Can Medicine Be Aesthetic?
Disentangling Beauty and Health in Elective Surgeries
Alexander Edmonds
Department of Anthropology and Sociology, University of Amsterdam
Search for more papers by this authorAlexander Edmonds
Department of Anthropology and Sociology, University of Amsterdam
Search for more papers by this authorAbstract
This article analyzes tensions between aesthetics and health in medicine. The blurring of distinctions between reconstructive and cosmetic procedures, and the linking of plastic surgery with other medical treatments, have added to the legitimacy of an emerging “aesthetic medicine.” As cosmetic surgeries become linked to other medical procedures with perceived greater medical necessity, health and aesthetics become entangled. One consequence is that medical needs are magnified while perceptions of the risks of surgery are minimized. Drawing on ethnographic work on plastic surgery, as well as other studies of obstetrics and cosmetic surgery, I illustrate this entanglement of health and aesthetics within the field of women's reproductive health care in Brazil. I argue that while it would be difficult to wholly disentangle aesthetics and health, analysis of how risk–benefit calculations are made in clinical practice offers a useful critical strategy for illuminating ethical problems posed by aesthetic medicine.
References Cited
- ACOG 2007 ACOG Advises against Cosmetic Vaginal Procedures Due to Lack of Safety and Efficacy Data. American College of Obstetricians and Gynecologists. Press Release, September 1.
- Al-Mufti, Raghad, Andrew McCarthy, and Nicholas Fisk 1996 Survey of Obstetricians’ Personal Preference and Discretionary Practice. Lancet 347(24): 544.
- Barrett, Geraldine, Janet Peacock, Christina R. Victor, and Isaac Manyonda 2005 Cesarean Section and Postnatal Sexual Health. Birth 32(4): 306–311.
- Béhague, Dominique 2002 Beyond the Simple Economics of Cesarean Section Birthing: Women's Resistance to Social Inequality. Culture, Medicine and Psychiatry 26: 473–507.
- Béhague, Dominique, Cesar Victora, and Fernando Barros 2002 Consumer Demand for Caesarean Sections in Brazil: Informed Decision Making, Patient Choice, or Social Inequality? British Medical Journal 324(7343): 942–945.
- Belizán, José, and Guillermo Carroli 1998 Routine Episiotomy Should Be Abandoned. British Medical Journal 317(7169): 1389.
- Bordo, Susan 1993 Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley: University of California Press.
- Braun, Virginia 2005 In Search of (Better) Sexual Pleasure: Female Genital “Cosmetic” Surgery. Sexualities 8(4): 407–424.
10.1177/1363460705056625 Google Scholar
- Braun, Virginia 2009 Selling the “Perfect” Vulva. In Cosmetic Surgery: A Feminist Primer. Cressida J. Heyes and Meredith Jones, eds. Pp. 133–152. Farnham, UK: Ashgate.
- Brownell, Susan 2005 China Reconstructs: Cosmetic Surgery and Nationalism in the Reform Era. In J. Alter, ed. Pp. 132–150. Asian Medicine and Globalization. Philadelphia: University of Pennsylvania Press.
- Caetano, André, and Joseph Potter 2004 Politics and Female Sterilization in Northeast Brazil. Population and Development Review 30(1): 79–109.
- Carranza, Maria 1994 Saúde Reprodutiva da Mulher Brasileira. In Mulher brasileira é assim, M. Muñoz-Vargas and S. Heleieth, eds. Pp. 95–150. Rio de Janeiro: Rosa dos Tempos.
- CGBS 2011 Consumer Guide to Bariatric Surgery. http://www.yourbariatricsurgeryguide.com, accessed June 23, 2011.
- Cirurgia íntima feminina 2006 http://www.plasticaparcelada.com.br/cirurgia-plastica-intima.asp, accessed May 14, 2013.
- Clarke, Adele, Laura Mamo, Jennifer Ruth Fosket, Jennifer Fishman, and Janet Shim 2010 Biomedicalization: Technoscience, Health, and Illness in the U.S. Durham: Duke University Press.
