Please help me decide how to best support my fiancee's choice to pursue cosmetic surgery.

November 21, 2006 11:40 AM

Please help me decide how to best support my fiancee's choice to pursue cosmetic surgery.

My fiancee has decided she wants some cosmetic surgery in the near future. In no particular order, she wants a breast augmentation, Botox, collagen, and potentially more if she can swing the cost. She's very early in the decision making process, but she's asked me to be supportive emotionally and, in all likelihood, financially. We've lived together for five years and are getting married this spring, so it's not the first time we've made big decisions together with our hearts or our money.

To help you answer my question, you need to know that she is ten plus years my junior and barely into her mid twenties. She is healthy, young, and attractive. She doesn't have any obvious physical need for any of these procedures. Sure, she has some signs of aging, but nothing remotely unusual for someone her age. She is small framed, thin, but according to various methods of measuring such things, she doesn't need to wear a bra. (I should probably add here that she is a small 32 A. She wears a 32 or a 34 B, depending on the manufacturer and padding material. She is by no means flat chested, just thin and not yet affected by gravity.) The problems she sees are not visible to others: she's symmetrical, proportional, and in my humble opinion, the standard of beauty. To put it another way, she spends time just about every day turning back the advances of young men and women who find her attractive enough to ask her out.

I can appreciate her issues with her own body image considering it is something I struggle with. That said, though, we don't proactively deal with it in any way. We eat conveniently and we exercise infrequently and irregularly. Worst of all, we don't really talk about it. Personally, I'd like to encourage her to exercise and eat healthy before she pursues the cosmetic surgery options, but I don't know if this is the healthy, right thing to do. She seems to be drawing on an inner fear that I can't help her conquer, but I'm also not certain surgery will help her overcome it either.

Oh great and wise hive mind, help me come to terms with the decision I face.

posted by sequential to Health & Fitness (32 answers total)

Does she know that saline implants feel hard and un-breast-like and that silicone implants are supposed to be replaced every decade?
posted by orthogonality at 11:49 AM on November 21, 2006

Well, I don't have any experience at all in this arena, but I'd worry that agreeing with her that she needs any cosmetic surgery would quietly confirm to her that you're as dissatisfied with her body as she is. I have no idea whether this is the 'right' way to deal with someone with body issues, but I would be vocal about being super attracted to her, and about her not needing these procedures at all.
posted by HighTechUnderpants at 11:51 AM on November 21, 2006

You question is how to best, and not whether or not to, support her decision, right?

Research the procedures and practitioners in detail. Go with her to consultations and let the doctors know that you are well informed. Assist her with post procedure support. For instance cosmetic surgery is best followed by a period of complete immobility, help make that possible and comfortable for her. Shield her skin from UV with an umbrella until she has completely healed. Apply coco butter and other salves regularly to incisions.
posted by StickyCarpet at 11:52 AM on November 21, 2006

Response by poster:

Does she know that saline implants feel hard and un-breast-like and that silicone implants are supposed to be replaced every decade?

Yes. She works with a woman who is at her ten year point and is trying to decide what to do. In addition, she's had ample opportunity to feel implants and talk to people who have them.

You question is how to best, and not whether or not to, support her decision, right?

I'm willing to listen to answers to either question, but it doesn't seem to me that I have much of a choice in the matter.
posted by sequential at 11:55 AM on November 21, 2006

Plastic surgery doesn't have to be a grave moral decision. You don't have to pay for her surgery.

Are you asking for ways to talk her out of getting breast implants? Or do you just feel guilty about liking big breasts?
posted by Human Flesh at 11:55 AM on November 21, 2006 [1 favorite]

Since the wedding is coming up, could some of this be tied to that? You know, the kind of impossible standard for wedding days being perfect that a lot of people have? How is the wedding planning going? Has her interest in cosmetic surgery crescendoed as you have come closer to the wedding date?
posted by 4ster at 11:56 AM on November 21, 2006

I would be worried when someone in their 20's feels a need for so much manufactured change. That said, different strokes for different folks. I would however take serious heed of your own writing

"Personally, I'd like to encourage her to exercise and eat healthy before she pursues the cosmetic surgery options, but I don't know if this is the healthy, right thing to do."

