Farah Khan, by contrast, has become a hero to some after owning up to post-pregnancy surgery of the sort Dr Arolkar says is increasingly popular: the ‘mommy-make-over’. Khan started as a choreographer before becoming one of Bollywood’s biggest producer-directors (with blockbuster credits including Om Shanti Om). Though she has appeared on screen, Farah is not the type to be seen in hot pants or tiny sari blouses, as Bollywood’s impossibly lithe starlets tend to. Rather, her figure is more like the average woman’s. Usually undertaken by women who want no more children, the ‘mommy-makeover’ comprises one or more procedures designed to counter the effects of pregnancy and active motherhood.
A few years after giving birth to triplets, and after researching the procedure thoroughly, she decided the hanging tummy she was left with and which dieting and exercise had failed to budge would have to go. When I spoke to her, her openness about double standards and women reclaiming their bodies after having children was refreshing. One of the ‘problems’ of being a celebrity is the back catalogue of available photographs that provide the media with ready-made ‘before’ and ‘after’ comparisons.
Women do come under far closer scrutiny in this respect than men. Even when some of Bollywood’s favourite male actors fall prey, they usually get off with the odd mentions of wrinkles filled. In India, as everywhere else, women’s bodies are perceived as fair game, hotness before childbirth mutating into mummy yumminess after. But, as Farah has often stated, ‘There is nothing to hide.’
Celebrities who stand up for themselves post-surgery in the press or social media are still relatively rare, but they do exist. Actress Anushka Sharma spoke out recently ‘to end the noise’, as she put it, after a barrage of tweets criticising her newly augmented lips. ‘I felt bullied. I didn’t know that people could be so mean,’ she told the newspapers. ‘Some of the stuff was quite funny but some of it was such pure vitriol that I cried. It’s because we don’t reply to them that people think they can get away with anything. I didn’t think I had to inform the world before getting my lips enhanced. It’s my body and my decision.’ In 2015, Shilpa Shetty (actress and star of Celebrity Big Brother in the UK) also admitted to having had four nose jobs; and the legendary Zeenat Aman came out publicly in support of cosmetic surgery in general. ‘To each his own … I’m in favour of it,’ she said.
Where Bollywood stars go, everyone else follows, from the older generations to what Dr Arolkar calls ‘nubile teenagers’ who want ‘dream’ bodies. But it’s no longer just about the more complex surgeries allowing women (and men) to emerge with better breasts or smaller waistlines. The cultural change Dr Arolkar had described to me had also, in recent years, extended to an explosion in what he called ‘office-procedures’ – faster, easier, cheaper and less risky quick fixes that take minutes instead of hours.
‘Once you look good, you only want to look better. Human nature! If something is available and affordable the beneficiary of a previous cosmetic procedure hankers for more. So people are opting more and more for these – like lasers for quick fixes, Botox and fillers.’
The first dermal filler approved for cosmetic use was collagen derived from cows. That was in the USA in 1981, since which time dozens of laboratory-made injectable filling agents have been developed. Botox was first used in Canada in 1992 and the big boom in ‘office procedures’ started building in India around a decade later. Today, with China, India has the fastest-growing market in Asia for such off-the-shelf cosmetic work.
I decided to meet a doctor who had filled, layered smoothed and sculpted Mumbai’s elite without ever lifting a scalpel. As my taxi pulled up outside her Bandra apartment on a pretty, tree-lined street, Dr Rashmi Shetty waved to my daughter and me, guiding us up from her second-floor balcony. Around forty, with clear skin, lustrous black hair and a conventional Indian beauty, she could easily be mistaken for an actress or model herself, an image which must also have been an excellent advertisement for her own practice.
Though she had been an accomplished dancer, Rashmi’s real talent was in medicine. I had been corresponding with her by email, trying to find a time when she wouldn’t be studying for further professional qualifications, writing articles for medical journals or lecturing at national or international conferences and seminars. We’d managed to find a slot and met over breakfast. Disarmingly friendly and whip-smart, she made the interview feel more like a relaxed conversation with a good friend than a rushed session with a woman who had everyone who was anyone in Bollywood knocking at her clinic door.
