My memory for the things people say is poor; names are a struggle, as are facts, places, under which clock we were meant to meet and when – but there are some things I’ll never forget. These are the things that have shaped how I felt about the way I look. The thrown-away lines from classmates about the shape of my face, or legs. The insults called across pavements in 1997 by groups of teenagers near the heath, or across Twitter in 2013 by men with enigmatic avatars that suggest pain and trapped wind.

Some of these things have been positive, from people I love. Some, from the same people, were things said with affection, but over time have left bruises.

The things people say about you seem to become true as they react with air. Until you hear that your chin is weak, you just think you have a small chin. Until you’re told your knees are saggy, you just think they’re knees. This has been underlined by one of the new cosmetic surgery guidelines issued by the Royal College of Surgeons.

There are some guidelines that were to be expected – seemingly obvious things, like the recommendation that only doctors should be allowed to perform surgery, rather than just… guys in gloves, with needles. “Botox parties” in people’s living rooms,  a sort of hen night for the forehead, a last hurrah for that deep crease between all your friends’ eyes, they say, are “wholly incompatible” with professional standards.

Other points, like having patients psychologically assessed before surgery, are more radical. But most interesting, to me, is the discussion of language. The recommendation that surgeons should avoid words such as “nicer” or “better” when discussing procedures, and instead use “objective terms” such as “bigger” and “smaller”. Harder. Higher.

Professor Nichola Rumsey explains that when people ask their surgeon for, say, Kate Middleton’s nose (the most requested plastic surgery procedure in the UK last year), “Their expectation is that their life is going to be more like the celebrity in question, and unfortunately that’s never going to happen.” Chopping off the end  of your nose, she reminds us, does  not guarantee us a prince, or a baby, or a mother who cares, or  a wardrobe of carefully altered Zara dresses. “Doctors might say, ‘I can make your mouth more in proportion to your eyes or nose,’ but what they shouldn’t imply,” she says, “is that in their opinion [the patient] would look more beautiful.” This is a lesson in how we talk about appearance; how a single word can change a body.

“Firmer, fresher, younger!” advertises one cosmetic surgery website – many promise to “improve” you. A smaller thigh is a more attractive thigh. A bigger breast is a sexier breast. These are not facts. These are opinions. These are words.

How we talk about how we look changes the way we look. Language can be pernicious: a joke about your arse in Year 7 will lead to you always carrying a cardigan to tie around your waist. A comment about your breasts from an otherwise forgettable ex might lead to the moments before you change them forever, looking  up at the ceiling and counting down as anaesthetic dulls your voice,  “Five, four, three…” It’s vital that those with the power to cut into our bodies are careful about the words they use when discussing them, but, by the time we’re listening to them, it’s often too late.

We can regulate the language used when marketing cosmetic surgery, but there is little that can be done to affect the language of our friends, our parents, the media we consume. We can’t mute the locker room of girls who said you were ugly, the colleague who suggested you didn’t have a “skinny jeans body”. But we can be aware when we use these words ourselves – words that get remembered, that act like paper cuts. They scar.


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