Becoming=Being a Cosmetic Surgery Patient: Semantic Instability and the Intersubjective Self
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Studies in Gender and Sexuality, 10: 119–128, 2009
Copyright # Taylor & Francis Group, LLC
ISSN: 1524-0657 print=1940-9206 online
DOI: 10.1080/15240650902979202
Becoming=Being a Cosmetic Surgery Patient: Semantic
Instability and the Intersubjective Self
Victoria Pitts-Taylor, Ph.D.
City University of New York
Against approaches that center the subject—the cosmetic surgery patient—as the primary site of
inquiry regarding the ‘‘truth’’ of cosmetic surgery, I argue that we must rethink the positioning of
the subject in considering cosmetic surgery’s meanings. Here I offer a brief discussion of various
feminist theories of the cosmetic surgery patient, as well as an account of my own experience of
cosmetic surgery, to explore how the cosmetic surgery patient is semantically unstable, named
and identified through a variety of discourses and social relations. This semantic instability suggests
a need to examine the ongoing processes by which cosmetic surgery comes to have meaning and by
which the subjectivity of the cosmetic surgery patient is produced.
Much investigation of cosmetic surgery, including a good deal of feminist scholarship, has
focused on examining the deep motives, mental health, or political consciousness of women
who undergo cosmetic surgery. If one looks to what various critics have said about the cosmetic
surgery patient, she can be historicized as an individual with deep psychoanalytic problems,
various psychiatric disorders, a variety of moral weaknesses, or a politically oppressed con-
sciousness. These approaches have often centered the subject—the cosmetic surgery patient—
as the primary site of inquiry regarding the ‘‘truth’’ of cosmetic surgery. Feminist researchers
have contributed to this discussion partly by debating the agency of the cosmetic surgery patient.
But I believe that we must rethink the positioning of the subject in considering cosmetic
surgery’s meanings. Here I offer a brief discussion of various feminist theories of the cosmetic
surgery patient, as well as an account of my own experience of cosmetic surgery, to explore how
the cosmetic surgery patient is semantically unstable, named and identified through a variety of
discourses and social relations. This semantic instability suggests a need to examine the ongoing
processes by which cosmetic surgery comes to have meaning and by which the subjectivity of
the cosmetic surgery patient is produced.
My broader project has investigated the interrogations of female subjectivity in contemporary
discourses on cosmetic surgery, including feminist, psychiatric, and medical discourses
(Pitts-Taylor, 2007). I argue that these, along with other discourses interested in the deep identity
of the cosmetic surgery patient, are epistemologically problematic to the extent that they have
generated what Foucault (1989) called a hermeneutics of the self. That is, they are not simply
Correspondence should be sent to Victoria Pitts-Taylor, Ph.D., Professor of Sociology, Department of Sociology,
Graduate Center, City University of New York, 365 5th Avenue, New York, NY 10016. E-mail: vpitts@gc.cuny.edu120 PITTS-TAYLOR
revelatory but rather productive and inscriptive, lending a deep interiority to cosmetic surgery
that locates its meanings as adhering in significant ways in the individual. For example, for
decades, psychiatrists and psychotherapists have argued that cosmetic surgery patients were
prone to a whole range of mental health problems. These range from a variety of sexual
neuroses, when Freudian analysis was more in vogue, to body dysmorphic disorder, the latest
psychiatric label for cosmetic surgery addiction. I have argued elsewhere that in psychiatric
discourse, the cosmetic surgery patient is not simply being understood; rather, the truth of her
identity is also being produced (Pitts-Taylor, 2007).
Feminist discourse can also constitute a hermeneutics of the self in the Foucaultian sense. In
feminism, the female cosmetic surgery patient has been the object of an intense debate over the
possibility of her agency. While linking cosmetic surgery directly to the social problem of patri-
archy, feminists have also questioned the mental health of individual female cosmetic surgery
patients. This approach was largely unchallenged until 1995, when Kathy Davis (1995) sought
to use the voices of cosmetic surgery patients themselves to explain why women undergo it.
Davis argued that women’s decisions to get cosmetic surgery were rational given the extensive
social pressures women faced. Despite Davis’s work, feminists like Virginia Blum (2003) and
Eve Ensler (2004) have continued to portray women who get cosmetic surgery as self-hating
and self-mutilating.
