Nobody is surprised that the number of people having cosmetic surgery continues to rise. No eyebrows have been raised. Nor are people surprised that 90% of the 50，122 people treated （that feels like the wrong word， never mind） in Britain last year were women. Nobody is surprised to note this creeping acceptance of surgery， of a rise in eyelid operations， earlobe lifts， people cutting out photos of celebrities to show the doctor， and asking for a more“Winslettey” chin.

When this weeks figures were published， surgeon Laurence Kirwan commented： “We should move the discussion on from the interminable hand-wringing as to whether it is morally acceptable and just accept it. Rather like motor cars， electricity and gay marriage.” Except， the purchase of a car doesnt involve general anaesthetic and a sharp knife to the tit. Except， gay marriage is an example of the pursuit of equality， rather than thinner thighs. Except， electricity companies do not advertise solely to the vulnerable， with cheaper heating packages for the recently divorced， or those raw from childbirth. It promises lighter living rooms， rather than successful relationships， or happiness.

The rise in demand for surgery is surely at least partly a response to the way it is advertised. The seasonal promotions， the advertisements carefully targeted to fuel and exploit peoples poor body image， ads （like Harley Medicals tweet suggesting a “boobjob” as an “original Christmas present”） that normalise and trivialise unnecessary surgery， with grinning bikini models and their white white smiles.

After the PIP scandal， a series of restrictions were recommended， but one—a clampdown on advertising—was dismissed. The Department of Health instead promised to “better enforce existing codes”， a judgment that “horrified”the president of the British Association of Aesthetic Plastic Surgeons. Because it wont work. The Advertising Standards Association is reactive， rather than proactive， meaning that clinics will publish ads that they know will be banned， but， in the short time they remain up， will have paid for themselves. In December， 52% of the top Google-ranked clinics were still advertising “l(fā)uxury perks” as inducements for surgery， and 37% of the incentives were time-sensitive， to pressure people into booking quickly.

I received an email this week about Valentines Day.“More than two-thirds of women say they welcome receiving a cosmetic treatment gift from their significant other on Valentines Day，” it read， quoting a poll conducted by the Good Surgeon Guide. Its audience rated “which non-surgical treatments they would love to receive on lovers day”—the top five were： dermal fillers， Botox， teeth whitening， a skin peel and lip enhancements. Each of which says， “I love you” in its own special， “He Hit Me （and It Felt Like a Kiss）” way.

Our poor bodies. What chance do they have， pelted with all these tiny bombs？When this year Alan Sugar invested in his Apprentices “Botox empire”？When iTunes sold an app for children in which the user played a liposuction doctor？ Few of us are immune to advertising， and most of us are anxious about the way we look， and it is this combination that leads us by the hand to the lunchtime clinics， to the ends of needles. Prescription medicines are not allowed to advertise， yet cosmetic surgery is. Thats bananas. Especially when we have seen womens breasts exploding with faulty implants and can clearly plot the tension between the goal of ads （cash） and public health.

Yet nobody is surprised that more people are going for surgery. Because as it is normalised， and advertised， and as more people choose it， yet more will choose it， and any concept of an alternative—a life trying to get happier in our skin will dim. We are starting to forget.

做整形手術(shù)的人數(shù)在不斷增加，但沒有人會對此揚起眉毛嘖嘖稱奇。去年英國“治療”（“治療”一詞似乎不太合適，但不管了）了50，122名整形人士，而其中90%是女性，同樣也沒有人會對此感到意外。不奇怪，人們漸漸開始接受這些手術(shù)：眼皮手術(shù)、耳部拉皮手術(shù)。人們剪下名人的照片給醫(yī)生看，要求下頜整得更像凱特·溫絲萊特的。

這周的數(shù)據(jù)公開發(fā)表后，外科醫(yī)生勞倫斯·柯萬說道：“對整形的討論，我們應(yīng)該從沒完沒了的苦惱絕望中跳出來，談?wù)勥@在道德上是否可接受，或者就干脆接受現(xiàn)實。這個問題跟汽車、電和同性婚姻很相似?！敝徊贿^，買車不會讓你全身麻醉，不會有一把鋒利的刀動你的乳頭;同性婚姻追求的是平等，而不是更瘦的大腿;電力公司也不會專給弱勢人群推銷，不會給剛離婚或經(jīng)歷生育巨變的人提供優(yōu)惠供熱套餐。電力公司只會承諾讓你的房間更明亮，而不會說讓你贏得好姻緣，幸福美滿。

當(dāng)然，對整形需求的增加至少部分與宣傳的方式有關(guān)。季節(jié)性推銷、別有用心地對“外形欠佳”煽風(fēng)點火并加以利用的廣告、把不必要的手術(shù)正?；⑤p巧化的廣告（就像哈利醫(yī)療集團(tuán)發(fā)的推特稱隆胸手術(shù)是一份“有創(chuàng)意的圣誕禮物”），廣告中穿著比基尼的模特向你展示著明眸皓齒的笑容。

PIP事件之后，一系列限制措施被提上議程，但其中之一被否定了，那就是對廣告的收緊限制。衛(wèi)生部則承諾“加強執(zhí)行現(xiàn)有法規(guī)”。這決定“嚇到”了英國美容整形外科醫(yī)生協(xié)會的主席，因為這是不會起作用的。廣告標(biāo)準(zhǔn)協(xié)會是被動反應(yīng)，而非積極主動的，這意味著診所會投放一些他們明知道會被禁止的廣告，但在短期內(nèi)，他們?nèi)匀荒芡瞥鲞@些廣告，并能獲得回報。在去年12月份，52%谷歌排名靠前的診所仍以“奢華犒賞”作噱頭，吸引人們做手術(shù)。另外，37%的優(yōu)惠條款是有時間限制的，施壓刺激人們盡快預(yù)訂。

我這周收到了一封關(guān)于情人節(jié)的郵件。郵件上寫著：“超過三分之二的女性稱她們樂意收到另一半送來的“整形手術(shù)”情人節(jié)禮物，” 調(diào)查數(shù)據(jù)引用自《好醫(yī)生指南》。

在“你希望在情人節(jié)收到哪些非手術(shù)治療”的調(diào)查中，受訪者選擇的前五位是：皮下填充、注射肉毒桿菌、牙齒美白、磨皮和豐唇。這些整形手術(shù)表達(dá)“我愛你”的特殊方式就跟“他打我（感覺就像一個吻）”一樣。

我們那可憐的身體啊。它們還能有什么機會呢？有那么多小炸彈投擲過來：艾倫·蘇格今年在《飛黃騰達(dá)》投資“肉毒桿菌王國”;蘋果應(yīng)用商店出售一款兒童應(yīng)用，小孩該在應(yīng)用中扮演吸脂醫(yī)生。看著這些，幾乎沒有人能對廣告免疫，而大多數(shù)人很在意自己的外表，這兩個因素導(dǎo)致我們走向“午餐診所”，走到針口之下。處方藥被禁止宣傳，但整形手術(shù)卻可以宣傳。真是瘋了！尤其是看到女性胸部植入的劣質(zhì)假體爆裂事件時，我們可以清楚看到廣告（金錢）與公眾健康之間的矛盾。

然而，越來越多人做整形手術(shù)也不足為怪。因為隨著整形被正常化、被宣傳，也隨著越來越多人選擇整形，更多人將會作出這種選擇，而另類的選擇（以自己本來面目爭取快樂生活）則會消失。我們開始忘卻。