Weekly Standard

Slice of Life

From the December 22, 2008 Weekly Standard

Former Senior Fellow

Once, while I was assisting on a "nose job" in medical school, the attending surgeon asked me if I knew what was wrong with his patient's nose. As the surgeon's tone was didactic, I assumed he was quizzing me. I carefully inspected the patient's nose and came up with a list of diseases. A deviated septum? A cartilage disorder? A connective tissue disorder?

He shook his head each time. Finally, he said: "No. The patient has a typical Jewish nose."

I mention this incident to illustrate the danger in writing a heady book about cosmetic surgery and culture. Although one might come up with intricate explanations for why people get cosmetic surgery, cosmetic surgery is ultimately about beauty. People want to look good, plain and simple.

The standard for beauty may vary from culture to culture. In pre-Communist China upper-class women bound their feet, essentially crippling themselves, because small feet were thought beautiful. African women lengthened their necks with stacked rings to conform to their culture's ideal of beauty. But unless a writer wants to impute a false consciousness to these people, and suggest that cosmetic surgery patients don't really know why they do what they do--that only the writer does--then going beyond the question of beauty is unnecessary.

Still, writers do go deeper, especially social scientists; they can't help themselves. Anthony Elliott, an Australian sociologist, does so in Making the Cut. And yet my complaint is not that he goes too deep, but that he simply goes where others have gone before.

Elliott gives three explanations for the explosive growth in cosmetic surgery in Western society over the last 20 years. The first is the impact of celebrity culture. In Elliott's words, people "are following the cult of celebrity straight to the operating theater." They worship celebrities and want to look like them. "Personal subjectivity in the media age is more and more fashioned in the image of celebrity culture," he writes.

Yet this is just the "beauty" argument dressed up in sociology-speak. Celebrities today set the fashion the way John F. Kennedy did in his day (declining to wear a hat) or the Union general Ambrose Burnside did in his (growing his whiskers down the sides of his face, later called "sideburns"). When Elliott writes that "individuals increasingly take celebrities as objects of knowledge for both the representation and the conduct of social life," he sounds irritatingly like an assistant professor using the "language of discourse" to get tenure. Which is totally unnecessary, since Elliott is not only fully tenured but also the chairman of his department!

Why doesn't he just say that average people want to look like famous people, and be done with the issue? And yet, even if average people do want to look like famous people, the celebrity culture argument fails to explain why celebrities themselves get cosmetic surgery.

Elliott's second explanation for the cosmetic surgery culture is consumerism. In his view, the consumer industry shapes our understanding of who we are and how we should look. He reserves special blame for aggressive advertisers who pitch beauty products to the masses.

Yet what feature of modern America has not been blamed on advertisers and consumerism? Sociologists have been working this angle since the 1950s, when C. Wright Mills accused slick Madison Avenue executives of manipulating people's fears and preying on their "status panic" to get them to buy certain products. This is nothing new. Nor can the advertising industry's aggressiveness explain why Americans are so receptive to the cosmetic surgery message. After all, advertisers can't sell low-calorie cookies; people don't want them. Advertisers can only sell people what they want. Elliott's argument begs the question why people want cosmetic surgery and the form of beauty it creates.

Elliott's third explanation is globalization. In his words: "The rapid pace of economic change today shapes wider cultural imperatives concerning employment adaptability as well as flexibility of identity."

Again, sociology-speak. Again, this angle is old. It is well known that capitalism creates a political economy of social mores, that capitalist principles infiltrate even the personal sphere. In Victorian England, this infiltration led to women crying, "Please, sir, stop, or you'll ruin me," or warning, "Nobody wants an old shoe." People in capitalist societies tend to adapt their understanding of product value--new is better than old, unused is better than used--to the body. Applying market lingo to the cosmetic surgery culture is simply a continuation of this trend. Today's motto might be: "More breast for the buck."

In one way, cosmetic surgery culture does reflect a new economic trend. In the 1930s, the image of the successful man was the portly, mustached banker on the Monopoly game cards. Today, the image of the successful man is youthful-looking and trim. This change reflects an effort on our part to judge a person's character by scrutinizing his or her body.

A job recruiter these days is barred from asking questions about a job candidate's family background or religious affiliation. Nor can he glean much information from references, since people writing bad references often get sued, and fib to play it safe. But a recruiter can still look at a candidate. If a prospective employee is trim and well-preserved, the recruiter can infer from this that the person is self-disciplined, judicious, energetic, and well-organized--all the virtues needed to succeed in business. If the candidate takes care of his body, he can likely be trusted to take care of a million-dollar account. Or so the thinking goes. The body has become our most moral organ; judgments about other people's characters are now made visually.

Stay superficial; do not go deep, I said. All right, if cosmetic surgery is all about beauty, then why do people think cosmetic surgery makes them look beautiful? I've often asked this question while anesthetizing patients for these procedures. I can understand a nose job for the patient who looks too Jewish. I can also see the value in a good facelift, not the kind that produces the wind-tunnel look but, instead, makes people say: "Hey, you look well rested. You must have gotten a good night's sleep last night."

But liposuction often makes people look ill; the skin overlying the sucked-out area sags and looks dimpled. Breast implants (in non-mastectomy patients) often look ridiculous. I've seen women with what a Frenchman would consider perfect breasts (in the shape of a champagne glass, which was supposedly the breast size of Marie Antoinette) stuff double Ds into their pectorals. Afterwards they look like--well, I'm not sure what they look like; no such animal exists in nature.

The conclusion I've reached about cosmetic surgery is this: Cosmetic surgery is not about beauty in the way that, say, jewelry and makeup are about beauty. Jewelry and make-up adorn preexisting beauty. Sometimes they bridge the divide between an ugly exterior and inner beauty. In either case, they tell men that the woman wearing these things is still full of heat and hormones, still interested in sensual things, still a part of life's universal chase. They invite men to see the woman in a romantic light, where she becomes charming, special, and unique.

Cosmetic surgery is not about the woman. It's about the man--or about the woman if it's a man getting the liposuction. It's about the man's science fiction fantasy of what beauty should be in the abstract. The man sees the vague silhouette of sucked-out thighs and protruding breasts, and his fantasy is triggered.

The woman herself is insignificant; cosmetic surgery doesn't invite the man to see her as an individual, let alone as a personality. She is neither charming nor special. She is a form, a set of parameters, organic material with curves and bumps. She is the opposite of warm and sensual and alive. She is a thing to poke and squeeze.

Indeed, when I was in grade school on a field trip to an aquarium, I wanted to touch a dolphin to see what it felt like. I was simply curious. It is in that spirit that I would ever want to touch a breast implant. Not exactly what I would call romantic feelings. My advice to a woman contemplating breast implants or liposuction: Buy yourself a nice pair of earrings. It'll save you both money and trouble, and be more likely to achieve your goal.

Making the Cut
How Cosmetic Surgery Is Transforming Our Lives
by Anthony Elliott
Reaktion, 196 pp., $19.95