‘A User’s Guide to Cheating Death: Fountain of Youth’ — is plastic surgery more harmful than we realize?



The ideal we’re sold by the beauty industry is impossible to achieve, ensuring the quest will never end.

The second episode of Timothy Caulfield’s 2017 Canadian series, A User’s Guide to Cheating Death, now streaming on Netflix, highlights the “The Fountain of Youth”. Caulfield adopts the same approach as in the opener, surveying various questionable medical practices and visiting patients and practitioners around the world in light-hearted travelogue segments, interspersed with more serious (but not deep) observations about the meaning, implications, and impact they each may have.

In this case, there is no literal youth-restoration or life-prolongation treatment in question; instead, what Caulfield examines are basically beauty treatments, including plastic surgery, intended to promote a youthful appearance.

As before, though he says he wants to disabuse viewers about fraudulent treatments, Caulfield’s approach is more descriptive than analytical. That may make sense given the content of this second episode. Though some of the beauty treatments he profiles in this episode are questionable, the bulk is devoted to cosmetic surgery by reputable physicians.

A woman submits to an “electrical facial”

Put your money where your face is

In his role as the George Plimpton of quack medicine, Caulfield sits for a “face reading” from a woman who says she can discern his personality traits and likelihood of professional success by viewing the shape of his face – basically a variation on the ancient practice of physiognomy. She gives exactly the kind of vague but encouraging statements you’d expect from any palm reader or “psychic,” which Caulfield accepts laughingly but without demurral.

He visits a clinic that provides “micro-current facials” – running electrodes over the face to produce an electrical current in the skin that is too mild to be felt. This is apparently based on the theory that “electricity” in the body “slows down,” and has to be stimulated to revive itself; this “slowing down” is what causes the facial muscles to droop in old age.

Caulfield notes that sagging facial skin is the result of the breakdown of collagen, not loss of muscle tension, and thus even by its own potted theory of electrical stimulation, this treatment can’t work. He adds this as a taped sidebar, after leaving the clinic, saying nothing to the scammer rubbing useless electrodes over the paying patient’s face.

Most alarmingly, Caulfield observes a “vampire facial” procedure, wherein a woman submits to “needling” using a vibrating wand, rubbed all over her face to perforate the skin and draw tiny droplets of blood to the surface. After her skin is pierced, a tube of blood is drawn from her arm and centrifuged, leaving only the plasma and platelets.

This pale, sticky fluid is then brushed back onto the surface of the woman’s face, mingling with the blood there and supposedly being reabsorbed into her skin through the needle holes. Much is said about the life-giving properties of plasma and the important role of platelets; having them absorbed into the facial skin, it is claimed, will rejuvenate it.

This is self-evidently absurd — you already have all the plasma you can hold in your face (remember: blood came out of it when she was poked with the needles, and plasma is the main component of blood). Platelets, which are cell fragments that help form blood clots in wounds, have nothing to do with making you look younger and, again, are found in the very same blood circulating through the skin of your face. Taking blood out of her arm and smearing it on the outside of her face, which is already leaking blood from the inside, is taking pseudoscientific gibberish to a ghastly level.

The scammer doing all this wears a professional-looking lab coat, and the procedure is done in what looks like a medical office, using medical equipment, like a sterile blood-draw kit and a centrifuge, while exposing the patient to the pain and (minor) risk of being punctured in the face and arm, in service of a “treatment” that is scientific idiocy. The patient, covered with a pink, drying mask of her own body fluids, looks quite pleased.

A woman undergoes a “vampire facial” procedure

Putting money into your face

This survey of marginal quackery precedes the largest segment of the show: a (comparatively) in-depth look at cosmetic surgery. Though Caulfield notes its worldwide popularity, he focuses on South Korea, which not only has a beauty-obsessed local culture, but is a Mecca for medical tourists. In the upscale Gangnam district of Seoul, which has a reported 1,000 plastic surgeons in the space of one neighborhood, he points out a garishly neon-lit block in which every office is a surgical clinic, and plastic surgery is openly advertised on pamphlets and billboards.

Caulfield interviews doctors and patients who are up-front about their acceptance of cosmetic surgery, and how positively they view it as an enhancement to one’s life. He ties this to South Korean values of competitiveness and personal and professional ambition, in a culture in which it is openly acknowledged that looks play a part not just in personal satisfaction, but in relationships and job opportunities.

Whereas Americans will freely discuss going to the gym or adopting a special diet, but are often coy about having had surgical enhancements, the Korean patients apparently see all such interventions as equally valid and available possibilities for self-enhancement. Caulfield cites an estimate that approximately one third of Korean women have had cosmetic surgery.

Caulfield notes that the single most popular cosmetic surgery procedure in South Korea is the “double-eyelid” blepharoplasty – a procedure to create a crease to divide the smooth surface that characterizes Asian eyelids, and makes the eyes appear larger and more Western. That this is a large and externally-driven cultural shift, influenced by exposure to Western standards of beauty through movies and advertising, is something that Caulfield acknowledges, but he does not ask whether there is anything problematic with such an overtly racialized denigration of one’s own cultural and genetic heritage.

A South Korean woman’s face is marked with a pen in preparation for a multi-procedure plastic surgery session to make her more beautiful, to enhance her employability as a model.

Likewise, although it is obvious that the overwhelming demand for cosmetic surgery is from women, who are famously faced with crushing demands for adherence to impossible standards of beauty, the unequal way this impacts the lives of men and women is never mentioned. Caulfield does note the mutually reinforcing nature of these social trends: as more South Korean women choose cosmetic surgery to pursue a particular definition of beauty, the more pressure women feel to live up to it.

Best face forward?

In a discussion of celebrity culture, Caulfield notes how unlike normal life it is. Because a celebrity’s bodily appearance is the product they sell, “it’s a full-time job” developing and maintaining it – something ordinary consumers cannot devote themselves to. Even then, appearance is not reality. Caulfield points out how heavily altered and revised every published image of a celebrity is. (He has his own image digitally cleaned up by a photo editor, and is dismayed when she erases the dimple on his chin.) .

At the end, Caulfield gives his customary two minutes of discussion on the episode’s issues. Maybe because his main focus – plastic surgery – is less obviously abusive than the bizarre quack treatments profiled in this and other episodes, he has little to say on how to view it.

“I don’t think we should judge people who make the decision to have plastic surgery,” Caulfield says, “but I do think we need to think about how these individual choices are going to shape how we think about beauty more broadly as a society.”

Yes. If only he had, say, a 45-minute long documentary video show where he could do that.