‘From the moment she noticed the first little line around her eyes – that herald of old age – poor rich Mrs. Clingsland sank into a profound melancholy. With tears streaming down her face, “looking like a martyred saint”, she solemnly announced to her masseuse: “My beauty, Cora – I saw it suddenly slipping out of the door from me this morning.”’ Thus begins The Looking Glass by Edith Wharton, one of my favourite stories about beauty. Cora, the narrator – masseuse, beautician and fraudulent clairvoyant – taken aback by the dramatic reaction of her employer, ‘well passed fifty’ first paused to reflect, then boldly concluded that for ‘thousands like us, beginning to grow old is like going from a bright warm room to one a little less warm and bright; but to a beauty like Mrs. Clingsland it’s like being pushed out of an illuminated ballroom, all flowers and chandeliers, into the winter night and the snow.’
Realizing that compliments were short-lived and would do little to restore her employer’s confidence, Cora decided to resort to her psychic powers. She began conveying to Mrs. Clingsland passionate love notes supposedly sent from beyond the grave by a former suitor, who had gone down on the Titanic before their romance had the chance to blossom. Revived by the dead lover’s honeyed words and deeply moved by his extravagant praises of her beauty, Mrs. Clingsland swiftly transformed from an insufferable mourner into a radiant rose, ready to hurl all her jewels rapturously into the ocean.
The story contains several further melodramatic twists, but its message is essentially simple: beauty is a construct that we have internalized as a sense of self-worth. It is all the more interesting that it was first published in 1935 in Cosmopolitan, the most famous women’s magazine, which historically played a significant role in reinforcing that very construct. Still, my interest was not sparked by Mrs. Clingsland’s longing for external validation, which is expected and understandable, but by the fact that she accepts it quite naturally from a dead man. Death and beauty are indeed connected in the most obvious way: death is the terrifying flipside of beauty. Everything that signifies beauty – youth, health, vitality – is precisely what death ruthlessly undoes. Yet Wharton’s story was, for me, a signpost toward some of their more bizarre encounters.
***
If I had to illustrate my aging through the language of electrical installations, unlike Mrs. Clingsland, I would sooner classify it as a contemporary dimmer than as a standard light switch. My lighting is ambient, and my melancholy, I like to believe, is purely generational. But that does not mean I am not afraid of the dark. ‘What’s wrong? You look sad,’ my hairdresser Coco recently remarked, while highlighting my hair. I glanced at myself in the mirror. A goth office siren. A sad girl, but the grown-up version. ‘Nothing, I’ve always looked like this,’ I replied defiantly, realizing that I found this aesthetic self-diagnosis oddly flattering. ‘All the worse!’, cried Coco. ‘Thanks,’ I said, rolling my eyes. ‘Look, it can easily be fixed,’ she continued, quickly identifying the critical points: two short vertical lines between my eyebrows (the result of a permanently critical attitude toward the world) and two nasolabial folds (bad genes). ‘You could also plump up your lips a bit, but that would only make you look sadder.’ My heart skipped a beat, I admit – after all, LDR is my favourite singer.
Coco herself had already done everything she was suggesting to me – and much more. Coco is a dazzling platinum-blonde know-it-all – a Pam A., the Balkan version. It was at her salon that I first saw filler injections, felt silicone implants (in her breasts, of course), and learned that a black eye can be the result of a recent blepharoplasty, rather than the common sign of domestic violence – from which I once clumsily attempted to liberate one of Coco’s clients with my well-meaning advice. She eventually cut me off and, rather emotionally, remarked that her husband was in fact a wonderful, quiet man who had, moreover, paid for her new eyelids. Oops! In any case, Coco was an informed enthusiast and an enthusiastic practitioner, and I readily put myself in her hands.
***
All of Coco’s procedures had been performed by a certain Dr. Ruža, an established specialist in aesthetic surgery, who carried out small corrections in the small hours for friends and friends of friends in a gynecology practice not far from Coco’s salon. The gynecologist whose clinic Dr. Ruža used for her side-gig surgeries pretended not to know anything about it. Dr. Ruža could not be contacted directly; you needed an intermediary. Coco. I know, 🚩🚩🚩!!! Desperate, I turned to the internet. As expected, Dr. Ruža had no social media presence, but her numerous medical triumphs were easy to find:
1) Ruža once successfully solved the medical mystery of a five-year-old girl’s foul breath, caused by an amorphous piece of black rubbery substance of as yet unknown origin that the child had inhaled while her parents were observing a solar eclipse. Dr. Ruža removed the foreign body just in time, preventing the child’s imminent poisoning. (See: Fig. 1).
