Carlson 1
Personal Looking Glass:
A Study into Elective Cosmetic Surgery
Michelle Carlson
Sociology 352: Qualitative Research Methods
Professor Lee Vigilant
December 18, 2009
Introduction:
Society is obsessed with beauty. This isn’t a novel concept…this isn’t a recently discovered fad. This is a fact of life. If one peruses the magazine aisles at the local grocery store, the covers are undulated with tips on how to be more beautiful…how to have a sexier body…how to have flawless skin. Society’s obsession with beauty is why the cosmetic industry grosses billion of dollars a year…why cosmetic companies and skin-care companies spend billions of dollars a year to advertise their latest and greatest product. Products, however, aren’t enough anymore. It’s not enough for someone to spend $25.00 on one ounce of the latest anti-aging, anti-oxidant skin moisturizer; no, it’s now time to spend thousands of dollars on cosmetic surgery. Enlarging and/or lifting ones breasts, removing the dimples from the thighs, letting out the excess air of the tire around the middle, filling in crow’s feet around the eyes and laugh lines around the mouth are the latest beauty trends. Let’s face it…it’s not our mother’s world anymore, where the old adage of, “True beauty is what lies inside,” are great words of wisdom. Great words of wisdom, now days, are, “Nip and Tuck”, “A dash of silicone”, and, “Just a simple, quick procedure.”
Elective cosmetic surgery is becoming the fastest growing, highest grossing industry out there, but one has to ask: Why would someone voluntarily go under the knife, voluntarily be poked and prodded to become more beautiful? Is it solely a vanity issue, the obsession with looking young? Or, are the reasons more complex than that? What I’ve found with this study is that there is no correct answer, no one certain reason. What I did find, however, is that the reasons some undergo elective cosmetic surgery are deeply personal and an internal battle within oneself to not necessarily be accepted by others, but to be accept by themselves.
Reflexivity Statement:
I’ve never really cared much for plastic surgery, personally, though I’ve never begrudged anyone who has made the decision to have it done. What I didn’t realize, however, was how many people within my intimate circle of friends have made the decision to undergo these surgical procedures. I’ve always considered plastic surgery to be a personal choice, albeit a slightly selfish one. What I’ve come to realize throughout this research project is, reasons are subjective. What I think may be true, isn’t, and what I may perceive as vanity may be low self-esteem. I must admit, I’ve come to see patients of these medical procedures in a different light, and have concluded that cosmetic surgery has definitely become a sociological issue.
Literature Review
Elective Cosmetic Surgery Facts and Figures:
According to the 2008 year-end report conducted by the American Society of Plastic Surgeons, there were 12.1 million cosmetic procedures done; 1.7 million of these were cosmetic surgical procedures (requiring hospitalization), such as breast augmentations, liposuctions and tummy tucks, and 10.4 million were classified as cosmetic minimally invasive procedures (classified as an in-house office visit), such as microdermabrasions, cellulite treatments, and laser hair removals.
Here are some other important facts from the American Society of Plastic Surgeons regarding gender: Ninety-one percent of all cosmetic surgery patients werefemale, with the top five surgical procedures being breast augmentation, liposuction, nose reshaping, eyelid surgery, and tummy tucks, and the top five minimally-invasive cosmetic procedures being Botox, hyaluronic acid, chemical peels, laser hair removal, and microdermabrasion. The other nine percent of cosmetic surgery patients are, of course, male, with the top five surgical procedures being nose reshaping, eyelid surgery, liposuction, breast reduction in men, and hair transplantation, and the top five minimally-invasive cosmetic procedures being Botox, laser hair removal, microdermabrasion, chemical peels, and laser skin resurfacing. It should also be noted that nineteen percent of all cosmetic procedures done in the United States are of the age group of this study’s participants, ages thirty to thirty-nine. What it comes down to, however, is that the year-end cost of money spent on elective cosmetic procedures in the United States in the year 2008 was $10.3 billion dollars. That is truly an amazing monetary figure.
The Feminist Theory:
There are some arguments, especially from the feminist theorist point of view, that look at cosmetic surgery as the ultimate form of coercion, “[Cosmetic surgery] overtly and covertly, pushes women to conform to feminine ideals of youth and beauty” (Brooks 2009:209). Let’s look at that for a moment. Any female knows that, from a young age, how we look, our outer appearance, is constantly being judged. Physical appearance is a female’s main identity, especially throughout their adolescence. Isn’t it conceivable, then, to believe that that particular thought process will stay with a woman throughout their entire adult life? Added to that, females are constantly swamped with images from magazines, books, movies, and television regarding how to be beautiful…or, more specifically, young and beautiful. Another concern is, “Those women who undergo cosmetic surgery for purely aesthetic reasons are regarded as victims of a patriarchal ideology in which the self-esteem of women is primarily dependent on their physical appearance” (Negrin 2002: 21). So, basically, critics are saying that it’s the men who are determining the requirements for what is considered beautiful, and women are striving to meet them.
