Cosmetic Surgery: Beauty as Commodity

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Qualitative Sociology [quso] HS069-27 January 20, 2000 15:31 Style file version Nov. 19th, 1999

Qualitative Sociology, Vol. 23, No. 1, 2000

Cosmetic Surgery: Beauty as Commodity

Debra Gimlin

Cosmetic surgery stands, for many theorists and social critics, as the ultimatesymbol of invasion of the human body for the sake of physical beauty. Interpretedas somehowqualitativelydifferent from other efforts at altering the body, plasticsurgery is considered to be so extreme, so dangerous, that it leaves no space forinterpretation as anything but subjugation. While such criticisms are compelling,they tend to operate at either the grand level of cultural discourse or the highlygrounded level of physiological effect. As a result, they leave out almost altogetherthe experience of the women who themselves have plastic surgery. This articledraws from qualitative interviews with 20 female clients of a Long Island, NYplastic surgeon to explore cosmetic surgery as an occasion for autobiographicalaccounting and a particular kind of account of the self. Interview data suggestthat plastic surgery allows women who undergo these procedures to successfullyreposition their bodies as “normal” bodies. At the same time, it also requiresthem to create accounts that reattach the self to the surgically-“corrected”—butpotentially “inauthentic”—body by invoking both essentialist notions of the selfand corresponding notions of the body as accidental, inessential, or degeneratedfrom a younger body that better represented who they truly are.

KEY WORDS: cosmetic surgery; beauty; the body.

After several unsuccessful attempts to schedule an appointment with her, Ifinally managed to meet with Jennifer,1 a 29-year-old grade school teacher whovolunteered to talk with me about the cosmetic surgery that she had undergone.On a typically cold November afternoon, I spoke with Jennifer in her apartmenton the south shore of Long Island. Jennifer, who is 5′6′′ tall and has long, straightblond hair and expressive light blue eyes, was dressed in an oversized gray pulloverand black sweat pants. While we talked, she peeled and sliced the crudités thatwould be her contribution to the “pot luck” engagement party that she would beattending later that evening.

Address correspondence to Debra Gimlin, VZ, Inc., 364 S. Cloverdale Ave., Ste. 201, Los Angeles,CA 90036.

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C© 2000 Human Sciences Press, Inc.



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Sitting at her kitchen table for nearly two hours, Jennifer and I discussedher decision to have cosmetic surgery. During our conversation, I noticed thatby far the most prominent—and largest—feature in her small studio apartmentwas the enormous black and chrome stair-climbing machine set slightly off fromthe center of the living-room/bedroom. I learned that Jennifer spends 40 minuteseach day on this machine and works out with weights at a nearby gym three tofour times per week. She eats no meat, very little oil or fat, no sweets and drinksvery little alcohol. Despite her rigorous body work routine, Jennifer’s legs haveremained a disappointment to her. Rather than appearing lean and muscular, theylook, by her account, thick and shapeless—particularly around her lower thighs andknees. Jennifer says that her decision to have liposuction performed was motivatedprimarily by her inability to reshape her legs through diet and exercise. During theprocedure, the fatty deposits were removed from the insides of Jennifer’s knees,making her legs appear slimmer and more toned.

During the time I spent with Jennifer, she discussed her reasons for havingliposuction, including her own significant ambivalence about taking surgical stepsto alter her body. Jennifer argued that, if possible, she would have preferred toshape her body through aerobics, weight training and dieting, and that liposuctionwas, for her, a last, desperate option. By her account, plastic surgery was an attemptto alter physical attributes that Jennifer referred to as “genetic flaws,” attributesthat she could change through no other available means. Expressing some shame,as she says, “for taking the easy way out,” Jennifer’s feelings of guilt are not sogreat that she regrets having surgery. Indeed, quite the opposite is true; Jenniferplans to have a second liposuction in the near future, this time to remove the fattytissue from her upper and inner thighs.

Cosmetic surgery stands, for many theorists and social critics, as the ulti-mate symbol of invasion of the human body for the sake of physical beauty. Ithas epitomized for many—including myself—the astounding lengths to whichcontemporary women will go in order to obtain bodies that meet current ideals ofattractiveness. Moreover, plastic surgery is perceived by its critics as an activitythat is somehowqualitativelydifferent from other efforts at altering the body (in-cluding aerobics, hairstyling, or even dieting) in that it is an activity so extreme, soinvasive, that it leaves no space for interpretation as anything but subjugation. Evenmore than women who may participate in other types of body-shaping activities,those who undergo cosmetic surgery appear to many observers—both casual andacademic—to be so obsessed with physical appearance that they are willing to risktheir very existence in order to become more attractive.

While cosmetic surgery has been dealt powerful (and some would say well-deserved) blows from the score of feminist writers who criticize body work gener-ally (Dally 1991; Kaw 1994), the cosmetic surgery industry is nonetheless rapidlyexpanding (Wolf 1991). Three hundred million dollars are spent every year on cos-metic surgery and the amount is increasing annually by 10% (Davis 1995, p. 21).In 1988, more than two million Americans underwent some form of cosmetic



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surgery. Between 1984 and 1986 alone, the number of cosmetic operations in theU.S. tripled (Wolf 1991, p. 251). Ninety percent of these operations are performedon women:virtually all breast augmentations and reductions, 90% of face-lifts,86% of eyelid reconstructions, and 61% of rhinoplasties (better known as “nosejobs”). In 1987, American women had 94,000 breast reconstructions, 85,000 eyelidsurgeries, 82,000 nose jobs, 73,230 liposuctions, and 67,000 face-lifts (AmericanSociety for Plastic and Reconstructive Surgeons 1988). At the end of World War II,there were only about one hundred plastic surgeons in the United States; todaythere are approximately four thousand along with an unknown number of additionalspecialists, mostly dermatologists, also performing face-lifts, eyelid surgeries andother “minor” procedures (Davis 1995, p. 21).

Criticisms of surgical alteration of the female body multiply nearly as rapidlyas the procedures themselves. One of the main critiques of cosmetic surgery de-rives from the dangers involved in many of the procedures. Cosmetic surgery isundeniably painful and risky and each operation involves its own potential compli-cations. For instance, pain, numbness, bruising, discoloration and depigmentationfrequently follow a liposuction, often lingering up to six months after the opera-tion. Similarly, face-lifts can damage nerves, leaving the patient’s face permanentlynumb. More serious disabilities include fat embolisms, blood clots, fluid deple-tion, and in some cases, death. Indeed, health experts estimate that the chanceof serious side effects from breast augmentation are between 30% and 50%. Theleast dramatic and most common of these include decreased sensitivity in the nip-ples, painful swelling or congestion of the breasts, and hardening of the breaststhat makes it difficult to lie down comfortably or to raise the arms without theimplants shifting (Goldwyn 1980). More serious is the problem of encapsulation,where the body reacts to foreign materials by forming a capsule of fibrous tissuearound the implants. This covering can sometimes be broken down manually bythe surgeon, but even when successful, this procedure is extremely painful. Whenit is unsuccessful, the implants must be removed; in some cases, the surgeon isactually forced to chisel the hardened substance from the patient’s chest wall.

