botox

Recently I ran into a friend who had a new face. Or more specifically, a finely chiseled nose and a jutting chin where there had once been a gentle slope. "Oh, my God, who did it?" I exclaimed.

"Did what?" she asked.

"Your face!" I continued, undaunted. "You look wonderful."

"Oh, you know, I'm just tan," she replied coolly. "I've been on vacation."

Did your nose go on vacation, too? I wanted to ask. Because it's still away.

For once in my life I kept my mouth shut, but I was gobsmacked. Why would anyone bother to lie about what was (har dee har) as plain as the nose on her face? In fact, why would anyone, at this point in time, bother to lie about plastic surgery at all? According to 247wallst.com, a site of news analysis for equity investors looking for growing industries, the total number of cosmetic procedures in the U.S. has almost doubled since 2000. Fourteen million procedures were done last year; 1.5 million of them were surgeries. These days, there are entire shows devoted to scalpel makeovers, and a study commissioned last year by the American Society for Aesthetic Plastic Surgery and conducted by an independent research firm showed that more than 67 percent of Americans would not be embarrassed if their friends and neighbors knew they had had surgery.

But, of course, that leaves about 33 percent who would be embarrassed. Why, exactly? Cosmetic surgery suggests we're vain — but so does getting contact lenses, and few of us lie about that.

Well, as it turns out, those who keep it on the DL have myriad reasons for lying — or, at the least, skirting the issue.

It's not so much that women fear seeming appearance-obsessed, though there's that; it's that they fear seeming vulnerable. "Women think getting surgery denotes a lack of confidence," says Park Avenue plastic surgeon Dr. Scott Blyer. Heather, a high-powered attorney and patient of Blyer's, agrees. First of all, she didn't want a spirited public debate about her decision to get a new nose ("everyone has an opinion"). But more than that, she didn't want colleagues thinking she didn't feel confident about her looks — or about anything else. "Once it was done, it was like, Surprise! I just thought discussing it beforehand would make me seem too wishy-washy."

But wait. We're all a little insecure, right? Who cares? Well, Grace, president of a health marketing company in Miami, cared very much. "In my line of work, you'd think that getting Botox and fillers before my kids' bar mitzvahs wouldn't be a big deal," she says. "But I didn't feel like broadcasting to the world that I felt insecure because my ex-husband would be there with his size-4 date."

Indeed, says Wendy Lewis, plastic surgery consultant and author of Plastic Makes Perfect, women in professions that are largely male or considered "serious" (finance, sciences, academics) are much less likely to fess up. "I had a client who was a VP of a pharmaceutical company who concocted an elaborate family emergency as an excuse for missing a conference during the healing process of her breast-lift," says Lewis.

Big life changes can make us secretive, too. I have a chatty, life-is-an-open-book friend who celebrated taking charge of a magazine by getting a face-lift — and hiding out for a month before starting the new job. Becoming a mother can have a similar effect: There's something so slapdash about a woman who's taking medical risks, even small ones, when she has a new life in her charge. "My mommy-makeover clients aren't bragging all over town that they had a nip-and-tuck to get back into shape," says Lewis. "Rather, they claim they gave up sugar, or are addicted to SoulCycle or Zumba."

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Women will confess to some surgeries and not others, depending on their own vain-o-meter. "Like, I didn't mind telling people I had breast reduction surgery, because my breasts were causing genuine problems — I had backaches all the time from carrying those puppies around," says Marion, a nurse in New Jersey. "But nobody knew about my chin-ectomy. I just told people I lost a little weight — because that was something I felt I could control, if I actually did lose weight. Which I didn't. Well, I did, but only thanks to a surgeon."

Reality-show stars notwithstanding, celebrities are generally even more secretive than civilians. "Living in L.A., it's astonishing how many plastic surgeons there are, but apparently if you are to believe what celebrities say, no one ever uses them," says Janice Min, editorial director of The Hollywood Reporter and author of How to Look Hot in a Minivan, a guide to what famous moms do to look so good. "There seems to be some virtue in just losing weight by 'chasing your kids' or having a 'high metabolism.'"

Partially, of course, it stems from the premium placed on youth in the entertainment industry. Santa Monica, California, dermatologist Dr. Ava Shamban, one-time resident dermatologist on Extreme Makeover, notes, "Celebrities are the gods and goddesses of our culture, and as deities they must be physically perfect sans help from a mortal. So, once in a while they admit to having had Botox, but then they swear off ever having it again."

Naturally, dermatologists and surgeons would like us all to advertise their handiwork when we're pleased; word of mouth is the best way to get business. But they're also sympathetic to our reluctance to spill, particularly when it comes to our boyfriends or husbands. Breast augmentation? Lipo? Well, it's not like you have much choice, unless you keep way more personal space between the two of you than the average couple. (And I say that as someone who lives in a separate apartment from my husband. Even I would find it hard to take the vow of omert if I had a serious surgical procedure.) But, says Shamban, "I actually think it's important not to share every little medical detail with your significant other. Beauty, after all, should feel like it comes naturally, the way Venus rose from her shell. So it's OK to talk about the nail salon but not the eye-lift or the Botox."

There can be consequences for even a sin of omission, though. When Sarah, a musician in California, had liposuction, she decided she wouldn't say a word, even if her boyfriend asked. "He took one look at the bruises I had and immediately assumed I'd cheated on him with some other dude — like, I'd fallen off some guy's motorcycle or something." By the time she'd fessed up to the lipo, he assumed that was a lie. "There was much rage and accusation. I even showed him the doctor bill, so he believed me eventually, but he still felt betrayed. Ultimately, he dumped me."

I realize feminism and plastic surgery don't often share the same sentence, but to me there is a feminist argument to the decision whether or not to reveal you've had some work done. It's important for women to know that other women aren't paragons of perfection by themselves. In every avenue of life we benefit from the help of others. Why should this be any different? It does take a village, and it's no secret — or shouldn't be — that some of those villagers wield a scalpel.

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