Read an Excerpt
The Makeover Myth
Cosmetic Medicine at the Millennium
"Do you know what thirty is? It's the beginning of middle age. Thirty to fifty. From fifty on you have no right or reason to expect to live another day."
The New Cultural Paradigm
Visits to a cosmetic surgeon used to be a rich woman's best kept secret. Today they represent merely one option in the endless public parade of equal opportunity lifestyle choices that constitutes cosmetic medicine. Now as in the past the selections consumers make frequently have less to do with health than with fad and fashion statements. Cosmetic interventions are about normalizing—that is, striving to achieve current cultural norms of appearance. They are also promoted as ways to restore or obtain beauty, youth, sex appeal, status, and happiness. As humanities professor Kathy Davis puts it, "The body is simply a vehicle for recognizing our individual desires and projects."1 More to the point, undergoing a cosmetic procedure has always been an intervention in identity. The difference now is that beyond seeking the norm, cosmetic interventions are perhaps themselves becoming the norm.
Contemporary society has discarded the early-twentieth-century theories that (1) cosmetic surgery is only for the psychologically impaired and (2) if a recipient isn't psychologically damaged before cosmetic surgery, he or she likely will be afterward. In fact, many people like to contemplate undergoing a physical change. Women, by far the biggest consumers of cosmetic medical care, are today less likely to accept the oldprevailing wisdom that one should "learn to live with it." The published results of a recent telephone survey indicate that 60 percent of American women are unhappy with their appearance,2 and it is estimated that approximately 20 percent of women have had or would consider having a cosmetic procedure. Physicians have been more than willing to oblige this growing market. In fact, one surgeon has proposed that cosmetic ser-vices be promoted in the context of a new and irresistible paradigm, namely that cosmetic surgery can reveal the youth that the person feels, thus putting one's body in harmony with one's inner self.3
Although striving to look good is a natural impulse, striving to look better after young adulthood is a more recent cultural trend. As Americans live healthier and longer lives and with medical treatments across the board more sophisticated and less risky, people of all ages believe they have the luxury of fulfilling desires as specific as wanting a smaller nose or as grandiose as seeking total rejuvenation or even reinvention à la reality TV. Like much else in our culture, this growth in demand for cosmetic medical care is driven not only by shifting social values but by technology—that of the procedures themselves and of the information age. We can credit the World Wide Web and related technology with providing users with unlimited opportunities to inflate, admire, and "celebritize" themselves and their images. Popular culture and advertisers encourage the ego-feeding frenzy, and cosmetic medicine flows seamlessly into this mind-set.
Nobody really knows how popular cosmetic medicine would be if themedia weren't stimulating the market by creating the perception that everyone is "having something done." As evidenced by the numbers, it is far from a universal obsession, yet there is no doubt that cosmetic medical care, previously offered by a few reputable but discreet surgeons as well as undocumented numbers of backstreet hucksters, is more popular and mainstream now. Between 1992 and 2005 the volume of documented cosmetic procedures increased roughly 2500 percent, largely because of the increased performance of lesser procedures such as injections, peels, and laser treatments. Even so, trends in America are not uniform from coast to coast. The Southern California, Florida, and New York City geographic areas, along with a few upscale enclaves, almost stand alone in the pure saturation of cosmetic procedures in local markets. Meanwhile, residents of the Midwest and other parts of the country, while hardly strangers to cosmetic medicine, are a bit more conservative.
The Business of Cosmetic Medicine Today
What Is It?
We can no longer use only the term "cosmetic surgery" to describe the wide and increasing array of medical procedures available for the purpose of enhancing appearance. Therefore, I use the terms cosmetic medical care, cosmetic medical ser-vice, cosmetic medicine, cosmetic intervention, and cosmetic procedure to refer to any operation or less invasive medical procedure that is performed on what most people would consider normal features, usually for the purpose of lessening or enhancing their prominence, correcting minor irregularities that would be too minimal to qualify as reconstructive surgery, or reducing the signs ofchildbearing or aging. In general, people seek cosmetic interventions to change aspects of their bodies that they consider unflattering.
Certain cosmetic procedures may be described as minimally invasive; these are procedures such as injections, laser treatments, dermabrasion, and chemical peels that may cause less severe injury than a major operation. Minimally invasive does not necessarily mean minimally risky—patients have died from procedures that are sometimes dismissed as minor—and certain procedures, like liposuction, are considered invasive surgery even though they are performed through very small incisions. In fact, the size of skin incisions per se has little to do with the invasiveness or risks of a procedure. It is also inappropriate to consider procedures such as full-face ablative laser resurfacing and phenol chemical peels to be minimally invasive, as both create significant burns. Noninvasive procedures are those in which there is no significant penetration of or damage to skin and underlying tissues. These procedures include certain laser and light-based treatments, microdermabrasion, and numerous newer procedures that may or may not have any measurable effects. Nonphysicians in nontraditional medical facilities such as spas and salons offer a variety of minimally invasive and noninvasive procedures.
Because many cosmetic medical ser-vices are not surgical and many providers are not surgeons, I frequently use the general terms "provider" and "practitioner" to refer to anyone offering cosmetic medical care ser-vices.The Makeover Myth. Copyright ? by Bethanne Snodgrass. Reprinted by permission of HarperCollins Publishers,Inc. All rights reserved. Available now wherever books are sold.