James cannot laugh or cry. He is unable to smile, raise his eyebrows, or even move his eyes from side to side. He has a rare condition called Mobius Syndrome. He believes his inability to register emotion on his face has suppressed his emotions. “People,” says James, “they are their faces.”

Mary noticed the first signs of aging on her face, “ugly little lines between my eyebrows, and they bugged me.” She opted for neurotoxin injections which, in effect, froze some of her facial muscles in the same way James' condition froze his. But she is thrilled with the results. Now, she says, “I can be planning a murder and it looks like I'm thinking about my grocery list.”

People have complicated feelings about their faces, as two new books make very clear. In About Face, neurophysiologist Jonathan Cole looks at people like James, with medical conditions that have dramatically altered their faces. In Venus Envy: A History of Cosmetic Surgery, University of Tennessee historian Elizabeth Haiken examines cosmetic surgery and the quest for physical perfection.

Haiken's project is the more ambitious: She attempts to both lay out a complete history of plastic surgery and examine the societal forces that propelled it. At the turn of the century, Haiken notes, less-than-ideal figures and features were thought to be our “crosses to bear.” Overcoming them gave us strength of character.

With World War I, however, and the high incidence of facial injuries, reconstructive and cosmetic surgery made great leaps forward, eventually opening the door to plastic surgery for anyone who could pay for it. Doctors began to theorize that attractive people have greater confidence and do better economically. Early plastic surgeons defended their profession by saying they were creating the kinds of workers who would get higher-paying jobs.

Very quickly, Haiken suggests, women began to see plastic surgery as ammunition for the war against roving husbands, aging and depression. At first, vanity surgeries were unpopular with the mainstream: People were outraged, Haiken notes, by Fanny Brice's nose job in 1923. But by the 1960s, things had changed so much that when Barbra Streisand didn't have her nose reduced, people asked, “Why not?”

Haiken's quotes from surgeons are chilling, as are the ads and articles she has chosen as illustrations. “Farewell to Ugliness” reads a 1946 American Weekly headline. A photograph accompanying the article is captioned, “To the homely girl, life may seem an endless succession of Embarrassments, Frustrations and Anguish until she decides to have a plastic-surgery operation. Then a remodeled nose, a rounded chin, may alter her personality – and her whole life.” In 1972, Dr. Robert Alan Franklyn, the well-known “Beauty Doctor,” told the Houston Chronicle about a 40-year-old patient. He said that by giving her a face-lift, he had “not only saved her job, but gave her a warmer personality, and a brand-new attractiveness to men who [had] previously shunned her as a 'crotchety old bag.'”

Some of the doctors express their doubts as well. One doctor told Esquire, “Sometimes it's very hard to decide about the patient. I had a woman patient recently: a very smart, chic, well-dressed woman. Middle-aged. She wanted a face-lift . . . She wanted to look better for her husband. It sounded okay. Later I heard she absolutely ran amuck – divorced her husband, ran off to Mexico, took a 25-year-old boy as a lover – the whole route. It was dreadful.”

But if Haiken has created a comprehensive chronology, she has not done as well at telling us what it all means. She writes about changing styles of beauty, how the bobbed Sandra Dee nose of the 1950s has been replaced by a more “Roman” or “ethnic” nose, like that of Meryl Streep or Christy Turlington. She includes before-and-after pictures of Cher and Michael Jackson, and discusses their desire to alter and enhance who they are – their age, their size and, in their own ways, their sexuality. She uses Michael Jackson to discuss the desire of many Asian, African and Middle Eastern people to conform to a white, Aryan ideal. But she never fully discusses the forces behind these changing norms.

In the end, it is Haiken's voice that is missing. She has clearly spent years immersed in the minutiae of cosmetic surgery, yet she never draws conclusions. I wanted to know what Haiken thinks about women having laser lifts and eye tucks and liposuction at 60, at 40, at 25 years old. And what about men with pec and penile implants? She hypothesizes that sometime in the next millennium, we will demand that every woman be a Venus and every man an Apollo. But is that good or bad? Haiken leaves us without an ending.

In About Face, Jonathan Cole is more than happy to examine the big picture. Through his interviews with subjects who have had to think about their faces more than they would like, he asks provocative questions. Where does the face end and personality begin? If you met someone who never smiled – or who could not, in his or her expression, react to anything you said – how would you know who that person is? The stories of Cole's “faceless people” are filled with loneliness, isolation and frustration. In the end, however, they reveal much about the complexities of being human.

To explore the importance of facial response, Cole interviews people blind from birth and discusses with them how they get to know a person. Their way of listening to a voice – its breath, its nuances of tone and inflection and, in particular, its silences – is wonderfully and sympathetically conveyed. The most startling section of the book is Cole's subsequent interviews with people who have only been blind since adulthood. They speak of their at times desperate need to see another person's face, and of their intense memories of faces they once saw, reminding us of just how important the sight of smiles, sideways glances and even tears are to each of us.

Cole writes about loss and, in the course of doing so, offers unusual insight into human dynamics. He writes with empathy, but without condescension. In the end, About Face gets at the basic truths of beauty, real beauty, in a way that Venus Envy does not, for in the end, a beautiful face is nothing without a living, expressive person behind it.

Diana Wagman wrote the novel Skin Deep, published last fall by University Press of Mississippi.

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