Clearly, the recipient of cosmetic surgery may very well emerge from the op-eration in worse shape than when she went in. Unsuccessful breast augmentationsare often disfiguring, leaving the recipient with unsightly scars and deformation.An overly tight face-lift produces a “zombie” look, in which the countenance seemsdevoid of expression. Following a liposuction, the skin can develop a corrugated,uneven texture so that the recipient looks worse than she did before the surgery.

Finally, some criticisms of cosmetic surgery focus on the implications ofsuch procedures for contemporary conceptualizations of the body and identity. Inparticular, cosmetic surgery has expanded in conjunction with such developmentsin medical equipment as magnifying lenses, air drills for severing bone and levelingskin, and perfected suturing materials, all enabling surgical interventions to beperformed with better results and less trauma for the patient (Meredith 1988).According to some critics, these developments, and the increasing flexibility in



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body altering that they permit, are inextricably linked to cultural discourses likeningthe body to what Susan Bordo (1990) has called “cultural plastic.” The body is nowunderstood as having a potential for limitless change, “undetermined by history,social location or even individual biography” (p. 657). Not only has the bodycome to stand as a primary symbol of identity, but it is a symbol whose capacityfor alteration and modification is understood to be unlimited. The body, insteadof a dysfunctional object requiring medical intervention, becomes a commodity,not unlike “a car, a refrigerator, a house, which can be continuously upgradedand modified in accordance with new interests and greater resources” (Finkelstein1991, p. 87). The body is a symbol of selfhood, but its relation to its inhabitant isshaped primarily by the individual’s capacity for material consumption.

Many of these criticisms are convincing. It is surely the case that, of the variousforms of body work, plastic surgery is the hardest to justify. The physical dangersare real. The symbolic damage done to all women by the apparent surrender ofsome to unattainable ideals of beauty is powerful. Yet the criticisms also leave outa good deal.

Most importantly, the criticisms operate either at the grand level of culturaldiscourse or the highly grounded level of physiological effect. As a result, theyleave out almost altogether the experience of the women who themselves haveplastic surgery. In this article, I focus on that experience. In particular, I look atcosmetic surgery both as an occasion for autobiographical accounting and as itselfa particular kind of account of the self.

First—and most importantly to those who undergo it—plastic surgery oftenworks. This fact stands in contrast to a rhetoric that concentrates on the unattainablecharacter of contemporary beauty ideals, portraying plastic surgery as a Sisypheantask. Like Sisyphus, endlessly pushing a rock up a hill only for it to fall to the bot-tom, the criticisms of plastic surgery imply that those who undergo it will completeone operation only to discover some new flaw. Yet this is not the case. Somewhatto my surprise, many of the women I interviewed expressed enormous satisfactionwith their procedures. While some did, indeed, intend to return for additional op-erations, others seem content to have fixed a particular “flaw.” To be sure, I do notmean to argue that all contemporary ideals of beauty are, in fact, attainable. Theyare not. Neither do I mean to argue that any woman in contemporary America canescape the nagging self-doubts caused by those unattainable ideals. They cannot.But the ambitions of those women who undergo plastic surgery often stop far shortof attaining ideal beauty. And given these limited ambitions—and within the cul-tural space marked out for the expression of female beauty—plastic surgery oftenachieves precisely the goals intended by those who undergo it.

Second, the criticisms of plastic surgery often understate the extent to whichthis activity involves not just gender issues, but issues of gender at an intersec-tion with age, race and ethnicity, and even class. Many women surely undertakeplastic surgery, most notably in the case of breast enlargement, to enhance distinc-tively female attributes. Others, however—Jewish and Italian women who have




rhinoplasty, Chinese and Japanese women who have their eyes reshaped—do soin a distinctively ethnic context. And many others have plastic surgery in an attemptto reproduce the bodies of their youth. If plastic surgery speaks to the depredationsof gender domination, we should recognize that it also speaks to the depreda-tions of Anglo-Saxon ideals of beauty and the attachment of ideals of beauty toyouth.

Third, the criticisms of plastic surgery ignore the complicated process bywhich the women who undergo that surgery integrate it into their identities. If notin feminist theory, then in popular culture, there lies an implicit notion that thebenefits of plastic surgery are somehow inauthentic and, therefore, undeserved.Although the critics of plastic surgery are insistent that appearance should notbe the measure of a woman’s worth, the women who have plastic surgery arenonetheless participants in a culture in which appearance is often taken as anexpression of an inner state. Yet, because the desired benefits of plastic surgeryare purchased rather than “natural,” the relationship between a new nose or widereyes or thinner thighs and the self seems often in doubt. The commercial characterof cosmetic surgery seems to sever the relationship between an inner state andits outer expression in physical appearance. In contrast to women I studied inan aerobics class, who were working hard to detach their identities from theirbodies, women who undergo plastic surgery must work even harder toreattachtheir identities to their new appearances. On the one hand, they are using plasticsurgery to tell a story about themselves: I am the woman with svelte thighs or abutton nose. But, on the other hand, they must also tell a story about plastic surgeryin order to counter the charges of its inauthenticity. They must show somehow, tothemselves even more than to others, that the new appearance is both deserved anda better indicator of the self than the old appearance—an appearance necessarilyrepositioned as “accidental.” The result, then, is that the woman who has plasticsurgery finds herself in a double bind. She is unhappy with her appearance. Butshe must also defend herself for the very efforts she makes to alter that appearance.

RESEARCH AND METHODS

The research for this chapter involves field work in a Long Island plasticsurgery clinic and interviews with the clinic’s surgeon and 20 of his female pa-tients. Finding a location to study cosmetic surgery proved difficult due, at leastin part, to many women’s hesitance to admit that they have undergone such pro-cedures. Having organized a larger project around both interviews and field workwithin identifiable physical locations—including a hair salon and an aerobics stu-dio (Gimlin, forthcoming)—I knew that I wanted to talk with a single surgeon’sfemale patients, rather than, for example, a “snowball” sample of surgery clients,which I could have located rather easily through advertisements in local news-papers, gyms, universities, or hairstyling salons. As a result, I needed to find a



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cosmetic surgeon who would permit me access to her/his patients. My search forthis doctor took nearly six months, during which time I contacted over 20 clinicsand interviewed seven physicians.

Dr. John Norris, a local surgeon specializing in aesthetic procedures, wasone of the physicians I interviewed. While I chose to focus my research attentionsprimarily on his clinic, I interviewed six other surgeons in the area. My discussionswith those physicians proved to be a rich source of data about the cosmetic surgeryindustry and cosmetic surgeons themselves. I learned, for example, that cosmeticsurgeons are often critical of their female clientele, seeing them as obsessed andimpossible to please. Moreover, often believing that the physical imperfectionsthat their clients observe are really quite insignificant, they frequently suspecttheir patients of trying to solve emotional problems by altering their bodies.