10.1515/9780822391258 Google Scholar
- Cleary-Goldman, Jane, and Julian N. Robinson 2003 The Role of Episiotomy in Current Obstetric Practice. Seminars in Perinatology 27(1): 3–12.
- Davis, Kathy 1995 Reshaping the Female Body: The Dilemma of Cosmetic Surgery. New York: Routledge.
- De Mello e Souza, C. 1994 C-Sections as Ideal Birth: The Cultural Construction of Beneficence and Patients’ Rights in Brazil. Cambridge Quarterly of Health Care Ethics 3: 358–366.
- Diniz, Simone, and Alessandra Chacham 2004 “The Cut Above” and “The Cut Below”: The Abuse of Caesareans and Episiotomy in São Paulo, Brazil. Reproductive Health Matters 12(23): 100–110.
- Edmonds, Alexander 2007 The Poor Have the Right to Be Beautiful: Cosmetic Surgery in Neoliberal Brazil. Journal of the Royal Anthropological Society ( 13): 363–381.
- Edmonds, Alexander 2009 Learning to Love Yourself: Esthetics, Health and Therapeutics in Brazilian Plastic Surgery. Ethnos 74(4): 465–489.
- Edmonds, Alexander 2010 Pretty Modern: Beauty, Sex and Plastic Surgery in Brazil. Durham: Duke University Press.
10.1215/9780822393115 Google Scholar
- Edmonds, Alexander, and S. van der Geest 2009 Introducing “Beauty and Health.” Medische Antropologie 21(1): 5–19.
- FDA 2011 Update on the Safety of Silicone Gel-Filled Breast Implants. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm259866.htm, accessed March 8, 2012.
- Fitzgerald, S. P. 2007 The Overall Benefits Risks and Costs of Multiple Medical Interventions May Be Less Favourable than the Sum of the Benefits Risks and Costs of Those Individual Interventions. Medical Hypotheses 69: 970–973.
- Garcia, Julio 2007 Hormone Administration in an Aesthetic Surgery Practice: One Surgeon's Experience. Aesthetic Surgery Journal 27: 212–214.
- Gilman, Sander 1998 Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery. Durham: Duke University Press.
- Gimlin, Debra 2007 Accounting for Cosmetic Surgery in the USA and Great Britain: A Cross-Cultural Analysis of Women's Narratives. Body & Society 13(1): 43–62.
- Goldstein, Donna 2003 Laughter Out of Place: Race, Class, Violence, and Sexuality in a Rio Shantytown. Berkeley: University of California Press.
- Gonçalves, Isabela Lopes 2001 “Cortes e Costuras: Um Estudo Antropólogico da Cirurgia Plástica no Rio de Janeiro.” Masters thesis, Department of Cultural Anthropology, Museu Nacional, Rio de Janeiro.
- Graham, Ian D, Guillermo Carroli, Christine Davies, and Jennifer Mary Medves 2005 Episiotomy Rates around the World: An Update. Birth 32(3): 219–223.
- Greer, Germaine 1991 The Change: Women, Aging and Menopause. London: Hamish Hamilton.
- Gruber, C. J., F. Wieser, I. M. Gruber, K. Ferlitsch, D. M. Gruber, and J. C. Huber 2002 Current Concepts in Aesthetic Endocrinology. Gynecological Endocrinology 16: 431–441.
- Haiken, Elizabeth 1997 Venus Envy: A History of Cosmetic Surgery. Baltimore: Johns Hopkins University Press.
- Hartmann, Katherine, Meera Viswanathan, Rachel Palmieri, Gerald Gartlehner, John Thorp, and Kathleen Lohr 2005 Outcomes of Routine Episiotomy: A Systematic Review. Journal of the American Medical Association 293(17): 2141–2148.
- Herbenick, Debra, and Michael Reece 2010 Development and Validation of the Female Genital Self-Image Scale. Journal of Sexual Medicine 7(5): 1822–1830.
- Hopkins, K. 2000 Are Brazilian Women Really Choosing to Deliver by Cesarean? Social Science and Medicine 51: 725–740.
- Jones, Meredith 2008 Skintight: An Anatomy of Cosmetic Surgery. New York: Berg.
