Female consumption of cosmetic surgery in the 1960s to the 1980s: a study of magazines, media, and medicine

The demographic for elective cosmetic surgery patients today is composed of an overwhelming majority of women. This compelling statistic is the result of decades of external pressures that conform with beauty standards that satisfy the male gaze. It is not widely known that after the initial development of cosmetic procedures in the 20th century, this industry was geared specifically towards targeting women using effective marketing methods and forms of social pressures. By analyzing primary sources from magazines, medical journals, and various news and advertising outlets from the 1960s to 1980s, the history of the cosmetic surgery industry and how it molds the industry today is apparent. The sources illustrate plainly how the industry was angled directly towards women and away from men through words, photographs, professional writing, interviews, and more. After these findings, it became clear that the conclusions for this paper argue that women's uneven consumption of cosmetic surgery, compared to men, is the outcome of several decades of enforced conformity to societal beauty expectations. Beauty standards, set by both men and women, combined with efficient advertising helped legitimize cosmetic surgery as a new branch of medicine and ultimately make billions of dollars from their targeted consumers.

FEMALE CONSUMPTION OF COSMETIC SURGERY IN THE 1960s to the 1980s: A STUDY OF MAGAZINES, MEDIA, AND MEDICINE By Brooklynn Segura Jensen A Senior Honors Thesis Submitted to the Faculty of The University of Utah In Partial Fulfillment of the Requirements for the Honors Degree in Bachelor of Arts In History Approved: _ Nadja Durbach, PhD Thesis Faculty Supervisor _______________________________ Janet M. Theiss, PhD Honors Faculty Advisor _______ Paul Reeve, PhD Chair, Department of History _____________________________ Sylvia D. Torti, PhD Dean, Honors College May 2023 Copyright © 2023 All Rights Reserved ABSTRACT The demographic for elective cosmetic surgery patients today is composed of an overwhelming majority of women. This compelling statistic is the result of decades of external pressures that conform with beauty standards that satisfy the male gaze. It is not widely known that after the initial development of cosmetic procedures in the 20 th century, this industry was geared specifically towards targeting women using effective marketing methods and forms of social pressures. By analyzing primary sources from magazines, medical journals, and various news and advertising outlets from the 1960s to 1980s, the history of the cosmetic surgery industry and how it molds the industry today is apparent. The sources illustrate plainly how the industry was angled directly towards women and away from men through words, photographs, professional writing, interviews, and more. After these findings, it became clear that the conclusions for this paper argue that women’s uneven consumption of cosmetic surgery, compared to men, is the outcome of several decades of enforced conformity to societal beauty expectations. Beauty standards, set by both men and women, combined with efficient advertising helped legitimize cosmetic surgery as a new branch of medicine and ultimately make billions of dollars from their targeted consumers. ii TABLE OF CONTENTS ABSTRACT ii INTRODUCTION 1 LITERATURE REVIEW 5 QUESTIONS AND SOURCES 8 DISCUSSION 10 COUNTERARGUMENTS 53 BIBLIOGRAPHY 58 iii 1 INTRODUCTION 1 The total American expenditure for cosmetic procedures in 2020 was $20,174,266,026, according to the most recent Plastic Surgery Report given by the American Society of Plastic Surgeons. Due to the pandemic, the total expenditure and total cosmetic procedures were lower compared to the previous year. The graph above is a representation of the gender dynamic in the cosmetic surgery industry, with women clearly being the primary consumers at over 90% of cosmetic surgery patients. While these statistics might not be surprising to all, it is thought provoking when considering how this trend in the industry came to be. Is this the doing of women and their consistent affinity for vanity or other players who pushed this agenda onto women at the dawn of the new age of cosmetic surgery? This paper will argue that women's consumerist role in cosmetic surgery wasn’t a result of a natural pattern of progression of female vanity with “Plastic Surgery Statistics Report,” American Society of Plastic Surgeons, https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgerystatistics-full-report-2020.pdf. Graph created by Brooklynn Jensen. 