I’ve lived in southern California for almost ten years. I guess it was inevitable that I would end up in a plastic surgeon’s office. What’s a nice, southern girl like me doing in this plastic surgeon’s office, you ask?

Being mildly rattled by the official sign declaring that this practice has been licensed by the California Board of Barbers and Cosmetologists. I searched quickly to find my doctor’s name to make sure I was in the right office. You know, there was a time when barbers and surgeons were the same. Reassured I was in the right place, I relaxed a little.

Then I saw the lips. All the plump lips of the staff.  All the pink, glossed, sausage lips that looked like they might belong somewhere else.

Flashback to 2012.  Just another stroll around our little beach town when someone with Donatella Versace grade lips walks by. The boy looks at me and says, “Wow, that’s the worst case of trout pout I’ve seen this week!” THIS WEEK!  Thanks, California. 

I know it’s a strong temptation to buy the merchandise wherever you work. I mean, I had a large collection of DKNY when I worked retail—some of it didn’t even make me look like a poseur. But when everyone on staff has the same lips, doesn’t it make your potential customers question, just a little bit, if their new lips will truly be custom fit to their face?

Flashback to 2008. Newly transplanted to California, I was eating lunch with the family in Orange County beside two women who were holding ice on their just injected lips. One would take the ice off and ask the other if she looked ok. Reassured, the ice would go back on then the other woman would remove her ice and ask the same. Over and over and over again. My girl asked me what happened to them. I got to explain cosmetic surgery to my seven-year-old.

Thanks again, California. I thought I would have a few more years before I had to muster a full-on fight against appearance culture.

I gave my insurance card to the receptionist, who in her defense, looked like she kept her natural lips when her face was pulled back taught, trimmed, then stitched back in place.

Hyperbole much? Maybe so, but really, that’s how a facelift was described to me.

Actually, she looked good, really good. Natural. Of course, she was only about thirty so maybe there was no stitching required just yet. I have to admit, her skin was flawless. Just for a second, I pondered the facial menu.

Able to resist the Obagi Blue Peel, I filled out the medical forms that were very concerned about previous medical conditions and family history. I felt a little more comfortable. It seemed more doctorish and less barberish.

Puffy lips and invisible pores aside, it was such an odd experience hearing staff talk to women about which hospitals have the best rate, where they can go to get a discount, the newest injection methods, and how things would be easier now that they had decided on surgery. Because, who has surgery on purpose?

I was there for a hematoma on my ass.

It was the hematoma I got in August after falling butt first down four steps in a torrential Irish downpour.  Over the last six months, it had only shrunk from papaya size to apple size.  As much as I loved having three butts, at this point, it was futile to wait for it to disappear on its own. I could live with it, cosmetically, I guess. But it hurt.  A lot.

Just because I was there for medically necessary reasons didn’t mean I had a problem with elective surgical enhancement. Although I hate to call it enhancement. It implies what was there before wasn’t quite good enough, and I don’t buy that. I have lines and scars others in my neighborhood would probably get “fixed.” But I see them as a map of my life and a measure of my strength. It’s disheartening to witness our culture view the natural results of a life well lived as a flaw instead of the beauty and strength it reveals. But, I digress.

The surgery is going to be icky. Afterward, there will be a drain, and compression shorts, and butterfly sutures on the inside. No activity that engages the glutes for at least a month.

My doctor told me I was lucky because the scar will be below my bikini line so it won’t be visible. She seemed so happy about it, I didn’t have the heart to tell her the last time I wore a bikini, I was sixteen. Appearance culture gave me almost ten years longer than it did my daughter.

There are as many valid reasons for elective cosmetic surgery as there are people. But, the appearance culture is so entrenched here, it makes me wonder what it takes to resist it. To not be the eighty-year-old lady spending her money on liposuction and instead be the one playing in the sand with her grandkids. What do we need to hear as women to truly believe we are good enough? To internalize the fact that a surgical procedure is not necessary for love, acceptance, or self-esteem.

What does it take to choose our well-being over our appearance?

Instead, maybe I should wonder if the two are mutually exclusive. It doesn’t have to be a dichotomy just because Hollywood makes it seem that way.   It makes me think about the kind of strength it takes to go under the knife to take control of your appearance, and the rebellion it takes to resist and say “hell yes” to the flabby cheeks and turkey neck. Both decisions take strength and purpose. Both come with their own type of pain. I look in a mirror and I speculate about how far down my eyelids have to droop before I seriously consider a surgical “fix.”

In the meantime, I will have the medically necessary kind of surgery and suffer the same post-surgical shit without any noticeable improvement in my appearance. Except, I will get rid of my third butt.

On the bright side, I get to skip exercise for at least four weeks—under doctor’s orders.  And when I go back to have the half-moon of stitches below my bikini line removed, I will have another chance to give into the Blue Peel, Botox, or laser treatments.

Fully certified by the California Board of Barbers, of course.

-Erin O'Brien 

From the moment she got her B.A. in English, Erin turned every job she got into a writing job. Then one day she thought, hey, why not just be a writer. She writes about family, feminism, parenting teenagers, and whatever else she thinks will make you laugh, or cry, or simply ponder. She is passionate about fighting the stigma associated with mental health disorders by writing honestly about her experience parenting a child with a complex diagnosis. Her work appears in her blog at www.giginon.com  and in online publications like The Mighty and Invisible Illness