There are others, however, who argue that making the decision to undergo cosmetic surgery is a form of female “empowerment” and “self-assertion,” by allowing women to “[take] control of their own destiny” (Negrin 2002: 22-23). This is a thought process that was also discovered by a study done by Kathy Davis. Davis (1997: 31) found that, “cosmetic surgery was as way for [women] to take control over circumstances over which they previously had had no control”.
Let’s be honest: When we’re born, we’re given certain genes by our parents. Not only do those genes give us our hair color and eye color, but these genes may also give us absolutely no control over physical appearance. There are also some studies that say that people may not even have control over the amount of body fat we have. In other words, there may be some people who were destined to be overweight and homely-looking. A cruel way to put it? Absolutely, but this is where that control comes into play. Elective cosmetic procedures give women, especially women who are not satisfied with what they are born with, the choice to change it.
From a Man’s Point of View:
One doesn’t have to do research into this topic to know that males are a small percentage of the population undergoing elective cosmetic surgery. That number, however, seems to be growing. The question that must be asked, though, is: why do men decide to have cosmetic surgery? Like females, is it about empowerment and control? Or are there different reasons? According to Judith Franco (2006: 478), “The motivation for these men to seek out surgery is presented as functional (’mending their broken down body and spirit…’) rather than the emotional and aesthetic reasons associated with female participants”. This could lead to the conclusion that, for men, cosmetic surgery is more about vanity. Going a step further, cosmetic surgery may now the dilettante’s way of staying young. There are those, however, that believe it may be more problematic than that.
Michael Atkinson (2008: 71) wrote, “The splintering and redistribution of masculine control across institutional landscapes has spurred on a ‘crisis of masculinity’, in that men are no longer certain about what constitutes men’s roles and statuses, or how to enact properly gendered masculine identities”. This is a very valid point. There are many theorist that believe, with the rise of feminism, and therefore the power of feminism, men have gotten lost in the shuffle. It used to be much simpler: Men brought home the bacon, the women cared for the family and children. Men and women had very distinct roles. Those roles, however, have changed, and the lines have become more blurred. It’s possible that men have decided that, in order to be accepted by women they may have to conform to certain feminine ideals, i.e. cosmetic surgery. This point is also stressed by Atkinson (2008: 72), “Men’s growing interest in cosmetic surgery might empirically hint toward the emergence of a late modern ‘male femininity’; a gender status that at once draws on and seeks to reaffirm traditional images of men and the power bases men hold, but also tactically poaches and re-signifies stereotypically feminine symbols and practices in order for their male deployers to appear as progressive, neo-liberal and socially sensitive”.
Going along with the above theory, Atkinson 2008: 76-77) points out that by having cosmetic surgery, men are showing that they don’t have to be masculine-aggressive in order to stay in shape or to stay physically pleasing, unlike what sports and working out in a gym may do. “…men feel encouraged to reflexively engage in forms of bodywork to shore up their traditionally masculine images in socially ‘non-threatening’ ways”. Pumping iron, boxing, games of football or basketball with the guys… All of these activities conjure up images of aggressiveness, the embodiment of raw, male, physical power. That’s not the way men should be anymore. They shouldn’t be strutting around, blatantly displaying their masculinity. Cosmetic surgery, on the other hand, can sculpt one’s body into perfection without the outward display of masculinity. In other words, a body shaped by cosmetic surgery is the non-threatening way to stay in shape. What is interesting, and should be pointed out is, that for men, cosmetic surgery is a double-edged sword. It’s perfectly normal for a man to feel dissatisfied with their physical appearance, yet admitting to cosmetic surgery may not be the “male” thing to do. As Atkinson (2008: 77) states, “It is both an admission of weakness (i.e. the failure to physically live up to masculine cultural expectations) and a moral gesture of the desire for self-improvement”. So, while there is no shame for a woman to admit that she’s been nipped and tucked, for a man, it’s a different story. This is just another example of how it’s possible that the idea of masculinity is fading for men, resulting in this population to undergo a secret shame, if you will.
A Sexual State:
While there is no doubt about the media’s influence on physical appearance, it’s also influential in regards to sexuality. We live in a sex-oriented society; therefore, x, y, z is what we need to do in order to feel and be sexy…and having a perfect body is one way to do that. Specifically, research done by Virginia Braun (2005: 413) shows that, “improved sexual function was identified as a key outcome of ‘cosmetic’ procedures”. This shouldn’t be too surprising. Sexual intercourse is the most intimate thing done between two people, and feeling awkward during sex is bad enough without having to worry about extra weight around the middle, dimply thighs, or saggy breasts. It should be mentioned, however, that Braun points out that a better sex life wasn’t just about changing physical appearance, “Although physical changes were often identified as resulting in increased pleasure, psychological elements were also highlighted as key in explanations for increased sexual pleasure, post-surgery” (415). Ergo, feeling good about yourself, physically, regardless of where it may be, will improve one’s psychological state, equaling better relationships, especially in the bedroom.