Something isnlt quite right in that statement for me. You obviously aren't entirely comfortable with the situation, you state you haven't talked about things you should talk about... and you are getting married... time to sit down on the sofa and have a good chat about a few things??

Especially if it is gonna cost you a load of dollar.
posted by Frasermoo at 11:57 AM on November 21, 2006

Exercise may help. I am nowhere near your fiancee's level of physical perfection - no heads turn, no advances - but I feel much more comfortable with myself and my body when I am using it. Indeed I feel more like I am my body when I'm exercising regularly, and much less inclined to view my body as some vehicle for getting my mind from A to B, that can be traded in or upgraded like any other vehicle.

So for me regularly doing something active really helps. In the past, it's been running, or step classes, or cycling, or swimming; right now it's yoga and pilates and the gym. So it doesn't seem important what exercise, just something that gives me that endorphin rush and reconnects me with my physical self. It does wonders for my self esteem, and becomes an end in itself. With any luck the same will be true for your fiancee. It has to be worth trying first, if only from a cost-benefit perspective.
posted by handee at 12:00 PM on November 21, 2006 [3 favorites]

Eek. Well, you probably already know that telling her that you think she's gorgeous, while nice to hear, doesn't address the problem, because SHE apparently thinks she needs improving.

Are they any signs of aging that are actually visible? Does she even have the crease between her eyebrows that people get Botoxed?

Could you persuade her to go in for regular facials with a really good aesthetician before getting anything else done to her face?

It makes me sad to hear of such a young women wanting breast implants (Personally, I'm not a fan of the look or feel.) Does she know how the finished product is going to look and feel? Is she aware of the potential dangers? Has she seen Tara Reid's boobs?
posted by desuetude at 12:04 PM on November 21, 2006

Are you asking for ways to talk her out of getting breast implants? Or do you just feel guilty about liking big breasts?

Do you even bother to read the fucking question before shooting off your mouth? Here, let me help you:

"Please help me decide how to best support my fiancee's choice to pursue cosmetic surgery."

Do you see anything about talking her out of it? Neither do I.

"she's symmetrical, proportional, and in my humble opinion, the standard of beauty"

Does that sound like he wants her to change her body? No, it doesn't. Thank you for your attention.

To the poster: if it were me, I would treat it the way I treat my wife's smoking—I wouldn't tell her not to do it but I wouldn't support it financially either. You can't stop her from insisting on unnecessary surgery, but you can make it clear that it's her thing and you don't think she needs it. That will be a good test of how she regards you, as an independent person with a right to his own views or as an extension of herself with an obligation to support her in whatever she does. (Obviously, you should be emotionally supportive—by all means, hold her hand, be there for her, &c—that's not what I'm talking about.)
posted by languagehat at 12:05 PM on November 21, 2006

And back to actually hepling her get this done: lots of rest, good food, plenty of water, low stress and perhaps nutritional supplements before and after the procedures can have a visibly noticeable impact on the outcome. Some people swear by tumeric and its extracted components as an aid to healing.
posted by StickyCarpet at 12:13 PM on November 21, 2006

"Exercise may help. I am nowhere near your fiancee's level of physical perfection - no heads turn, no advances - but I feel much more comfortable with myself and my body when I am using it. Indeed I feel more like I am my body when I'm exercising regularly, and much less inclined to view my body as some vehicle for getting my mind from A to B, that can be traded in or upgraded like any other vehicle." - handee

I so completely agree with this. I have a terrible self image and one of the few things that makes me feel better about myself is physical activity. That, and therapy. I'm not saying that your fiancee does need therapy but if she feels such a powerful need to "fix" herself at a relatively young age... I don't know, maybe a few sessions would help.

Also, I don't know if this is exactly comperable, but I used to weigh about 30 lbs. more than I do now, and I really thought that when I lost the weight, I would magically start feeling better about my body. The thing is, I don't, that much. I have pride that I was able to lose the weight, pride that I'm wearing smaller sizes, but a lot of mornings I wake up and feel just as shitty about my appearence as I did 30 lbs. ago. I guess what I'm saying is that it kind of sounds like your fiancee is looking for cosmetic surgery to fix her own self-image. It's not going to work. It comes from within yourself (however cheesy that sounds).
posted by sutel at 12:16 PM on November 21, 2006

Response by poster:

You don't have to pay for her surgery.