I met John Norris at a gym where I had earlier studied an aerobics class. Asa member of the gym myself, I spent a considerable amount of time there eachweek, both in research and on my own “body work.” John and his wife, Monica,were other gym regulars, who, like myself, tended to exercise in the mornings.As a result, I saw them several times each week. Even though I had met himpreviously, I contacted John formally as I did the other cosmetic surgeons in thearea. I explained my project to his receptionist and made an appointment to speakwith him. After our second meeting, I asked John to allow me to interview 20of his female clients. He agreed and asked his receptionist to contact 20 womenwho might be willing to talk with me. After obtaining his patients’ approval, Johnthen provided me with their names and telephone numbers. This procedure surelybiased my sample in favor of successful cases, a consideration that should be keptin mind. In addition to his patients (one of whom I was able to interview bothbefore and after she had surgery), I conducted several interviews with John aswell. I also attended informational sessions at another local surgery clinic, in orderto learn more about the specifics of many of these procedures.

The women I interviewed ranged in age from 24 to 50. The procedures they un-derwent include breast augmentations, nose jobs, face-lifts, eye reshaping, tummytucks, and liposuctions. The women are Asian American or European American;among the latter, the group members’ geographical heritage varies in terms ofEastern and Western, Northern and Southern Europe. Three of the women areof Semitic ancestry. All but one (a full-time mother) held salaried jobs or werestudents at the time of the interviews. They were employed as opticians, med-ical technicians, receptionists, insurance agents, teachers, office administrators,hairstylists, and secretaries.

STORIES OF A FACE-LIFT: ANN MARIE

Ann Marie, a slender, soft-spoken 50-year-old medical technician with up-swept blonde hair, was one of the first surgery patients I interviewed for this




research. Married for nearly 30 years, Ann Marie carried herself with a carefulgentility. The type of woman my mother would refer to as a “lady,” Ann Marie’sdaintiness and obvious concern for her appearance made me self-conscious of thebulky sweater and combat boots I was wearing. Dressed in snug-fitting woolenpants, low-heeled brown pumps, and a fuzzy light mauve sweater, Ann Marieinvited me into her small, tidy home and asked demurely if I would like coffee.Anxious to begin my first interview with someone who had had a face-lift, I re-fused her offer. Ann Marie brought her own drink back from the kitchen in a tiny,flower-painted china cup and saucer and began telling me about her experienceswith plastic surgery.

Somewhat to my surprise, Ann Marie was not at all shy about discussing herface-lift. In fact, she actually seemed eager to tell me the reasons for her decision.By her account—and, as anyone with even the most limited understanding ofphysiology would expect—Anne Marie’s appearance began to change in her latethirties and forties. She developed “puffiness underneath the eyes,” and “droopingupper eyelids.” Most unattractive by Ann Marie’s account, “the skin of my throatstarted getting creepy.” In her words, “You get to an age” when “you look in themirror and see lines that were not there before.” Because her physical appearancehad begun to reflect the aging process, she explained, “All of a sudden the need[for cosmetic surgery] was there.”

While Ann Marie described her need for a face-lift as “sudden,” she actuallyplanned to have the procedure long before she believed that she needed it. AnnMarie recalled that “about ten years ago,” she spoke with several close friendsabout having a face-lift at some point in the distant future. She explained,

We talked about it a long time ago. I guess I have never accepted the axiom of growing oldgracefully. I have always sworn I would never picture myself as a chubby old lady.

Ann Marie and her friends “talked and decided that when the time was just right,we would definitely do it.” Even so, Ann Marie was the only member of the groupwho actually went through with the surgery.

Despite her seemingly firm decision, Ann Marie did not enter into cosmeticsurgery lightly. Instead, she considered having the procedure over several years,during which she “thought about it from time to time. There was a lot to be con-sidered.” In her estimation, “Having plastic surgery is not something to undertakelightly.” Among the issues she contemplated were the physical dangers involvedin the operation, the potential for looking worse after the surgery than before andthe importance of choosing a well-qualified doctor with an excellent reputation.She explained,

You are putting your face in the hands of surgeon; there is the possibility of absolute disaster,very possibly permanently. You have to choose the surgeon very carefully.

Ann Marie chose John to perform the face-lift. Largely because he had per-formed an emergency procedure for her just over one year earlier, Ann Marie



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claimed that she felt completely comfortable with her selection of a surgeon. Sheexplained,

John was recommended to me by my dermatologist. I had an infection on my face; it wasquite serious. The dermatologist told me I had to go to a plastic surgeon and John was theonly one he would recommend.

Because of the dermatologist’s recommendation and her satisfaction with John’searlier work, Ann Marie returned to him when she decided to have the face-lift.She visited his office in Long Island for a consultation and, not long after herappointment, decided to have the procedure.

During their first meeting, Ann Marie learned what she refers to as two“surprises.” She learned the price of the operation and that she would have tostop smoking, due to the health risks associated with nicotine intake. Accordingto Ann Marie, John explained that she must stop smoking because “you will notheal as well if you continue to smoke. Because it impedes circulation, smokingdecreases your ability to heal properly.” She said, “The most difficult part was tostop smoking. I was puffing away a pack and a half a day for over 20 years.” Johntold Ann Marie that she would not be able to smoke for three months in advanceof the surgery. She said, “I thought, ‘What? I will never be able to do this.’ But Idid, I stopped cold. That was the real sacrifice for me.”

While giving up cigarettes may have been the greatest sacrifice for Ann Marie,there were clearly many others. For a full year, Ann Marie had to work “one dayjob, one night job, occasionally a third job” in order to afford the surgery. She hadto “bank” four weeks of overtime at her primary job so that she could take time offto recover from the procedure. She also postponed repairs on her home becauseshe could not afford to pay for both the repairs and the operation. She explained,“There were things my house needed but my feeling was, I needed a face-lift morethan my house did.” Like many of John’s patients, having cosmetic surgery was apriority for Ann Marie.

Ann Marie spent most of our interview explaining her reasons for havingthe face-lift. By providing me with a long and detailed account of her need forthe procedure, she hints at an awareness that her behavior is somehow subjectto criticism, that it might, for example, be construed by others as superficial orshallow. With a hint of defensiveness in her tone, Anne Marie explained that she“needed” the face-lift—despite its financial costs and physical risks—not merelybecause she is concerned with her appearance, but instead, because of pressuresin “the work field.” She says,

Despite the fact we have laws against age discrimination, employers do find ways of gettingaround it. I know women my age who do not get jobs or are relieved of jobs because of age.This [the face-lift] will ensure my work ability.

Ann Marie, by her account, decided to have a face-lift not out of narcissism butout of concerns for her professional well-being. Justifying her behavior as a career




decision, she implies that she is sensitive to the social disapproval of plastic surgery,that she knows that the behavior requires some justification.