THE STRUCTURE-AGENCY DEBATE AND BEYOND
The so-called structure-agency debate, centered on the character of women’s subjectivity, has
shaped a great deal of feminist scholarship on cosmetic surgery in the past several decades.
The cultural or radical feminist responses to cosmetic surgery, where the cosmetic surgery
patient is enacting bodily self-hatred as an outcome of patriarchal pressures, represents one
side of the debate. Writers like Blum, Ensler, and Sheila Jeffreys offer contemporary examples
of the decades-long view that women’s desires to get cosmetic surgery are evidence of
self-hatred. Some of these writers, like Blum (2003), have identified women cosmetic surgery
patients as self-mutilators and have theorized that female patients have body image problems
that can be comparable to, if not equated with, mental illness. Blum describes a process of
‘‘becoming surgical,’’ where women begin to see themselves through the narcissistic, techno-
logical lens of perfectionism. Once they experience one cosmetic surgery, they will want
others because they will have become obsessed with the promise of a perfect body. Addiction
to cosmetic surgery is part of the practice, she argues, and women cosmetic surgery patients
are always in danger of being perversely addicted. Other radical feminists, including Eve
Ensler, have emphasized problems with the consciousness of female cosmetic surgery patients
on a political level, depicting them as male-identified or as having false consciousness. In her
play The Good Body, for example, Ensler (2004) depicts a woman who undergoes numerous
plastic surgeries as a surgery junkie entirely under the influence of her husband, a cosmetic
surgeon. The woman undertakes surgery after surgery in order to keep him interested in
her. Although she appears to be indifferent to her health, she sees her body as a zone of
perfectibility.
Liz Frost (1999) points out, however, the essentialism implied in such treatments of
cosmetic surgery. The idea that women’s bodies are authentic only when they are leftBECOMING/BEING A COSMETIC SURGERY PATIENT 121
alone—Ensler, for example, wants women to ‘‘love the body . . . stop fixing it’’ (Ensler, 2004,
p. xv)—problematically constructs a natural, essential, authentic body to be contrasted to a
technologized, ‘‘unnatural’’ body. Further, Frost sees an essentialist idea of an ‘‘authentic’’
consciousness at work: an authentic subject would not undergo cosmetic surgery, and cosmetic
surgery cannot be seen as an authentic choice. As many critics of radical feminism have pointed
out, such views of the body=self are falsely dichotomous and homogenizing. They universalize
and fix women’s embodied subjectivity and treat cosmetic surgery patients monolithically. In
this logic, cosmetic surgeries are pretty much all the same, and so are the women who get them:
to greater or lesser degrees victimized, self-hating, and estranged from their authentic selves and
bodies.
Kathy Davis’s seminal 1995 work, Reshaping the Female Body, represented a departure
from what was then the expected feminist condemnation of cosmetic surgery, and in particu-
lar, from the view that there was something wrong with the subjectivity of female cosmetic
surgery patients. She has been called an ‘‘agency’’ feminist for this view, and her work
sparked a structure-agency debate that had already been, or would be, rehearsed in relation
to other controversial practices like pornography, sex, work, and body art. What motivated
Davis to examine women’s experiences with cosmetic surgery is what she calls her ‘‘moral
dilemma’’ as a feminist, wherein she felt a need to criticize the practice of cosmetic surgery
without treating women cosmetic surgery patients as ‘‘cultural dupes.’’ Based on her inter-
views with cosmetic surgery patients in The Netherlands, Davis argued that cosmetic surgery
does not modify the body as a passive object. For her, practices like cosmetic surgery are
expressions of the self’s dynamic relation to and with the body rather than instances of
extreme bodily objectification. They are instances of women’s negotiations of their embodi-
ment and of the social pressures regarding appearance. Moreover, she suggested that women
who chose cosmetic surgery were exercising rationality rather than self-hatred. Women saw
their surgeries as reasonable given their awareness of how much beauty and youth are socially
valorized.