Fig.1. An amorphous piece of black rubbery substance as yet of unknown origin. Courtesy of the author.
2) Ruža performed, with astonishing precision, a complex replantation of a hand amputated by a rampaging rope on an amateur Czech alpinist. The hand remained permanently stiff, which was considered the best possible outcome, prompting him to devote his life to his other passion: sausage-making. OK!
Also, Dr. Ruža once shared in an interview that she had been a goth in high school, planning to become a pathologist. This impressed and reassured me. (An autopsy table surely sounded worse than an illegal gynecological chair). For me, Dr. Ruža became the embodiment of medical excellence and expertise, my sole medical reference point, my Dr. Robby.
***
Let me be clear: before I decided what I was going to have injected into my face – the bare minimum, baby botox and baby filler – I made sure to inform myself responsibly. I researched what to watch out for: first and foremost, the qualifications of the chosen practitioner (🩺🌹, ✅, 🙏), then the dose and type of botox (i.e., the manufacturer of botulinum toxin type A), and the hyaluronic filler (I used those most popular in Croatia: Vistabel and Juvéderm). The risks of these procedures are generally minimal (but not non-existent!), and botox is about as popular as a manicure. For example, an elite event organized in the third season of the reality show Selling Sunset in 2020 by (my personal favourite) real estate agent Christine Quinn, titled ‘Burgers and Botox’ – which, as you might guess, involved touring a luxury villa with free injections and burgers for potential buyers – today, in various forms, has become a main attraction at bachelorette parties or milestone birthdays after thirty. Botox parties, for many millennial women, are what Tupperware parties were for boomers: domesticated ‘emancipation’. Treatments are done while drinking with friends at home, at significantly lower prices than in clinics. But the procedures are carried out by various dilettantes (sometimes even the partygoers themselves!), often using uncertified products – a cocktail guaranteed to give you a headache.
My TikTok algorithm flooded me with terrifying images of unruly fillers migrating from lips into chins, cheeks and foreheads; pictures of drooping brows and distorted smiles. The girls’ heads swelled as if they had gorged on wild yeast, wandered into a wasp nest, as if they just might start singing from the radiator. Luckily, the consequences are mostly reversible. Just remember the playboy Christian Troy whom the gangster Escobar vengefully stabs with Botox injections in the pilot episode of Ryan Murphy’s Nip/Tuck; the poor man’s face and groin (ew!) remain painfully curdled until the end of the episode, but he goes on to live a potent and smooth life for six more seasons. I sighed with relief: it seemed that the darkness I feared was, in my case, only an eclipse.
***
Lest you suspect my knowledge is limited to TikTok and reality TV (which I unironically consider quite useful, if only as a reality check), or to literature, I feel compelled to legitimize myself with SCIENCE – the sacred pillar of modern civilization. Alongside countless medical articles pointing to the various risks associated with botox use (some already cited in footnotes: the one that startled me most being a study suggesting that botox diminishes our ability to emotionally engage with literary texts – to each their own priorities!), I also became interested in how it found such widespread use in the first place.
Los Angeles Review of Books – a (literary🤷♀️) magazine whose critical judgment I generally trust – enthusiastically recommends Death to Beauty: The Transformative History of Botox, a recently published book by the distinguished American ophthalmologist Eugene M. Helveston, who himself participated in some of the earliest clinical trials involving botulinum toxin type A. Unusual, you may think, but not impossible, given that Dr. Helveston was no less than ninety years old at the time of the book’s publication. According to him, two physicians were crucial to the history of botox: Justinus Kerner and Alan B. Scott.
***
In 1817, Justinus Kerner began one of the first scientifically grounded investigations into deaths caused by contaminated blood sausages. To clarify, botulinum toxin is produced by the bacterium Clostridium botulinum, widespread in nature. In anaerobic environments and at suitable pH levels, bacterial spores germinate, producing a toxin commonly ingested through food.
In Kerner’s time, one of the more popular dishes was, as you might guess, blood sausage. In the period following the Napoleonic Wars, Europe faced food scarcity, and these sausages became an efficient way to use every part of the deceased (sic!) animal, as well as an important source of iron and calories for a largely malnourished population. Sausages were typically stored at room temperature and were not adequately heat-treated (prolonged boiling was often avoided because it could cause the casing to burst; and apparently the English drew the line at bolognese for breakfast.) All of this created a safe space for the growth of this deadly bacterium.
