Flesh Wounds Flesh Wounds The Culture of Cosmetic Surgery Virginia L. Blum UNIVERSITY OF CALIFORNIA PRESS Berkeley Los Angeles London University of California Press Berkeley and Los Angeles, California University of California Press, Ltd. London, England © 2003 by the Regents of the University of California Library of Congress Cataloging-in-Publication Data Blum, Virginia L., 1956–. Flesh wounds: the culture of cosmetic surgery / Virginia L. Blum. p. cm. Includes bibliographical references and index. ISBN 0-520-90158-4 1. Surgery, Plastic—Social aspects. 2. Surgery, Plastic—Psychological aspects. I. Title. rd119 .b58 2003 617.9Ј5—dc21 2002154915 Manufactured in the United States of America 13 12 11 10 09 08 07 06 05 04 10 987654 321 The paper used in this publication is both acid-free and totally chlorine-free (TCF). It meets the minimum requirements of ANSI /NISO Z39.48–1992 (R 1997) (Permanence of Paper). To my father, David Blum and to my mother, Fern Walder CONTENTS Acknowledgments ix 1. The Patient’s Body 1 2. Untouchable Bodies 35 3. The Plastic Surgeon and the Patient: A Slow Dance 67 4. Frankenstein Gets a Face-Lift 103 5. As If Beauty 145 6. The Monster and the Movie Star 188 7. Being and Having: Celebrity Culture and the Wages of Love 220 viii / Contents 8. Addicted to Surgery 262 Notes 291 Works Cited 315 Index 341 ACKNOWLEDGMENTS Many people have contributed to this project, from reading chapters to helping me think through a range of ideas and possibilities, from pro- viding close editorial scrutiny to sharing enlightening telephone con- versations. For their encouragement, good humor, and editorial advice I would like to express my gratitude to my writing group, Susan Bordo, Dana Nelson, Suzanne Pucci, Sue Roberts, and Ellen Rosenman. They were my first guides on this project, and their criticisms, both compas- sionate and critical, were indispensable. I thank Claire Kahane for an early and crucial response to the project as well as Steve Pile and Dan Smith, who both raised important questions. To Jim Kincaid, who read the whole manuscript in less than two weeks, complete with abundant notes and encouragement, I cannot thank you enough for what I can only describe as heroic feats of friendship. Thanks to those people who sent me materials and made recommen- dations along the way: Mardel Blum, Sandy Blum, Bonnie Burman, Janet Eldred, Susan Kessler, Heidi Nast, and Michael Uebel. Thanks to my two brilliant workaholic graduate students who as- sisted me with the research, Ann Beebe and Ann Ciasullo. Thanks also to Meredith Jones for her painstaking transcriptions. ix x/Acknowledgments I thank the Institutional Review Board of the University of Kentucky for advising me through this project and finding ways of accommodat- ing someone with so little experience in the realm of human subject re- search. I especially thank Graham Rowles for his time and effort in teaching me how to conduct interviews. Thanks also to the University of Kentucky for generously supporting this project with a research grant and research assistant stipends. I want also to offer particular thanks to the numerous surgeons and cosmetic-surgery patients who contributed so generously to this project. While their names remain anonymous for the reader, I am deeply grate- ful for their sincere commitment to expanding the range of commentary on this complicated cultural phenomenon. Special thanks go to those surgeons who allowed me to observe their surgeries. I thank as well their staffs who gave me so much information about the nature of the proce- dures, not to mention good-naturedly tolerating my intrusion into their work space. I thank the patients for their willingness to speak with me so openly. Thanks go to my project editor, Cindy Fulton, for all of her efforts toward making this a better book. Without the expertise of my copy- editor, Robin Whitaker, this book would be considerably less readable, so I cannot thank her enough. And thanks so much to Sierra Filucci, assistant to the editor, for all her time, attention, and concern. Finally, I thank Naomi Schneider, my wonderful editor at the University of California Press, for her extraordinary patience in seeing this project through. one The Patient’s Body THE BEGINNING My first nose job was performed by an otolaryngologist (otherwise known as an ear, nose, and throat doctor) who, in concert with my mother, encouraged me to have surgery. Without consulting me, my mother made an appointment and then convinced me to go with her— just to see what he had to say. He had operated on the nose of a neigh- bor, and my mother liked her result. Having a parent criticize a physical feature is a