A startling account of the price to be paid for beauty has come from Helen Bransford, wife of the American author Jay McInerney.
After her husband interviewed the actress Julia Roberts - and rhapsodised on her charm and looks - Ms Bransford listened, assessed the situation, telephoned a cosmetic surgeon and underwent a complete facelift, she reveals in a book which is currently gripping the US. "I always knew there'd be a price to pay for marrying a man seven years younger than I am," she said.
The price was considerable in every sense. The cost of cosmetic surgery in the States usually starts at $44,000 (pounds 27,000). And while beauty may be the end result, the day after surgery Helen was, in her own words, a "mass of mutilation" with a face like a pumpkin.
The nausea that followed led to the terrifying prospect of her stitches being ripped out. Throwing up had to be achieved under vice-like control. Full internal recovery from the surgery took around eight months. The account of what happened includes pictures of the aftermath in which she is completely unrecognisable.
Helen, now 49, thinks she would not have had it done if she lived in England. "It's pretty ridiculous, this obsession with youth and beauty in the States," she said from the couple's New York home this week. "I think in the States it's really gone beyond the pale. In some parts of the country, like California and New York, the standard of women's self- maintenance is so high. The technology is here and it's awfully tempting. But I don't think this would have occurred if I lived in the Cotswolds."
To British ears, the story told in Welcome To Your Facelift sounds slightly unnerving, conjuring up visions of the 1975 film, the Stepford Wives and its passive clones of real women. Those who had met Helen Bransford before her transformation two years ago tell of an attractive redhead with the kind of lines you expect of a woman in her forties.
But she said in explanation: "My husband is seven years younger than me. I had had massive sun exposure. Suddenly at about 46, 47, I didn't recognise myself in photos."
Jay, who joined the elite of literary hell-raising with his first novel, Bright Lights, Big City, about drugs and decadence in New York, was horrified when she told him what she planned. But when she emerged looking like a classic American beauty, they were both delighted.
"I achieved what I wanted - I set the clock back a little and it seemed to close the age gap.," she said. "And he's thrilled with it. My husband has a lot of younger friends - there's often a 20-year age spread. There was probably never a problem, but now I'm much less self-conscious about it."
Helen says she "couldn't give a crap" what any feminist might say. "I think they have misled a lot of people in some ways. Nobody brushed their hair before hairbrushes, but once you've got a hairbrush available to you, you do."
Despite her reservations about the American cult of beauty, she is now much in demand to discuss going under the knife. The book came out in America in June and has been a steady seller since. In addition to relating her own experiences, it contains advice on how to find your surgeon, preparing for the operation and what to do afterwards. There are no plans at present to release it in surgery-sceptical Britain.
Helen, who also designs jewellery and has two-year-old twins, said her self-confidence had soared and she is less concerned with her looks than before because she is happier with them. "I assumed there would be some cosmetic improvement but I didn't know I would feel so much better," she says. "Nobody is whistling when I walk down the street, but I feel I'm doing the best with what I have and to heck with it."
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