1 2 medical advancements, but the result of external forces and pressures originating from the beauty standards that appealed to the male gaze and manifested in magazines, media, and medicine in the 1960s to the 1980s. Plastic surgery was born in the midst of World War I as a remedy for soldiers who had suffered traumatic facial injuries.2 The primary motivation of the medical doctors at the time was to help men be able to return to their lives before the war and be able to secure employment to provide for themselves. It was believed that a heavily scar-strewn face would prevent soldiers from doing so and ultimately living a normal life. Surgeries that doctors performed were reconstructive, meaning their purpose was to restore damaged tissue to as close to its original appearance and function as possible. After the war, plastic surgeons realized they could take their skills forward and forge a new branch of medicine in plastic surgery, what is known today as cosmetic surgery. They began to experiment with new surgical techniques intended not only for reconstructive purposes, but aesthetic purposes as well. This aimed to improve one’s appearance according to personal desires as well as conform with the standard of beauty set by society. This new field of medicine originally had both male and female patients due to the fact that plastic surgery began with mostly male patients. However, plastic surgeons gradually shifted their skill set towards women and continued to develop surgical techniques for changing specific features such as the nose, breasts, eyes, body, and face, and explicitly targeted women as patients. The focus of their work went from mending to altering as the “Male Gaze” took control of the industry as male doctors focused on 2 Beth Haiken, “Plastic Surgery and American Beauty at 1921,” Bulletin of the History of Medicine 68, no. 3 (1994); 429-53. 3 surgically transforming women to become the ideal objects of femininity and sexuality. 3 Practices changed with dodgy experimentation using different chemicals and implants, such as paraffin and silicone.4 Doctors were able to discover what failed and what succeeded in achieving the desired outcome of procedures. It is a common misconception that plastic surgery was inspired solely for women when it is the opposite that is true. Plastic surgery was founded in reconstructive techniques and procedures designed to ameliorate lives, then quickly formed a cosmetic branch that turned into a business seeking profits and gains explicitly from female consumers using any means necessary. This is important in beginning to understand how cosmetic surgery has evolved and how it impacted women then and now. The rise in popularity of cosmetic procedures has been a result of specific advertisements and the dramatic change of the social environment that is enveloped by social media. From the American Society of Plastic Surgeons, the Plastic Surgery Statistics Report states that 15.6 million Cosmetic Procedures were done in the United States in 2020, with 92% of them being done on females. 5 Women see hundreds of advertisements each day on their phones, while driving, and on TV that persuade them that certain features are more attractive than others. Advertisements on the internet use technical algorithms to target specific populations. This means that women, for example, might get an advertisement for a premium deal for lip fillers while their male counterpart 3 Alessandra K. Heggenstaller, Asta Rau, Jan K. Coetzee, Anne Ryen, and Ria Smit, "Reflecting on female beauty: cosmetic surgery and (dis) empowerment," Qualitative Sociology Review, Volume 14, Issue 4, (2018): 48-65. 4 Haiken, “Plastic Surgery and American Beauty at 1921.”. 5 “Plastic Surgery Statistics Report,” American Society of Plastic Surgeons, https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgerystatistics-full-report-2020.pdf. 4 would get a completely different advertisement on the same social media platform, never seeing the cosmetic surgery campaign. Internet devices collect data from users, feeding the user more content similar to their interests, meaning the influence of advertising over the past several decades has only encouraged and increased America’s consumer-minded society. People buy material things and alter their appearances to appeal to ulterior motives, even to the extent of hoping that their lives at work and in their relationships will improve.6 Society has told, and continues to tell, women the same thing that injured soldiers were told: the importance of your appearance will determine your success in your career and family life. While this is certainly a legitimate concern for someone who has a severe deformity or injury, it shouldn’t carry the same concern for someone who fears that their nose is preventing them from having a successful career and life. Over time, beauty standards evolve to drain never-ending consumers, which largely benefits the cosmetic surgery industry. This is an important topic of historical research that will help society to understand why 92% of cosmetic procedures are done on women today. The damaging effects of body modification are astronomical with high rates of body dysmorphia in women, especially amongst racially diverse populations. 