Correct, but if I don't she will take a part time job with a cosmetic surgeon to pay for it, so I'll pay for it in time alone if nothing else.

Are you asking for ways to talk her out of getting breast implants?

I believe that's her decision to make. I don't think she needs them.

Or do you just feel guilty about liking big breasts?

I have no guilt about my appreciation of any part of the human form. Furthermore, I am not, in any way, disappointed with my fiancee's breasts. I'd go as far as saying they are a huge turn on just the way they are.

How is the wedding planning going?

The wedding planning is going well, but we're eloping. There will be a handful of people there, but no more than ten people.

Has her interest in cosmetic surgery crescendoed as you have come closer to the wedding date?

No. We're having a very casual wedding. The only thing that seems to have influenced her decision is working as a cosmetologist, where a significant number of women in her salon have implants.

you state you haven't talked about things you should talk about

You're taking things a little out of context. We don't talk enough about our issues with our body images, that's all. It's an open secret, one we've talked about many times, but not enough that it's something that we easily deal with when someone is having an issue with it.

Are they any signs of aging that are actually visible? Does she even have the crease between her eyebrows that people get Botoxed?

Yes. She has very small laugh lines and what she thinks are the beginning of crows feet. However, nothing is visible when she puts on foundation.

Could you persuade her to go in for regular facials with a really good aesthetician before getting anything else done to her face?

She works in a salon with several aestheticians. I'll ask her about this, but it sounds promising.

Has she seen Tara Reid's boobs?

Hasn't everyone?
posted by sequential at 12:19 PM on November 21, 2006

Eight years ago, my partner decided to undergo gender transition. What a ride that was for us! Talk about changing a body I loved as it was--pre-transition he had these wonderful peach-fuzz cheeks and now he's hairy all over, just to mention one change.

However, he loved the changes and felt great in his body in a way he never did before. Seeing that gives me a warm happy glow even when I'm in a "mourning my lost lesbian identity" kind of mood.

OK, gender dysphoria is not the equivalent of wanting bigger breasts or a premature Botox treatment. But supporting him in making the changes was really good for our relationship--saved our relationship, pretty much.

Maybe your fiancee isn't making the perfect-world decision when she plans her cosmetic surgery (as in, "in a perfect world, women would just accept their bodies as they are, and beautiful women would know they were beautiful") but it may very well be the best decision she can make in an imperfect world.

If she has cosmetic surgery, it may be just the thing she wants. It may make her happy. She might have a breast augmentation and then say, "This is great. This is how I've always pictured myself, and now the inside matches the outside." That's what happened for my partner (heck, and for my mom when she finally had a breast reduction in her 40s).

Or maybe she'll have the surgery and find out that, as you say, that there is an underlying fear or dissatisfaction that is not resolved, and it will lead her to deal with that fear.

It's hard to know for sure what is the best thing for her re: cosmetic surgery. But cosmetic surgery isn't hard drug abuse or even (with respect to Mr. Hat) smoking: it's not so clear-cut whether it's good for her, bad for her, or some complex mix. So I would say, make your decision about how to act based on what is best for the relationship. And that might very well be 100% support, emotional, financial, and otherwise.
posted by not that girl at 12:24 PM on November 21, 2006 [1 favorite]

Jesus, languagehat, chill -- the poster overtly states that he's willing to entertain advice on both the how-to-help and whether-to-support-the-decision questions.
posted by delfuego at 12:27 PM on November 21, 2006

She has very small laugh lines and what she thinks are the beginning of crows feet.

Chemical peels run a whole range from harsh to mild. There is something to be said for a mild peel like retin-a to nip those in the bud before they can reinforce themselves.
posted by StickyCarpet at 12:27 PM on November 21, 2006

Response by poster:

Jesus, languagehat, chill -- the poster overtly states that he's willing to entertain advice on both the how-to-help and whether-to-support-the-decision questions.

