Mitch McCabe, Director of HBO 'Anti-Aging' Doc Youth Knows No Pain: The Movieline Interview

Mitch McCabe realized when she was young that aging horrified her, and as she grew older, she resorted to expensive facial salves and chemical hair-coloring treatments to reduce the signs of natural evolution.

A tragic event in her past compounded her lifelong fears: Her highly successful father, a plastic surgeon, died in a car accident. Though his work concerned concealment of mortality, his own mortality expired in one terrifying second. McCabe, now an award-winning documentarian, peels back the skin of the billion-dollar anti-aging industry in her new film, Youth Knows No Pain, which premieres on HBO tonight. McCabe spoke with Movieline about aging, the film's subjects (including e-media entrepreneur Julia Allison, who has a memorable scene looking in a mirror and declaring a wrinkle "unacceptable") and how her father's work influences her today.

When did this idea come about?

My friend is very new age-y and was talking about the film, which she saw at the HBO premiere. She was talking about aging and obsession with death -- I think I've always been obsessed with that [too], certainly as I got older, and I think especially when my dad died. I think for most people when a parent dies, there's a new awareness of our mortality. I think I really became aware of what he did, and of his profession. And as I came to my thirties, [I thought about] the whole obsession with aging in just different terms; I've always wanted to key into this. I tried to find grant money for the film in 2002, so I guess I was about 32 at that time. And already I was pretty obsessed then. When I originally spoke with people about it, they said, "You have no reason to be obsessed with aging," then years later again, they said, "OK, you have reason to be obsessed."...I guess you have to be closer to 40! In that time, the industry has seemed to double every year. Everything has really come together and now it's a timely film.

Your subjects are very candid. Any revelations that shocked you?

There was a lot of personal information that we didn't include in the film that surprised me, that I knew was just too much personal information for an audience. It would've given a sensational element to the film; it just didn't pertain to the topic. You know, I feel protective to these characters, who are also my friends. They are incredibly honest and especially about a topic that the public has a pretty strong opinion about - whether you should age gracefully, naturally, or what aging is, what plastic surgery is, should you, shouldn't you, and whatnot. I mean, everything that came out of Sherry's [a Dallas housewife who spent $35,000 in one year on plastic surgery] mouth is pretty fantastic. I have about 50 hours of, like, "Whoa." She's just so uninhibited and silly. And so honest. When she watched the film, she just laughed throughout her scenes, and laughed louder at herself than at anyone else in the film. She loves to perform, you know what I mean? She was in Times Square going up to anybody and telling them.

What personal stuff hit the cutting room floor?

Traumatic events, personal information, and with a couple people, maybe racist things they would say. It would make a couple of the people look unlikable -- actually, wait, I think it's just one person. [Laughs.] You can only give so much time to things, you have to cruise it along. We're trying to go through the progress of the topic, going through the peaks of the anti-aging industry. Some people have a problem with the phrase "anti-aging" in this field in general because we're all going to age. It's more "aging management." But that includes a lot of things, and we could go down a lot of avenues -- growth hormone, immortality spirits, anti-aging architects -- a lot of theorists. But it was so cerebral, and the film is visual.

I noticed celebrity culture wasn't a fixture of the film. I was surprised not to see Joan Rivers pop up.

I guess we tried not to do that, [though] there was a lot of talk going down that route. The great thing about doing a film like this, among other projects I have, is that people corner you at a cocktail party, and talk to you about their fears, or how much they hate the idea, or whatever. And they always bring up the "cat woman" [socialite Jocelyn Wildenstein]. But I feel like those people have so much exposure anyway, and they're in the public eye, and they have the means to do what they want. It's not about society as a whole. I wanted to focus on people from different geographic areas, instead of celebrity, which is covered all the time in magazines and tabloids.

How did Julia Allison enter this film?

Ironically, I did not know who she was when I got her. Of course, by the time I'm showing rough cut, my friends, a lot of whom are based in New York and are in social media, were like, "Do you know how people are going to react when it comes to her scenes?" And I did not know what she meant. She said a lot of things that were actually in my treatment for the film -- the whole idea of Sophia Loren being quoted on aging gracefully, when she'd had breast implants back in the '50s or '60s. So that's how that came to be. Of course, now I know who she is!

Julia Allison is a poster child for DIY social media fame. Now that anyone can make him/herself a celebrity, is there a pervading sense that anyone and everyone should go in for touch-ups?

It's interesting because there's a lot of reasons for the rise of this industry, the biggest one being that we're an aging society. We'll be in the work force longer, dating longer, just around longer. We want to hold on to our attractiveness to society longer. I don't know when we're going to have our attitudes toward aging change. Another part is celebrity culture and accessibility to these things. In the film it's said that technology has kept up with the desire to look young and beautiful. I think that's one of the things that kind of enrages people, like these people are going against the contract we have with each other to age naturally.

The other element in this, celebrities, most of them have made some kind of attempt [at staving off aging], whether through injectables or knife-work. Simon Doonan [a style maven featured in the film] had many great things to say that we couldn't include. He said, "I have nothing against people in the public eye who need to have their hair un-grayed or surgery, but if you're just a normal person, what's that about?" There is that mentality that anyone can be a celebrity and people try to emulate that. We're just a country where anything can happen. But there's so many young women I've met who get Botox, especially more in the big metropolitan areas as far as the age bracket. Julia happened to be somebody without a filter.

Can you talk about the surgeries you've had?

What I did isn't technically plastic surgery -- I forget what the technical word is. Like I say in the film, I came from being a product addict, a cream addict, and really almost against getting anything beyond that. I remember there was this woman in Texas, a makeup artist, and when she heard my dad was a plastic surgeon, she said, "I had a lift in my forties, would you ever do anything?" I told her flat-out, "No." I really believed I never would. I really think filming this so intensely and meeting so many people, and hearing over and over again [about the lack of] difference between getting a little filler or Botox and coloring your hair. Meeting these people just changes your opinion. And then these creams, all this stuff I'm spending my money on -- just what is this? On the other hand, once we finished the film and life goes on, and you continue to see things and life doesn't stop, like for some people they'll get too much done. It's a never-ending cycle. I think finishing this film was almost as cathartic for me dealing with my own mortality.

The doctors in the film were interesting. One asked you if you "liked" your chin and criticized your tricep.

There was Dr. Rose and Dr. Braverman, who both made comments about me. I think they field people who come into their offices and want to know how to make themselves perfect. Unfortunately, nowadays, movie stars don't have gaps in their teeth. What I found almost most horrifying were the growth hormone [advocating] doctors, and internal anti-aging [advocating] doctors, and their attitudes toward women who'd flat-out say to your face -- to women over 25 who aren't hormonally balanced -- that you basically are worthless. But I don't have a thing toward doctors; I more want to question our attitudes. There are certainly doctors, non-certified doctors, injecting things, which I think is a real problem. And they'll do it to their own daughters, verging on child abuse. I think if you're going into the plastic surgeon's chair, you have to be a little careful. But none of that really made me really feel bad -- except the tricep comment. Like chin, I don't care about. "The forward mandible?" Yeah, I found that pretty funny. That was a test of my own self-esteem, I was like, "You know? No. I don't care. I would never in my life do anything about that." But that's something that tells me there are people out there who'd respond to that.