for the privilege?

Moreau has been unhappy with his pecs for years. His first wife, he says, sometimes mentioned his chest lacked muscle. Like the rest of his body, his upper torso, while not buff, appears well-proportioned enough in the waiting room at the Institut Européen de Chirurgie Esthétique et Plastique. But, says Moreau of his ex-wife's commentary, "I took it well, but maybe deep down it kind of got to me." Dr. Paul Seknadje, the surgeon who is shortly to perform Moreau's operation, confirms that among the growing numbers of men seeking his services, a significant proportion are spurred to do so by female voices. "In many cases wives are the ones to suggest that their husbands get rid of fat to look sportier," says Seknadje.

Yet the rising demand for Seknadje's varied skills — he performs all manner of procedures including some 200 penis enlargements every year — cannot simply be explained by the emergence of a vocal generation of women. There are other voices, siren voices of the media and of a deeper collective unconscious, that are sending supplicants to his clinic and to similar private centers, hospitals and beauty parlors across Europe. The voices, as insistent as nagging spouses and as urgent as adolescent sex, promise that cosmetic interventions will deliver more than just better chances in the dating game or improved conjugal relations. They whisper that surgery can grant a gift greater than immortality — the chance to stay young until you die.

There are no comprehensive statistics to chart the astounding surge of Europeans demanding elective cosmetic surgery along with a gamut of "noninvasive" procedures that inject threads, compounds and potions to lift and remodel, smooth and tighten. Competing practitioners' associations collect information only from their own members, and many practitioners in Europe operate outside the ambit of any of these associations. Nor is there any reliable way to measure the numbers of budget-conscious Europeans nipped, tucked and stitched up in distant resorts or the haphazard metropolises of the developing world. But even fragmented data on Europe's booming transformation industry tell an extraordinary story.

Once an indulgence of the moneyed élite and a professional necessity for actress-model-whatevers, cosmetic alterations are becoming a mass-market activity. Think you don't know anyone vain enough or desperate enough to try it? Think again. Odds are that a friend, a colleague, the teller in your bank or that commuter you sit opposite most days has already gone in for a little work. It won't be someone you consider vain or desperate or from a different planet. According to the International Society of Aesthetic Plastic Surgery (isaps), a body representing 1,315 practitioners, Europe accounted for more than 33% of cosmetic procedures conducted in 2004, second only to all of the Americas.

In Britain, the market for elective cosmetic surgery grew by an astonishing 35% last year, says the British Association of Aesthetic Plastic Surgeons (baaps). Still, the British have yet to develop the ravening hunger for beautification displayed by some fellow Europeans. isaps places Spain, France, Germany and Turkey far ahead of Britain for consumption of cosmetic procedures. And opinion polls conducted all over Europe point to a widening acceptance of cosmetic surgery as a part of normal life — particularly among the young. The research company Forsa found that 13% of Germans say they would consider surgical enhancement; that number rises to 20% — 1 in 5 — among the under-30s. Fifteen percent of 14-year-old British girls and boys wouldn't rule out going under the knife, according to a survey by the Priory mental-health-care group.

Why is cosmetic surgery growing so fast in Europe? The Continent's aging profile may go some way to explain why older Europeans regard plastic surgeons as high priests. But the newly powerful appeal of the religion for younger generations — and for men of all ages and every sexual orientation — is tougher to interpret. Time reporters spoke to practitioners, social scientists and psychologists to try to fathom why Europeans place such a high value on beauty. And we talked to patients of different nationalities, from teenagers to retirees, about the choices they have made, their expectations and their lives — before and after. They mentioned the temptingly wide range of options on price, procedure and location. But their answers hinted at deeper cultural shifts, too. Cosmetic surgery today isn't just the preserve of the anciens riches who parade their taut faces along the promenade at Puerto Banus, or the starlets whose undernourished frames barely support their embonpoints. Rather, the cosmetic-surgery boom reflects changing patterns of behavior in Europe. Plenty of patients go under the knife for the oldest reason of all — because they want to look more beautiful. But a surprising number attribute their passion for cosmetic surgery to television — to the rash of programs designed to convince viewers that a makeover is something they need feel no guilt in desiring. Something else is new, too; increasingly, cosmetic surgery is for men as much as for women. In the intersection between the search for beauty, the power of TV and the needs of the new male, Europe's face is changing. Literally.

Breaking A Taboo
A woman perches on the only wooden chair in an overupholstered hotel lobby. She could be any one of the genteel 50-something ladies wandering past outside, up from the country for a day's shopping in London. She jumps to her feet as her friend enters from the street, already trumpeting a series of questions: "How was it? Did you find her scary? What are you having done?"

The pair have emerged from consecutive appointments with "the Knife Coach," as she calls herself — Wendy Lewis, a turbo-talking, wisecracking New Yorker. It has been a day of firsts for the ladies, and it's only lunchtime. They have signed up for their first elective surgeries — both will have face-lifts — a decision made easier by their first opportunity, courtesy of Lewis, to examine the results of this operation up close.

Later, in a busy café, Lewis grants me the same privilege, guiding my fingertips to scars under her hairline. Her forehead is preternaturally smooth for someone so expressive, and she has no laughter lines — though she laughs often and heartily. She doesn't look younger than her 46 years but she appears well rested — inexhaustible, in fact. Lewis is a walking advertisement for her self-created profession: she is a consultant on cosmetic surgery, independent from any practitioners, who makes her living by charging clients for advice on how they can improve their appearance and whom they should entrust with the task. She started in the U.S., but has seen clients in Europe since 2000. After this trip to London comes Paris, then Greece this summer. "The growth over here is exponential," she says.
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