On TV: Youth Knows No Pain
Just so we're clear, Mitch McCabe's gripping, grotesque plastic surgery documentary Youth Knows No Pain (premiering tonight on HBO) is not quite about plastic surgery. Nor is it really about the "anti-aging industry," the designated euphemism for the $60 billion subculture comprising said surgeries, wrinkle creams, injectables, implanatables and numerous other treatments used to preserve Americans' illusion of freshness, fitness and vigor. Rather, Youth is about the dynamics of vanity -- particularly that of its filmmaker, who, along with so many of her subjects, seems too preoccupied with fending off age to contemplate that she's old enough to know better.
Still, there isn't much room in McCabe's survey for pity or judgment. A few egregious exceptions do arise (Julia Allison's pre-Botox warm-up is enough to turn you off to movies, let alone cosmetic surgery), but on the whole, McCabe presents individuals whose self-obsession happens to dovetail with good intentions. There's Sherry, the fascinating Texas housewife who intends her $35,000 worth of work over one year as her way of aging gracefully. Or Norman, a middle-aged schlub who made a new life out of cultivating his resemblance to Jack Nicholson. Or Cindy and Erica, the wife and daughter of a Houston surgeon whose famous (and philandering) reputation fuels family tension over the idealized female form.
Amid them all, McCabe ties in recurring footage and tales of her late father, himself a hugely respected plastic surgeon who settled on his profession as a means to help the wounded and disfigured. Bundled as a whole, his and the others' stories offer a humane counterpoint to Youth's anti-aging zealots -- the skin resurfacers, the peptide-brokers, the "galvanic-current" witch doctors, the smooth, seamless septuagenarians who admit to rigging their own teenagers up with Botox, and all the other animals sniffing through culture for people's fear of old age. McCabe offers them up as professionals simply doing their jobs, yet she cleverly sets those jobs up as ambiguous. Are they healers? Quacks? Miracle workers? Butchers?
McCabe isn't so sure herself, and in keeping with Youth's wry tone, she probably lets them off the hook too easily. In any case, she does seek answers in a trove of home movies, videotapes, self-portraits and other resources (including a cabinet of impoverishing high-end facial creams) documenting her own dread toward aging. The decades' worth of material anchors her film in the memory of youth -- that lingering awareness and regret of having taken vitality for granted. And even while avoiding the knife and needle for much of the film, McCabe's obsessive self-recording still signals a decisive edge over her subjects' own vanity. As such, her third act could use a tuck of its own; McCabe's surrender to Botox -- at age 37 -- compounds her self-regard in a way that's just too difficult (and too overextended) to watch.
But despite its filmmaker's exposure, Youth Knows No Pain has little use for the pitched drama or spirit of reality-TV confessionals, and nobody walks away much more enlightened than when they started. Their pathologies, compulsions and apprehensions are fascinating -- and inoperable. Yet the curious community McCabe finds here seems to live happily day-to-day with those concerns; worst-case scenario, there's always another procedure on the horizon. Or at least, eventually, the promise of a sort of good-looking corpse.