Before & After photos are ubiquitous: we see them in advertisements for diet supplements, home improvements, anti-wrinkle cream. For Jonny Pelham, the Before & After are related to the major (and expensive) facial cosmetic surgery offered to him on the NHS. His discussion of how the NHS justified its expenditure because of possible psychological distress for his appearance (affected by a cleft palate and a number of facial surgeries as a child), is made more potent by his reflections on the cosmetic, as opposed to medical, goals of the surgery. In The Cancer Journals, Audre Lorde famously recounts a similar surgical dilemma, discussing how breast reconstruction is one of the few surgeries that doctors recommend which serves no medical function aside from making others more comfortable. A similar energy is discussed in Lucy Grealy’s Autobiography of a Face, who recounts the horrific process of being subjected to years of painful and unsuccessful facial surgeries. Although Pelham’s interaction with surgeons and the NHS is overall very positive, these assumptions about appearance (and who the surgery will benefit) seem to be a still-deeply rooted issue inside of medical care, recognising a medicalised norm that we all must aspire to. While Before & After presumes a singular start and finish to the journey, it is exciting to think of Pelham’s journey as one which will move and grow and change over time, with new Afters to the current After, as well as new beginnings. 

JONNY PELHAM: BEFORE AND AFTER, 7-31 August, Pleasance Courtyard (Bunker). Venue is wheelchair accessible.

More about Jonny Pelham:

On Audre Lorde’s Cancer Jounrals:

On Lucy Grealy’s As Seen on TV