Over time, Grahame became increasingly concerned with her physical appearance; she particularly felt her upper lip was too thin and had ridges that were too deep. She began stuffing cotton or tissues under it, which she felt gave her a sexier look. Several co-stars discovered this during kissing scenes.

In the mid-1940s, Grahame began undergoing small cosmetic procedures on her lips and face. According to her niece, Vicky Mitchum, Grahame's obsession with her looks led her to undergo more cosmetic procedures that rendered her upper lip largely immobile because of nerve damage.
Mitchum said, "Over the years, she [Grahame] carved herself up, trying to make herself into an image of beauty she felt should exist but didn't. Others saw her as a beautiful person, but she never did, and crazy things spread from that