7 The mental, physical, financial, and social stakes are high when it comes to cosmetic surgery. Even in the 20th century, several decades ago, procedures cost thousands of dollars. Cosmetic surgery, which is different from reconstructive surgery, is elective for every patient. Each patient willingly decides to undergo a painful, invasive surgery, with a long recovery time. The focus for 6 Soohyung Lee and Ryu Keunkwan, “Plastic Surgery: Investment in Human Capital or Consumption?”, Journal of Human Capital 6, no 3 (2012): 224-50. 7 Sharon Heijin Lee, “Beauty Between Empires: Global Feminism, Plastic Surgery, and the Trouble with Self-Esteem,” Frontiers: A Journal of Women studies 37, no. 1 (2016): 1-31. 5 this paper will be on the trends in media and medicine in the 1960s-1980s, which resulted in a change of attitude towards cosmetic surgery from being vain and luxurious to necessary and expected for women. Women were not single-handedly responsible for this trend, but the victims of a medical practice that focused not on the patient, but on dehumanizing the patient and fitting them into the most convenient biomedical paradigm. This is known as the “medical gaze,” coined by philosopher Michael Foucault, whose ideas influence how society thinks about medical clinics and the role of medical doctors in today’s landscape of health and medicine. 8 There are countless topics that could be researched in connection to my topic, namely racism, body dysmorphia, and medical malpractice. LITERATURE REVIEW Most historians recognize the need for research of certain aspects of the cosmetic industry in understanding its root causes and effects. It is a part of history that is underestimated for its harm both physically, financially, mentally, and socially. They are interested in the economic motivations behind the cosmetic industry; how do things like money influence their marketing strategies for their targeted client and “ideal consumer”? Furthermore, what does this tell us about society as a whole in conjunction with the cosmetics industry and its influences on women? Trends in the marketing of cosmetic surgery have increased to a point today where it seems like there isn’t a question of if, but a question of when for many women. Kathryn Morgan argues that ‘real’ women are needed to analyze what is happening and why women “reduce themselves to ‘potential 8 Michel Foucault, The Birth of the Clinic : an Archaeology of Medical Perception, (New York : Pantheon Books, 1973). 6 women’… as they buy ‘contoured bodies’, ‘restored youth’ and ‘permanent beauty’.” 9 It should be noted that Morgan, and other historians with a similar perspective, use strong language that shows a negative bias against the cosmetic industry. This is not a reflection of my opinion, but used here to demonstrate different sides of the argument. Sander Gilman10 and Beth Haiken11 help contribute to this conversation by exploring historical contexts in line with medical procedures in understanding why cosmetic surgery has altered so drastically in purpose and intention. Through writings like those of Morgan, Haiken, and Gilman, many questions of the cosmetic industry reveal themselves and stand as a gateway to other questions and ideas about cosmetic surgery. How did this medical practice become the norm? We now live in a time when women pay thousands of dollars for multiple surgeries to keep up with trends such as nose and breast shapes. Historians largely agree on the significance of the cosmetic industry in influencing women towards body modification and alteration. However, some historians argue outside of this scope, and supply different reasons in explaining the rise of cosmetic surgery in the late 20th century and early 21st century. Debra L. Gimlin argues that one reason for self-transformation is that it demonstrates the ability and willingness of one to invest so much capital into the body. This creates the desirable impression of being someone who is financially successful or even famous. 12 By saying this, she implies that someone who elects to get cosmetic surgery is perhaps someone who wants 9 Kathryn Pauly Morgan, “Women and the Knife: Cosmetic Surgery and the Colonization of Women’s Bodies,” Hypatia 6, no. 3 (1991): 25–53. http://www.jstor.org/stable/3809838. Sander L. Gilman, Making the Body Beautiful : A Cultural History of Aesthetic Surgery (Princeton, N.J. : Princeton University Press, 1999). 10 11 Beth Haiken, Venus Envy, (Baltimore: John Hopkins University Press, 1997), 101. Debra L. Gimlin, ""TOO GOOD TO BE REAL": The Obviously Augmented Breast in Women's Narratives of Cosmetic Surgery," Gender & Society 27, no. 6 (2013): 913-34. 12 7 to give off the appearance of someone who is wealthy, established, desirable, and respected. Cosmetic surgery is not usually covered by insurance and is therefore expensive, so this is truly an investment in oneself and image Continuing with the same narrative, Peiss argues against the typical victimization of women in the cosmetic industry, which differs greatly from other historical arguments. In her book, she illustrates how average women have contributed to the beauty standard and the development of the cosmetic industry. 