complicated emo- tional experience that induces both anger and guilt. You feel as though you have let the parent down. Why didn’t you come out right? At the same time, the pervasive mythology of parent-child relations tells you that parents think their children are perfect, no matter what. From my mother’s perspective, however, criticism of my nose didn’t seem harm- ful because it wasn’t permanent. Such problems could be resolved— fixed. Ballerina Allegra Kent writes about the nose job similarly imposed upon her by a mother invested in “conventional beauty” (79). “Allegra [said her mother], if you had a little more chin and a little less nose, you would be so much prettier” (78). And then: “Aren’t you interested in a 1 2/The Patient’s Body face that would be closer to perfect proportions? Then you would be beautiful” (78). When a friend had her nose fixed at age seventeen, that settled it. She and I never spoke about her surgery, but somehow the mothers got to- gether and conferred. Even though I couldn’t see the difference myself following my friend’s surgery, my mother was more than enthusiastic. I suppose her postsurgical nose was slightly smaller. In those days, the only kinds of noses that made me think of surgery were very large noses. Slightly large (like my friend’s) or wide noses (like mine) or noses with bumps all seemed fine to my adolescent perception of faces. Young children and adolescents receive their body images wholly from the outside. The adolescent girl, especially, enters the world ten- tatively and waits for it to say yes or no to her face and body. Now that my face had emerged from its childish amorphousness, it was finished enough to predict its disadvantages. Negotiating adolescence can feel like traveling in a herd of sorts, always under fire or under threat of some dangerous predator; you hope that you will escape notice. Then one day you are singled out—shot down in the field—just when you imagined yourself safely swallowed in anonymity. My experience of learning there was something wrong with my nose is inscribed in my mind (and on my body) as a story of imperfection that “required” correction. The story goes this way: Your body is recalci- trant. It came out wrong. If you don’t intervene on some level, you are compounding the original failure. A plastic surgeon I interviewed cor- rected my terminology: “It’s not an intervention. I hate that word. Let’s call it what it is. It’s surgery.” But psychically, it feels like an in- tervention in the body’s wayward path. This holds true for both image- changing surgeries like rhinoplasty and rejuvenation surgeries like a face-lift. Your body is heading in a certain direction that threatens to make “you” worthless unless you rise up in resistance—unless you in- tervene. With surgery. It is important to remember that if you don’t intervene now while there’s still time, you will lose. Something. Every- thing. Love. Money. Achievement. This is what we learn even from the The Patient’s Body /3 body-image scholars who write about how much easier it is to thrive in the world if one is good-looking. I worry about these supposedly objec- tive studies, because I think they have the unfortunate effect of making us all more anxious than we already are. You! Yes, you there, because you are plain, you will be sentenced to ten years in prison instead of three. And you—don’t even think about applying for that job until you have those jowls and double chin sucked smooth. We require streamlined faces to match our precision office spaces. Body-image studies become yet more fodder for plastic surgeons, who explain to me that men “need” to have their eyelids tucked in order to be considered young and ener- getic in business. The story of my household is like that of many Jewish American fam- ilies whose assimilation is symbolized through physical appearance. Fea- tures, body styles—these have meaning. They tell stories all by them- selves. Certain kinds of noses speak Jewishness. I have heard too many people say that he or she “looks” Jewish on the basis of the size of a nose. Jews assimilating into a largely gentile culture thus strip from our fea- tures the traces of our ethnicity. We have other aesthetically assimilat- ing rituals. We straighten curly hair, dye dark hair light. We get very thin to disguise what we often imagine are Jewish-coded thighs and hips. What we choose to treat are precisely the features that are culturally se- lected as our distinguishing physical traits. My nose was not what my family would call “typically Jewish.” It was wide. It was turned-up but “too wide,” as my mother declared. Every picture of me would become an aesthetic catechism.