Perhaps the most shocking thing about the picture of the "plus size" model Lizzie Miller in American Glamour magazine is that we find it shocking at all. You look at that little roll of fat on her stomach, something familiar to many women, and it looks out of place, so used are we to seeing perfect images where every blemish has been eliminated. Within days of this unairbrushed photograph's publication, Glamour's editor, Cindi Leive, had received hundreds of emails of support from readers, pleased to see someone who more closely resembled them. It is tempting to see this as heralding a new era where natural beauty is celebrated in all its forms, but that isn't really the case – this picture wasn't on Glamour's fashion or beauty pages, and certainly not on the front cover; it was a 7.5cm photograph to illustrate a piece on body image. Still, the publicity it has generated for the magazine, and the reaction from readers, may get other magazine editors thinking.
"People don't ever see images like this in magazines," says Miller. "It shows how hungry the world is to see all different body types. On any fashion shoot, there is a whole lot of smoke and mirrors – hair, makeup, lighting, retouching. But this photograph wasn't airbrushed, it was real. That was what people were reacting to." She describes it as "a revelation" when she first went on a shoot with other models, "skinny girls, and they had stretch marks. But by the time you saw the pictures those had been airbrushed out. But just seeing that thin models had stretch marks too made me feel better. Models aren't perfect, nobody is perfect."
Just about every image we see now in magazines, adverts and most newspapers will have been altered in some way. It isn't the photographers who are the ones with the creative skill now, it's the retoucher who knows everything there is to know about Photoshop.
We remember the famous examples of extreme retouching – Kate Winslet complaining in 2003 that GQ had lengthened and slimmed her legs for its cover shot; last month in America the singer Kelly Clarkson was shrunk for the cover of a US magazine. In the new film The September Issue, the editor of American Vogue, Anna Wintour, describes the actor and that month's cover star, Sienna Miller, as too "toothy" so another picture of her head is Photoshopped on to a different picture of her body. In 2004, Keira Knightley was given a heaving bosom for the publicity pictures of the film King Arthur (she said at the time "those things certainly weren't mine") and it has been alleged that her recent advert for Chanel has been heavily retouched to give her larger breasts. This isn't just about making people look thinner – in fact, recently Alexandra Shulman, the editor of Vogue in the UK, said she was increasingly having to make models look bigger – it is the removal of any kind of "flaw" so a new level of human perfection has been reached, a world where women don't have wrinkles or eye bags, and nobody has pores or veins or facial hair.
"We even out skin tones, remove moles, take out the creases under the armpits, remove stray hairs, soften veins," says Chris Howes, a retoucher for Metro Imaging, a company in London that works for some of the biggest fashion magazines and advertising clients, when I ask him what he routinely does to a picture. "We don't tend to make people look slimmer because the girls aren't fat to begin with, but if someone is sitting on a chair and it makes their thigh look an odd shape, we can sort that out. If an elbow looks a bit lumpy, we'll see to that."
On the website for Digital Retouch, based in New York, which has worked for magazines such as Vogue and Glamour, and has worked on images of celebrities including Drew Barrymore, Jennifer Lopez and Cate Blanchett, there is even a section called "correction". I'm sure by that, they mean the change in colour and brightness levels, but judging by the before and after photographs, you can't help feeling it could also refer to the lifting of a bosom here, the slimming of a model there.
"I try to make people look good without changing too much," says Stewart Price, chief executive of the company. "I remove a smile line here and there, make them look a little younger. You can thin out someone's neck or fix a blemish, whiten teeth, brighten eyes, change hair, drop a few pounds – whatever is not aesthetically pleasing to our eye." Beauty is indeed in the eye of the retoucher, although Price insists "it isn't me, it's the magazine editors who have most power, and the publicists who control how they want their client to appear. The image usually has to be approved by the publicist and the celebrity so it becomes a group decision." He says pictures go back and forth "at least two or three times, sometimes more. The things people pick out are different every time, but it could be that they want [the model or celebrity] to be made thinner, their teeth whiter, change their hair or eyes or clothes. People pick out weird things – there could be a wrinkle or a bulge they don't like, or they don't like the look of the position of the arm and ask for another arm to be put on."
When Liz Jones, now the fashion editor of the Daily Mail, became the editor of Marie Claire she says she was shocked when she first saw what retouchers could do. "They showed me how they had given a model on the cover of Vogue a new nose. Did I airbrush? Of course: even the most beautiful women in the world – Heidi Klum, Renée Zellweger, Nicole Kidman – had what we have all been brainwashed to believe are 'imperfections'. I was told over and over again by management that unadulterated women wouldn't sell magazines. I once left all the lines on the face of one actress, and was roundly told off." Jones says the reason we are sold "perfection" really is as blunt as trying to make us to buy more products. "The advertisers and publishers need us to believe the lie that if we do what we are told – buy stuff – we will look like the women in the pages of the magazine. People in the industry always say women prefer fantasy and aspiration, but I don't think that is true: we want honesty, we don't want to feel bad about ourselves, thinking we are the only women with cellulite or wobbly tummies."