- Jones, Meredith, and C. Heyes 2009 Cosmetic Surgery in the Age of Gender. In Cosmetic Surgery: A Feminist Primer. Meredith Jones and C. Heyes, eds. Pp. 171–190. Farnham, UK: Ashgate.
- Kinney, Brian 1998 The Coming Impact of Anti-Aging on Plastic Surgery. Aesthetic Surgery Journal 18(5): 392–393.
- Klein, Renate, and Lynette Dumble 1994 Disempowering Midlife Women: The Science and Politics of Hormone Replacement Therapy. Women's Studies International Forum 17(4): 327–343.
- Kleinman, A., and A. Becker 1998 Sociosomatics: The Contributions of Anthropology to Psychosomatic Medicine. Psychosomatic Medicine 60(4): 389–393.
- McCallum, Cecilia 2005 Explaining Caesarean Section in Salvador da Bahia, Brazil. Sociology of Health and Illness 27(2): 215–242.
- Marshall, Barbara 2009 Rejuvenation's Return: Anti-Aging and Re-Masculinization in Biomedical Discourse on the “Aging Male.” Medicine Studies 1(3): 249–265.
10.1007/s12376-009-0019-3 Google Scholar
- Morgan, Kathryn Pauly 1991 Women and the Knife: Cosmetic Surgery and the Colonization of Women's Bodies. Hypatia 6: 25–53.
10.1111/j.1527-2001.1991.tb00254.x Google Scholar
- Naugler, Diane 2009 Crossing the Cosmetic/Reconstructive Divide: The Instructive Situation of Breast Reduction Surgery. In Cosmetic Surgery: A Feminist Primer. Meredith Jones and C. Heyes, eds. Pp. 225–238. Farnham, UK: Ashgate.
- Pochin, Edward 1982 Risk and Medical Ethics. Journal of Medical Ethics 8: 180–184.
- Rebelo, Fernanda, Camilla Medeiros Macedo da Rocha, Taísa Rodrigues Cortes, Carmem Lúcia Dutra, and Gilberto Kac 2010 High Cesarean Prevalence in a National Population-Based Study in Brazil: The Role of Private Practice. Acta Obstetricia et Gynecologica Scandinavica 89(7): 903–908.
- Ribeiro, Cláudia, and José Horácio Aboudib 1997 Você e a cirurgia plástica: tudo o que você precisa saber sobre cirurgia plástica. Rio de Janeiro: Record.
- Safarinejad Mohammad Reza, Ali Asgar Kolahi, and Ladan Hosseini 2009 The Effect of the Mode of Delivery on the Quality of Life, Sexual Function, and Sexual Satisfaction in Primiparous Women and Their Husbands. Journal of Sexual Medicine 6(6): 1645–1667.
- Sahlins, Marshall D. 1974 Stone Age Economics. New York: Tavistock.
- Salant, T., and H. P. Santry 2006 Internet Marketing of Bariatric Surgery: Contemporary Trends in the Medicalization of Obesity. Social Science and Medicine 62(10): 2445–2457.
- Sanabria, Emilia 2011 The Body Inside Out. Social Analysis: International Journal of Social and Cultural Practice 55(1): 94–112.
10.3167/sa.2011.550105 Google Scholar
- SBME 2011 Sociedade Brasileira de Medicina Estética. http://www.sbme.org.br/portal, accessed May 20, 2011.
- SEME 2011 Sociedade Español de Medicina Estética. http://www.seme.org/area_seme/libroblanco.php, accessed June 24, 2011.
- Sokol, D. K. 2008 The “Four Quadrants” Approach to Clinical Ethics Case Analysis: An Application and Review. Journal of Medical Ethics 34: 513–516.
- Tiefer, L. 2008 Female Cosmetic Genital Surgery: Freakish or Inevitable? Feminism and Psychology 18: 466–479.
- Wajcman, Judy 1991 Feminism Confronts Technology. University Park: Pennsylvania State University Press.
- Zuckerman, Diana 2010 Reasonably Safe? Breast Implants and Informed Consent. Reproductive Health Matters 2010: 18(35): 94–102.