I'm willing to listen to any advice, but I can say emphatically that I do not believe it's in anyone's best interest for me to try to make the decision for her. I don't want to stop her, but I do want to give her the right support to encourage her to make healthy decisions for herself. Maybe it's a subtle difference.
posted by sequential at 12:33 PM on November 21, 2006

Some thoughts:

My only relevant concern is that these procedures will kick off a lifetime of continuing procedures. She is concerned right now about the very minimal, possibly reversable signs of age in her mid-twenties. Changing the topography of her body will result in a new set of variables that will display their own wear and tear over time, in addition to the regular issues of aging. So after a few years when things inevitably don't look quite as good as they did at first, or she has had time to scrutinize them and grow dissatisfied, won't she most likely decide to have more work done?

For most people, a beauty regimen consists of changes to diet, exercise, hygiene, and cosmetics, all things an individual can control and acquire for themselves, some of which have long-term benefits that make miraculous changes in a person's appearance over time. I'm sure she employs all of these tactics, but skipping past them by asking someone else to pay for one surgical operation after another is unfair and does not bode well for either of you.

If you pay for these procedures, you'd better be pretty sure you are going to like what you see when they are done, because you will have participated and invested in them. If she paid for them herself, less pressure would be on you to approve of her appearance as well as the concept of plastic surgery altogether.

How are other people (and other men) going to react to her in her new incarnation? Are they going to treat her with respect? Ordinarily, none of your business-- but if you are paying for it, and the two of you will be married, then it certainly bears consideration.

If you can't tell, I think that at the very least, you should not be financially responsible for this.

Perhaps you could agree to help her out, and say that you will pay for the surgeries if she will first complete six months of counseling, which you will also pay for. That way the two of you can feel perfectly safe that you are making the right choice. After all, you want to get more professional opinions on the matter than just a plastic surgeon's-- who has a stake in selling you the procedures.

Good luck!
posted by hermitosis at 1:14 PM on November 21, 2006

I think a version of what you just wrote would be something you could say to her. If it were me, I would probably sit her down and say "I think you are beautiful as you are and I don't think you need to change anything about yourself, but if this is what you really want, I will help you and hold your hand through the whole thing. Before you sign up for any procedures though, can we try taking a gym class (pilates, yogay, weight training, kickboxing...) together and see how that goes?"
posted by rmless at 1:15 PM on November 21, 2006

It pains me to hear about this, because a decision this drastic at such a young age seems like it *has* to be rooted in a deep sense of not-good-enough. Doesn't it?

I've struggled with body image ever since I went from being teased for being flat-chested in grade 7 to being teased for sticking out my C-cups in grade 8. I've got a curvy figure, a soft belly and a bit of junk in the trunk, and although I accept intellectually that this is how I'm made, I can't say I've never thought about a tummy tuck or a little lipo or a breast reduction. It's always in flux -- I might have a few outfits that I feel fucking fantastic in, but then I'll go through a period where I feel shabby and awkward all the time. I identify as a "fat person" and see things from that perspective, which I know is a sign of complete disconnectedness from the reality of my body, because objectively I know and have been told I'm not fat. I just can't shake that identity though.

All that being said, I could never take that step, make that committment to surgically alter myself.

Not everyone views their body with the same level of sanctity, though; I know that. Some people see their body as a canvas for tattoos and some people just think they would never mark themselves permanently.

I can't tell you what to do, but I can tell you what has helped me.

For a while I attended a group therapy session on body image. We were a varied group -- some with teenage kids, some spinsters like me, a couple of university-age women. As they were talking it staggered me how someone so beautiful could feel so terrible inside. I didn't feel better for it, because it was painful to hear. But it did make me feel like the things I feel and say about myself by rote are just so distant from the truth about me.

Exercise. Starting to run was the single best thing I ever did for myself. The sense of accomplishment of running my first 5k was incredibly powerful. I wasn't and won't ever be an elite athlete, but I feel good that I have done things that not only take true effort but that most people never accomplish.

Sex. When I'm having sex the most is when I feel the most impervious to the negative energy in the world.

I think the most important thing for your girlfriend to realise is that she's not finished. She's so young. Building up character and deepening your knowledge of yourself is so much more important than having thick lips. Can you make a deal with her -- if she still wants this at 30, or 35, then she should do it without hesitation. In the meantime, both of you can embark on measures that will improve your self-image, together.

