“Are you sick of depending on your inner beauty?” a brunette newscaster asks, as the camera zooms in on a frizzly, pimply woman wearing glasses, looking so dejected she may as well be posing for a mug shot. “The Fox series The Swan is looking for new contestants.” The footage, included in the new Hulu documentary The Swan: Behind the Mirror, dates from sometime around the early 2000s, post-9/11 and pre-Instagram, when reality television was in its human-experiment era and body positivity was barely a twinkle in a Unilever advertising executive’s eye.
In that particular media moment, gossip magazines routinely sneered at celebrities for having visible breakouts or the shadow of a thigh dimple, and beauty was widely understood to be synonymous with happiness, virtue, and wealth. “This show, if anything—don’t shoot me!—it was empowering,” the cosmetic surgeon Randal Haworth, who operated on contestants on both seasons of The Swan, explains in Behind the Mirror. “Because it shows you that beauty is power.”
With respect to Haworth, which I don’t think he deserves, only power is power. The best that beauty can offer is attention, which is why our current social-media ecosystem is so fixated on it, offering up “Get ready with me” reels and product reviews and close reads of celebrity faces with joyless frenzy. More quaint is that, when The Swan debuted in 2004, many contestants had heard about the show via a radio ad. “Have you ever looked in the mirror and wondered how it would feel to finally become the person you’ve always imagined?” a gentle voice inquired. “Have you dreamed of plastic surgery but never thought you could afford it?” Listening in their cars, women all over America pondered the question, and 16 were eventually selected each season to appear on a series now understood to be one of the most monstrous ever made.
[Read: The cruel social experiment of reality TV]
The Swan wasn’t the first show to subject individuals with self-esteem issues to total physical overhaul while the cameras rolled—that was ABC’s Extreme Makeover, which debuted as a one-off special in late 2002 to more than 13 million viewers, prompting executives to book a full season. Critics were horrified—“American television bosses desperate for ratings are being accused of turning mutilation into entertainment,” The Guardian reported—but the show’s success spawned a wave of copycats. On MTV’s I Want a Famous Face (2004), young people obsessed with celebrities underwent multiple surgical procedures to look more like aughts icons. But The Swan gave the makeover-under-anesthesia an evil twist: After contestants were isolated from their families for three months and subjected to surgeries, low-calorie diet plans, and severe workout regimes, they were forced to compete, pageant-style, against one another to see which one was deemed to have become the most beautiful.
Behind the Mirror doesn’t delve too deeply into the reality-TV landscape in the moment The Swan premiered, possibly because the access that the director, Erin Lee Carr, received to former contestants, producers, and even doctors offers up a trove of such astonishing anecdotes that there wasn’t space for much else. When the contestants first arrived in the show-sponsored, mirror-free apartments, they were given a pile of celebrity magazines and told to make inspirational binders of how they wanted to look. In one scene, filmed during surgery, Haworth jokes with another doctor about “the size of my wand” while he brandishes an oversize syringe—you get the sense that they’d high-five about the tag-teaming of it all if they weren’t wearing surgical gloves. Several women recount how, while they were recovering from multiple surgeries simultaneously, there was, at one point, only one nurse to check on the 16 of them. And if we never hear the words lipo leak in a documentary again, let’s take it as progress.
But beyond the fat-shaming (The Swan’s creator, Nely Galán, who reportedly warned one contestant that she’d be “a tub” if she didn’t stop eating, wisely refused to participate), the performative cruelty, the resplendent tackiness of every visual aspect of the series lies an awkward kind of realization: This show was horrific, yes, but it was also honest. Neither Galán nor Haworth nor the then–Fox uberproducer Mike Darnell made any attempt to disguise their conviction that physical beauty is worth going to extreme measures for. “Plastic surgery is barbaric,” Haworth can be heard saying in a voice-over as the documentary begins. “You’re putting a cold scalpel onto flesh, and certain things fail.” The Swan reveled in scenes of women trussed from head to toe in bandages, grotesquely swollen, and seemingly so doped out on painkillers that they had to be propped up for interviews. This was the process—a particularly American confluence of suffering, aspiration, and surveillance. No pain, no gain.
