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Plastic Surgery Meets Suspense in Allie Rowbottom’s ‘Aesthetica’

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The cover of Allie Rowbottom's 'Aesthetica' shows a distorted, surgically enhanced face.
In Allie Rowbottom’s ‘Aesthetica,’ a former influencer wants to reverse her plastic surgery. (Penguin Randomhouse)

In Robert Zemeckis’ 1992 black comedy Death Becomes Her, Meryl Streep plays Madeline Ashton, an aging Hollywood actress who pays a pretty penny for an elixir from a mysterious rejuvenation expert (Isabella Rossellini’s Lisle Von Rhuman). The elixir not only de-ages her, but also immortalizes her youth.

In the pivotal transformation scene, she drinks the glowing pink potion and her butt is instantly lifted to a perkier position. The liver spots on her hand disappear. The gap between her breasts closes. And the skin on her face tightens and is visibly more supple, as if the collagen she naturally lost as she aged was returned to her. In sheer elation she exclaims, “I’m a girl!”

Author Allie Rowbottom. (Roeg Cohen)

In 2022, these body transformations are possible through surgical lifts of the butt, breasts and face, or digitally through apps like Facetune, which has been downloaded upwards of 200 million times. In writer Allie Rowbottom’s debut novel, Aesthetica, there is an equally desirable and dangerous inverse surgery, one that restores bodies by undoing previous procedures. In her fictional world, the magic potion is an edit button with the power to delete.

Aesthetica’s protagonist, Anna Wrey, is a 35-year-old former Instagram influencer who has elected to have the Aesthetica surgery — a costly and experimental procedure that is only available in Los Angeles. That’s in the present day, in 2032. Back in 2017, she is a hungry but naive 19-year-old who gets wrapped up in Los Angeles’s influencer cult(ure) and is catapulted into mid-tier celebrity status with the help of a much older manager-boyfriend named Jake, who constantly uses and mispronounces the word “aesthetic.” The timing is a useful frame as Anna comes of age in a not-long-ago era, which The New Yorker’s Jia Tolentino declared “The Age of Instagram Face” in a 2019 essay. Readers can readily remember the clashing cultural mores, aesthetic goals and feminist beliefs that we continue to grapple with today.

Media outlets that cover beauty constantly announce new trends as pathways to the ideal body. The Brazilian butt lift came to define the 2010s despite worryingly high mortality rates. And more recently, as The New York Post noted crassly, some celebrities have returned to the “heroin-chic” thinness of ’90s supermodels. The constant stream of new beauty and body trends, some cyclical, some diametrically opposed, are a reminder that the concept of an ideal body was only ever meant to be a marketing goldmine, not an achievable goal. On TikTok, videos tagged ‘plastic surgery’ have reached over 15 billion views and birthed a cottage industry of plastic surgeons analyzing people’s faces.


Aesthetica opens with Anna — already scheduled for the surgery that’s going to “free” her — instinctively playing the same speculative game on young girls in her eyeline. This is the beauty industrial matrix.

The book moves fluidly between Anna’s last year as a teen and her present day, on the eve of surgery. Through flashbacks we learn how Jake helps her build a social following and her body (the modifications she will later want Aesthetica™ to reverse). We also learn that something bad happened, bad enough for a reporter to be presently sniffing around her seeking a quote. In a simpler novel, this would be the impetus for a standard but thin revenge narrative: A woman goes after the man who wronged her and gets a happy ending. But Rowbottom’s writing is more complex, less obvious and in accordance with Wes Craven’s ideology of horror: “Horror films don’t create fear, they release it.”

We know something bad happened — something to do with Jake, something traumatic enough to make her abandon Instagram as a platform and life path, and something involving other women — but not exactly what. Rowbottom releases fear into her novel using tried and true horror notes. Not cheap jump scares, but haunting ambiguity, psychological turmoil, the slow buildup and unfolding of information around the incident. This way of building up terror is horrendously effective. As I read, I felt uneasy, waiting for more information but also afraid to receive it — a credit to Alfred Hitchcock’s belief that “there is no terror in the bang, only in the anticipation of it.”

This is what makes the book work so well: There are several undercurrents allowed to throb simultaneously. There’s the Jake storyline, which could reductively be referred to as a #MeToo plot; Anna’s relationship with her mother and her illness; early female bonding in Houston; and her post-Instagram retirement life working at a beauty counter in the days leading up to the surgery.

Rowbottom’s writing is not some cliché-ridden, girl-power critique of the global beauty industry. The industry is such an obvious villain that a moral argument against it would be an easy lay-up. Aesthetica’s appeal is that it is difficult. It doesn’t critique Anna. Neither her desire nor her regret are pathologized, simply explored. Aesthetica is concerned with showing you who the characters are, how they rub against each other, how their lives and purposes bleed into each other and create mess. It is interested in that mess and contradiction.

What Zemeckis’ film and Rowbottom’s book both understand is that the most interesting part of the beauty industrial matrix is the way it has altered women’s relationships to other women. In the film, Streep and Goldie Hawn (who plays Helen Sharp) portray two women whose intense personal rivalry has been the defining relationship in each of their lives. Ashton steals Sharp’s fiancé away, not because she is interested in him but because Sharp desires him. Through a complicated need to both best each other and be each other, Sharp’s desires become Ashton’s desires.

In Rowbottom’s book, Anna’s also self-aware enough to know, “it was always about the women…whether or not I was better than them. Sexier, but not sluttier, my wants smaller, my body smaller, though not too small.” Her relationships to the other women in the book are rendered with lacerating emotional precision. The strife is between Anna and her ailing mother, her childhood friend whose athletic body she envied, and other women she sees and consumes by the pool, on the street, on screens. She studies the exact way models adjust themselves to meet a camera’s eye or a man’s. “My body was the result of those other women’s bodies,” she thinks to herself.

Many women want to look like girls, and the beauty-industrial complex sells the lie that girlhood is a commodity that can be returned to you. It has convinced us all to see our bodies as capital. When Ashton shouts “I’m a girl,” it’s with the same gusto someone would use to announce they won the lottery. Rowbottom’s protagonist sees influencing as a social ladder, a financial parachute that will help her escape and become as free as she imagines rich people to be. In one characteristically witty line from her internal monologue mid-coitus with Jake she muses, “I was close to power, but not fully in possession of it, neither a child nor a woman, and not yet a wolf.” A clever riff and escalation of Britney Spears’ iconic song lyric that encapsulates the teetering she does throughout the novel, a woman caught between the drive to invent herself and the cost of that reinvention.

The human body has so many needs. It feels hungry, cold, dry, love-starved. Our lives are spent attending to these needs. What makes the beauty-industrial complex so formidable is it long-ago determined which of those needs was the easiest to exploit. It’s a lucrative hamster wheel and even though it has been exposed — articles abound about the industry’s dystopian labor conditions, and studies show how social media is contributing to rising rates of depression in girls, its chief users — it continues to run apace.


When some people realize they’re on a hamster wheel, they run harder. Are they trying to escape? To convince themselves they have agency and are not trapped, but choosing to be part of it? Aesthetica works because Rowbottom sees and understands the whole iceberg, or in this case, the whole wheel.

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