The toxin acted quickly and insidiously. The victim would suddenly appear suspiciously lethargic, with a blank, expressionless face – much like an unengaged reader! Yet beneath the blasé exterior, fully conscious, they would slowly shut down. First, the eyelids would droop, vision would blur and double. Then swallowing and speaking would become increasingly difficult. And once the paralysis reached the lungs, they would meet a miserable end by suffocation. There were so many such cases that an epidemic was initially suspected, but the sceptical Kerner tested countless sausage recipes, examined more than a hundred patients, and killed who knows how many innocent animals in experiments before concluding that the culprit was, indeed, a biological toxin. It was only when he placed a drop of the poisonous sausage fat on his own tongue, which immediately went numb, that he realized the toxin could have medical applications.
Kerner’s prediction came true, but only a century and a half later, in the self-financed laboratory of the Californian ophthalmologist Alan B. Scott, who attempted to use the toxin to treat strabismus. Injecting a lethal substance into the eyeball did not initially impress the U.S. Food and Drug Administration (FDA), but Scott’s dedication and vision eventually resulted in what we now know as botox. Indeed, botox works by temporarily blocking nerve impulses to the muscles, thereby preventing their contraction, and today it is used across various fields of medicine, from ophthalmology and neurology to, of course, aesthetic medicine.
***
It is worth noting that Justinus Kerner was also a renowned Romantic poet. Naturally, for the purposes of this research, I read his complete oeuvre available in English, though the only thing worth mentioning here is that it is quite likely that Kerner, too, was prone to mournfully gazing at his reflection in the mirror – it was, after all, the golden age of sad literary boys.
As for Helveston, had I not known he was a doctor, I would have assumed he was a gourmand with unmistakable literary ambitions and an impressive talent for navigating Medical Wikipedia. The sections of his aforementioned book devoted to medical research and procedures are indeed as sharp as if written with a scalpel, but the rest is overflowing with absurd digressions that read as though they were written by John le Carré and Martha Stewart – together. After several chapters unnecessarily devoted to the Second World War – which, while perhaps not unhelpful to revisit in the current global political climate, are rather irrelevant to the history of botox – I decided to google the doctor more thoroughly. And I was right: he had also written several spy novels!
The cookbook, for the time being, remains unwritten – a pity. In the chapter on the history of food preservation and the importance of its standardization in preventing botulism, Helveston gives particular attention to the menu of one fatal banquet. In 1919, an unusual case of mass poisoning was recorded at the Lakeside Country Club. Seven people died from contaminated olives. The disaster was inadvertently set in motion by Mrs. Helen Sebring Gahris, a respected member of the local high society, entrusted with arranging the table for the evening’s most distinguished guests. Unlike the other hostesses, who served green olives, celery and pickles, followed by stuffed turkey with tomatoes and mayonnaise, scalloped corn with pimento, and ice cream and cake for dessert, Mrs. Helen Sebring Gahris decided to go all out: in addition to nuts and candies to snack on, she replaced the ordinary green olives with exotic black ones. One of Gahris’s honored guests was a decorated war veteran who had only just returned from the horrors of the overseas trenches, unaware that he would soon be undone by an unassuming Mediterranean bite. Several survivors later claimed that the victims spat up clumps of black, strange-smelling matter. Fortunately, Mrs. Helen Sebring Gahris’s ambition was never regarded as manslaughter, though I can easily imagine her, humiliated and in tears, running to her beautician for consolation.
To conclude this digression: science and literature seem to be heroines of the same story. I felt that my research had thereby come full circle, and I knew I was ready for Dr. Ruža.
***
Coco greeted me at the salon with a couple of Skinny Bitches and blasted Severina and Sajsi MC’s Silicones – ‘for courage’. I told her she was being trite and literal, and she retorted I was being a smartass. Chin–chin! The women waiting for their appointments stared at us in justified horror, awkwardly peering over their fashion magazines. Still, they readily joined the toast to my new face. We left them slightly tipsy under the hooded dryers and hurried off to Dr. Ruža’s.
In the sterile waiting room we joined a small group on vitamin drips: one straight couple, one gay couple, both middle-aged, both in extraordinarily good spirits, ‘hihi, haha’, both had recently recovered from the flu, nothing serious; Dr. Ruža had infused them well and good, ‘hihi, haha’, the gays had also recently had botox, can’t you tell, you definitely can tell, ‘hihi, haha’, what’s in that drip exactly, I wondered, ‘hihi, haha’??? We were interrupted by Dr. Ruža herself – cold and blonde, refined, porcelain, exactly as I had imagined her.