13 Instead of seeing cosmetics as a weapon, Peiss explores how it is used advantageously amongst women. It gives an opportunity for women to pursue entrepreneurship and success within a realm they feel very connected to. This is helpful in understanding the dynamics of cosmetics in order to understand how it has molded into what it is today. If Peiss and Gimlin uplifts the cosmetic industry as empowering, other historians explore the historical danger of cosmetic surgery when it comes to racial identity. This perspective is the opposite of empowering; it is oppressive. Cultural and social history molds self-identity in the realm of beauty more intensely for women who are in the minority, specifically Latinas, Asian Americans, and African Americans. Kaw discusses why Asian American women are undergoing facial reconstructive surgeries to change their noses and monolids to alter their facial expressions. 14 Many Asian Americans are born with monolids, which are distinguished by the lack of a crease between the eye and the eyebrow. The lack of a simple, paper-thin crease is the cause for a racial stereotype 13 Kathy Peiss, Hope in a Jar: The Making of America’s Beauty Culture, (New York: Metropolitan Books, 1998). 14 Eugenia Kaw, “Medicalization of Racial Features: Asian American Women and Cosmetic Surgery,” Medical Anthropology Quarterly 7, no. 1, 1993): 74–89. http://www.jstor.org/stable/649247. 8 that solicits Asian Americans' natural facial features and expressions as “passive and lack [of] emotion”. Kaw argues that medicine “effectively promotes these racial and gender stereotypes and thereby bolsters the consumer-oriented society, of which it is a part and from which it benefits”. We live in a country where many prejudices towards ethnic features persist today, and they have impacted the cosmetic industry to a point where by the 1990s, the percentages of racial and ethnic minority women receiving surgery were exponentially increasing. In addition, Kaw argues that the medical system benefits from a consumer mindset of maintaining a certain beauty standard, which promotes racial markers to be altered in order to abide by the standard. Medical practitioners are at fault for normalizing a society that forces Asian American women to conform and adopt selfhatred and image disorders. This perspective contrasts Peiss’s view by placing blame on others, not on the women who receive surgery. These contrasting historical reviews don’t represent everything that has been said on the topic, but lays a firm foundation for this paper by illustrating some of the arguments for and against the cosmetic industry and its impact on women. By getting the full picture, one can understand the societal struggle which women are faced with when it comes to the way they look. QUESTIONS AND SOURCES Several facets surrounding this research engage with questions of cultural, economic, social, and gender history. Imperative questions surrounding the logistics of the empire of cosmetic surgery industry leads this research to focus on marketing strategies that have been used to advertise and lure women towards the cosmetic industry. Who is involved in this industry that is directly benefitted? This will shed light on the 9 values and intentions of this industry as it has changed to mold and uphold beauty standards for women. Additionally, it is important to look beyond the scope of cosmetic procedures and to the larger picture of who is performing the procedures and to look at this industry from the medical viewpoint. The history of medicine has their ‘Quacks’, or people who pose as legitimate doctors, yet don’t provide quality accurate or acceptable healthcare. Can we trust the knowledge of amateur plastic surgeons? It would be interesting to unveil the reasoning behind their practices as primary sources are examined. Naturally, primary source research leads to questions on gender relations and gender history in the field of cosmetics. Why do women have such a higher rate of cosmetic procedures than men? How does this reflect differences in relationships at home, work, and other social spheres between men and women? One is led to wonder if these observed relationships and attitudes from the focused time period, 1960s-1980s, have a lasting consequence on women today, particularly when it comes to modern day consumerism of cosmetic surgery. These questions are the foundation for this research as the topic is explored further. The focus of this paper will revolve around very specific primary sources from the 1960s to the 1980s, with a greater abundance of primary sources coming from the two latter decades. The majority of these primary sources will come from American magazines, medical journals, and the general news/media of the 1960s to 1980s. Sources from magazines will be from female-catered magazines and drawn from the Women’s Magazine Archive from the Marriott Library. These magazines have been combed for cosmetic-surgery related articles, advertisements, and discussions. Similarly, medical 10 journals are examined for similar content related to cosmetic surgery, male and female. Sources are extracted from JAMA, the Journal of the American