What do you dislike about yourself?

Your clothes? Your make up? Your interior décor? Your garden? Your cooking? You name it and there will be a TV programme out there to dangle before you the possibility, not only of a new living room, but of a new life. In the last two years or so, the beady eye of makeover TV has fixed its exploitative gaze increasingly on the body and treated us to what seems like a plethora of programmes about plastic surgery. There have been documentary stories about plastic surgery's capacity to transform terrible deformities and injuries; there's been the reality show Extreme Makeover; and most popularly there's been the fictional adventures of a right pair of mixed-up Miami surgeons in Nip/Tuck who begin every consultation with a prospective patient with that question: "What do you dislike about yourself?"

Well, as far as appearance goes, I hardly know where to start. For years my family has wanted me to use Just for Men to stave off those distinguished flecks of grey but I've steadfastly taken a kind of Robert Redford view of aging - let it come, let it come. At least, that's the view he once took, though some observers are now sceptical as to whether the subsequent ravages of time served to loosen his convictions and tighten his face. In any event, one thing is clear: I've got a big nose. At least I think I have. And so does my family, among whom the received wisdom is that my daughter has a button, my son has a nose and I have a snout. I wouldn't call it elephantine but it's certainly Toucanesque.

Now, you may be surprised by this admission because it's tough to gauge the magnitude of my proboscus from the tiny little photo that graces this article but those Christianity editors know what they're doing - a photo so small the passport office wouldn't accept it, with lots of reflected light off the back wall, and of course front-on. They won't be publishing many profile shots of me. In fact, my best side is front-on. As Woody Allen once said, "Just because I'm paranoid, doesn't mean they're not getting at me. "So let me tell you that it's certainly no accident that Red Nose day fell on my birthday (March 11th in case you forgot and want to send me something), and certainly no coincidence that Mr Nosy in the Mr Men series happens to be the only character who is all green. Frankly, I've never considered a nose job - because I rather like the thing - and anyway not many people have got one quite like it.

But watching Nip/Tuck begins to make you aware of possibilities. Incidentally, Nip/Tuck is a tawdry, predictably hypocritical series that pretends that it is exposing the hollow world of plastic surgery whilst simultaneously trading on its moral turpitude to get its ratings. It's not something I'd recommend to anyone and, having seen three episodes fits neatly into the category of Psalm 101:3: "I will set before my eyes no vile thing." In any event, watching Nip/Tuck made me aware of possibilities that it seems huge segments of the population have long been taking advantage of. Certainly, in this instance, TV is not setting trends but merely reflecting them: the number of people paying for cosmetic surgery grew by 50% last year and over 100,000 Botox injections were administered.

Nevertheless, it's worth noting that in the UK at least the bulk of plastic surgery remains restorative - burns, bat ears, cleft palates, and so on. Of course, there are also the more spectacular cases like the 13 year old girl whose breasts weighed 6 kilos each, equivalent to a quarter of her bodyweight, and the size of footballs. Few people would grudge her breast-reduction surgery - she could hardly move. Similarly, few cannot but gasp at the extraordinary advances in technology. There is one plastic surgeon in Britain who can actually construct an outer ear from a rib. And today surgeons can take flesh from the abdomen and tunnel it up through a woman's body and create breasts for women who have gone through mastectomies. Such procedures are primarily motivated by a desire for social ease. However, the massive increase in elective procedures over the last five years seem motivated by an enormous increase in social dis-ease - breast enlargement, breast reduction, face-lifts, brow-lifts, silicon implants in calves to improve their shapeliness, injections into the lips to increase the promise of sensuality.

And this dis-ease, this increasing dissatisfaction with the bodies and faces God has given us finds ever younger victims. Recent research, for example, in Australia revealed that 47% of girls between the age of 5 and 8 want to be thinner. Well, we may not have the data yet but I would be extremely surprised if this were not the case in the UK. Certainly, we have been treated to seemingly endless reports about the rapid rise of child obesity, about poor school food, about the ubiquity of vending machines full of junk food, about the decline in facilities and time for sport in schools, and about the decline of adults willing to run sports clubs for kids. Similarly, since Twiggy in the 60s we have been bombarding girls and women and, more recently boys, and men, with images that have vaunted and reinforced the idea that you need to be thin to win.