Although Davis’s (1995) work created a considerable stir at the time, more recently a
number of feminist scholars writing on cosmetic surgery, including Frost (1999), Rebecca
Ancheta (2002), Suzanne Fraser (2003), and others have identified this debate as a dead
end, oversimplifying and polarizing the matter, in Ancheta’s terms. One of the problems
shared by both sides of the structure-agency divide is that they insist on the centrality of
women’s subjectivity in problematizing cosmetic surgery. For instance, she is either rational
or she is self-hating; the status of a female cosmetic surgery patient’s subjectivity offers the
answer to most of the questions we are asking about the practice. Either way, this debate
assumes a fixed individual subject, the ‘‘truth’’ of whom can explain the real essence of
cosmetic surgery. I make the case that we ought instead to think of the subject of cosmetic
surgery as shaped in and through the process of becoming and being a cosmetic surgery
patient (Pitts-Taylor, 2007). Similarly, Suzanne Fraser has pointed out that aiming to figure
out the ‘‘‘true’ interior of the subject’’ reifies and fixes her (Fraser, 2003, p. 28). Instead,
Fraser argues that we ought to look at the political and ideological underpinnings to any
understanding of agency and think through the agency of the subject as something that
is shaped in the processes of the subject being created. Meredith Jones (2008), too, displaces
the subject of cosmetic surgery from the center of analysis. She looks at cosmetic surgery
through the lens of actor-network theory, displacing the patient as the center of inquiry122 PITTS-TAYLOR
and positioning her as only one of multiple ‘‘actors,’’ including the surgeon, the technolo-
gies, the media, and other aspects of cosmetic culture. For her, the world of cosmetic surgery
is one in which agency moves through various relationships between humans and technolo-
gies. All of these approaches might be termed ‘‘postessentialist’’ in that they refuse to valor-
ize an authentic, natural female body or a proper female subjectivity, and they insist that we
must think of the meanings of bodily practices like cosmetic surgery as neither solely internal
nor external but rather as intersubjective.
I see the urgent need for such a move. Although they identify patriarchy and heteronorma-
tivity as the root problems of cosmetic surgery, the meanings of cosmetic surgery in
‘‘structure-agency’’ analyses ultimately rest on making sense of the cosmetic surgery subject.
But this is problematic to the extent that both sides assume a cosmetic surgery subject that
precedes the experiences of surgery itself. She is either rationally seeking empowerment, as
in Davis’s (1995) account, or irrationally pursuing suffering, as in Blum’s (2003) account.
Along with Suzanne Fraser and others, I argue that instead of looking at an oppressed or
liberated cosmetic surgery patient, we ought to think about cosmetic surgery in process to
understand its significance. As Fraser (2003) puts it, we must shift ‘‘the object of analysis
from the ‘true’ interior of the subject to the ideological and political implications of
the subject’s use of language’’ (p. 28). Further, as Jones (2008) suggests, the patient=subject
ubject should be considered only one of many involved in producing that language. The
meanings of cosmetic surgery and of the patient are produced by multiple actors and forces
and unfold through the processes of cosmetic surgery.
In personal narratives of cosmetic surgery, such as those found in interviews, we can find
evidence of deep social interaction between the subject and the cultural and social context.
For example, in recent interview accounts by Debra Gimlin, Liz Frost, and Rebecca
Ancheta, women’s narratives reveal complex grappling with stigma, pathologization, and
the judgment of others, and they suggest that women use narrative strategies in order to
be heard (Frost, 1999; Ancheta, 2002; Gimlin, 2002). The broader social and medical con-
text might influence these strategies. For example, women desiring coverage from a national
health service (like Davis’s interviewees) might emphasize how much they suffer from feel-
ing ugly or abnormal, and women speaking in an American context might emphasize liberal
goals like personal empowerment and equal opportunity.1 The ways in which cosmetic sur-
geries are represented and sold to women in these different contexts may also be significant
factors influencing their meanings, as are other prominent discourses circulating around
what cosmetic surgery means and about whom cosmetic surgery patients are. These contexts
can shape not only the social climate in which they are undertaken but also the personal
significance of cosmetic surgery for women themselves.
My own cosmetic surgery experience underscored the need to think about the narrative of the
self in such temporally complex and intersubjective ways. From my patient’s-eye view, cosmetic
surgery is a very personal experience, but it is also incredibly social, public, and semantically
unstable, one that is not static but unfolds through various processes of imbuing the body and
self with symbolic meaning.