‘I always wanted to be a surgeon,’ Dr Shetty began as we, and our daughters tucked into aloo parathas and chai. ‘I got into general surgery and my initial postings were in plastic surgery – that’s where I started liking tissue reconstruction, realising how we can put a face back together in a beautiful way. I realised how important looks were to people. To a patient, that small mark on a face could be a reminder of abuse, or a burning, or a disease. For many people beauty is not just vanity. The way you look can change your whole life course.’
As Rashmi recounted stories from her surgical training and of her voluntary work for Smile Train – a charity providing corrective surgery for children with cleft lips and palates – she also alluded to the rapidly growing appetite of Mumbaikars for cosmetic surgery. Fourteen years earlier, when she stopped working as a surgeon proper and first set up as an ‘aesthetic physician’, ‘I sat there for six hours a day and not a patient turned up. So gradually I went down to two hours a day on alternate days,’ she said. ‘A few years later patients started spilling over. I never advertise, I don’t even have a board outside my clinic. Now, I see up to sixteen patients a day. A consultation takes twenty minutes and the treatments, if they decide to have one, take twenty minutes to an hour.’
Rashmi’s clientele includes some of Bollywood’s biggest names, male and female, and they have not been shy in praising what ‘Bollywood’s favourite aesthetic physician’ has been able to do for them. On the ratings-topping chat show Koffee with Karan, Rakhi Sawant, a Mumbai celebrity best known simply for being famous, declared, ‘My doctor is Rashmi Shetty … as they say, what God didn’t give, the doctor gives instead.’ ‘But that was at the time I did her face,’ Rashmi clarified, laughing. ‘Now she has had other procedures done – not my work.’
Even those willing to admit to cosmetic procedures seem reluctant to go into detail. Shilpa Shetty (no relation), wrote about how she trusted Rashmi’s knowledge of skin; Sania Mirza, a world number one women’s doubles tennis player, praised her for producing results that other doctors couldn’t; and Anita Dongre, one of India’s best known fashion designers added, ‘What kept me from going to aesthetic doctors was my apprehension for anything invasive and drastic. [Rashmi] just fixed me with the least that there can be.’ There are many, many endorsements in this vein, but needles don’t get a single mention.
Such vagueness is perhaps intended to maintain a myth of beauty naturally enhanced, rather than medically manipulated. Ethically, of course, Rashmi could disclose no individual details, but her website makes clear the procedures on offer, ranging from simple skin treatments such as laser and retexturing to fillers that would pump up lips, sculpt facial features and iron out wrinkles, plus, naturally, Botox and treatments for baldness.
I visited her clinic in nearby Santa Cruz, where Rashmi told me about the ‘vampire facelift’ – a bizarre procedure familiar to some from the ‘after’ shots of their blood-smeared faces posted online by both Kim Kardashian and Israeli model Bar Refaeli. The procedure uses the patient’s own blood, separating out the fraction containing the platelets, growth factors and stem cells and then injecting what’s left into multiple sites on the face. The initial result is a gruesome mess, but it remains a favourite of celebrities in the West, allegedly helping the body to repair itself, rebuilding collagen and thus rejuvenating the skin. I couldn’t imagine any of Rashmi’s Mumbai celebrity clients showing off their bloodied and swollen faces so freely; that would hardly
fit the immaculate image most Bollywood actors project, even if the procedure is helping them maintain it.
As it turned eleven a.m. the influx of clients began, and while Rashmi juggled consultations and preparation for medical procedures with perfect ease, I sat in her waiting room and watched the passing show. As I leafed through the coffee table magazines in the waiting room, admiring yachts, poring over the articles in Millionaire Asia, dermatology journals and women’s magazines, a receptionist offered me a patient form to fill in. ‘Oh, I’m just here to interview Rashmi,’ I explained, as she apologised and took the paperwork away. I can’t say it wasn’t tempting: at thirty-nine, I was probably already nearly two decades older than some of her clients and after looking at images of what filling, sculpting, lifting and plumping could do I had started to see things wrong with my face that I hadn’t noticed before.