Personally, were I in your situation, I wouldn't be able to put my money towards her plastic surgery. Maybe your gentle refusal to do so would be a sign to her that you want her just the way she is.

Good luck.
posted by loiseau at 1:19 PM on November 21, 2006 [1 favorite]

Help her find a safe, trusted plastic surgeon. This is not something you can do by having a nice chat with a doc and looking at some before and after photos. Unfortunately, I don't have any resources to help you find out what to look for, since this is not something I've ever dealt with myself. There are a lot of doctors out there who take advantage of the huge demand for surgery from people who can't afford it to run some terrible scams. Unnecessary or not, these are REAL medical procedures, and she needs someone capable of performing them.
It sounds like you've already made your decision to support her financially, which I respect. But maybe a part time job in a cosmetic surgeon's office would help her gain some perspective on the procedures. She'll see the people with scarring and deformities whose lives can really be improved by cosmetic surgery. She'll see the Jocelyne Wildensteins. And if, in the end, she still really wants it, she'll know what she's getting into and it won't be on your dime.
Also; botox only works a few times. It's kind of silly to use up your few chances when you're so young and wrinkle-free.
posted by Juliet Banana at 1:20 PM on November 21, 2006

Are you guys planning on having kids together? If so, her breasts will change during and after the pregnancy and nursing process. I would encourage her to wait for implants until her breasts have finished changing - by the time she's done, she may not need them anyway.

<sarcasm>I suppose the really supportive thing to do would be to get her pregnant now, thus playing the odds that her boobs would grow without requiring surgery. </sarcasm>
posted by crazycanuck at 1:49 PM on November 21, 2006

To put it another way, she spends time just about every day turning back the advances of young men and women who find her attractive enough to ask her out.

This sentence stopped me cold. The image it conveyed was of a woman who may seek out the advances of others, so as to make herself feel good about her own body.

Her desire for cosmetic surgery at such a young age seems pathological. Does she value herself or do the opinions of others determine her self-worth?

I doubt that you can change her mind about the surgery. She's an adult, she's entitled to do it. But you might want to seek some counseling before marrying a woman who is so concerned about her physical appearance.
posted by Carol Anne at 1:58 PM on November 21, 2006

Have you asked her about maybe getting some counseling for her body image? It sounds like she has some dysmorphia going on, considering she's only in her 20s.

She could always try it and if it doesn't work she has the rest of her life to get plastic surgery.

I know you don't want to make the decision for her but I really would try to discourage her if I were you. Make sure she knows that you'll love her whatever her decision but that you also think she's perfect the way she is. Even if it seems like she's not listening and doesn't value your opinion, trust me, she is and does. And I agree with the person who said that if you openly support this she's going to take it as confirmation that's she's ugly and and undesirable. I know the twisted way the brain of a woman with low self-esteem works.

Help her to learn to value herself independent of her looks because they will fade in time no matter how much work she has done.
posted by Jess the Mess at 2:05 PM on November 21, 2006

Regarding her skin: encourage her to visit with a reputable, board-certified dermatologist. Such a doctor will not encourage harsh measures at her age -- at most, perhaps some light skin resurfacing and a high-quality moisturizing regime, something that the aestheticians she works with can help her with. Certainly, not Botox.

As for breast augmentation: I interpret "support" broadly, and I think it's supportive to do careful research on this, and give her the information you uncover with an attitude of loving concern. She should know that she may experience capsular contracture in the tissues inside the breast, which is painful and can be disfiguring. She may lose nipple sensation or have trouble nursing (if kids are a possibility). At the very least, she'll have to have revision, probably more than once, because implants have a limited shelf-life. Then there are the usual risks posed by anesthesia and postoperative infection. These are worst case scenarios, but she should face them head on and make a fully informed decision about what she's doing.

I'd also do as others suggest and encourage her to get counseling to address her body image issues. You know her well, and if your instincts are telling you that surgery will not be enough to make her comfortable in her skin, you should address this with her. Again, loving concern: emphasize that this isn't about pleasing you or conforming to your will, but rather making sure that she is not setting herself up for disappointment because she has a goal of perfection that is unattainable. Best of luck.
posted by melissa may at 2:22 PM on November 21, 2006

Since you guys are getting married, do you plan to have children in the (near) future? Breast augmentation MIGHT get in the way of breast feeding, and as someone who WAS quite flat-chested at the age of 23 (and wore a 34B bra, as well as complained that she had no cleavage to speak of) and now has more than enough in the boobs department after having had a baby little more than three weeks ago can tell you, they only get bigger. So three years after I thought "bigger breasts would be nice," I got bigger breasts. Without having to go under the knife.