1
Gimlin’s current project compares her U.S. interviews with those in the UK; she has found significant differences.BECOMING/BEING A COSMETIC SURGERY PATIENT 123
BECOMING=BEING A PATIENT
I became a cosmetic surgery patient in the midst of researching my book Surgery Junkies:
Wellness and Pathology in Cosmetic Culture (2007). After having spent many months in
cosmetic surgery clinics as a researcher, I decided become a patient.
I was significantly motivated by my curiosity about cosmetic surgery. I was fascinated by the
physical processes of cosmetic surgery—would a rhinoplasty really transform my whole face,
for example?—and even more by the social contests that stormed around the cosmetic surgery
patient. Having spent considerable time in cosmetic surgery clinics, I had already felt sympathy
for the women and men I encountered there. Most of them seemed to be enthusiastic about their
surgeries and the results they achieved, with the exception of those who were still in bandages,
who were generally miserable. Some were thinking of having another surgery at some point. But
they did not seem to be the crazy junkies one might expect from media accounts, nor did they
seem to be the self-hating victims depicted in some feminist descriptions. They were in many
ways unremarkable, but their world was filled with social tensions, scrutiny, and advice that each
of them had to negotiate. With magazines, advertisements, television and media accounts pre-
senting strong opinions about cosmetic surgery, and family, friends, and colleagues debating
each of theirs in particular, they seemed to be surrounded on all sides with conflict. When I
became a patient, so was I.
Although the experience of having cosmetic surgery was fraught with social conflict, which
I describe in more detail later, the personal decision to transform my face was not an agonized
one. The technological achievements of cosmetic surgeons are impressive, even if they do not
live up to the exaggerated promises of the industry. I was attracted to the possibility of being
better looking, normatively speaking. My nose seemed a good candidate for transformation;
submitting it to aesthetic judgment, it was not what I would have called a beautiful nose.
And I did not feel the moral weight of the decision as many do; as a scholar of body practices
for the past decade, I frankly disagreed with the reigning moral imperatives surrounding
the ‘‘natural’’ body. Bodies, it seems to me, have always been transformed, in every culture
and period, including indigenous ones; there simply are no ‘‘natural’’—in terms of pristine—
bodies to emulate.
Surely, it is useless to argue on my own behalf against theories that would describe my deci-
sion as an act of self-hatred; my own ability to speak for myself is rendered mute by theories of
false consciousness. At the same time, I hesitate to use the liberal terms of empowerment and
choice employed by so-called agency theorists. This language is sometimes used by many
women describing the decision to undergo major body transformation, but it makes me uneasy
that the same language, borrowed wholesale from liberal feminism, is used by the cosmetic sur-
gery industry to trumpet their products and procedures. It is a language that is easy at hand and
that is culturally legible in a society like ours. Moreover, it is often offered after being asked to
give an account of oneself, to defend one’s decision. Altering my face through surgery may have
been an act of agency, in the sense of my having willfully acted, but I can’t argue that it was an
attempt to empower myself any more than getting a new hairstyle is. I neither hated myself nor
thought I might truly have more power.
Although many will disagree with me, I want to argue that there was no central or fundamen-
tal cosmetic surgery patient inside of me waiting to be given the opportunity to express herself
through surgery; my being a cosmetic surgery patient can be understood only through examining124 PITTS-TAYLOR
the various processes involved in getting cosmetic surgery. It seems obvious when put this way,
but only in getting cosmetic surgery was I a cosmetic surgery patient.
In January 2005, I shopped for surgeons; was interviewed by doctors and nurses to determine
whether I was a ‘‘good candidate’’ for surgery; read books, magazines, and brochures about rhi-
noplasty; debated with my friends and family about permanently altering my face; and went
under the knife in an ambulatory clinic in Manhattan. When I emerged, my face was bandaged,
one eye was swollen shut, and the pain seemed unbearable for 8 t or 9 hr. Over the next few days
I dealt with bleeding, swelling, and bruising. I went to my doctor’s appointments in taxis wear-
ing a scarf around my head, which was the best I could do to camouflage the state of my face.
