From liposuction to labiaplasty

Historian Elizabeth Haiken talks about the culture of plastic surgery in America.

Published January 14, 1998 8:00PM (EST)

Modern technology, eager surgeons and consumer demand have conspired to create breasts that defy gravity, noses sculpted to pug perfection and thighs that have been sucked svelte. In 1996, more than 100,000 American women and men had liposuction; 90,000 women had breast implants or reductions; and 50,000 had face lifts. As TV starlet Jenny McCarthy, who got breast implants when she was 18, writes in her new memoir, "Isn't that the American dream? To purchase fine new breasts on credit?"

Salon recently spoke with Elizabeth Haiken, author of "Venus Envy: A History of Cosmetic Surgery" (Johns Hopkins University Press) about surgery junkies, feminism and -- hold your breath -- labiaplasty.

Are there any areas of the body where people have not elected to have plastic surgery?

There really is nothing, as far as I know, that hasn't been done. I came across an article during my research about a labiaplasty! Before crotch shots were published nobody was interested in this, but now everyone knows what labia are supposed to look like. Even though this is not something that millions of women are doing, the fact that it exists was proof to me that nothing has been left untouched.

There are ads for plastic surgery on subways, in the back of magazines, on late night TV. How has the marketing of plastic surgery changed over time?

People who advertised in newspapers before the late 1970s were just not accepted by their peers -- they were seen as quacks. Now, you see ads all over the place. Part of it is simply self-defense -- if one doctor is doing it, you've got to keep up. Some of it has do with the nature of plastic surgery itself. Because it's elective, and because it doesn't usually involve irritating things like insurance companies, it's simple in terms of payment. You decide you want a nose job, you go in and plunk down your $5,000 or whatever and that's it.

In 1992, 30 percent of plastic surgery patients came from families with incomes under $25,000 a year. That suggests that plenty of people who elect to have cosmetic surgery are regular folks without wads of cash.

I found records from the 1930s of single secretaries who would have cosmetic surgery and arrange to pay the surgeon over time. But the people who get multiple procedures are very wealthy.

Is that a growing phenomenon, plastic surgery junkies?

There have been a few Oprah-type exposis on these people. In a sense, we're all plastic surgery junkies. It's become so much a part of our culture. Even if you don't read articles about it, you can't help but see the ads. You look at the list of conditions that can be corrected and it's very difficult not to think of yourself in those terms of "what can I correct?" or "should I take care of these thighs?" We are all so aware that solutions are available. I'm almost 35, and I don't know any woman around my age who hasn't thought about it or made a joke about it. A lot of people might choose not to do it, but that doesn't mean they aren't aware of it and that they don't wonder if they might be losing out on something if they chose not to do it.

It seems women are getting plastic surgery at a younger age, before the effects of age have even set in.

Teenagers have always gotten nose jobs. But this idea that you can not only fix the effects of age once you've experienced them, but prevent them, is a fairly new phenomenon and partly has to do with technology.

While your writing is certainly not preachy, it is clear that you are ambivalent about, even critical of, the proliferation of plastic surgery. But can anyone -- you, me or a surgeon -- argue against it when it is such a personal, individual decision? Many people who undergo plastic surgery say it is a question of self-esteem.

When I was looking at the notes and correspondences of surgeons, I found that they often struggled with this question. Someone would come to them and say, "I hate my life, I'm miserable." But to the surgeon this person looked fine. The surgeon then asks themself, who am I to draw the line? Who am I to tell this woman that she can't have a safe surgery if that's what she really wants? It is difficult to draw the line at an individual level. But to me that doesn't mean we shouldn't think about this at a macro level as well. Why do so many people feel uncomfortable in their own skin?

If cosmetic surgery is so widespread, why does it remain a taboo conversation topic?

What this says to me is how conflicted we are about this. Even though we think it's so important that we cut our bodies up, we also think it's so terrible and shameful that we don't want to admit that we are doing it. To talk about it means that you acknowledge that you care about externals, which everyone is reluctant to do. I think more people are talking about it -- look at Cher. But I think that people who do talk about it: A) have to have had good results, and B) have to have balls.

Is plastic surgery anti-feminist?

There has actually been a lot of debate in feminist circles about whether plastic surgery can be feminist. In the book I talked about how Ms. magazine gave Cher an award for being an authentic feminist hero because she's someone who decided what she wanted to be and went out and created herself. I've been called a hard-line feminist and an anti-feminist for taking the position that I do. People call me hard-line because I'm critical of plastic surgery and anti-feminist because of that criticism -- people say women should be able to do whatever the hell they want, and isn't that what the battle was all about? My feeling is that feminism tried to create a world where no woman would feel the need to get liposuction. But I think that more feminists than we would ever conceive of have probably had different surgeries -- they just haven't told us.

By Lori Leibovich

Lori Leibovich is a contributing editor at Salon and the former editor of the Life section.

MORE FROM Lori Leibovich

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