She drew breath to speak, and I froze, delighted, anticipating something somber, resonant – a cello, a tuba, Cate Blanchett, or something – but instead a tiny songbird twittered: ‘Happy birthday to you, happy birthday to you…’ She waved (fluttered?) her arms, trying to animate us: ‘louder, louder’, she gestured. ‘She must have seen Tár,’ I thought. ‘Is this Black Mirror?!’, I thought next, but sang along anyway – what can you do. The cake was brought in by a jubilant birthday girl – Dr. Ruža’s nurse. Only one candle was burning; in this clinic age doesn’t count, there could have been thirty or fifty of them, as far as I could tell. Good job, Dr. Ruža. ‘Happy birthdaaaay, dear Elaaaa’ – the drip ward roared. Everyone knew her name; how touching, how familiar, I noted, and I had never felt cozier in a gynecologist’s office. ‘Happy birthdaaaay to yoooou’ – Dr. Ruža drew out the final line herself; she had to have the last word.
***
Ela froze my face with anesthetic cream; the closest I had ever come to tasting a botulin sausage. Dr. Ruža noticed my restlessness and turned her full attention to the atmosphere. She darkened the room, lit a scented candle, put on soft music, and then took out two silicone implants. I couldn’t move my face, so I began to blink in panic. ‘I use these instead of stress balls,’ she explained. ‘Is she flirting?’, I wondered, ‘I hope so.’
She pulled on her gloves and said calmly: ‘No one has ever left here a monster unless that’s what they came for,’ then drove the needle straight into my forehead. She was decisive, precise and oddly passionate. She pierced me quickly and lightly – across the forehead, around the eyes, the nose, the lips, down the neck. The stings weren’t painful, just irritatingly tiny; I imagined a colony of bloodthirsty ants swarming my face. ‘It’s dark but just a game,’ Dr. Ruža hummed along to LDR from the speakers, but I wasn’t scared. Her eyes glittered with delight – she was clearly pleased with her work.
***
I looked relatively unchanged, only fresher, as if I had finally found time for a proper vacation. What followed surprised me somewhat. In a few social situations, while desperately trying to liven up stale and shallow conversations, I announced that I had had botox. And I regretted it. Many of my girlfriends reacted with shock, as if they had just witnessed a sudden and dramatic drop in my IQ, and some were even openly appalled, as though I had told them I was casually shooting heroin. I could understand it – in the feminist cultural bubble I usually move in, aesthetic procedures are still largely reserved for reality TV stars and turbo-folk celebrities, and resistance to the oppressive beauty system, however inconsistent, is a matter of political integrity. Fair enough. Beauty has indeed always been a patriarchal construct designed to discipline women+. The packaging has changed, but the product has remained more or less the same. There is no debate about that.
To speak meaningfully about beauty today, in the words of Jessica DeFino – the Guardian’s beauty columnist, whom I consider an absolute authority in this field – is also to engage with the concrete ways in which it is inscribed into our bodies. This includes the beauty industry: skincare, cosmetic treatments, botox, aesthetic surgery. All of these are, as a rule, unnecessary and serve to sustain a system, which not only produces them but produces them as a need. Yet this need is not an individual weakness or vanity but a fundamental political issue.
***
To be fair, many of the women did try to compliment me, saying I looked good because I hadn’t gone overboard; if I hadn’t told them, they wouldn’t have noticed. It haunted me. Should I have kept quiet, pretending I woke up like this? I can look in the mirror again, but I am fairly sure I won’t see Beyoncé. I know they meant puffy, soggy, dough-like faces. Sausage lips. Ducks. Filler fatigue: a condition caused by prolonged and excessive filler injections that gradually stretch and weaken the facial tissue. The filler craze peaked about a decade ago, when beauty trends dictated that we should all look voluptuous and pouty. Everyone wanted to be a sexy baby, and these are the consequences.
The only ones who have not aborted them, logically, are American Republicans. A viral photograph of Karoline Leavitt, the current White House press secretary, taken by Christopher Anderson for Vanity Fair late last year, cemented the idea of a ‘Republican face’ in the public imagination. In close-up, we see fresh, stubborn filler injection marks, enlarged pores, bad makeup. Leavitt’s foundation is chalky, a recognizable orange tint; the blush is an aggressive pink, and the eyebrows two heavy strokes of permanent marker. High contrast for low blows. But this is not bad drag. The Republican face is a class performance, a demonstration of status: of money, time and effort this woman can (and every woman should, but cannot) invest in the production of her own femininity.
On the other side of the political (though not class) spectrum, we encounter what Anne Helen Petersen has called ‘resting rich face’. It is the facial equivalent of quiet luxury: a face that is visibly well cared for yet still appears natural. The priority is a healthy look and no-makeup makeup, a visual minimalism clearly underwritten by maximal resources.