And yet, even though Ann Marie believes that looking younger would helpher professionally, she also admitted that she had “not seen anything that has reallychanged in that area [her career].” Instead, the procedure had affected her primarily“on a personal basis, a social basis.” Explaining these effects in more detail, shesaid,

I meet people I haven’t seen for two or three years who will say, “There is somethingdifferent about you, but I don’t know what it is.” I met a sister of a very good friend of minein June, which is five months after my surgery. She looked at me and said, “I don’t knowyou.” I said, “Of course you do. I’ve known you nearly all of my life.” She realized who Iwas and was astounded at my appearance.

Plastic surgery, then, in Ann Marie’s telling, provides an account of herself as ayounger woman that has, in turn, improved her self-image. By attributing a seriesof positive experiences—and the resulting improvement in her self-perception—to her face-lift, Ann Marie justifies her decision to have cosmetic surgery. Incontemporary Western culture, “feeling good” about oneself is understood to bean accomplishment worthy of effort in that it makes us better workers, spouses,and, more generally, better able to contribute to the society. Among children,self-esteem is credited with the ability to improve grades and to keep kids fromusing illegal drugs or having sex before they are emotionally ready to do so. Inexplaining her choice to have plastic surgery—as “a matter of personal esteem. Ifyou feel you look better, you feel better about yourself”—Ann Marie is makinga moral claim about the effects of the story plastic surgery tells about herself. Byconceptualizing cosmetic surgery as having the power to provide self-esteem, AnnMarie—and many of the other women I spoke with—effectively legitimizes anotherwise illegitimate activity.

At the same time, Ann Marie’s explanation of her decision to have plasticsurgery suggested that she was also somewhat ashamed of her choice—or at leastthat she was aware that cosmetic surgery is an activity subject to criticism. AnnMarie’s defensiveness is most obvious when she describes her decision to havea face-lift as “not purely vanity,” and then responds to her own statement bysaying,

If it is vanity, so what? That does not make me a bad person. I don’t want to look bad.Idon’t want to look my age. I want to look younger. I want smoother skin.

Not only is Ann Marie not “a bad person” because her actions suggest vanity,but, in fact, she is actually agood person, as evidenced in the other forms ofbody work in which Ann Marie participates. She explained, ‘My weight is onlya variance of six pounds heavier from what it was 30 years ago. I keep in shapein addition to the surgery. I jog, I exercise, I diet.” Ann Marie has maintained heryouthful physical appearance in every way possible—failing only to control theappearance of her facial skin, which she could not keep from “getting creepy.”



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In her account, Ann Marie deserved the surgery—an act tinged with deception—because she has proven her moral character through other (physically demandingand highly symbolic) forms of work on her body, by the expense she was willing toaccept, and by her struggle to quit smoking. Ann Marie is entitled to an appearancethat reflects those activities, even if that appearance is obtainable only throughcosmetic surgery.

“A DEEP DARK SECRET”: HAVING LIPOSUCTION

John arranged for me to speak with a woman named Bonnie, who was plan-ning, but had not yet had, cosmetic surgery. In sharp contrast to the other womenJohn suggested I interview, Bonnie was hesitant to speak with me about the pro-cedure, because, as she later acknowledged, she considered it to be “a deep darksecret” which she had discussed with no one but her husband of five months.Bonnie worked out at the same gym that both John and I frequented. Becauseshe and I were previously acquainted, John suggested that Bonnie speak with meabout the procedure she was considering and she agreed. Over the next six months,Bonnie and I met several times to discuss cosmetic surgery; during that period,she decided to have liposuction, underwent the procedure, and recovered from it.

Having recently completed a masters degree in a New England university,Bonnie moved to the east end of Long Island to take a position as a chemist in alarge biomedical research firm. She explained to me that she had, over the years,spoken casually to various women about cosmetic surgery, and had “fantasizedabout” having liposuction herself, though she had never considered it seriously.Prior to having the operation, Bonnie told me why she had been reluctant, eventhough the procedure had always been, as she described, a “fantasy” of hers. Sheexplained her hesitation as follows:

It’s always seemed to me to be one step too far. I have dieted and exercised my whole life,and sometimes I’ve gone over the edge and done some things that probably weren’t veryhealthy, but I could always stop myself before I became totally obsessed. I guess I havealways thought that I would never get so obsessed that I would allow my body to be cutinto just so I could look better. At least that’s what I had always hoped. I couldn’t imaginemyself as one of ‘them,’ as one of those weak women who would go that far.

Despite her stated objections to cosmetic surgery and her characterization of itspatients as ‘weak,” Bonnie considered, and, after extensive deliberation, under-went, liposuction on the outside of her upper thighs. Bonnie described this area ofher body as

. . . flabby, no matter what I do. I’ve always had these lumps that I couldn’t get rid of. Myfriends used to tease me because whenever I’d look at myself in the mirror, I’d always pushthat part of my leg in, so you couldn’t see the lumps. I wanted to imagine how I’d lookwithout them. I exercise five or six times a week; I cycle with my husband. I do all theweightlifting that is supposed to tone up the muscles in those areas. Nothing works!




Despite her frustrations, Bonnie had never seriously investigated the proce-dure until, at age 26, she finished graduate school and began full-time employment.She explained, “This is the first time I’ve ever made enough money to think aboutdoing something like this. The liposuction will cost $2,000, which is less than itusually costs because I won’t have to have general anesthesia, but it’s still a lotof money.” Bonnie noted that she would never have seriously considered havingcosmetic surgery while she was living near her family and friends.

The other thing is that I wouldn’t want any of my friends or my family to know about it,only my husband. My family would all be like, “You don’t need to have that done. You’recrazy. You are thin enough already.” That doesn’t keep me from thinking these lumps onmy thighs are really ugly. They are the only thing I see when I look in the mirror.

Bonnie continued, explaining that her hesitance to discuss her desire to have lipo-suction with her friends stems from their perception of cosmetic surgery as partof a process of “giving in to pressure, giving in to these ideals about how womenshould look, when none of us real women are ever going to look like that.” Bonniebelieved that her friends would react to her interest in plastic surgery by makingher ‘feel so ashamed, like I am not strong enough to accept myself like I am, likeI hate my female body.”

Bonnie was one of the few women I interviewed who articulated her am-bivalence about plastic surgery in what could be construed as political, rather thanexclusively personal, terms. Her description of her friends’ imagined protests toliposuction was one of many examples of her concern with the political meaning ofher actions. Bonnie also explained that her own interpretation of cosmetic surgerywas the main source of her dilemma over having the procedure. She said,

I am not worried about problems with the operation itself. I know that Dr. Norris has agreat reputation. I’ve talked to other people at the gym who have used him and they wereall really happy. He does so much of this stuff, I’m sure he’s really good at it.