Consumer beauty culture now tends to be more evasive. For all of the buzzwords that have entered common parlance, the “deep-plane facelift” (in which someone’s skin, fat, and muscles are repositioned and lifted as one composite piece) and the cutesy “bleph” (cutting off loose eyelid skin), there’s much less analysis of how brutal cosmetic surgery is. (On Reddit’s community-driven plastic-surgery page, by contrast, people can be much more honest and frequently overwhelmed by how painful recovery is.) People pore over celebrity faces with the zeal of medical professionals—I recently saw someone comment blithely about a laundry list of imaginary procedures one actress had supposedly had when all I could ascertain was a haircut—but in fixating on the results, we miss the process.
The writer Jessica DeFino has argued that modern beauty culture has “lobotomized us all” by reducing the complexity and richness of human life to a single question: Do I look hot? We use words such as liberating and choice to obscure the stark physical reality of procedures that pass down pretty privilege and ageism as burdens to the next generation. And rarely, if ever, do we publicly debate whether it’s a good thing that women are having their faces essentially cut off and reattached to look 10 years younger. Or whether erasing all signs of aging in the pursuit of perpetual girlishness is limiting women’s ability to convey qualities such as maturity, experience, and expertise—attributes that mass culture has not historically wanted to associate with women in the first place.
[Read: Reclaim imperfect faces]
If you spend much time scrolling through certain swaths of social media, you might be inclined to think that everyone, everywhere is at least injecting their face with neurotoxins and filler (not actually true), if not getting an eyelift, or even having their ribs broken for a more angular silhouette. Plastic surgeons, perhaps the most savvy self-marketers since P. T. Barnum, now seem to spend more of their time making TikTok content than they do seeing patients. And celebrities, wisely deducing how pointless it is to deny something a thousand MD influencers will identify on YouTube, have taken to radical transparency.
Earlier this year, the actor Denise Richards shared the story of her facelift with the beauty magazine Allure, including pictures pre-op of her face marked up like a crime scene and post-op bruised like a soft fruit. And last year, the reality star turned entrepreneur Kylie Jenner, who sparked a 3,233 percent increase in searches for filler when she confessed, at the age of 17, to having had her lips plumped, caused a minor ruckus by revealing the exact specifications of her breast implants (“445cc, moderate profile, half under the muscle!!!!!”) and the name of the surgeon.
During the 2000s, when many fans expressed their devotion to celebrities by seeking to emulate them, Single White Female–style, this attitude of openness might have provoked a frenzy of patient inquiries. And the most popular doctors today will tell you that it has: Thanks to stars, according to one Vogue analysis, having cosmetic work done is getting destigmatized the more popular it becomes as content. “The trend of judgment is lessening,” one surgeon told the magazine. All of the experts surveyed agreed that “interest in plastic surgery is only going to grow.” Facelifts, “especially good ones, spread like a contagion,” a story in The Cut—that in turn propagated like knotweed among women my age—argued last year.
But is it actually happening? Despite the spate of recent viral articles lamenting our surgery-saturated social environment, the number of cosmetic surgical procedures performed in the United States in 2025 declined by 9 percent compared with the previous year for patients aged 18 to 25 and by 5 percent for patients 26–35, per a report released by the American Society of Plastic Surgeons. A recent search for #facelift on TikTok brought me almost 450,000 posts, but fewer than 78,000 procedures were actually performed in 2025—roughly half as many as in 2004, the year The Swan aired. The business of cosmetic surgery is currently being driven by seniors and by people wanting to address excess skin and sunken cheeks after substantial GLP-1-associated weight loss, not by Gen Zers coveting a snatched jawline.
This is in part because the gargantuan beauty industry has sprawled out in so many other directions: neuromodulators such as Botox, fillers, lasers, LED masks, and microneedling, not to mention an endless array of consumer products. But the visible overuse of filler on celebrity and civilian faces seems to have prompted a backlash. The total transformation proffered by shows such as The Swan—in Behind the Mirror, one contestant recalls being reunited with her son after three months apart and multiple surgeries, and how he failed to recognize her—is no longer the goal. Instead, beauty culture now promises that we can look like the best version of ourselves—sculpted, rested, forever young. It’s a message even more insidious than the outright brutality of The Swan, because it keeps us in a perpetual state of want, convinced that the one product or procedure that might actually work is just a click away.