I want to be like that (porn) actress: the global plastic surgery craze

To tell anyone, without humor or sarcasm, that you want to be more beautiful than you are is still considered an alarming sign of vanity or a childish and ridiculous desire. However, it's undeniable that virtually everyone wants to look better. Few people don't look in the mirror at least once a day, especially before going out. To a greater or lesser extent, we are all aware of and concerned about the image we project to others. For some, soap and water are enough, many others need a comb, for others, makeup is essential, but millions of people invest fortunes in beauty procedures that range from pleasurable to painful and even dangerous, just to look better.

The most aggressive form of appearance modification and alteration is plastic surgery , which involves, among other things, cutting skin, suctioning fat, and modifying bone structures or cartilage. Essentially, these procedures come in two forms: reconstructive (surgical work dedicated to repairing physical damage of catastrophic, accidental, congenital, or deformity origin) and corrective (associated with improving self-esteem, social status, and even career opportunities). The former aim to normalize appearance and, in some cases, result in improved health and physiological functions. People who undergo the latter procedures are not considered patients but clients, and their desires are strictly related to aesthetic judgments and the unhappiness or frustration they feel with their bodies. The reality is that in many cases, the line between reconstructive and corrective treatment is thin and is related to dissatisfaction .

During the Enlightenment, the idea emerged that human beings could reinvent themselves because the prospect of freeing themselves from the social and economic chains imposed by one's social class opened up. Added to this, thanks to the technological advances of the time, was the possibility of altering facial and bodily characteristics to make them more pleasing to the eye. In a rapidly urbanizing world, physical appearance began to take on great importance. Scientific developments promised to remedy bodily defects, making people more beautiful and desirable. As early as the late 16th century, Renaissance surgeons were experimenting with cosmetic surgery. Their main focus in this field was the reconstruction of noses and other organs destroyed by syphilis , to avoid the associated social stigma.

Gaspare Tagliacozzi (1545–1599) is considered one of the pioneers of plastic surgery for his achievements in reconstructing noses using skin grafts. It was a dangerous procedure, reportedly taking about a month to perform. As medical historian Sander Gilman points out, Tagliacozzi emphasized that his procedures were not cosmetic, but rather sought to heal the patient's spirit. For this physician, the face was the mirror of the soul, as Galen had proposed. His techniques gave the sick the opportunity to "pass as" healthy.

In the mid-19th century, a variety of surgical techniques that had fallen out of use resurfaced. This was largely due to the work of German surgeon Johann Friedrich Dieffenbach (1792–1847), known as the “father of plastic surgery.” This term began to refer to a number of specific surgical procedures for the face and body, such as rhinoplasty and blepharoplasty . These two operations are so popular today that some don't even consider them surgery.

Modern cosmetic surgery appeared in 1890, when faces and bodies that did not suffer from malformations began to be operated on.

Modern cosmetic surgery emerged in the 1890s, when people began operating on faces and bodies that were not affected by malformations but whose appearance was sought to be improved for whatever reason. The practice soon took on a clearly racial connotation , as the most common goal was to eliminate ethnic features , such as the crooked nose associated with Jews, the flat nose associated with Black people, or the slanted eyes associated with Asian appearance. All in an effort to "pass as" something they are not, to create a new appearance to reinvent themselves and thus be more accepted.

Surgeons who performed these procedures were considered not so much doctors as swindlers who gave their patients the opportunity to "deceive" society, either by obscuring the traces of a sinful illness, such as syphilis, or by erasing the differences in their features from those of the dominant racial and social group, as Gilman points out.

With the introduction of ether anesthesia in 1846 , the number of patients willing to undergo surgery to alter their appearance increased. Beginning in 1867, surgeries became much safer thanks to the proliferation of antiseptic methods. Local anesthesia began to be used in 1880 , and with it, the number of deaths under general anesthesia decreased.

From its beginnings, plastic surgery enjoyed less credibility and prestige than other medical specialties. Those who underwent it unnecessarily fell far short of the empathy commonly evoked by patients or accident victims. Many of the plastic surgeons of the late 19th century had little or no training, and clients risked their lives with their scalpels. Hence, there was no shortage of doctors who denounced beauty surgeons as quacks and charlatans.