Bonnie’s concerns focused instead on the social and cultural significance of heraction. She said, “If I am proud to be a woman, then I should be proud to looklike a woman, with a woman’s butt and a woman’s thighs.” Reacting to her ownaccusations, she said, “I am proud to be a woman, but I really hate it when I get aglimpse of my backside and I just lookbig. I feel terrible knowing that it is thoseareas of my body which are understood to be most ‘female’ that I dislike the most.”Expressing her interest in cosmetic surgery as her only viable option for reducingher dissatisfaction with her appearance, she added,

I don’t really know how to get around it, though, because I really do not like those parts ofmy figure. Plastic surgery seems like a pretty good way, and really, a pretty easy way, todeal with that dissatisfaction, to put those negative feelings behind me. . . to move on withthe rest of my life.. . .Like, I’d really like to put on a pair of biking shorts and not evenhave it cross my mind that my butt is going to look big in them. I’d love to get dressed forwork in the morning, and have only the work in front of me, rather than, you know, what’sliterally behind me, be the thing that concerns me the most.



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Bonnie is explicitly aware that the body and the self are understood culturallyto be equivalent. When she says that she dislikes the “female” parts of her figure,one can easily imagine replacing the term “figure” with the term “self.” Indeed,it is Bonnie’s ambivalence about her female identity that is most troubling toher; by eradicating the physical signs of femininity—and the imperfection whichis necessarily a component of those attributes—she believes she will be able toconstruct a self that will be less imperfect and more culturally acceptable, andwhich will, as she puts it, allow her to “move on with the rest of” her life. Bonniecontends that having plastic surgery will allow her to focus more attention onother activities and concerns, including her career, the sports she enjoys, and hernew marriage. At the same time, her decision to undergo liposuction comes ata considerable cost for Bonnie, who says explicitly that, if possible, she wouldprefer to change her perceptions rather than her body. The “pressure” she feels,however, limits Bonnie’s ability to actively rework her self-image, leaving her tochoose between two options—plastic surgery or a negative self-concept—neitherof which is satisfactory. Bonnie’s decision to undergo liposuction suggests that,in the end, the costs associated with having plastic surgery were somehow lesssignificant than were those attached to accepting her appearance flaws.

Ann Marie and Bonnie present two quite disparate images of the concernswomen face as they consider having cosmetic surgery. While Anne Marie strug-gled to work out the financial and physical requirements of her face-lift, Bonnieagonized over the political dimension of her decision to have liposuction. So dis-tinct are these preoccupations, in fact, that they can be conceptualized as oppositeends of a continuum, along which the perspectives of the other 18 women I in-terviewed can be placed. For most of these women, the political implications ofcosmetic surgery, though not entirely ignored, were far less significant than theywere for Bonnie. Compared to her, the other women I interviewed were more oftenconcerned with the health risks and financial costs involved in cosmetic surgeryand, even more significantly, with how they would look after their procedures.

While the character of Anne Marie’s and Bonnie’s pre-operative anxietiestook different forms, both constructed elaborate accounts regarding their entitle-ment to plastic surgery. Like Anne Marie and the other women whose voicesI will recount later in this article, Bonnie justifies her decision to have plasticsurgery by explaining that she has done all that is humanly possible to alter a failedbody and argues that no act short of plastic surgery will allow her to live peace-fully with herself. Significantly, the women I talked to provided accounts in whichthey attempted to dissociate themselves from responsibility for perceived bodilyflaws. Each woman’s body was imperfect not because she had erred in her bodywork but because of aging, genetics, or some other physical condition that thewoman could not control. In effect, they argued that their flawed bodies were in-correct indicators of character, and, as such, effectively lie about who the womenreally are. Accounts like these not only justify cosmetic surgery but attempt to




convert it into an expression of a putatively true identity. Plastic surgery becomesfor them not an act of deception, but an effort to align body with self.

“THE BODY I WAS MEANT TO HAVE”: WHY WOMEN HAVECOSMETIC SURGERY

While some writers have dealt with cosmetic surgery as if it were an attemptto accomplish idealized female beauty in order to gain the approval of men (Wolfe1991), the women I spoke with claimed that the goal of plastic surgery is neither tobecome beautiful, nor to be beautiful for husbands, boyfriends, or other significantindividuals. Indeed, these women adamantly insisted that they altered their bodiesfor their own satisfaction, in effect utilizing such procedures to create what theyconceptualize as a normal appearance—an appearance that reflects a normal self.While I do not accept their accounts without some skepticism, I believe that womenwho have plastic surgery are not necessarily doing so in order to become beautifulnor to please particular individuals. Instead, when women have plastic surgery,they are responding to highly restrictive notions of normality and the “normal”self, notions which neither apply to the population at large (in fact, quite thereverse) nor leave space for ethnic variation. In effect, plastic surgery, as I haveargued earlier, “works” for women who have these procedures, but it works onlywithin the context of a culture of appearance that is highly restrictive and whichis less a culture of beauty than it is a system of control based on the physicalrepresentations of gender, age, and ethnicity.

Throughout the interviews, my respondents claimed that prior to havingsurgery, some particular physical feature stood in the way of their looking “normal.”This feature distinguished them from others and prohibited them from experienc-ing, as Marcy, a 25-year-old student, explained, “a happy, regular life.” Marcydecided at age 16 to have the bony arch in the middle of her nose removed and itstip shortened. Prior to having the procedure, Marcy had never been involved in aromantic relationship, a fact that she attributed to her “hook” nose and unattractiveappearance. Marcy said,

I have always felt terrible about how pronounced it was. No matter how I wore my hair, itwas in the middle of my face and everybody noticed it. It’s not like I could just wear mybangs long.

Marcy decided to have rhinoplasty near a date that was particularly symbolic forher. She explained, “I was having my nose done just before Valentine’s Day. Ithought to myself, maybe if I have my nose done for Valentine’s Day, by nextValentine’s Day, I’ll have a valentine!”Although she did not find a valentine forthe following year—she explained that “[dating] didn’t happen until a few yearslater”—Marcy claimed that over time, she was able to experience pleasure thatshe would have missed without having her nose surgically altered. Because Marcy



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uses cosmetic surgery to make herself more appealing to others, her experienceseemingly supports the criticisms of authors like Wolf (1991). However, a centralfeature of Marcy’s account is that she does not expect plastic surgery to makeher beautiful. Neither does she believe that winning male affection requires herto bebeautiful. Quite the contrary, Marcy clearly imagines that a merely normalappearance is sufficient to garner the male attention that she desires.

The women I interviewed frequently described the ways in which their phys-ical features had kept them from living ordinary lives. For example, Barbara,a 29-year-old bookkeeper, told me that her breasts—which were, by her ac-count, too small to fill out attractive clothing—made her appear “dumpy” andill-proportioned. Her “flaw” had, in turn, contributed to the negative self-imageBarbara described having in her teens and early twenties, and this negative self-image served to limit the education and career goals Barbara set for herself, thefriendships she attempted to foster, and the romantic and sexual relationships shepursued. Barbara decided to have her breasts augmented (from a 36A to a 36D)to make herself, as she said, “more attractive to myself and others.” While herlarger breasts have in fact made Barbara feel more attractive, like other patients Iinterviewed, she nevertheless laments her (and all women’s) inability to be self-confident despite self-perceived physical shortcomings. She said,

For women, the appearance is the important thing. That’s too bad that we can’t worry aboutnot being judged. [Small breasts] made a big difference in how I felt myself being perceivedand how I felt about myself as a person.