Otherwise I spent a lot of time in bed and also looking in the mirror examining my new face,
with which I was eventually pleased. In a week or so I went outside, met strangers and friends,
and taught my first class of the semester wearing a bandage on my nose. I wore bandages of
various sizes for several weeks and watched my face transform over months of healing.
The physical aspects of cosmetic surgery are worth relating, but the social experience of
becoming and being a cosmetic surgery patient is more to the point. Cosmetic surgery is coded
on the one hand as a sign of empowerment and self-enhancement and on the other hand as a sign
of moral, political, or mental weakness. In getting cosmetic surgery myself, I saw firsthand how
in cosmetic surgery, the body and self become a zone of social conflict. The media and the
advertisements I read urged me to transform myself, to constantly improve, and presented
images of cosmetic surgery that were saturated with heteronormative promise. The doctors to
whom I presented myself as a prospective patient expected a certain set of attitudes about me
and my body. Others I met liked to identify cosmetic surgery’s junkies and fools, the Joan Rivers
and Jocelyn Wildensteins of cosmetic surgery. My students, my friends, and a few of the stran-
gers who stared at me on the subway asked for explanations, and many of them offered strong
opinions that implicated me in one way or another.
Becoming a cosmetic surgery patient begins with, among other things, being positioned as a
prospective patient, where one’s looks, motivations, and psyche are examined by cosmetic doc-
tors. For me this included an evaluation of my nose and my profile. I did not enjoy subjecting
my face to intense scrutiny. I had thought that my nose was unremarkable. It was ordinary;
I didn’t love it or hate it. Even though I suspected that falling on it once while learning to
ski might have changed it a bit, no one had noticed. In any case, I’d never heard anyone com-
ment on it in a negative way. It seemed to me that even so, it was not a perfect nose, in normative
terms. Rather than a straight nose, which seemed to me to be the ideal, it was shaped with a
bump on the bridge. All but one of the five doctors I consulted was ready to pathologize it.
The exception, an otolaryngologist originally from Central Europe, said, ‘‘Your nose is fine.
It has character; you shouldn’t change it.’’ He said that he would do the surgery if I ‘‘really
wanted’’ it, giving me the feeling that he would be indulging me.
The four others, however, insisted that my nose needed to be changed. They saw a clear case
for cosmetic surgery. Following are some of my notes after seeing a doctor on Long Island, who
wanted to operate not only on my nose but also my chin:
Me: I was thinking about the bump on my nose, getting a straighter nose. But I don’t want a
turned-up nose. Nothing obvious.
Dr. J: You need a smaller nose with more definition at the tip. Not turned up but refined. You
could get a chin implant, too. It’s something to think about. Your profile could be more balanced.BECOMING/BEING A COSMETIC SURGERY PATIENT 125
Me: Just my nose. I don’t want anything implanted.
Dr. J: It’s often the case that we suggest a chin implant with a rhinoplasty because we’re
looking at the whole profile. But it’s just something to think about. Your chin is not bad.
Another doctor, the one I picked to do the surgery, was a man in his 60s who treated me pater-
nalistically. He was likeable, matter-of-fact, and arrogant about his role as a beauty doctor. More
than anyone, he disliked my nose. He said that he needed to ‘‘straighten out the bump, refine the
tip, make it look nice,’’ and added that ‘‘your nose is wrong for your face.’’
The sorting of patients into good and bad candidates is now a significant part of the cosmetic
surgery process. Although it was disagreeable to hear someone describe my nose as ‘‘wrong,’’ I
understood that in his view, the aesthetically problematic status of my nose rendered my desire
for cosmetic surgery reasonable. This is important because in addition to my face being scruti-
nized, so was my psyche. Although cosmetic doctors champion the practices as life-empowering
and self-caring, prospective patients are not automatically embraced as empowered. Patients’
aesthetic aims must correspond to doctors’ opinions. In addition, patients generally need to
appear to be pliant, amenable to suggestions, and, above all, willing to accept cosmetic surgery’s
risks. All the surgeons I consulted screened me psychologically to varying degrees, usually
informally. In one case, I was also given a written survey that included psychological questions.