Many of the plastic surgeons of the late 19th century had little or no training and clients risked their lives with their scalpels.

The First World War gave many surgeons the opportunity to test new techniques on combat victims, the infamous gueules cassées (broken faces). Given that the majority of plastic surgeons' clients are women (86.7% of all cosmetic surgeries worldwide are performed on women, according to Statista), there is a tendency to consider this specialty as having been oriented from the outset to meet their demands. But the reality is that cosmetic surgery does not privilege any specific category, and a history of it that considers only the gender perspective would distort the role and definition of the patient, as well as the surgeon, as Gilman writes.

Celebrated theorist and scholar Anne Balsamo says that “cosmetic surgery represents a form of cultural signification where we can examine the literal and material reproduction of beauty ideals.” She further states: “Cosmetic surgery is not simply a discursive site for the ‘construction of images of women,’ but a material space in which the female physical body is dissected, stretched, sculpted, and reconstructed according to cultural and eminently ideological standards of physical appearance.”

86.7% of all cosmetic surgeries worldwide are performed on women.

While elective plastic surgery—meaning surgery that isn't necessary, at least not immediately—has become normalized and is increasingly common as a technology available to women not only to please men but also to satisfy their own needs and desires, there will always be those who view it as a technology of subjugation to standards and the renunciation of individuality , a "devaluation of the material body," in Balsamo's words. But Balsamo also notes that plastic surgery is a practice in which women consciously make their bodies mean something to themselves and others. Similar to tattoos and piercings, it is a way of staging a cultural identity.

Certain cosmetic surgeries have become extremely popular in the first decades of the 21st century and have become somewhat cheaper, so undergoing them is considered comparable to clothing fashion, exercise, and psychological therapy. In the United States alone, the leading country in this trend, more than 26.2 million cosmetic surgical procedures and treatments were officially performed (excluding those performed clandestinely) in 2022, ranging from the most complex to the minimally invasive. The most popular surgeries were, in this order: breast augmentation, liposuction , nose reshaping, eyelid surgery, and abdominoplasty. Less invasive procedures are Botox injections , soft tissue fillers, chemical peels, laser hair removal, and microdermabrasion. According to statistics from the American Society for Aesthetic Plastic Surgery, the number of surgeries increased by 457% between 1997 and 2018. That year, $16.5 billion was spent on these types of procedures in the United States. Of these, only 9% were performed on men. Furthermore, it is striking that countries with serious economic problems and social inequality, such as Mexico and Brazil, rank highly among those where the most cosmetic surgeries and procedures are performed.

In 2022, more than nine million Americans received Botox injections and more than three million received fillers for their lips and other body parts. It's striking that more than 50% of these procedures are sought by people with middle-class household incomes . And since these types of treatments are rarely covered by health insurance, this indicates that people are willing to make great sacrifices to change their appearance.

The most popular operations are: breast augmentation, liposuction, nose reshaping, eyelid surgery and abdominoplasty.

Jason Diamond, a celebrity plastic surgeon in Beverly Hills, defines his practice this way: “We’re always trying to create balance in the face. And when you look at Kim [Kardashian], Megan Fox, Lucy Liu, Halle Berry , you’ll find common elements: the high, contoured cheekbones, the strong, projecting chin, the flat platform under the chin that forms a ninety-degree angle.” Many plastic surgeons say their clients often bring photos of their favorite celebrities to the office to use as models. But filters and applications for modifying faces have also been fundamental in the way in which plastic surgery has become popular, since it is not uncommon for patients to offer their doctors images of themselves that they have digitally manipulated, to be taken as a reference for their surgeries, even though these photos often demand interventions that are impossible or unrealistic, such as having bigger eyes or completely eliminating nasolabial lines, the laugh lines that run from the nose to the corners of the mouth, and without which a face would not truly appear human.

The work of plastic surgeons is always performed on individual faces and bodies, to which they apply general measurements and guidelines in order to get as close as possible to the dominant ideals. The full lips so common today, the result of high estrogen levels, were popularized by celebrity and influencer culture, with the Kardashians being their main motivation. The massification of these procedures implies a standardization of appearances , the creation of a kind of sisterhood of manufactured features in pursuit of a dominant beauty ideal . This has popularized procedures that were previously exotic, unusual, or practically unknown, such as vaginal labia reduction or reconfiguration surgery, nipple rejuvenation or sculpting, or buttock implants . Some of these treatments are a reflection of the pornification of culture and the aspiration to meet the standards of the models who star in pornographic videos.