Prior to having cosmetic surgery, Barbara was both abnormal (because her smallbreasts made her appear and feel awkward and self-conscious) and, at the sametime, normal for her gender (in that all women are abnormal because they all failto meet standards for female beauty).

Because physical attractiveness shapes the way women are ‘judged,” appear-ance must be guarded as women age. Like Ann Marie, several of the patients Iinterviewed underwent cosmetic procedures aimed at reducing the natural signsof aging. These women claimed that aging had changed an acceptable appearanceinto an unacceptable one, with the resulting appearance reflecting negatively onidentity. For instance, Sue, a 44-year-old optician, decided to have the loose skinaround her eyes tightened. She explained why she had the operation:

My eyes had always been alright, nice eyes. I guess I had always liked my face pretty well,but with age, the skin around them started getting puffy. They just didn’t look nice anymore.I looked tired, tired and old. That’s why I had them fixed.

While Sue had, according to her own account, once been satisfied with herappearance—even thinking her eyes were “nice”—she grew to dislike her faceas the signs of aging became apparent. Basically, Sue had lost an acceptable ap-pearance over time and so used cosmetic surgery to regain the face she liked “prettywell.”




The women who had cosmetic surgery told me that they had chosen to havethese procedures not to make themselves beautiful or outstanding in any particularway, but instead simply to regain normal physical characteristics that they once hadbut had lost through the aging process (see Davis 1995 for similar findings). LikeSue and Ann Marie, Carmine, a 48-year-old receptionist, used cosmetic surgery tocombat the physical changes associated with growing older. Carmine underwentliposuction to reduce what she referred to as “secretarial spread,” the wideningof her hips and buttocks that had come, by her account, with Carmine’s 25-yearcareer in office management. She explained,

When I was younger, I had nice hips, curvy but narrow enough, and my rear was well-shaped.After a lifetime of sitting, growing older and flabbier, it had gotten really huge.

Having lost the ‘well-shaped’ figure she once had, Carmine hoped to restore herappearance to its more youthful form. Believing that her only means of doing sowas cosmetic surgery, Carmine opted to have liposuction, rather than to surrenderto the aging process that had so drastically altered her body.

Youth—or at least a youthful appearance—is not the only characteristicwomen attempt to construct or regain through aesthetic procedures. Indeed, threeof the patients I interviewed—all of whom were under the age of 30—had cosmeticsurgery in order to reduce the physical markers of ethnicity. These women under-went procedures intended to make their physical features more closely approximatethose associated with Anglo-Saxon nationalities. Marcy, a Jewish woman who—asdescribed earlier—had rhinoplasty to diminish the “hook” in her nose, noted thatthe procedure also removed physical features “more frequently associated withJewish people.” Jodie, a 28-year-old student who also had her nose reshaped, said,“I had this Italian bump on my nose. It required a little shaving. Now, it looksbetter.” By a “better” nose, Jodie implies a more Anglo-Saxon, less Italian, and,therefore, less ethnic nose. And Kim, a 22-year-old Taiwanese-American student,underwent a procedure to make her eyes appear more oval in shape. She said,“We [Taiwanese people] regard girls with wide, bright eyes as beautiful. My eyesused to look a little bit as if I was staring at somebody. The look is not soft; itis a very stiff look.” While none of these women are consciously attempting todetach themselves from ethnicity per se, they nevertheless chose to ignore the factthat their efforts to appear more “normal” are, by definition, explicitly intendedto diminish the physical markers of that ethnicity. Clearly indifferent to the lossof ethnic identity that their actions imply, these women simply accept the no-tion that normalized (i.e., Anglo-Saxon) features are more attractive than ethnicones.

As I listened to these women’s accounts of their cosmetic surgery, I wasstruck by the fact that all of them claimed—quite adamantly, in fact—to havebenefited from their participation in an activity that has garnered widespread andhostile criticism from feminists and nonfeminists alike. These women contended



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that plastic surgery was, for them, a logical, carefully thought-out response todistressing circumstances that could not otherwise be remedied. Moreover, as aresult of their procedures, the women perceive themselves to be more sociallyacceptable, more normal, and, in several cases, more outgoing. As Bonnie, thewoman whose political concerns made her initially reluctant to undergo liposuc-tion, explained, I got exactly what I wanted from this. My body isn’t extraordinarilydifferent, but now I feel like, well, I have a cute bottom. I have a cuter figure. Idon’t feel like the-one-with-the-big-butt anymore. And for me, that lets me put mybody issues away pretty much.

At the same time, implying that some remnants of her original ambivalenceabout having cosmetic surgery still remained, Bonnie explained that she wishesshe could have said, “To hell with it, I am going to love my body the way it is. . .butI had tried to do that for 15 years and it didn’t work.” She adds, “Now, I know I’llnever look like Cindy Crawford, but I can walk around and feel like everything isgood enough.”

During my interviews with these patients, I was also struck by the fact thatplastic surgery provides for the pleasure not only of the observers/lovers/partners ofthe women who undergo these procedures, but also of the women themselves. Forinstance, some of these women say that they are able to wear clothes that they didnot feel attractive in prior to their operations; others, as I mentioned earlier, claimto have greater self-confidence or to be more extroverted. In one such example,Jennifer, the 29-year-old teacher who had liposuction to remove fatty tissue fromthe inside of her knees, explained,

When I walk out that door in the morning, my head might be a little bit higher when I’mwearing a certain outfit. Like before I had [liposuction] done, it used to be, I feel good, butI hope no one will notice that my legs aren’t too nice.

The clothing these women are now able to wear includes items such as bathingsuits, dresses with low-cut necklines, and lingerie—all of which are likely to befeminine and revealing. Wearing these clothes, and perceiving themselves as at-tractive in them, shapes the women’s perceptions of themselves and increases theirself-confidence. For example, Tara, a 27-year-old student, told me that before shehad breast augmentation surgery, she avoided wearing bathing suits in public andhad refused to shop for bras. She said,

[Breast augmentation] has given me more self-confidence than I ever had. Ifit in when I’m with my girlfriends now. Before, I never went to the beach withanybody around. After I had [plastic surgery], I couldn’t wait to buy a bra. I couldnever buy one before because I was so pathetically small.

By her account, prior to having breast augmentation, Tara had been too “pa-thetically small” to enjoy going to the beach or shopping with friends. Havingplastic surgery, however, served to make Tara appear more normal. Being ableto “fit in,” Tara now participates in activities from which she previously feltexcluded.




Barbara, who also had breast augmentation surgery, recounted a similar ex-perience. She said,

I used to wear super-padded bras when I dressed up but they just never did it for me. I didn’tlook like the other women. But now, like tonight, I am going to a party and I know I’ll beable to fill out the dress.

Barbara added, “[Breast augmentation] has made me feel very confident. I thinkthat’s the difference.”

