The grind of the 21st century throws up obstacles at every turn. Nikolaus Oliver is on hand with advice to guide you through. This week: how a little nip and tuck can lead to a Wacko Jacko Cosmetic surgery goes back further than one might think, certainly to the late 18th century, when two British medics wrote an account of watching an Indian bricklayer getting a nose job. The man had had his proboscis cut off as a punishment for adultery and surgeons were attempting to repair the damage.
Descriptions of similar techniques go back many centuries, originating in India and finding their way to the West via Arab scientists. But plastic surgery as we think of it really got started during the First World War, as a way of trying to repair the hideous wounds inflicted. The first beneficiary was Walter Yeo, who sustained dreadful facial injuries during a battle at sea. He was left looking as though he was wearing a Lone Ranger mask made of skin.
Today, most cosmetic surgery is less about trying to repair nature than improve on it, or to remove the consequences of unhealthy lifestyles. In the UK, the big growth area in the industry - recession notwithstanding - is male breast reduction. Off-putting thought, that, somehow. Indeed, the western world seems to have become obsessed with the fact that overweight men sometimes have fat deposits in that area. Twenty years ago no one cared a hoot about it. Now we're forming orderly queues to go under the knife.
Some people become addicted to surgery. Consider the late Michael Jackson who, over the years, transformed himself from a natural and attractive-looking boy into one of the oddest-looking creatures to walk the Earth since archaeopteryx. He is testament to the damage that "procedure creep" will do. Jackson, having been on the far edge of whatever motivates people to engage in this sort of self-harm by proxy, tells us a great deal about the milder forms of the condition. To a greater or lesser extent, there is an inability to come to terms with life, to - as a psychiatrist might put it - grow up.
We probably all, at some stage, want bigger, smaller, or no breasts, or a different nose, or someone else's bottom. Most of us get over it and find something useful to do. Those who grasp at the straws of cosmetic surgery are confessing their emotional sterility. They may achieve Pammy's bustline, but probably at the cost of having Pammy's personality.