Medical Association. News articles will not be used as extensively as the other two main sources, but will be sources from a variety of data-bases including the Women’s Magazine Archive and secondary literature. These sources are vital to understanding how consumers, cosmetic surgeons, and beneficiaries promoted, reacted to, and valued the cosmetic surgery industry at a crucial part of time when the industry as a whole was just entering a new era of credibility and establishment. Those who directed the future of the industry had the accountability and agency to determine the path of consumerism in this new and exciting age of beauty and technology. How involved persons conceptualized, rationalized this new medical practice, and how they laid the foundation for what it has become today is found by examining words, photos, drawings, and even professional medical literature. Analyzing these sources show that cosmetic surgery was geared primarily towards women, as opposed to an industry that many believe was made at the request and desire of women. Why was it decided to be done this way and what have been the long-lasting consequences on society in terms of health, gender relations, consumerism, and perhaps other factors that haven’t been thought about? DISCUSSION Magazines and Cosmetic Influence There are several forms of reading materials that exist to entertain and educate their readers from the classic novel, reliable newspaper, comic book, to the magazine. Magazines stand out as a source of literature for their distinct format using short articles 11 and aesthetic spreads designed to hook its audience, sell products, and leave readers coming back for more. Authors don’t have to worry excessively about whether every detail printed is unquestionably true. Magazines are not held to the same accountability for credibility as a newspaper or educational journal might be held to. Given these looser reins, magazine editors are free to transform their glossy pages into a landscape of fanatical photos and words designed to sell a product or an image, often envied by its viewers but nonetheless unattainable and unrealistic. The power of photos in the cosmetic lens was underestimated for its extreme impacts and effects it had and still has on women. As a new and emerging way to advertise, female-catered magazines carried the unique position for influence on women in the era before widespread internet media. They were the source of information for virtually all fashion trends, insights to celebrity life, and all up and coming things to know in order to ‘stay in the know’. How did magazines wield this great power when it came to the realm of body images, cosmetic surgery, and all-things “glamorous” in the 20th century? This investigation into magazines begins with how its photos served a unique and powerful purpose to market a specific message to their female readers. This can be analyzed first by looking at who is modeling for the photos, how they are posed, and by what they are wearing. When we look closer at these details, the true message of the photo and therefore, the magazine, is unveiled. For one example, this photo from a Good Housekeeping magazine from 1965 followed a short article about simple stretches, exercises, and other small methods that women can do to ‘feel better’. 15 The last step 15 Marie Fromow, “17 Ways to Look and Feel Great!,” Good Housekeeping, January 1965, 74. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/17-ways-lookfeel-great/docview/1884686571/se-2 12 involves drinking a warm glass of milk and having a nice bath before bed, thus the photo of the woman wrapped in a towel drinking the milk. One might reckon that this looks like a lovely woman before wondering why she is made-up the way she is for the photo. Not many people look like this, with their hair and makeup impeccably in place, at the end of a day- no matter what that person did that day! Notice the perfect blond curl which accents her face nicely. Not a wisp of hair is out of place. Additionally, it is odd that she is drinking her milk from glass stemware. If one drinks warm milk, it would make more sense to have it in a mug, not a stemmed glass. The purpose of the analysis done on this photo is meant to illustrate how virtually all photos in magazines, even the simple and harmless ones, are posed in the best lighting, with the most perfect details and accents, most complimentary coloring, and additions of luxury which makes the onlooker desire to be like the person in the image. “Ah, yes, the life of luxury is having my hair and makeup done, dipping into a fancy bath, wrapping oneself in a nice towel, and drinking my warm milk from my best crystal glass,” one woman might rationalize. This is just one photo of a seemingly unlimited amount cut from the same cloth. They all have the same underlying message saying ‘this is how everyone’s life and appearance should look like.’ Unrealistic expectations for women that are as silly as a nightly ritual of drinking dairy from a fancy glass before bed to as serious as altering the face and body through serious medical procedures all begin with the power of photos. 