Sandra, a 43-year-old office manager who had liposuction to reduce her “thickthighs” and “saddlebag” hips, explained that she underwent the procedure not onlyto appear youthful or to wear feminine clothing, but also to approximate a culturalideal involving social class. She said,

I used to put on nice clothes and still look like a bag lady, you know, unsophisticated.NowI feel like I can wear good clothes and look like they are appropriate for me. Now, my bodyfits the clothes.

Here, Sandra likens appearance to a tableau of social class, both in the contextof the clothing one chooses and the extent to which one’s body appears to be“appropriate” for that clothing (and the social standing that it implies). Simplyput, before Sandra’s surgery, her “flabby” body suggested a lower social statusthan did her clothing. Despite her efforts to wear “nice clothes”—i.e., clothesthat would not be considered appropriate for a “bag lady”—her body underminedher efforts to use appearance to stake out a particular social location. In effect,Sandra’s body not only makes her clothing an ineffective class identifier, but alsoinvalidates Sandra’s claims to a particular status. Plastic surgery, however, allowsSandra to more effectively display social class through clothing. Bringing her bodyinto line with her self-appointed social class—particularly as its enactment reliesupon clothing—cosmetic surgery serves as a tool for legitimizing Sandra’s claimsto social status.

Like Sandra, Tara, and Barbara, the other women I interviewed claimed thatcosmetic surgery had helped them to feel more self-confident. For example, Kimtold me, “I guess I feel better when I am out with friends, like maybe people willthink I am attractive. I feel attractive and, I guess, I act more attractive.” In essence,the women imagine that they are being perceived more favorably than they wereprior to their operations, and so behave in a manner that they believe is appropriatefor “attractive” women. At the same time, the women recognize that they maysimply be imagining others’ perceptions of them, meaning that their behaviorshave changed independent of any alteration in the way they are viewed. Kim said,“Maybe nobody even notices, but I feel like I look better. I guess just thinking Ilook better changes the way I act a little.”

Furthermore, in nearly every case, the women told me that their romanticpartners believed that the cosmetic procedures were unnecessary. For example,prior to her breast augmentation procedure, Tara’s boyfriend voiced significant



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apprehension concerning the physical effects of the operation. She said, “He wasvery, very frightened about it. He kept on telling me, ‘I love you just the way youare,’ that type of thing.” And Barbara’s fiancé blamed himself for her dissatisfactionwith her breasts. She recalled, “My fiancé thought he was doing something wrongthat would make me feel like this about myself.” In fact, in many cases, the women’spartners attempted to convince them not to undergo cosmetic surgery. Jenniferdescribed her boyfriend’s behavior: “He tried to talk me out of it, but finally hedecided, ‘If it’s going to make you happy, go ahead and do it.’” Some of John’spatients even claimed that their partners have had mixed reactions to the resultsof the procedures. For instance, Barbara said that even though she had alwaysconsidered her husband a “breast man, because his eyes would pop out if hesaw a big-breasted woman,” he nevertheless had always told her that she was“perfect.” She added, laughing, “He still says he liked me better before, but I’lltell you, I can’t keep him off of me. I keep saying ‘I’m taking them back for arefund.’”

Clearly, the frequency with which I heard such assertions points to the con-siderable importance women attach to having “freely” chosen to have cosmeticsurgery, to not having been somehow coerced into the procedures by their lovers,or even having chosen to undergo them in order to please men. Furthermore, theseassertions make sense in light of the women’s accounts of their surgery. Specifi-cally, plastic surgery cannot be both something women “deserve” and somethingthat they were forced or manipulated into doing. In their accounts, plastic surgeryis positioned as a final option for women who could not otherwise live peacefullywith themselves. This conception of plastic surgery is clearly inconsistent with animage of acts forced upon them by others—particularly others who might actuallybenefit more from the procedures than do the women themselves.

PLASTIC SURGERY AND INAUTHENTICITY: THE HIGH PRICEOF BODY WORK

In its own terms, the process of making an abnormal body into a normal one,plastic surgery succeeds. The women who have undergone plastic surgery believethemselves to possess, as they had not before, the bodily expression of a normativeself. However, at the same time, plastic surgery fails. If women are attemptingto use plastic surgery to recreate themselves—to make claims through the bodyabout who and what they are—they must also deal with charges of shallowness.In high irony, the very same women who are attracted to plastic surgery becauseof a belief that the body is an indicator of the self must now deal with charges thatthe surgically altered body is a deception, that it is an inauthentic representation ofthe self. Some of the costs of cosmetic surgery—including the danger of physicaldamage and the high financial price—are obvious to those who have undergonethese procedures and, perhaps, even to those who have not. Most of the women I




talked to had plastic surgery only after serious consideration (often accompaniedby research into the medical technology involved in the operations). Likewise, fewcould easily afford the surgery they underwent; nearly all of them had to sacrificesome other large purchase or to weather some financial hardship in order to havethe surgery. Some have accrued considerable debt while others have had to requestfinancial help from relatives. Only a very few of the women I interviewed wereable to waylay some of the costs through insurance.

It is, however, the other costs associated with cosmetic surgery that I wishto focus on here. In particular, I want to explore the taint of inauthenticity thatwomen must deal with after surgery. Despite their efforts to tell a story in whichthey have earned the right to plastic surgery, the women who have undergone thatsurgery are still alert to charges that they have merely bought a new appearance.At the same time that their bodies approximate normality, the method that theyuse invites charges that their character is suspect. Not the results of plastic surgery,but the very fact of having had plastic surgery, becomes the primary indicator ofidentity. Although the women I interviewed do not formulate the complexitiesand contradictions involved in their activities in the way I have here, the accountsthey construct show that they struggle to deal with a self-concept that contin-ues to be deviant despite the women’s normal appearances. Indeed, the accountsthemselves—which attempt to deny inauthenticity by positioning cosmetic surgeryas somehowowedto the women who partake of it—show that plastic surgery failsto align body and self.

While the women’s accounts take a variety of forms, they suggest a singularconclusion with regards to the success of plastic surgery for establishing a norma-tive identity. More specifically, women like Anne Marie and Bonnie invoke theirrigorous body work regimens as evidence of moral value and as the basis for theirentitlement to cosmetic surgery. At the same time, they remain unsatisfied withthe results, physical and moral, of this body work. Unlike the women I studied inan aerobics class—who, by virtue of their hard work, successfully undermined thebody’s power to reflect character—the women who had plastic surgery seemed un-able to escape the social and moral meanings they attributed to their own bodies.Had they accepted the hard work they put into exercise and dieting as an ade-quate indicator of identity, they would not have needed to turn to plastic surgeryto correct what they saw as their bodies’ failings. Needing to establish the act ofplastic surgery (as distinct from its results) as irrelevant for selfhood and needingto position the surgically altered body as the putatively true indicator of selfhood,women who have had plastic surgery revert to accounts that have already provedunsuccessful. The critical implications for self inherent in cosmetic surgery it-self require women to resort to accounts that they know—either consciously orunconsciously—will fail to support the identity claims of youth or ethnicity thatthey want to make. Indeed, in the very act of making these claims, women whohave undergone plastic surgery attest to the failure of that surgery to position thetransformed body as a convincing representation of the self.



