Tuesday, June 9, 2009

Worthy of a second read

How the pitch for cosmetic surgery co-opts feminism

-It’s debatable why cosmetic medicine has become so popular. Might it be the result of articles on “scalpel slaves” and “secret surgeries” that saturate women’s magazines? Or could it be a result of makeover-focused reality TV shows that have proliferated since the 2003 debut of Extreme Makeover?

-Once considered clandestine and risky, cosmetic procedures are currently treated across a variety of media as if they were as benign and mundane as whitening your teeth. Advertisers, TV producers, publishers, PR personnel and even physicians themselves are touting it as an effortless, egalitarian way for women of all backgrounds to “enhance” their looks and “stay young.”

-Not only have cosmetic procedures become more acceptable, but they’re being promoted in less sensationalized ways to whole new markets. Increasingly, reality TV’s Cinderella tale of surgical transformation is being replaced with a smart woman’s narrative of enlightened self-maintenance. Media sources now compliment potential customers as mature women who are smart, talented and wise. Such women are supposedly savvy enough to appreciate their own wisdom— but, then again, they should want to soften the telltale marks of how many years it took them to acquire it. “I am not using these injectables to look 25...I don’t want to be 25. I just want to look like me.”

-Alex Kuczynski in her book 'Beauty Junkies' calls these appeals “the new feminism, an activism of aesthetics.” That ignores the work of feminists from Susan Faludi to Susan Bordo, who have argued for years against the global beauty industry and its misogynistic practices. Ironically, the term “feminist” has long been wielded by right-wing politicians, comedians and talk-show hosts as a pejorative label for a “masculine” woman who “lets herself go.” Yet the cosmetic surgery industry is doing exactly what the beauty industry has done for years: It’s co-opting, repackaging and reselling the feminist call to empower women into what may be dubbed “consumer feminism.” Under the dual slogans of possibility and choice, producers, promoters and providers are selling elective surgery as self-determination.

-The cosmetic-medicine industry also appeals to the power of sisterhood. The blurb for a popular book entitled The Smart Woman’s Guide to Plastic Surgery describes the author, Jean M. Loftus, as a female plastic surgeon who will offer “compassionate advice for...any woman considering plastic surgery.” Similarly, the cover of the Internet Guide to Cosmetic Surgery for Women sports a collage of women’s faces of various ethnicities, suggesting that the reader is in this with her sisters. Women with supposed insider knowledge give other women advice and support on how to revamp their faces and bodies through surgery. (Does this make them “aesthetic activists”?) The implication is that the male physician, advertiser, network producer or cosmetic-medicine mogul has been sidestepped, and women are empowering each other to be more informed consumers.

-Moreover, much of the media covering cosmetic surgery centers on the idea of choice... just another lifestyle choice with little difference from working out and eating well, Cosmetic Surgery for Dummies promises the reader will discover how to “decide whether surgery is right for you,” “find a qualified surgeon,” “set realistic expectations,” “evaluate the costs,” “make the surgical environment safe” and ultimately “make an informed choice.” The word “choice” obviously plays on reproductive-rights connotations, so that consumers will trust that they are maintaining autonomy over their bodies. Yet one choice goes completely unmentioned: The choice not to consider cosmetic surgery at all.

-It seems that this pseudo-feminist message works. A British survey found that over half of the 1,000 women who were polled (average age 34) expect to have cosmetic surgery in their lifetime. And that’s music to the ears of all those who benefit from women’s insecurities about their looks, for cosmetic surgery is big, big business.

-Cosmetic surgery is now being packaged and sold in conjunction with other leisure activities for “smart” women. In every major U.S. city, there are “medi-spas” offering one-stop beauty shopping, from salon treatments to outpatient surgical procedures, including chemical peels and injectables such as Restylane . A company called Surgeon & Safari puts together medical tourism packages to South Africa that include airfare, hotel, meals, breast enlargement, a face-lift and a week at a wild-animal game reserve.

-Within such a marketplace, some cosmetic surgeons are no longer just doctors: They are vendors. Thanks to a 1982 Supreme Court ruling, all physicians may openly advertise their wares, and cosmetic surgeons have become particularly adept at working with professional marketing consultants to brand and promote their practices.

-To boost sales even further, cosmetic medical equipment and injectables are being sold to physicians who aren’t even cosmetic surgeons. One Maryland college professor found that out during her annual Pap smear appointment, when her gynecologist offered to “take care of her elevens”—unknit the “teacher’s frown” between her brows—with Botox.

-The beauty industry has long traded on women’s body angst and low self-esteem as a means of creating permanent customers. With consumers able to “choose” from among a dizzying array of procedures and providers, even the most minute areas of the female body are potential sites of worry and “intervention.”

-With the media’s suggestion that cosmetic surgery for the discriminating consumer is almost as easy as choosing any beauty product, it’s not surprising that the targeted demographic for cosmetic medical procedures has widened.

-While the vast majority of customers continue to be Caucasian women, “ethnic surgeries” are also on the rise. Eyelid surgery that remakes eyes from ovals to orbs is one of the top three cosmetic procedures for Asian Americans. The No. 1 procedure for African Americans was rhinoplasty to slim wide noses, and at the top of the list for Hispanics were breast implants to mold cleavage into a “standard” shape and size. The media pressures every woman—regardless of class, age or ethnicity—to modify herself in order to feel “normal.”

-The most graphic consequences of these trends are the stretched, alien, expressionless faces worn by certain celebrities and increasing numbers of “everyday” women. There are also the disfigurements and deaths that can result from surgeries gone wrong. While the ASPS keeps no statistics on botched procedures, permanent scars, severe reactions to injectables, burst implants or deaths due to hospitalacquired infections or administration of too much anesthesia, the stories certainly exist. Indeed, Kuczynski devotes an entire chapter to “The Fatal Quest for Beauty.”

But then Kuczynski ends her string of horrific examples by telling consumers to “educate themselves.” Time and again, even critical assessments of cosmetic surgery conclude in this way. Rather than grapple with the hard questions of whether such surgeries should be undertaken at all, or what the cultural forces are behind the pressures to undergo cosmetic surgery, even critical voices ultimately reaffirm the industry’s message: If the woman is an empowered consumer, she will be smart enough to shop safe. Ultimately, both promoters and detractors keep the question of choice to whether a woman will choose to do her homework, listen to other women and not overreach.

At the end of Beauty Junkies, Kuczynski asserts that “looks are the new feminism.” Yet it's feminists who have emphatically and persistently shown that cosmetic medicine exists because sexism is powerfully linked with capitalism— keeping a woman worried about her looks in order to stay attractive, keep a job or retain self-worth. To say that a preoccupation with looks is “feminist” is a cynical misreading; feminists must instead insist that a furrowed, “wise” brow—minus the fillers—is the empowered feminist face, both old and new.

For further information on feminists challenging cosmetic surgery, visit NOW, loveyourbody.nowfoundation.org; About- Face, www.about-face.org; and the Real Women Project, www.realwomenproject.com.