The most extreme manifestation of this trend is the recent craze for the newest facelift techniques. It was kicked off by Lindsay Lohan, stepping onto the red carpet with a face shinier than all the morgue floors she had polished during her community service. But it was Kris Jenner who truly broke the internet when she appeared in Paris last May with a face so unnaturally rejuvenated that the whole of Chinese Gen Z replaced their social media profile pictures with Jenner’s youthful image, hoping to manifest happiness and prosperity in their own lives. I cannot resist noting that this was the closest anyone has ever come to Greta Garbo’s face, as described by Roland Barthes in his famous Mythologies as ‘an admirable face-object’. Jenner reassured the youth with her iconic motivational message – ‘you’re ALL doing amazing, sweetie!’ – while her PR team was forced to explain to the public how this miracle had occurred.
Such transparency was unthinkable until recently. As late as 2024, we could still watch two sweet, glazed doughnuts – Zac Efron and Nicole Kidman – fall in love in A Family Affair, while sharing their medical traumas on a sofa. Ridiculous casting, given that the surgical procedures their characters undergo amount to two mere stitches on the chin and a minor scar on the hand. Kidman, incidentally, is a favourite target of acting purists who claim cosmetic procedures have irreversibly damaged her talent. Yet, unlike many of her colleagues whom Hollywood ruthlessly discarded once they turned fifty, she has managed to brand her tightened face. In Babygirl, this is also indirectly addressed: Botox injections are explicitly shown and become a key element of the image and success of the troubled executive Romy, whom Kidman portrays.
I cannot claim that celebrities’ transparency about cosmetic procedures is particularly empowering – by my calculations, it would take me roughly a hundred years at my current income to afford Kris Jenner’s face, and by then I would likely be in greater need of a comfortable burial plot – but it is at least somewhat comforting, reminding us that alongside ‘good genes’, it also helps to have a good surgeon.
***
In enormous glass cylinders, naked corpses float, astonishingly symmetrical and eerily well preserved. ‘To call them donors is crass’, the doctor explains. ‘I call them my epidermis angels. Beautiful people, who left the earth far too soon. And who were so generous as to pass along their good fortune to others.’ The doctor will soon begin to butcher them – removing smooth skin, a straight nose, round breasts, a symmetrical face – and transplanting them into the living. Beauty, he says, should not be ‘wasted on the dead’.
A lot of dead bodies have made an appearance since the beginning of this text, and these ones come from Ryan Murphy’s latest series The Beauty. It is conceived as a dystopian satire, but it is closer to reality than you might think. Fear not – so far, Bella Hadid has only exploded in the show, but there is a good chance that in real life she has already tried the latest beauty trend: necrocosmetics.
In aesthetic surgery, parts of donor tissues and organs have long been used for reconstructive purposes. Skin from cadavers, for instance, is transplanted in cases of burns or severe accidents, as with Dr. Ruža’s alpinist. However, when it comes to cosmetic procedures that are not medically necessary, autologous transfers have been the norm until now. Most commonly, this involved fat extracted via liposuction from one part of the body and injected into areas where more volume was needed: the lips, breasts, buttocks, or biceps.
But a recent phenomenon is zombie fillers: the latest injectable treatments made from transplant-grade adipose tissue from dead bodies, lab-processed and stripped of DNA. They are used to fill the cheeks, nasolabial folds, cellulite, as well as for breast augmentation, or buttock enhancement. Over time, they fuse with the recipient’s body, and the procedure itself does not require general anesthesia or a long recovery period. It takes less time than an average funeral.
***
Finally, I would like to return once more to Dr. Ruža’s clinic, and to its waiting room, where something inexplicable occurred, which I have so far failed to mention. When Dr. Ruža turned off the lights for Ela to make a wish and blow out the candle, the room suddenly lit up with an eerie bluish light. We were not left in darkness. I looked around and saw that we were all emitting an uncanny glow: Ela, like a shy firefly; Coco, like Edward Cullen on a beach; and I, a dead fish in moonlight. It seemed I was the only one who noticed it. Strange. I thought of Anne Carson, who wrote: ‘A wound gives off its own light surgeons say. If all the lamps in the house were turned out you could dress this wound by what shines from it.’
To see light in darkness, I thought, may in fact mean recognizing this is our darkest hour. What am I even doing here? Am I just a more self-aware version of Mrs. Clingsland? Probably – and without the bluish jewels. But one thing I was certain of: should botox someday turn me into a disgusting monster, like Demi Moore in The Substance, I will still carry my monstrosity with dignity. After all, I am writing this text from the tangled relationship I have with my body. ‘I write to find out what I think about something,’ Anne Carson has also said. So do I. I write to see whether I can, short of escaping my contradictions, at least write them out beautifully. That, in the end, is all the validation I need.