13 Modern day magazines have hardly changed in the way they feed photographs to their readers. If anything, it is even worse. With new technologies, it has become routine to touch-up models, erasing all visible and even invisible flaws. Lengthening necks, adding shine, whitening teeth, blurring blemishes, contouring features, the list goes on. Forged photos have grown outside magazines and catalogs and have migrated to billboards, social media feeds, and unsolicited digital advertisements. These photos have permeated every aspect of society and it is common knowledge that retouched photos have the potential to have detrimental effects on mental health by setting unrealistic beauty standards. Some countries, such as Norway, 16 are attempting to take action and require retouched photos by social media influencers and advertisers to include disclaimers stating that the photos are retouched and edited. The United Kingdom was presented with a similar bill in 202117 to require retouched images to be transparent with its origins when releasing to the social media sphere. Although many argue that this won’t solve the problem of mental health at hand, it is evidence that the power of photos has reached a point where people in politics are questioning if they need to be regulated for the common good of the people, especially youth. This isn’t a result of something that happened overnight. It began with seemingly harmless and unquestioned use of perfected and unrealistic photos in magazines, tabloids, and more. Naturally, the next question would lead one to wonder why photos are used the way they are in this forged context. Why are photos used as vital selling points for any 16 “Why experts say Norway’s retouched photo law won’t help fight body image issues,” The Washington Post, Published July 8, 2021. https://www.washingtonpost.com/lifestyle/wellness/photo-edit-social-medianorway/2021/07/08/f30d59ca-df2c-11eb-ae31-6b7c5c34f0d6_story.html 17 “Body Image Campaign," Dr. Luke Evans, accessed November 9, 2022. https://www.drlukeevans.org.uk/body-image 14 business or industry? As visually oriented beings, there is a simple assumption that magazines and other forms of marketing target the public’s trust in photos as the main selling point for their product. Logistically, it is easy to see why photos are as powerful as they are. For humans, visual cues incite emotional, physical, and mental reactions. A stunning photo showing someone helping a stranger might be inspiring to many. A tragic photo from the holocaust would be devastating to all. People are influenced by what they see as they soak in every detail of images that are particularly inviting. This includes using women in advertisements, who pose themselves as objects to be consumed, satisfying the male gaze. Therefore, when a magazine uses a photo to accentuate a column, advertisement, or their main cover, they are going to make sure it is absolutely perfect to the point where it isn’t even real anymore. One might not even think twice about the circumstances the photo was taken under. Because of the ethos and credibility established with photos, it would be quickly accepted as genuine, because it is satisfying to the viewer. This unchecked influence of photos can mislead many people. Now that the power of photos has been established, this argument is led to look more closely upon how the cosmetic surgery industry uses photos in magazines to target women to look a certain way. This trend rapidly heightened to an extreme in the 1960’s-1980’s. Magazines, like mentioned before, were a remarkably popular source of media, arguably more so than it is today. Editors could publish almost any article and any image they wanted when it came to beauty and fashion in order to stay ‘relevant’. Publishers knew that it would appeal to their audience, which was essentially women and girls of all ages. Content could be fed to this audience without fear of retribution or social consequences because 15 women would keep buying and reading them. For example, take this two-paged image from a 1976 Cosmopolitan magazine urging women to think about the cosmetic procedures that they will “need”.18 This implies that this advertisement isn’t necessarily targeting women who are older, but to women of all ages. It specifically combs over the entire female body for errors as if it is a decrepit house that needs updates such as new light fixtures, a new roof, new paint, and refinished floors. A woman who sees this when she opens up her magazine after going to the mailbox or local market will start to think about how she doesn’t look like the woman in this photo. How does she start to feel when she believes that this image is how she is supposed to look? This is just one of thousands of similar photos that can be found in archives. The same cannot be said about male magazines, which further demonstrates the female experience during this time period. The female body becomes a machine or an object in a process of dehumanization and materialization. 