Last Night's TV - The Ugly Face of Beauty, Channel 4; Between Life and Death, BBC1; The Fairy Jobmother, Channel 4

Naked truths cruelly exposed
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The Independent Culture

If it was just a bit more flatter it would look much more better," said a 17-year-old woman in The Ugly Face of Beauty, explaining why she hankered after a bit of liposuction. If you spent a bit less time reading Hello! magazine and a bit more time doing your Eng Lang homework, I thought, you might sound a bit more cleverer, but it's possible I was missing the point here. She was hardly alone in thinking that appearance counted for more than content, with many of her peers explaining that they too would have cosmetic surgery if they could only afford it. The Ugly Face of Beauty, a four-part series on Channel 4, is ostensibly intended to discourage them, with its horror stories of botched operations and sharp practice. Curiously, though, this discouragement was presented in the form of an encouragement. "I'll explain how to become a much savvier shopper when it comes to changing your body," said Dr Christian Jessen, the Nordic hunk from the Embarrassing Bodies series. Not "don't do it", then, but "just make sure you get good value for money".

As with Embarrassing Bodies, there's a bit of an exposure-for-treatment deal going on here, with women revealing the gruesome results of cowboy surgery in return (I take it) for getting the expensive operation that will put things right again. So, Rachel, who wanted enlargement and uplift but got sag and distortion instead, flashed her strange, sock-puppet breasts to the nation as part of the necessary cost of restoration. That was for later, though – a gruesome surgical money shot to cap the programme off. First, we got secret-camera work of the clinics performing their most important operation, which is getting the client to sign on the dotted line as quickly as possible. Using the same techniques – limited-period special offers and transformation on the never-never – a fake clinic set up by the programme in Southend High Street persuaded a string of people to sign up for surgery they knew virtually nothing about.

In Spain, meanwhile, Wayne Rooney's cousin Natalie was confirming the family reputation for analytical intelligence by undergoing surgery to give her a double J-cup. In the teeth of her surgeon's advice, she also insisted on liposuction, despite the possibility that it could leave her with a stomach like the rough side of a Ryvita. "I'm sure if it goes wrong I'll just ask him to pump the fat back into me," she explained. Natalie, at least, was presented as a person who may have psychological problems, but elsewhere in the programme there was a curious sense that cosmetic surgery isn't inherently ugly but only depends on the results you end up with. "If I knew then what I know now," said Rachel at the end, showing off her repair job, "I would definitely be looking for the higher end, paying an extra £2,000 just to ensure that I was having the best." So, an advert for the premium brand, not a serious questioning of the product itself.

Nick Holt's excellent film Between Life and Death offered a more admirable view of medical expertise, spending time in Addenbrooke's neurointensive care unit, where patients occupy the "grey area" opened up by modern medicine. It is a place, paradoxically, where loving relatives hope that there won't be signs of hope when they come to do the scans, so fearful are they of the medical limbo into which a coma plunges both patient and family. "He would not wish to survive and we would not wish him to survive with this degree of injury," said the father of a young man injured in a motorcycle accident. Astoundingly, though, Richard's eyes flickered meaningfully in response to questions from his doctors, and they felt they had to wait to find out whether there was a person still in that paralysed body to take a view on its treatment. There were no miracles here. A lovely young girl, also the victim of a road-traffic accident, never recovered, and Beckii, the mother of three young sons, finally left hospital in a "minimally conscious state". But the last shot of Richard – eyes alight with pleasure at the presence of his family around him – underlined the fact that what you think you can bear in advance of an accident may bear no relation to what you will put up with after one.

Hayley Taylor, the Fairy Jobmother, is a bit like Pauline, the restart officer from The League of Gentlemen, approaching the jobless with upbeat mantras and slightly childish visual aids (a road map titled "Hayley's Drive to Life"). But where Pauline was malign and undermining Hayley is tender-hearted, encouraging and briskly effective. When Dean whined and whinged that his unemployment was everybody's fault but his own, she didn't see exasperating fecklessness – she saw fear of failure, and she soothed it away in a briskly maternal manner, transforming his resentful hoodie hunch into something close to upright posture. He got a job anyway, and – more to the point – he still has it. Set alongside a film like Between Life and Death, The Fairy Jobmother could easily look like the terminal decay of the serious documentary. In fact, it effectively smuggles a lot of education and information inside the boilerplate, can-do narrative arc. Did you know that one reason the jobless are so reluctant to take a chance on short-term jobs is that you lose your benefits as soon as you get work but it will take six weeks to get them restored if something goes wrong? Quite a gamble when you can't afford to lose.

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