In a viral Tiktok video, posted at the top of last 12 months, a receptionist at Georgia’s Merriman Plastic Surgery Clinic is seen lipsyncing to Taylor Swift. “Nobody has to know what we do,” she mimes, with a knowing wink to the camera. She then proceeds to take an untraceable money payment from a customer, somewhat than a standard card.

The caption guarantees potential customers that their “secret is protected with us”, and the comments are full of women expressing their relief that their husbands won’t discover about their treatments and surgeries. That is just one among many videos from beauty clinics across the UK and US, all promoting themselves to clients who don’t want anyone to find out about their cosmetic surgery.

Altering our appearances through surgical and “non-invasive” means is – sadly and undeniably – on-trend in the mean time. The International Society of Aesthetic Plastic Surgery reported that cosmetic treatments enhancing the face and body increased by 15 per cent between 2018 and 2019. Cosmetic surgery, once considered a rarity, is now increasingly commonplace – plainly regardless of the communities and circles you occupy, you’ll know a minimum of a number of pals who’ve had some sort of treatment to change their appearance. But despite the sheer number of ladies partaking in these treatments, many still feel ashamed to confess to them – some even going to drastic, dangerous lengths to maintain them a well-contained secret.

23-year-old personal assistant Elle* didn’t tell most of her family and friends when she got a tummy tuck between lockdowns in 2020, as she didn’t want people to know she felt insecure about her stomach. “It’s embarrassing admitting to my thin friends that I even have fat I hate enough to spend money on eliminating,” she tells Dazed.

Elle was so eager to keep it a secret that she didn’t have a trusted person pick her up after her hospital day (against the clinic’s advice). She only ended up telling her stepmum because she needed someone to assist with bandages after being discharged. “I begged her not to inform my dad,” she says. “I don’t think she ever told anyone. She understood why I didn’t want anyone to know.”

It’s hard to assume that in a supposedly body-positive era, anyone would feel the necessity to hide this decision. But in point of fact, body positivity can feel like one other sort of body pressure. Krista K. Thomason, creator and philosophy professor at Swarthmore College, says that not feeling positive about our bodies (when it looks like everybody else does) can feel like failure. Although we’ve put a variety of effort into reducing the stigma around surgery, and around our bodies typically, it still “hasn’t resulted within the healthy open conversations that individuals might need expected,” she says. Shame is so individual and deeply embedded, that it’s complicated to undo and takes more work than easy discussion to deconstruct.

Thomason explains that having beauty treatments in secret signals more of a way of shame over our identities than our bodies. “Often once we feel shame, it comes from receiving information that contradicts who you think that you’re. For instance, many ladies have a fear of being perceived because the sort of stereotypical one that gets surgery – the vapid, image-conscious ‘Stepford wife’ image many will conjure when we predict of cosmetic surgery – and we associate this with an enormous amount of shame.”

Beauty is demanded from women on a every day basis, yet they’re expected to make the work put into beauty seem effortless

Women might also wish to sustain perfect appearances without exposing the “behind the scenes”, says Thomason. Beauty is demanded from women on a every day basis, yet they’re expected to make the work put into beauty seem effortless, like no big deal. Showing your work is by some means considered unsophisticated.

That is the case for 35-year-old stay-at-home mum Jo, who recurrently gets treatments to “reverse the results of ageing”. Jo gets regular botox, peels and fillers to remain looking young and healthy, she says. “It helps me feel more confident as a mum and a wife. My husband pays for all my treatments but we don’t discuss what I’m getting.” While Jo doesn’t go so far as paying in money, she prefers for her treatments to remain under the radar. “I do prefer to pass the treatments off as natural. All of my friends get treatments too but we don’t really discuss it – it’s just one among those unspoken things. My husband would somewhat not find out about it as he doesn’t like anything obviously fake. He doesn’t must know!”

Certain treatments and surgeries are also deemed more appropriate than others, which is often determined by the communities we exist in and the influences we now have around us. For instance, Jane, a 47-year-old psychologist, had a tummy tuck, liposuction, a breast reduction, and a breast lift. “My family and friends know in regards to the tummy tuck as I believe people don’t query a mother wanting her stomach tidied up after having kids, but having my breasts reconstructed appears like a special thing. I don’t want people to think I’m fake. Feeling natural is very important to me, and folks could be really judgmental about women having surgery,” she tells Dazed.

Jane also kept her surgeries secret because she felt “ashamed”, and now questions whether she ever really wanted the procedures in the primary place. “I felt like I needed to have [them]. It was just after my husband of seven years left me without telling me why. That was the motive force behind getting the treatments. Looking back I didn’t look bad in any respect. And in hindsight, I believe the surgery was also about rejecting myself which makes me so sad after I look back on it.”

Jane is in a latest relationship, and won’t be telling him about her surgery. “The scars are healed so he won’t notice.” While she doesn’t regret keeping her surgeries a secret and believes all women have a right to withhold or disclaim their treatments as they please, she says she wouldn’t get the surgery today. “I’m concerned that some women, like me, is perhaps getting the surgery for the flawed reasons, and can skip a likelihood for intervention in the event that they don’t tell anyone. Perhaps counselling must be offered in beauty clinics so we are able to discuss why we don’t wish to tell anyone and work through that shame.”

Thomason notes that we’re living in a time where there’s a variety of conflicting messaging about how we’re speculated to feel about our faces, bodies, and surgery. “Different voices are telling you your body doesn’t conform and must be modified, that you must just love your body as if it’s that easy, and that surgery is superb. It’s hard to dam out all of those voices and understand your relationship to your body with the absence of pressure,” she says.

For those considering treatments and battling shame, Thomason suggests “trying to search out people in your life who you trust who can aid you work through the emotions that you could have without judgment. Don’t beat yourself up about shame, all shame is telling you is that you just’re not quite sure who you’re. And that’s an OK experience to have.”

*names have been modified