In this accessible monograph, Abigail Brooks provides a theoretically rich analysis and extensive discussion of the accounts of 44 women, aged 47–76 years, who were interviewed about their perspectives on ageing in the context of the widespread use and availability of cosmetic anti-ageing interventions in the United States of America (USA). Her intent was to turn the spotlight on ‘real, everyday women’ (p. 27), whose views have been less evident in the public discourse on the topic compared to those of celebrities and journalists. Adopting a feminist epistemological framework, Abigail Brooks is careful to highlight the culture in which the participants and the research is located, while also pointing out that the use of cosmetic interventions occurs globally. Indeed, this is a clear strength of the book, as she situates the women's accounts within a cultural context in which women's beauty and visibility is dependent upon a youthful physical appearance; individualism supports the understanding of attention to one's body, including its appearance, as part of the ‘self’ project; and profit-based, de-regulated medicine actively markets technologies that presumably keep the ageing process at bay and are treated as ways to promote health. Social media and relationships with other women, men and children (in the case of the women who are mothers) are also discussed as a means of facilitating these cultural meanings and the practices that they foster.

Besides the national context in which the research was conducted, there are a few other important limitations regarding how applicable the conclusions may be to women generally. Virtually all of the women lived in New England and identified as white and heterosexual. In addition, they were similarly engaged in various forms of physical activity, an indicator of their common concern for bodily health. These similarities were accompanied by interesting differences. There was some economic diversity among the women, however, interest in anti-ageing technologies was not specific to the more economically privileged women (although, this is relative if one extends the analysis to a global context). Further, the women differed with respect to their perspectives towards ageing. Some had already used cosmetic anti-ageing surgeries and technologies, some were ambivalent about such interventions and had not yet come to a final decision, and others were critical of these ‘unnatural’ attempts to remain physically youthful. By comparing women who actively resist the cultural prescription to remain youthful with those who recognise it and respond strategically by conforming, Abigail Brooks is able to show us the cultural terrain that women in the USA must navigate as they age.

A grounded theory methodology, guided by the constructivist approach of Kathy Charmaz, was utilised for data collection, analysis and writing the book. Some of the details and an insightful discussion of how feminist epistemology informed the research are found in Appendix A. Those hoping for full disclosure of all the methodological details will be disappointed, however. Missing, for example, are the particulars of the interview questions. Nevertheless, the work stands as an informative model of feminist research. A particularly interesting aspect is how the author negotiates between her own critical stance on cosmetic intervention and her feminist principles that orient her to valuing the women who are ‘users’ of those interventions.

The categorisation of the women as ‘natural’ and ‘unnatural’ agers lends itself to identifying and emphasising similarities and differences, which is the chief contribution of this book. However, it also de-emphasises possible contradictions in the women's both taking up and resisting dominant cultural prescriptions. Some contradictions are noted in passing, but the overall conclusions assert the differences between ‘users’ and ‘refusers’ of cosmetic intervention. In a world where technology is unavoidable, what it means to age naturally is unclear and the likelihood of engaging in practices that at times use, and at other times refuse, that technology is high. For example, I wonder if the women advocating natural ageing at times ‘give in’ to the forces pulling them towards a youthful appearance through their clothing practices, just as the women who use cosmetic intervention might at times resist these cultural forces by refusing further technological interventions offered by their doctors?

Situating herself as wanting to be a ‘natural’ ager, Abigail Brooks nevertheless remains true to her feminist framework in adopting a respectful tone in her presentation of the perspectives of those who embrace cosmetic interventions. In highlighting the risks of those interventions and how they reinforce ageism and traditional meanings of femininity, she portrays those who refuse cosmetic intervention as heroically standing in opposition to the daunting forces of culture, championed by social media, that deny them citizenship. This is an important narrative, but no woman can escape the culture in which she is embedded, and the ageing process may best be described as a complex negotiation between competing and contradictory meanings of being an older woman. Whether advocating refusal of cosmetic intervention will serve to undermine the value placed on a youthful appearance remains to be seen.

The book is appropriate for a varied audience. It will be of great interest to researchers in the field, but is equally informative for ‘real, everyday women’ like those who offered their stories as the foundation for the analysis. Students, both graduate and undergraduate, will also find it useful for what it brings to the understanding of women and ageing, and as an example of rigorous research guided by feminist epistemology. In this brief review, I have not done justice to the important connections made between the personal and the political in the context of cosmetic intervention. The particularities of how individual, heterosexual women's stances on cosmetic intervention are linked to cultural forces are clearly American, yet this engaging book provides an excellent starting point for anyone interested in exploring this topic in other contexts.