Did she or didn’t she—have a facelift! Only she and her plastic surgeon know for sure if it’s “great work.” We hear about four, five, even eight hours of scapel wielding under general anesthesia, performed exclusively for aesthetic reasons. We’re not talking about tragic birth defects, illnesses or accidents that have caused disfigurement. We’re speaking image obsession, the ultimate vanity card. Some women (and men) who have been “refreshed” by plastic surgery give off superiority vibes. They look disdainfully upon the hooded eyes, sagging jowls, faded thin lips, baggy lower lids, loose fleshy necks of other women (or men). A not so secret smile dawns on the recently tightened face. One woman openly cried out: “The facelift changed my life.” Now, she could feel “good” about herself until the next inevitable crop of wrinkles appeared.
Today there is tremendous social pressure against looking older, or showing the beginning signs of aging. In certain socioeconomic circles, having the first face lift has become a right of passage for women in their forties and certainly by fifty. There are female and male film and television stars who have already had lifts by their early thirties. In a culture obsessed with eternal youthfulness and terror of death, it is not surprising that many people turn to plastic surgeons in a desperate attempt to stay artificially young. It is true that many workplace environments are partial to young attractive employees. Older more experienced colleagues who have worked competently for many years are pushed aside or edged out.
There is a segment of those who undergo facial and other plastic surgeries who are narcissistic personalities. These individuals are distinguished by a grandiose self, an overblown sense of entitlement, patterns of deceit and manipulation, and a total lack of empathy. One of the signal personality traits of a narcissist is his fixation with the outer image. How he appears is critically important to him. It matters deeply how he is assessed by others. For narcissists, image is a staple of self worth and value. This includes the homes they live in, the cars they drive, the people they marry, their social status.
For many narcissists, external appearance is a core aspect of their identity. Looking great maintains the delusion that they are perfect. Some narcissistic individuals are obsessively focused on their faces and bodies. They spend inordinate periods of time receiving aesthetic treatments. Every wrinkle or crease sends them into dark moods. Many narcissists have frequent regular appointments with their dermatologists that include injections that fill wrinkles and firm up sagging skin. Once a narcissist has had one face lift, he or she knows that the work will not restore their fresh youthful look indefinitely. There is always another eye job, laser skin treatment, collagen injection, tuck or enhancement waiting to be done. Some narcissists are so obsessed with these procedures, it takes up most of their thinking process. What I call facelift narcissism has no end. The plastic surgery is done and for a while the individual feels pleased and enlivened, He compares himself with co-workers, friends, companions, even strangers who are creased, haggard, discolored, droopy, old. The narcissist is disgusted by these imperfections but swells with pride about his image.
Beneath the perfection of the narcissistic mask lies feelings of emptiness, rage, depression, paranoia and envy. The narcissist is unconsciously terrified of these feelings. He uses massive psychological defense mechanisms to keep them from surfacing. The entire sense of self is determined by the externals: how they look, financial status, power position in the world, their ultimate control of others, and the constant flow of praise and adulation that they insure will flow towards them.
Not everyone who has a facelift is a narcissist. It is a very personal decision and has as many reasons and stories as there are individuals. I am struck by the statement of a gym acquaintance made some time ago. “Look, my husband of thirty years had an extended affair with an old girlfriend and suddenly left me. I went into therapy and worked through the grief. I am sixty four years old. I want to find a partner and possibly marry again. Since the facelift, I am competitive now. I no longer go through checkout lines at the health food store and have smirking female clerks loudly call out ‘Do you want the senior discount?'”