While it's impossible to deny that the image of Caucasian beauty continues to dominate the media, the "Kardashian model" has taken hold in much of the world. It's fair to say that, at least in recent times, her beauty ideal has become universalized and consists of a collection of hybrid features that overlap different ethnicities : tanned skin, wide hips, full lips, large, round breasts, and a pointy nose.

Anthony Elliott , author of the essay "Making the Cut ," in which he explores how cosmetic surgery transforms society, points to three crucial factors in appearance modifications. The first is the cult of celebrity. The second is consumerism and the ability to enhance the appearance of both one's own face and different parts of the body. The third is the globalized economy, which impacts employment and the flexibility of identity.

When cosmetics and plastic surgery are used on noses, eyelids, jaws and teeth to modify unwanted characteristics that are not the result of the effects of aging, we have to say, in essence, what is being attempted is to deceive evolution . These methods designed to alter or hide supposed defects in physical appearance, as well as to emphasize attractiveness by accentuating, enlarging, marking, reducing, disguising, mutilating or transforming features of the physiognomy, have the singularity that they alter the appearance but obviously not the genetic code . That is to say, these supposed defects or imperfections rejected by the person remain latent in the genes to re-emerge in their descendants, if they have them. In this way, it is almost inevitable that a son or daughter will inherit the characteristics that were corrected by their mother or father in their own physiognomies. It is conceivable that they too would want to eliminate this trait in their offspring, and that in doing so, they perpetuate the inability to accept inherited characteristics and develop obsessive fixations with what are perceived as defects or deformities.

Plastic surgery offers the ideal of a world without differences , where everyone is happy with their appearance, where the standardization of the ideal leaves no one out, where everyone can "pass as" whatever they aspire to; it means escaping the negative categories into which certain people tend to be pigeonholed based on their appearance and adopting the physical features of the dominant group. This is a quintessential cyborg fantasy: social engineering through body modification.

The point is first and foremost to avoid attracting negative attention, and secondly, to please with what is conventional and common . To achieve this, we resort to a symbolic, modified body, capable of contending with social demands, even if its usefulness is limited and eventually the flesh betrays the ideal of beauty, ages, collapses, wrinkles, and deteriorates. It is also important to consider that the number of male cosmetic procedures has multiplied in recent years, and that their main beneficiaries are businessmen, corporate executives, politicians, lawyers, and professionals who believe they need a youthful and attractive appearance to survive and be competitive in the job market. Therefore, they do not consider these modifications as a symptom of vanity or narcissism, but rather as professional investments.

Businessmen, politicians, lawyers and professionals believe they need a youthful and attractive appearance to be competitive.

In recent decades, South Korean beauty procedures have become a global obsession. It is the country with the most cosmetic plastic surgeries per capita in the world , with between 13.5 and 20 procedures per 1,000 individuals, and one in three women between the ages of 19 and 29 have undergone some type of intervention. Few cultures have an obsession like Korea's with having "naturally pale and glowing skin, what they call 'glass skin,'" a soft V-shaped chin, large eyes (with the help of blepharoplasty, or double-fold eyelid surgery, one of the most popular graduation gifts in the country), full lips, and a slim, athletic body. The popular obsession with these characteristics has its origins in tradition, Confucianism, and classism. Its impact has been largely due to the global success of K-pop and its attractive idols . This has given rise to a society that perhaps like no other aspires to a homogenization of appearances.

* On Beauty' (Alpha Decay ): This essay by Naief Yehya on human beauty, and particularly feminine beauty, is based on the certainty that appearance occupies a crucial place in our lives and operates as a "gravitational field" that distorts perceptions and shapes behaviors. Tracing a fascinating arc from prehistory to the Instagram age, from the first pigments and body ornaments to genetic surgery, Yehya demonstrates that technology has always been the key mediator in the construction of beauty ideals.

* Naief Yehya (Mexico City, 1963) is an engineer, writer, cultural critic, and pornographer. His work, both fiction and essays, addresses topics such as the impact of technology on culture and politics, pornography, and war.