All of them asked me to define what might be a good result. Some also asked if I had ever been
on antidepressants or been depressed. As I learned from the research interviews that I had done
with cosmetic surgeons, these informal conversations were occasions for the surgeon to get a
‘‘gut feeling’’ about my personality and psyche, to quote one New England doctor. They wanted
to know whether I’d be a happy patient or an unhappy one, likely to pleased or likely to be
picky, difficult, or even litigious.
There are many other people, beyond doctors, who are ready to make a series of distinc-
tions between good and bad surgery patients. I had countless conversations with friends and
acquaintances about cosmetic surgery ‘‘junkies.’’ For example, there was a woman named
Andrea who had a conversation with me about breast implants. She wanted to discuss how
common it is for women to get ‘‘huge’’ breasts that are ‘‘inappropriate for their size,’’ includ-
ing her sister-in-law, who has a tiny body but chose DD implants. The contradiction between
Andrea’s criticisms of her sister-in-law and her general approval of cosmetic surgery was by
now to me familiar. In the clinic, we were surrounded by fashion magazines depicting surgi-
cally modified celebrities and brochures advertising Botox and breast implants. The rhetoric in
these advertisements suggests that cosmetic surgery is something a woman does to treat her-
self well. On television, we are shown countless examples of positive, life-fulfilling extreme
makeovers. But we are also inundated with warnings about bad or botched cosmetic surgery,
discussions of cosmetic surgery addiction, and images of supposedly ugly or overprocessed
consumers of cosmetic surgery. Thinking of Andrea’s sister-in-law, I pondered how much
pressure lands on the shoulders of the patient: she must not be a junkie or too extreme,
but she should recognize how much her body needs improvement. The discourses of cosmetic
surgery operate in part pedagogically, training women about which aesthetics and attitudes are
acceptable and which are not.
In my academic milieu, cosmetic surgery carries a charge of victimization, pathology, or
vanity. Most of my friends and colleagues tried to talk me out of the surgery. One said that I
would lose all my character if I changed my face. Some said that if my nose had been ugly, they126 PITTS-TAYLOR
may have understood my decision more. Several suggested that I had been seduced by spending
too much time in cosmetic surgery clinics. Others worried that I would become addicted. Before
and after the surgery, I was asked to explain and defend my surgery a great deal. Some of my
students, who immediately noticed the bandage on my nose, were aghast at the idea that some-
one they saw as a feminist would have cosmetic surgery. They openly debated my surgery.
Some of them wanted to defend me against suspicions of vanity or false-consciousness. Of
course, in many social milieus, cosmetic surgery is acceptable and even expected; some of
my more affluent students knew many people who had had cosmetic surgery, and they were
morally indifferent.2
My own sense of self has changed, of course, as my body has. Without endorsing cosmetic
surgery in general, I can say that am more pleased with the look of my face than I was before.
This is an aesthetic issue but it also matters; it is, I could say, deeply superficial, with all of the
contradictions that term might imply. I also now have a different biography. I am a person who
has had cosmetic surgery, which changes the way people who know this might view me and
influences the way I evaluate myself and my choices. For example, the process of surgery
rendered me even less sentimental than I might have been about the material fact of my body
as an indicator of self while paradoxically underscoring the social investment in my body as
an indicator of self. Despite the horror with which some people received my surgery, it left
me less worried about the existential and moral implications of self-transformation.
What surprised me most about my experience was the following irony: people were so bent
on finding a deep reason for my interest in cosmetic surgery that they overlooked the practice’s
inherent superficiality. Both the superficiality and fluidity of cosmetic surgery—its skin-thinness
and its changing meanings—seem to violate our collective desire to understand our inner selves
as stable and fixed, true and authentic. Cosmetic surgery raises not only the issue that the body
has become, in a postmodern world, a primary sign of one’s identity but also that our bodies are
malleable sites for change. That malleability is discomforting.