Perhaps it was due to watching those droves of people come and go as if they were simply visiting a dentist or a hairdresser, that the whole thing was starting to appear completely normal. I took a moment to post a status update on Facebook about how easy it would be to have some filler. If there had been a ‘dislike’ button, it would have saved my friends the time they took to write lengthy comments asking whether I’d gone mad and pleading with me not to do it.
My temptation (which I conquered) clearly wasn’t an isolated one – I had first come across Rashmi while reading an article in the Times of India headlined ‘Mumbai’s got a serial cosmetic surgery club’. As the headline suggests, it reported how the quest for the Bollywood ideal of bodily perfection had become all-consuming, both inside and outside the industry. I had noticed that many of Rashmi’s clients were middle-aged women, presumably in search of rejuvenation. Surely, though, there must be a downside?
‘People understand the risk, yes, they do, but they say let’s go ahead and do it,’ Rashmi told me. ‘The next woman from the party has become thinner, let’s do it. Thin is very desirable – to the extent that women try to get into their teenage daughters’ clothes – but older women need a fat percentage: your overall weight distribution changes with age. But they all want to maintain a waistline. We are fighting the natural [ageing process] – they cut down on carbs so much they come to me with hair falling out, with dark circles under their eyes …’
I could see how it could easily become a vicious circle and how quick-fix procedures would become desirable, even necessary, to people whose lives were not lived in front of audiences of hundreds of millions.
‘My patients are mostly from the film industry, but there are also bank employees, teachers, housewives – today everyone wants to look beautiful. I have lots of male patients now too. Before, if there was one scratch to their car men would get annoyed, yet they didn’t seem to care about how they themselves looked,’ Rashmi joked.
Indeed, though I didn’t see any men in Rashmi’s waiting room while I was there, most of my companions were just ordinary citizens – an older woman, probably in her late fifties, wearing a bindi on her forehead and a traditional salwar kameez; another woman in her late twenties maybe, in jeans; another in her early thirties wearing a mini skirt; and a fourth girl in ripped jeans and comfortable loafers.
While I waited, I chatted with a woman in her twenties who had moved to Mumbai from Tanzania to go to medical school. ‘I think in this period in time we are very self-conscious,’ she told me. ‘Even as a doctor, when a patient comes to you, they look up to you and if I have pimple, they think, why doesn’t she take care of herself? Or if we tell them to lose weight, then we have to be fit too. Even my mother is a patient here. She has Botox. She was sceptical the first time, so Rashmi did half her face to show her how it would compare. Rashmi does not want her to look unnatural – she says you should age gracefully. And every year my mother comes from Tanzania to see her.’
One of the more interesting improvements Rashmi offered was skin lightening. Cosmetic skin-lightening products are a sizeable industry in India, with ‘before and after’ advertisements on billboards across the country and pages of classified bridal ads in the Times of India every Sunday seeking ‘Slim, Fair, B’ful girl’; ‘beautiful, professionally qualified, fair Hindu girl’; ‘seeking cultured fair beautiful girl’; ‘Qualified, Fair, Slim girl’; ‘Beautiful tall girl for very fair, handsome vegetarian boy’ …
‘The ideal of beauty is light skin,’ Rashmi explained to me. ‘Actually you can look like a frog. But the ideal bride is a woman with light skin; at front desks in offices the receptionist should have light skin. We are not one “race” in India – we have so called Aryan, Mongolian, Dravidian types. So we are used to working with different skin. Even in south India, where people are thought of as darker-skinned, the Iyengars [high caste Brahmans] are lighter; in Mangalore people are lighter. I used to think the desire to be lighter was socio-economic but now I don’t – we don’t get lower economic groups at our practice. But the thing is, if you are dark, it is harder to maintain an even skin tone, so I think it’s more about that than a particular shade. The biggest thing people come to me for is skin tone or colour. But tone can change with facial structure. For example, the area below the eye can get sunken with age and that can give the appearance of dark circles. So changes on the skin cannot be addressed by changing the actual skin tone alone – I have to also look at the tissue and face structure. You need to work beyond the skin with all the layers to get an even skin tone.’