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CONCLUSION

My research points to three general conclusions. The first bears on the reasonswomen have plastic surgery and suggests a modification of the criticisms of suchprocedures. The second bears on the ways in which women create accounts ofplastic surgery, an omission from the criticisms of plastic surgery. The third returnsmore sympathetically to those criticisms.

First, none of the women I spoke to embarked casually on plastic surgery.The costs of these procedures—measured in dollars and in the risk of physicaldamage—are well known to those who have undergone cosmetic surgery. Most ofthese women had plastic surgery only after serious consideration, often accompa-nied by research into the medical technology involved in the operations. Nearly alleither had to sacrifice another large purchase or to weather some sort of financialhardship to pay for the surgery. More importantly, although physicians may serveas gatekeepers, preventing some women from receiving surgery, physicians donot, in any direct sense, recruit patients. Neither did the women I spoke to reportthat they underwent surgery at the urging of a specific other—husband, parent,lover, or friend. Rather, the decision to seek surgery seems to have been driven bythe desires of women themselves, at least in the immediate circumstances. To besure, the women’s decisions to undergo surgery were shaped by broader culturalconsiderations—by notions of what constitutes beauty, by distinctively ethnic no-tions of beauty, and, most importantly, by the assumption that a woman’s worth ismeasured by her appearance. Yet to portray the women I talked to as some sort of“cultural dopes,” tossed and battered by cultural forces beyond their understanding,as passively submitting to the demands of beauty, is to badly misrepresent them.A more appropriate image, I would suggest, is to present them as savvy culturalnegotiators, attempting to “make out” as best they can within a culture that lim-its their options. Those who undergo plastic surgery may (ultimately) be wrong,but they are not foolish. They know what they are doing. Their goals are realisticand they, in fact, achieve most of what they set out to accomplish with plasticsurgery. Although their actions surely do, in the long run, contribute to the repro-duction of a beauty culture that carries heavy costs for them and for all women, inthe short run they have succeeded in their own more limited purposes.

Second, plastic surgery demands accounts. Much like the women I studiedin the aerobics classes, those who undertook plastic surgery are working hardto justify themselves. But the accounts of the former group are very different innature from those of the women who attend the aerobics classes. The aerobicswomen use hard physical work as an indicator of character that allows them tosever their conception of their selves from their bodies. In contrast, the womenwho have had plastic surgery work hard to reattach the self to the body. Theydo this in two steps. First, they must convince themselves that they deserve thesurgery, whether by the hard work they put in at the gym or the effort they investin saving the money that surgical procedures require. In so doing, they make thesurgery, psychologically and ideologically, their own. Second, they must convince




themselves that the revised appearances theyhave been given, however well-earned, are somehow connected to the self—i.e., that they are innocent of thecharges of inauthenticity.2 To do this, they invoke essentialist notions of the selfand corresponding notions of the body as accidental, somehow inessential, or adegeneration from a younger body that better represented who they truly are.

I do not mean these observations as a defense of plastic surgery so much asan effort to understand better the activity and its implications. Indeed, if we are todistinguish plastic surgery from other forms of body work, we will be able to doso on precisely the grounds I have just suggested. I do not find it convincing thatmaking legs thinner is somehow less “real” than dying hair from gray to brownor that even eye surgery or rhinoplasty is somehow less authentic than a decisionto have a stylish, rather than an ethnic, hairstyle. However, what characterizes theefforts of women in aerobics and even in hair salons is that they are attempting,in somewhat different ways and with varying degrees of success, to neutralizeappearance as a measure of character. Far more than the other women I studied,the women who undergo plastic surgery help to reproduce some of the worst aspectsof the beauty culture, not so much through the mere act of the surgery itself asthrough their ideological efforts to restore appearance as an indicator of character.

Finally, I return more sympathetically to the criticisms of plastic surgery. Buthere, too, I return to those criticisms tempered by my observations of the women Ireport on elsewhere. Although I have described plastic surgery as a research “site”parallel to an aerobics class or a group of women in a hair salon, this parallelis in certain respects misleading.3 In an aerobics class and a hair salon, I foundwomen working together to find common solutions to a shared problem. But thewomen who underwent plastic surgery were not a group in the strong sense towhich that term applies to the other women I studied. Rather, they were a grouponly in the sense that they shared a common surgeon. For the most part, they didnot know each other. They did not speak to each other. And, although they mayhave had both common problems and a common solution, they did not develop thissolution working together. In the other settings I studied, the local production ofan alternative culture is very much in evidence. Among the women who chose tohave plastic surgery, there are the aesthetic judgments of their plastic surgeon andthe ignored expressed opposition of friends and family, but no local culture of theirown. Elsewhere women are challenging, however haltingly, however partially, abeauty culture. In contrast, the women who undergo plastic surgery are simplymaking do, perhaps as best they can, within a culture that they believe rewardsthem for their looks.

ACKNOWLEDGMENTS

I am deeply indebted to “Dr. John Norris,” his staff and clientele, withoutwhom this research could not have been completed. Thanks are also due RobertZussman, Ph.D. for his intellectual support throughout the project and extensive



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revisions to the manuscript, and Sven Mattys, Ph.D. for his patience and editorialassistance. Finally, I very much appreciate the insights provided by Lisa Handler,M.A., Leslie Irvine, Ph.D., Nilufer Isvan, Ph.D., Anna Linders, Ph.D., and NaomiRosenthal, Ph.D.

ENDNOTES

1. All names are pseudonyms.2. Concern about authenticity may well be class-specific. However, my sample, based on references

from a plastic surgeon, most likely includes those patients who are least troubled by what they havedone.

3. I would like to thank reviewer Raquel Scherr for this observation.

REFERENCES

Bordo, S. (1990). “Material girl”: The effacements of postmodern culture.Michigan Quarterly Review,29, 653–677.

Dally, A. (1991).Women under the knife: A history of surgery.London: Hutchinson Radius.Davis, K. (1995).Reshaping the female body: The dilemma of cosmetic surgery.New York: Routledge.Finkelstein, J. (1991).The fashioned self.Philadelphia, PA: Temple University Press.Gimlin, D. (Forthcoming).Bodywork: The business of beauty in women’s lives.Berkeley: University

of California Press.Goldwyn, R. M. (Ed.) (1980).Long-term results in plastic and reconstructive surgery, 2nd edition.

Boston: Little, Brown and Company.Kaw, E. (1994). Opening faces: The politics of cosmetic surgery and Asian American women. In N.

Sault (Ed.),Many mirrors: Body image and social relations(pp. 241–265). New Brunswick, NJ:Rutgers University Press.

Meredith, B. (1988).A change for the better.London: Grafton Books.Wolf, N. (1991).The beauty myth: How images of beauty are used against women.New York: William

and Morrow.

Cosmetic Surgery: Beauty as Commodity

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