A woman’s sexuality is definitely one area that seems to be centered around societal expectations. “Women’s reports of genital anxiety reflect a range of negative sociocultural representations of women’s genitalia, and it seems some women ‘live these [negative] cultural meanings in their embodiment” (Braun 2005: 411). Interestingly enough, it’s considered taboo to talk about a woman’s sexuality, yet society’s expectations regarding female sexuality is almost expected. Hence, a woman is expected to be sexual, just not be able to talk about it. Or, as Braun (2005: 418) states, “Women’s sexual pleasure – or ability to orgasm, appears as a central concern for women, and indeed for society. The account is almost exclusively one where, sexually, women should be comfortable in their bodies and should be able to enjoy sex – and the more sex, and sexual pleasure, the better”.
Beyond Fixing a Flaw:
There can come a time when the idea of simply changing ones appearance goes beyond “wanting” and travels into the obsessive. According to Cressida J. Hayes (2009: 75), it isn’t abnormal for a woman to have “a painful preoccupation with one’s own defective appearance”. It is however, abnormal for this “preoccupation” to suddenly take over one’s life. Body Dysmorphic Disorder (BDD) is a mental disorder recognized by the American Psychiatric Association and the World Health Organization (2009), and is defined as “a preoccupation with a defect in appearance that causes significant distress and/or impairs normal work or social functioning. BDD sufferers typically persist in the belief that their defect is real [and] if they seek help it will often be surgical, rather than psychiatric” (Hayes 2009: 75). The interesting argument that Hayes presents is that it’s entirely possible that BDD may be a learned disorder. In other words, can society’s own form of obsessive beauty cause BDD, or is it possible that a patient may enter a doctor’s office wanting one procedure done and come out wanting more?
Obviously, the whole point of cosmetic plastic surgery is fixing a flaw; however, “visual economy of advertising and marketing cosmetic surgery is also pedagogical teaching ways of reacting negatively to one’s own embodiment. This is done indirectly, through the still image, and especially the popular ‘before and after’ photo set” (Hayes 2009: 79). Women, especially, will be very familiar with these ‘before and after’ photos. Watch any talk show, from Oprah to The Tyra Banks Show, or any television show whose subject is makeovers; flip through any fashion magazine, since they always have at least one article on makeovers, and they consistently include the ‘before and after’ shot of the subject. It’s almost as if they are daring, or giving a permission slip to the makeover participants, and the viewers, to look for even more flaws to improve. After all, the results are miraculous, astounding! What could be wrong with fixing just one more flaw?
Then, of course, there are the plastic surgeons. During a cosmetic surgery consultation, and this is just common sense, the doctor will look and examine the area in which the patient is requesting improvement, but it’s entirely possible that the doctor may go beyond that. “…surgeons go further, and point out flaws the [surgery] candidates was herself not even aware of. It takes a tough-minded individual to walk out of a consultation having refused a procedure that an ‘expert’ on bodily aesthetics thinks is warranted, without any further psychological consequences” (Hayes 2009: 80-81). It could be argued that most patients are probably not that strong-minded, considering they’re visiting the doctor to fix what they see is flawed, so it is not inconceivable to convince the patient of other flaws. Unfortunately, while this practice may be morally repugnant, there is nothing wrong with suggesting other improvements. It’s no wonder that Hayes argues that the cosmetic surgery industry only heightens levels of BDD or may create them.
Sample, Methods, and Ethical Concerns:
The data in this study comes from in-depth interviews that I conducted with seven people; three men and four women. All of the interviewees are in their late thirties, and all but one is of Caucasian descent. The one that isn’t, is a female of Asian ethnicity. All of the interviewees are also college graduates, with three of them having post-undergraduate educations, and fit the classification of being in the middle-upper to upper socioeconomic income level.
The interviews were conducted in the late fall of 2009, with each interview lasting about an hour-and-a-half to two hours. The interviews were conducted mostly at eating establishments; however, two of them were conducted at the participants’ homes. Now, the interview participants were asked questions from a pre-set interview schedule that contained questions regarding their personal experiences with elective cosmetic surgery, some of which included how they came to the decision to have cosmetic surgery, how they felt before and after the surgery, and responses from family and friends regarding their decision. My initial list contained approximately twenty questions, although, because all participants had different experiences, I often times found myself asking many questions that were not on my list. I did, however, try to ask all of them. It should be noted that all of the participants are close, personal friends of mine. Three of them I have known since kindergarten; the other four, since seventh grade. Therefore, I’ve known all seven of them for over half my life.