And even if all that media and all that cumulative peer pressure hadn't made the average girl paranoid about her shape then just contemplate the reality that the majority of girls are living with adult women who do not like their bodies much and who are constantly concerned about their weight. They're called 'mum'.

Certainly, the impact is clear for girls of almost any age. Bliss, the early teen-zine, that trades in sylph-girl imagery and 'should-you, shouldn't you' advice for the already all too knowing, surveyed 2000 of its readers to discover that 92% were unhappy with their bodies. Well, if you'd read a year's worth of Bliss you'd probably be unhappy with your body. In fact, if you're a woman and had read even a single issue of almost any woman's magazine, you'd probably be unhappy with your body. Indeed, research I read a while back (but can't locate now) revealed that women are more depressed after they've read the average woman's magazine than they were before. The March 12th - 18th issue of Heat would be enough for me. Its front cover leads with "Stars who hate their bodies!" plus quotes from Tina wailing, "I've got no curves," Michelle bemoaning, "I hate my legs," and someone complaining that she can't stand her bum Well, what hope for the rest of the female population then? In the US, a Harvard study revealed that when women over 18 look in the mirror 80% of them are unhappy with what they see. ?

Almost everything in our culture serves to increase this anxiety among women about their shape. And the hugely sad thing about this is that thirty years on from The Female Eunuch and the feminism that was intended to liberate women from such obsessions, women as a group seem more in bondage to image than they were before. Perhaps twas ever thus. Simply ask yourself, or ask your grandma, if she ever heard anyone go up to a three year old boy and say, "Doesn't your hair look lovely today?" We treat little girls differently from little boys and pay more attention to the prettier ones. Little girls learn from a very early age that looks matter.

The sadness about our present culture is that our anxiety is not decreasing but increasing. The technologies that release people from the social discomfort of terrible injury also create the possibility of changing something relatively minor - from crooked teeth to smallish breasts. A hundred years ago you accepted your lot. Today, we might be able to save up enough money to have it changed. And increasingly we do. And why not alter nature a bit? Isn't it Ok to dress in clothes that enhance our good features and disguise our less attractive ones? Indeed, it is. But it is one thing to cut your hair so you don't resemble a yeti and another to cut off a bit of your nose so that you don't look like your mother, or so you don't look Jewish, or Italian or Greek or Moroccan.

Meanwhile, deeper questions are not addressed. Why are we so dissatisfied with the way we look? Do we covet our neighbour's face-lift? Is it simply envy? Why is it that any aspect of our physical appearance can become a cause of personal dissatisfaction and social shame?

Fifty years ago, the question "What do you dislike about yourself?" might have been more likely to elicit confessions about character flaws - painful shyness, quick-temperedness, a wandering eye, a weakness for cream cakes, and so on. Surely, this remains the core issue.

A culture obsessed with surface is a culture that won't address the deeper issues, which have more to do with character than looks, not so much: "What do I look like?" but rather "What kind of person am I?" Certainly, plastic surgery can liberate some people from conditions that make it difficult for them to operate without stigma in society but it is fast becoming one more way to stave off that awful moment when I ask the question: "What do I dislike about myself?" And have to give a truthful answer.

Never mind that nose, what about my judgementalism, my bitterness, my anger, my inability to be the person I want to be, my lack of love for others, my lack of confidence in my own worth as a human being?

Have we not been created in the image of the living God, have we not been redeemed by His son, rescued by a prince who was not, as the Scriptures tell us, particularly good-looking? Indeed we have. And as long as we train our sons and daughters to look in the mirror, mirror on the wall for the answer to who they are and what they are worth, their anxieties will multiply and their agonies increase. When, however, they look in the Father's eyes, what will they see? They will see a God who made them and loves them, who does indeed want them to grow more beautiful every day, more into the likeness of his beloved son and who has made it possible through the most extraordinarily ugly sacrifice. Because we are indeed worth it.