18 Mallen de Santis, “HOW TO BE UPLIFTED ALL OVER,” Cosmopolitan, May, 1976, 226. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/how-be-upliftedall-over/docview/1851624856/se-2 16 If a popular Cosmopolitan magazine feels brash enough to encourage women, even those who wouldn’t “need” to see a cosmetic surgeon for several years, to investigate what surgeries and operations to get in the future, what are they telling young girls? Tweens and teenage girls had their own magazines apart from adult women, which still exist. What sorts of things did Seventeen magazine have in its pages 50 years ago? The magazine, unbeknownst to many, debuted in 1944 as a source of entertainment for female readers aged 13-19. Many young women and girls read these consistently, then and now, because of its catchy articles, fashion segments, and social advice. While it seems like mostly harmless material, one might be surprised when discovering an article published in a 1980 Seventeen issue called “Staying well: Plain facts about plastic surgery,”19 which gives details on all that goes into a cosmetic procedure that changes one’s looks. It gives guidelines for young girls to “talk over your plans with your parents” and to “find a good plastic surgeon” if they are going to go through with the procedure. It lists costs and expectations amongst other things that a young girl should expect should they decide to get a chin implant or rhinoplasty. Only a few sentences exist which cautioned girls to consider the weight of getting such a surgery. Most of the article is going over logistics and things to ease the procedure. Many people today would find an article like this alarming if it were to be published in Seventeen or any other teenage magazine. However, contextually, cosmetic surgery during this time period was encouraged, revered, and accepted as the norm for several reasons that will be discussed. This applied even to those under 18 years of age, 19 Eve Scott, “Staying Well: Plain Facts about Plastic Surgery,” Seventeen, April, 1980, 34. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/staying-wellplain-facts-about-plastic-surgery/docview/1855835469/se-2 17 who were seen as future consumers, or even present targets for cosmetic surgery. In an adult female magazine, Ladies’ Home Journal, a Q&A featured a “money expert” who answered financial questions sent in by readers in 1982. One reader wrote in, “Our daughter feels her nose is too big, so we’re planning to give her the “nose job” she wants. But the local plastic surgeon wants $2,500 for the operation!” 20 The blatant concern of the writer is the cost of the operation rather than advice for helping her daughter accept the features she was born with. As a response for advice, the “money expert” told the reader the typical fees for a rhinoplasty and gave information as to where they could get a second opinion. While it is true that this was primarily a financial segment of the magazine, it is important to think about why they chose this question to answer when they certainly did not have to. If this magazine did not condone plastic surgery for young girls in any capacity, one would think that they would not give advice to parents on how they could make it more affordable for their daughter. What message does this send people about the cosmetic surgery industry when young girls are being targeted? One would reckon that these advertisements would have been regulated and that those in positions of power, meaning the magazines would have taken more responsibility for at least shielding those who truly are too young to be contemplating permanent alteration to their faces. However, this was not the case, because a growing industry will only survive if it manages to ingrain its doctrine into future generations who will one day become willing consumers. Magazines did not differentiate on what was age appropriate or not. Instead, they consistently emphasized 20 Sylvia Porter, “Q our Daughter Feels Her Nose is Too Big, so we're Planning to Give Her the "Nose Job" She Wants,” Ladies' Home Journal, July, 1982, 144. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/q-our-daughterfeels-her-nose-is-too-big-so-were/docview/1879238134/se-2 18 for years that it was not merely a matter of if but when. Cosmetic surgery should be on every woman’s mind, because aging is inevitable, but can fortunately be corrected. Take, for example, an article on cosmetic surgery from Women’s Day in 1975. The very first sentence, which is breathtakingly morbid, said, “As time goes on, the saddest moment in the day often comes in the morning when we first look in the mirror.” 