COSMETIC SURGERY AS SEMANTICALLY UNSTABLE
Cosmetic surgery is semantically unstable. It is aggressively advertised and championed by cos-
metic surgeons and others involved in the industry. It is represented in the media as fabulous and
necessary and also as horrifying and potentially sick. It is seen by people in various social mili-
eus as unacceptable, immoral, and risky and in others as normal and ordinary. The woman who
becomes a cosmetic surgery patient does so in the context of popular and medical pedagogies,
moral pressures, and medicalized scripts that create a contested social and symbolic terrain. My
experience, for example, points to the influence of beauty culture and gender norms. It shows a
wrestling with the political debates about cosmetic surgery, both conceptually and interperson-
ally, with my friends and students. It suggests the influence of doctors, their ability to accept or
reject my cosmetic desires and to judge the quality of my body image. It shows the specter of
2
Although an analysis of class is beyond the scope of my work here, class is a significant issue in cosmetic surgery
and I believe that it may significantly affect its ‘‘intersubjective’’ relations. That some of my students found my cosmetic
surgery ordinary attests to the regularity with which they see people who have had cosmetic surgery. Despite the recent
surge of cosmetic surgery by members of all economic classes, cosmetic surgery remains less unusual in some more
affluent circles; conversely, it remains extraordinary in many working-class cultures.BECOMING/BEING A COSMETIC SURGERY PATIENT 127
pathology haunting my interactions with doctors, who are screening me, as well as with others
who make distinctions between good patients and bad.
This context needs to be examined when we try to understand how women might variously
experience and describe themselves and their surgeries. The cosmetic surgery patient is a sub-
jective role that unfolds through being a prospective patient, an operated-upon body, a person
in recovery, and as someone with a cosmetically transformed face or body part. Such unfolding
happens in deeply social and intersubjective ways. Women are becoming and being patients in
the face of forces that both sell the practices to them and that seem to demand explanation of
cosmetic surgery. We are expected to employ methods of description that make sense to others,
thus complying with already scripted codes of meaning that are set out before us. We are asked
to address what are established as generic aspects of cosmetic surgery and the issues that are
already raised as significant: the pain, the beauty norms, the political debates, and the
doctor-patient relationship, among others.
The subjectivity of the cosmetic surgery patient is not fixed but rather fluid and created in the
process of becoming and being one. I call myself a cosmetic surgery patient, but this identity has
no meaning outside its continual creation by the interactions between me, others, and the social
world. It is an identity that is produced as the cosmetic surgery is happening, as it is planned and
undertaken and narrated. The self of cosmetic surgery is continually coconstituted by the self and
others, even though stories of selves often mask this temporal and ontological complexity.
Feminist scholarship on cosmetic surgery that focuses on women’s interiority is problematic
when it, too, masks the temporal and ontological complexity of the cosmetic subject. Along with
psychotherapeutic perspectives, feminists have often pursued the notion that the status of a
woman’s psyche, her consciousness, or some other aspect of her interiority will help explain
the cosmetic surgery patient along with cosmetic surgery’s apparent problems. But these
approaches ignore the processes by which one becomes and is identified as a cosmetic surgery
patient and the various ways in which the meanings of her cosmetic surgery are contested.
I argue for decentering the subject of cosmetic surgery. Repositioning the subject is partly a
matter of thinking differently about how the personal is implicated in the larger social relations
of cosmetic surgery. An alternative, intersubjective approach does not mean that we are limited
only to macrolevel analyses of cosmetic surgery’s power relations or of abstract, discursive con-
structions of meanings. Neither does it mean that we cannot consider the personal experiences of
women themselves. What we can do is understand women’s experiences, and their subjectivities
as cosmetic surgery patients, as being created in and through the interactive experiences of cos-
metic surgery. We can look at the ways cosmetic surgery comes to have meaning in a complex
set of social and symbolic interactions rather than having meaning that is primarily generated out
of the patient’s (fixed, predisposed) sense of self. In pursuing cosmetic surgery this way, we may
avoid the kind of hermeneutics of the self about which Foucault warned us, and we can be more
critical of the power relations that work to produce the cosmetic surgery subject.
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AUTHOR BIO
Victoria Pitts-Taylor is Professor of Sociology and (as of July 2009) Coordinator of the
Women’s Studies Certificate Program and Director of the Center for the Study of Women
and Society. She is Coeditor of the journal Women’s Studies Quarterly. She is author of books
and articles on the sociology of the body, including Surgery Junkies: Wellness and Pathology in
Cosmetic Culture (Rutgers University Press, 2007).You can also read
