Nobody is surprised that the number of people having cosmetic surgery continues to rise. No eyebrows have been raised. Nor are people surprised that 90% of the 50，122 people treated （that feels like the wrong word， never mind） in Britain last year were women. Nobody is surprised to note this creeping acceptance of surgery， of a rise in eyelid operations， earlobe lifts， people cutting out photos of celebrities to show the doctor， and asking for a more“Winslettey” chin.

When this weeks figures were published， surgeon Laurence Kirwan commented： “We should move the discussion on from the interminable hand-wringing as to whether it is morally acceptable and just accept it. Rather like motor cars， electricity and gay marriage.” Except， the purchase of a car doesnt involve general anaesthetic and a sharp knife to the tit. Except， gay marriage is an example of the pursuit of equality， rather than thinner thighs. Except， electricity companies do not advertise solely to the vulnerable， with cheaper heating packages for the recently divorced， or those raw from childbirth. It promises lighter living rooms， rather than successful relationships， or happiness.

The rise in demand for surgery is surely at least partly a response to the way it is advertised. The seasonal promotions， the advertisements carefully targeted to fuel and exploit peoples poor body image， ads （like Harley Medicals tweet suggesting a “boobjob” as an “original Christmas present”） that normalise and trivialise unnecessary surgery， with grinning bikini models and their white white smiles.

After the PIP scandal， a series of restrictions were recommended， but one—a clampdown on advertising—was dismissed. The Department of Health instead promised to “better enforce existing codes”， a judgment that “horrified”the president of the British Association of Aesthetic Plastic Surgeons. Because it wont work. The Advertising Standards Association is reactive， rather than proactive， meaning that clinics will publish ads that they know will be banned， but， in the short time they remain up， will have paid for themselves. In December， 52% of the top Google-ranked clinics were still advertising “luxury perks” as inducements for surgery， and 37% of the incentives were time-sensitive， to pressure people into booking quickly.

I received an email this week about Valentines Day.“More than two-thirds of women say they welcome receiving a cosmetic treatment gift from their significant other on Valentines Day，” it read， quoting a poll conducted by the Good Surgeon Guide. Its audience rated “which non-surgical treatments they would love to receive on lovers day”—the top five were： dermal fillers， Botox， teeth whitening， a skin peel and lip enhancements. Each of which says， “I love you” in its own special， “He Hit Me （and It Felt Like a Kiss）” way.

Our poor bodies. What chance do they have， pelted with all these tiny bombs？When this year Alan Sugar invested in his Apprentices “Botox empire”？When iTunes sold an app for children in which the user played a liposuction doctor？ Few of us are immune to advertising， and most of us are anxious about the way we look， and it is this combination that leads us by the hand to the lunchtime clinics， to the ends of needles. Prescription medicines are not allowed to advertise， yet cosmetic surgery is. Thats bananas. Especially when we have seen womens breasts exploding with faulty implants and can clearly plot the tension between the goal of ads （cash） and public health.

Yet nobody is surprised that more people are going for surgery. Because as it is normalised， and advertised， and as more people choose it， yet more will choose it， and any concept of an alternative—a life trying to get happier in our skin will dim. We are starting to forget.

做整形手術的人数在不断增加，但没有人会对此扬起眉毛啧啧称奇。去年英国“治疗”（“治疗”一词似乎不太合适，但不管了）了50，122名整形人士，而其中90%是女性，同样也没有人会对此感到意外。不奇怪，人们渐渐开始接受这些手术：眼皮手术、耳部拉皮手术。人们剪下名人的照片给医生看，要求下颌整得更像凯特·温丝莱特的。

这周的数据公开发表后，外科医生劳伦斯·柯万说道：“对整形的讨论，我们应该从没完没了的苦恼绝望中跳出来，谈谈这在道德上是否可接受，或者就干脆接受现实。这个问题跟汽车、电和同性婚姻很相似。”只不过，买车不会让你全身麻醉，不会有一把锋利的刀动你的乳头;同性婚姻追求的是平等，而不是更瘦的大腿;电力公司也不会专给弱势人群推销，不会给刚离婚或经历生育巨变的人提供优惠供热套餐。电力公司只会承诺让你的房间更明亮，而不会说让你赢得好姻缘，幸福美满。

当然，对整形需求的增加至少部分与宣传的方式有关。季节性推销、别有用心地对“外形欠佳”煽风点火并加以利用的广告、把不必要的手术正常化、轻巧化的广告（就像哈利医疗集团发的推特称隆胸手术是一份“有创意的圣诞礼物”），广告中穿着比基尼的模特向你展示着明眸皓齿的笑容。

PIP事件之后，一系列限制措施被提上议程，但其中之一被否定了，那就是对广告的收紧限制。卫生部则承诺“加强执行现有法规”。这决定“吓到”了英国美容整形外科医生协会的主席，因为这是不会起作用的。广告标准协会是被动反应，而非积极主动的，这意味着诊所会投放一些他们明知道会被禁止的广告，但在短期内，他们仍然能推出这些广告，并能获得回报。在去年12月份，52%谷歌排名靠前的诊所仍以“奢华犒赏”作噱头，吸引人们做手术。另外，37%的优惠条款是有时间限制的，施压刺激人们尽快预订。

我这周收到了一封关于情人节的邮件。邮件上写着：“超过三分之二的女性称她们乐意收到另一半送来的“整形手术”情人节礼物，” 调查数据引用自《好医生指南》。

在“你希望在情人节收到哪些非手术治疗”的调查中，受访者选择的前五位是：皮下填充、注射肉毒杆菌、牙齿美白、磨皮和丰唇。这些整形手术表达“我爱你”的特殊方式就跟“他打我（感觉就像一个吻）”一样。

我们那可怜的身体啊。它们还能有什么机会呢？有那么多小炸弹投掷过来：艾伦·苏格今年在《飞黄腾达》投资“肉毒杆菌王国”;苹果应用商店出售一款儿童应用，小孩该在应用中扮演吸脂医生。看着这些，几乎没有人能对广告免疫，而大多数人很在意自己的外表，这两个因素导致我们走向“午餐诊所”，走到针口之下。处方药被禁止宣传，但整形手术却可以宣传。真是疯了！尤其是看到女性胸部植入的劣质假体爆裂事件时，我们可以清楚看到广告（金钱）与公众健康之间的矛盾。

然而，越来越多人做整形手术也不足为怪。因为随着整形被正常化、被宣传，也随着越来越多人选择整形，更多人将会作出这种选择，而另类的选择（以自己本来面目争取快乐生活）则会消失。我们开始忘却。