"It is fine to fix photos if it was one of a variety of ways [of presenting human beauty], but if it is the only way then it is damaging," says Susie Orbach, writer and psychoanalyst. "It makes you think, 'I ought to fix myself.' But any model will tell you it takes an army of people to make her look amazing – a good photographer, lighting, makeup – and then a whole other army of people sat at a computer to produce an image. It makes you wonder why they bother to use a human model at all."
In 2007, a study at the University of Missouri found that a wide variety of women felt noticeably worse about themselves after viewing pictures of models in magazine adverts for just three minutes. Another study in 1999, found that nearly 70% of teenage girls surveyed said their idea of the "perfect" body shape was influenced by the pictures they saw in magazines.
Teenage girls might be influenced, but isn't it insulting to assume that grown women are so easily duped by an image we know to be airbrushed? "It doesn't matter that we know, because these images are too powerful," says Gail Dines, professor of sociology and women's studies at Wheelock College, Boston. "I've been studying this for 20 years and yet when I open a magazine I start thinking 'I should go on a diet.' We are not stupid, but we are cultural beings and we take our cues from culture. Young girls are not reading the New York Times and seeing images of Hillary Clinton and Nancy Pelosi – their entire media diet consists of airbrushed images of models and celebrities and it has a profound impact." Dines believes children should be taught how to "read" images. "We live in an image culture now, but people are not taught how to deconstruct images. It's like living in a print culture and not being taught how to read."
As some kind of warped balance, as images of retouched perfection became so prevalent, gossip magazines started showing "real" photographs of celebrities, pointing out and mocking their flaws. When I interviewed Mark Frith, the former editor of Heat, the magazine which popularised this in the UK with their Circle of Shame feature, he said he believed the "reality" pictures actually made his readers feel better about themselves. "Celebrities always want to give the idea that they are higher beings and more perfect than everyone else," he said. "That whole thing was saying, 'Celebrities are just like you and me, don't be bullied by them.'" In a way, I can see Frith's point – nasty though the circle of shame is, perhaps we should be thankful that there is a market for pictures of celebrities looking ropey, especially now that supposedly candid paparazzi shots are increasingly being retouched by photographers trying to win favour with publicists – and gain access to their clients.
The feminist website Jezebel has become a kind of self-appointed Photoshop watchdog and regularly updates its Photoshop of Horrors section, where magazine covers and photographs are compared with their real-life subjects. In 2007, they showed how the country singer Faith Hill had been transformed – slimmed down, eye bags removed, nose refined – by Photoshop for the cover of a magazine. When they posted comments from the TV presenter Jenny McCarthy, who had described how she had received "a crap load of airbrushing" to remove freckles and stretchmarks on the cover of Shape magazine, they were contacted by the magazine's PR director who asked them to print what amounted to a retraction from McCarthy, who claimed she had been talking about "airbrush makeup". Price is all too aware of the fuss a leaked original cover image, pre-Photoshop, could cause. "Gossip magazines pay big money – maybe $10,000 [£6,100] – to find a cover that has been heavily retouched. We have to guard our pictures."
In 2007, the British Fashion Council set up the model health inquiry after concerns were raised about the health of models during London Fashion Week, but they also looked at the issue of retouching, concluding airbrushing could "perpetuate an unachievable aesthetic", and asked the Periodical Publishers Association to consider setting up a working group to look at the issue. So far nothing has happened.
Other countries do appear to be taking it seriously. The Swedish government has a website for young women on which they show how an image can be altered by retouching, and in Australia last year, the Victoria government introduced a media code of conduct, albeit voluntary, to discourage the use of Photoshop to change images of women.
In the UK, the Liberal Democrats are calling for adverts that have had a lot of retouching to have disclaimers printed on them, detailing which parts of a model have been altered, and for retouching to be banned altogether on adverts aimed at children under 16. "I think there is a difference between digitally removing a spot someone had on the day, and airbrushing a picture so heavily that the model has no flaws at all," says Jo Swinson, MP for East Dunbartonshire. "I think people are unaware of how much manipulation goes on. Continually seeing these images of perfection, that aren't even real, affect self-esteem. I would like the Advertising Standards Authority to take this seriously, and would encourage people to complain about the images they see."
There could be signs that excessive retouching may be going out of fashion anyway. Katie Grand, editor of the style magazine Love, says she is tired of seeing overly manipulated images. "There used to be a time when retouching would mean removing a pimple, but now all manner of things can be done," she says. "When I was at Pop [magazine] I found it interesting but now I feel bored with this idea of beauty that has become more like a painting than a photograph. When we started Love I wanted to remind people of real photography and a representation of people that was much more honest."