That's the practical side of things, in case you guys do plan to have kids. Now, onto the whole "cosmetic surgery" side.

If she's having things "done" because of bad body image, changing it ISN'T going to help. She'll only find more things to fix after what she wants done. The road to so-called perfection is addictive. If she's happy with herself and just thought "bigger boobs would be nice" then it's a healthy decision. If she's not happy with herself and thinks that bigger boobs would make her happier, then it's an unhealthy decision. When it IS done, and she isn't happier, she'll find something else to fix thinking that THIS will make her happier.
posted by Sallysings at 2:41 PM on November 21, 2006

Boy, it is going to be very tough for me to give out impartial advice here, because I'm emphatically opposed to these types of procedures. So if you want advice on supporting an inevitable surgery, please skip this comment. I'm overtly going to advise you to use all means necessary to dissuade your fiance if you want things to remain how they are currently. Otherwise, be prepared for major changes in your relationship, which YOU will have to adapt to and accept. Again, this is going to be a totally biased comment, based on my own personal experience, and in no way should be construed as some kind of prophecy. I would love for you to prove me wrong, and if I seem out of line, I apologize.

First of all, I'll disclose that I'm male and I like boobs, and my girlfriend of 12 years has a good-sized pair, so the issue has not come up for us. My personal experience with boob jobs has come via close friends: 3 good friends of mine had their relationships end within 2 months of their girlfriends upgrading their assets. In two of those relationships, they had been dating for 3+ years, but had known each other for longer. All of the people involved were in their 20's, the girls were all small-framed asians, all of whom attracted guys on their looks alone before the surgery. In each scenario, the guy was like you: against the surgery on the grounds that they loved the girl the way she was, but "supportive" in that they didn't feel they could dissuade her from doing something that was going to make her "happy." This should all sound very familiar.

Now, this part may be coincidence, but I am also not lying. After the breakups, 2 of the girls did stints as "exotic dancers," and the other merely changed her entire wardrobe to low-cut outfits and took nude pictures of herself that she hung on her wall.

Not that there's anything wrong with them becoming dancers and nudists. The problem was that the breast augmentation was merely a symptom of other emotional problems/insecurities they had, which eventually manifested in a pair of super-sized rock-hard chest protrusions that altered the entire dynamic of their relationships.

Looks aren't everything, they say, but I'm wagering that looks are quite a lot to someone who obsesses over them to the point that they elect for surgery to change themselves. What you might not want to realize (or actively ignore for your own sake) is that the person you love right now may not be the same person after the surgery. Changing appearances really DOES something to a person. In my 3 examples, the girls were absolutely thrilled to be noticed by tons of guys - moreso than before. Even though we pointed out to them that the kind of guys they now attracted were obviously only checking out their two new "brains." They didn't care so much, which surprised everyone because they weren't shallow before, but now... They were reveling in the attention, went out clubbing a lot more, and even though the sex was (apparently) awesome for a little while, the girls eventually "grew out" of their previous relationship. Not to mention the guys were getting fed up: pissed at all the flagrant displays of cleavage to any random perv, the abrupt change in lifestyle, and the strange transformation from a previously demure girlfriend to a full-on Paris Hilton fan.

So even if all goes well procedurally, there are going to be some major waves set off that you will not be able to ignore. In my opinion, you should strongly protest this if you truly do not think it's in her best interests. The procedure may be a short-term success for her self-image, but in the long-term, her emotional and physical health are going to be compromised. I would even suggest that doing all this is extremely selfish on her part, if she is willing to wager her health and your relationship on something that might make her look or feel better, for just a little while. And if she makes that kind of bet, you may be better off finding someone with more self-worth, not to mention someone who values you and your opinions a bit more.