Though that was what Rashmi’s clients came to her to address, in India there is undeniably a very deeply rooted worship of light skin colour, as the matrimonials illustrate. I remember an English friend of mine being taken aback when I told him that Bollywood actors were actually Indian. ‘But they’re all so white,’ he said. ‘Are you sure?’ Today, of course, they’re not all Indian. A few have one south Asian and one white parent; many films have formulaic nightclub scenes with backing dancers who are entirely European – and generally also all blonde.
In terms of ideals of beauty, in India people with light skin and/or eyes occupy a place of privilege for a variety of perceived reasons: dark skin is associated with poverty because the poor are more likely to work in the harsh sun; it may also be associated with underprivileged classes or castes. Blame is variously laid with the Persians, Aryans, or the British, or Westernisation. They point to the traditionally dark skin colour of certain Hindu gods; the description in ancient epics of dark-skinned princesses celebrated as great beauties in a time before white was right.
The reality, as Rashmi had alluded to, is that outward appearance and status in a country as populous as India is far more nuanced by geography and genetics. A friend of mine, a doctor from a so-called low ‘untouchable’ caste, is not dark skinned at all (and has green eyes). My mother’s family consists of nine siblings and close relatives who vary from having extremely dark skin to almost white. Among them they also have a pick and mix of dark brown, hazel, green and blue eyes. None the less, however flawed the reasons that link whiteness with desirability might be, the fact is that it still exists.
There are those who hope to bring down this chromatocracy and several activist movements (whose membership lists include some Bollywood stars) have united against the products and advertisers, while the non-Bollywood film industry produces many thoughtful films employing more natural-looking actors. There is also the ‘Dark is Beautiful’ campaign, launched in 2013 by actress and producer Nandita Das, which aims to promote the celebration of ‘beauty beyond colour’.
It could be a losing battle. A 2012 BBC news story reported more sales of skin-lightening creams in India than Coca-Cola and featured a shower gel that claimed to whiten the genitals of Indian women. It was promoted with a television advert showing a (fair-skinned) wife, first ignored by her handsome husband and then ecstatically reunited with him after using the product. The skin-whitening industry is now worth an estimated £283 million. Even-handedly, it doesn’t exclude those without vaginas: like the ‘Fair & Lovely’ skin-lightening cream
marketed to women, ‘Fair & Handsome’ has hired heavyweight brand ambassadors in the form of Bollywood megastars Shah Rukh Khan and Hrithik Roshan. Nor does the marketing stop with ‘fairness’ products. There is an amusing, often politically-incorrect range of tonics, potions and even exercise equipment that reek of quackery, targeted at the uncritical. I’d even seen an ad campaign for a product promising to ‘increase your height or your money back’, pasted on the backs of auto-rickshaws. The watchdogs are reacting. In 2015 the Food and Drug Administration issued notices for, and physically seized two steroid-containing fairness creams: UB Fair for men and No Scars cream for women. The products contained steroids like fluocinolon acetonid and mometasone as well as skin bleaching agents, the side effects of which include skin thinning, rashes, and even excess facial hair growth over time.
Knowing the risks, and thinking of those ubiquitous and miraculous billboard transformations I had seen, I was curious to hear from Rashmi why so many people persist in using them, and whether these creams really work.
‘Yes, they do. Companies have a responsibility to stand behind their claims, but the extent of change customers get can be very, very small. Usually, creams include some form of sunscreen. Plant extracts such as liquorice, mulberry or any of the acids that block enzymes of the melanin pathway. Also hydroquinone, which actually bleaches the skin, or light reflective particles. Product engineering has improved so much now that you get that instant satisfaction. There are gold and glitter particles to make skin look like it’s glowing. And then people get to like the glow so they keep using it.’
In the Bonesetter's Waiting Room Page 6