Naomi Wolf described all this in 1991, in her pathbreaking book The Beauty Myth. "The more legal and material hindrances women have broken through, the more strictly and heavily and cruelly images of female beauty have come to weigh upon us," she wrote. But Wolf was writing before plastic surgery was considered a prerequisite for ongoing employment, before Botox, before ubiquitous Brazilian waxes, before images of natural breasts started seeming like an odd retro novelty. Almost 20 years later, the period Wolf was writing in seems like a prelapsarian paradise of female self-acceptance.

Given the way women perceived as unattractive are treated, it's no wonder so many find the pressure intolerable and seek surgical relief. Laurie Essig, author of a forthcoming book on plastic surgery, recently reported that a third of plastic surgery patients make less than $30,000 a year; many pay for their surgeries with credit cards charging usurious interest rates. Blogging on True/Slant, Essig argues that it's unfair to tax these women further, especially since there's no objective way to figure out which operations are and are not necessary. "'Necessary' is an impossible word when it comes to cosmetic surgery because ultimately, almost none of it is necessary for pure physical survival, but we are social animals who increasingly depend on 'first impressions' to survive," she writes.

There's some truth to what she says, but stretching the term "necessary" to encompass cosmetic surgery means acquiescing to the last decade's most pernicious trends. The more time women are compelled to spend fighting their own bodies, the less they have to fight for anything else.