Time to wrap this up. If your relationship is strong, you may get through this all with no problem, and I welcome an "EAT IT!" response. I sincerely hope I eat it. Good luck.
posted by krippledkonscious at 4:32 PM on November 21, 2006

Sequential--it's troubling to read about your fiance. I've been close to attractive women with body-issue images, so I've got some idea what that's like, and I don't have a problem with cosmetic surgery, but even still…it sounds like your fiance is jumping ahead a few squares on the board by opting for cosmetic surgery when she is, as you say, young and attractive.

I'd encourage her to exhaust other possibilities, like exercise. You hint that you'd like an excuse to exercise more yourself--this is your excuse. Get her to talk with you in more depth about why she feel like she needs it. It may be difficult for her to discuss, but you're getting married, and this will probably be minor compared to some of the discussions you'll face down the road. This is one point where you should be stubborn.

You also mention she works in an environment where cosmetic surgery is the norm. This has to feed into her thinking. While I wouldn't try to get her to quit her job over it, I would encourage her to be more conscious of that, to ask herself "if I worked in a completely different line of work, would I still want it?".

After all that, she may still want to go through with it, and you may be satisfied with her reasons or you may not--part of this whole process is to help you figure out where she's coming from. At that point, though, just be there to hold her hand, because plastic surgery is no picnic.
posted by adamrice at 4:59 PM on November 21, 2006

A few things jumped out at me from your comments:
[S]he wants a breast augmentation, Botox, collagen, and potentially more ... The only thing that seems to have influenced her decision is working as a cosmetologist, where a significant number of women in her salon have implants ... Worst of all, we don't really talk about it....

At her age and for someone who by all accounts is quite attractive, that's quite a list, and suggests someone who may be well along the road to Never 'Nuff Nipsntux. Moreover, she's surrounded by those who have surgically achieved what passes for beauty in some circles, thus reinforcing an artificial standard that she seems to buy into. And to compound the problem, you have trouble communicating with her.

I'd suggest you make a strong effort to discuss this with her. You suggested you share some of her body-image concerns, so could you propose that visiting a counselor together, as much for you as for her? Perhaps you might share this thread with her to convey some of your feelings. You've written nothing that could be construed as anything other than supportive, and there's much good advice here as well.
posted by rob511 at 5:42 PM on November 21, 2006

I had surgery on my ears at the age of 12. They stuck out, I hated them. I had a wonderful surgeon that spoke with me for several hours before agreeing to operate on me. He asked me questions about my expectations, how others saw me, how I saw myself.

I aspired to be a ballet dancer, having my hair in a bun made my ears very noticeable.

The point I am trying to make is, what is her expectations after the surgery?

Make sure that the surgeon takes time with her to find out if the "knife" can fix her problems.

I never regretted having my ears done, I'm now 45 and love wearing my hair up!
posted by JujuB at 9:43 PM on November 21, 2006

Botox and collagen are relatively harmless and non-invasive, as well as temporary, when performed by a competant surgeon. Maybe you could encourage her to keep a diary of her feelings related to her appearance. You may not want to encourage her to dwell on how bad she feels about her appearance, but I often find that writing things down can keep you from thinking them over and over and over in an endless cycle, and can allow you to think more rationally about what you're feeling.
After a while of keeping the diary, she can get the collagen or the Botox, whichever she wants more, and keeps recording her daily feelings on how pretty and good/bad about herself she feels. If there's not a change, and she still finds herself thinking the same things, it makes a case for spending that money on counseling instead of surgery. If she finds herself magically transformed into a well-adjusted person without problems, she can go ahead and get herself some fake titties.
posted by Juliet Banana at 1:52 PM on November 22, 2006

Another thing about her breast size...she might get the size she wants in a few years anyway. I'm small-boned, little, was always barely a B cup, but between 30 and 33 have gradually graduated to a C. This isn't unusual.

I think that it's okay for you to express your reservations about her changing her body. Could she agree to just put off the surgeries and procedures for a year? Meanwhile she does her homework and gets surgeon recommendations, and goes to a good derm/aesthetician to explore non-surgical facial stuff, and you agree to not try to talk her out of surgery. At the end of the year, she can either put it off or start making plans, if she still wants it.
posted by desuetude at 7:18 PM on November 22, 2006