Skin Deep

Illustration by Jason Raish

I couldn’t help noticing the new billboard: a pretty, serene woman, her whole body haloed in white like an angel, smiling down at her pregnant belly, streaked blond hair stylishly framing her face.

“MOMMY MAKEOVER,” the billboard announced, “restores desired figure and confidence.” A blue-and-green butterfly flew off the top of the billboard while the words “Complimentary Consultations” lined the bottom.

After having a baby eighteen months before, my body was not the same. My breasts had actually become different sizes after this pregnancy and my erstwhile flat stomach, once my best feature, was pooching out. With four young children it was hard to find time to go to the gym, and nursing made me hungry all the time. No matter how determinedly I resolved to eat less and exercise more, I didn’t. The advertisement played perfectly to my insecurities.

I also was interested because of the investigative book I’m writing, The Business of Baby, about how corporations and private interests influence the way we make choices about pregnancy, childbirth, and the first year of a baby’s life.

Though abdominoplasty and breast augmentation have been around since the late nineteenth century, “mommy makeovers” have become popular only in the past six or so years. In 2006 the American Society of Plastic Surgeons reported that doctors had performed more than 325,000 such procedures on women of childbearing age, up 11 percent from 2005.

This rise dovetails with our ever-present obsession in America with youth, beauty, and thinness. Headlines proclaim that “forty is the new twenty” (it’s not), and celebrity moms return to their size-two jeans just weeks after giving birth. We are bombarded with the insistent idea that our bodies can and should remain flawless as we age.

Hence my visit to the doctor’s office, a low gray building with the familiar green-and-blue butterfly on the sign. I feel like a caterpillar as I shyly head inside. A forty-something woman with a bandaged, swollen face, like she’s been in a car accident, leaves as I enter. The assistant who calls me back has melon-sized breasts straining against a white T-shirt. Her face is heavily made up and her eyes bulge, as if she’s had her skin stretched, like the head of a drum. The video they have me watch depresses me: an already beautiful, clearly affluent woman deciding to have a tummy tuck. Why would she want that, I find myself wondering. Why would I?

Insurance won’t pay for cosmetic surgery, I’m told, but the doctor offers his own convenient monthly payment plan. Liposuction (it turns out I have “good skin” and don’t need the more invasive tummy tuck) plus saline breast augmentation will cost $10,050 (that’s a $500 discount for the two surgeries at once!) for the 2.5-hour operation. The doctor, the financial consultant says, does four to five boob jobs a week. I do the math: capitalizing on women’s insecurities is big business.

But it’s the obligatory before and after pictures that upset me the most. In the “after” pictures, the women look unnatural: Not only are their breasts ridiculously and uncomfortably oversized, but their bellies, once bearing stretch marks and some extra baby fat, now have long jagged scars. Why trade the proud marks of childbirth for the even larger scars of cosmetic surgery?

After a tummy tuck, you can no longer have children. After a breast job, they tell me, you have a fifty-fifty chance of breastfeeding. I ask the doctor if I can talk to a satisfied patient or two about the experience. He and his assistant laugh—there are so many happy clients in the Valley, it will be hard to recommend just two!

They promise to call with some names. They never do. I ask my neighbor, who had a breast enhancement with the same doctor. (I knew about the surgery because she asked me to take her before and after pictures.) She wanted it so she could lose weight and still have breasts. I remember how her breasts were surprisingly pert and pretty when I photographed them and how her daughter, thirteen, was going through puberty at the time, indubitably struggling with body image issues of her own.

“He made them too big and too high,” Maria says, looking troubled. “I told him what I wanted but he didn’t listen. I wish I had never gotten it done.”

I enrolled my ten-year-old daughter Elizabeth in a local “Body Basics” class with four friends. They talk about how beauty comes in many shapes and sizes, and how different cultures have different ideas about what women should look like. Elizabeth shares that in West Africa, where we lived for a year, fat women are considered beautiful and telling someone “you’ve lost weight” is insulting.

I tell Elizabeth I like my green eyes; I don’t admit I often felt ugly and awkward as a young adult. What matters is how you feel on the inside, my daughter reads to me from her journal, not what you look like. When you are kind and generous and thoughtful, we decide together, your inner beauty shines out.

A few months later I take Elizabeth and her older sister shopping for a graduation dress. After finding a dress, they beg to go to one more store. But the baby is restless, and so am I.

“I hate the mall,” I grump. “I’m ready to go home.”

“Why, Mommy?” My daughters look genuinely perplexed.

“Because there are mirrors everywhere,” I blurt out, “and I hate to look at myself.”

Both my girls are so startled they stop walking. “I love to look at you,” my fifth grader says. “You’re so beautiful.”

Jennifer Margulis 99PhD is a senior fellow at the Schuster Institute for Investigative Journalism. Her book, The Business of Baby, is forthcoming from Scribner in April 2013. Visit

Email the Editor

Share This Story