21 The authors, which are two male surgeons, go on to discuss the various ailments and their respective cures and treatments that accompany aging. “Even the very young are beginning to realize that small imperfections need not simply be lived with- they can be corrected.” The role of surgeons will be discussed later in this paper, but it is worthwhile to pause and contemplate the position male medical authorities held during this time period, which didn’t afford women the same opportunities to have high-ranking medical positions. This article is another manifestation of the male gaze and its perpetration into the medical field. The impact an article such as this would have on a female reader who feels insecure in any way is consequential. Even if she has no insecurities, she might stop to wonder if she is not keeping up with new trends and medical advancements. Magazines followed this similar thread of preparing women for the day that they will need to visit their local plastic surgeon in order to revitalize their youthful features. For example, this cropped image from the article, “What About A Facelift?” discusses that there is no harm in “looking ahead” if one is not ready for cosmetic surgery right at this moment.22 Published in Cosmopolitan in 1976, it is another example of the idea of 21 Ralph L. Dicker, M. D. and M. D. Victor R. Syracuse, “LOOKING BETTER, FEELING LIKE A MILLION: A Report on Plastic Surgery Today,” Woman's Day, September, 1975. 36. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/looking-betterfeeling-like-million-report-on/docview/1824575183/se-2 22 “WHAT ABOUT A FACE LIFT?”, Cosmopolitan, October, 1976. 106. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/what-aboutface-lift/docview/1830359754/se-2 19 perfection that was pushed onto women during this time period. Women were told to always be looking ahead, even a decade or more down the line, for when they won’t look like they do now. Even if they are happy with how they look at the present moment, there is probably something wrong with their appearance anyways. Cosmetic surgery is for everyone of all ages and stages of life. It is accessible and adds value to a person’s appearance. This explains why many columns and articles on plastic surgery mainly counsel on making sure readers are educated when making decisions to alter their features, not much about legitimate factors that should deter them from pursuing cosmetic surgery. “If your expectations are reasonable, your health and your bank account thriving, cosmetic surgery could be the answer to your facial flaws.”23 The goal for magazines was to get female patients in to see plastic surgeons rather than keeping them away from making appointments. Dangerous expectations set for women were reinforced through magazine articles that urged women to ‘stay in the know’, particularly with keeping up with new procedures and medical advancements. When articles wrote about “quick guides” to plastic surgery, they often mentioned the risk of procedures, but the benefits always 23 Pat Ohlendorf, "A Quick Guide to Cosmetic Surgery: If Your Expectations are Reasonable, Your Health Good and Your Bank Account Thriving, Cosmetic Surgery could be the Answer to Your Facial Flaws. but First, Read all about it," Chatelaine, June, 1986, 52-97. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/quick-guidecosmetic-surgery/docview/1767269028/se-2. 20 outweighed the risks. So, when a new cosmetic procedure was rising in popularity, magazines were always sure to make the information about the procedure readily available for its readers. It was an effective source of advertisement for cosmetic surgeons as well as helped magazines stay relevant for its readers. Many of these trends, which will be detailed later, were dangerous and largely lacking in research and credibility, making procedures very dangerous for women. However, the industry was growing rapidly with female patients as the main patient base for the industry. When an industry is making a lot of money and doing well, they will do what they need to do to keep patients coming back for more and referring their friends to get the same procedures. In an article from Town & Country, 1969, “NEW BEAUTY DIVIDENDS” is written to excite Women about new cosmetic surgery options for them. 24 This article lists things such as the classic facelift, rhinoplasty, blepharoplasty, dermabrasion, and more. The author writes it in a way that makes it appealing to the reader, assuming that everybody has been on the lookout for different options for surgery. The article, which uses the word “dividends” in its title, denotes that this is a feature in this magazine that comes regularly. A dividend is something, usually money paid, that comes regularly to its investors. In a way, this article is inferring that beauty is an investment that should be made by every woman. This is a justification for the high costs of procedures, which always ranged in the thousands. It is worth noting that this particular article was 24 Bettie Wysor, "NEW BEAUTY DIVIDENDS: COSMETIC SURGERY COSMETIC DENTISTRY," Town & Country, February, 1969, 68-69, 129, 131, 133-134. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/new-beauty-div idends/docview/2137419333/se-2. 21 published a few years before magazines ‘took off’ with its promotion of plastic and cosmetic surgery. At this time, they were still advertising this newer field of medicine, but not exactly to the extent that is seen in the 1980s and late 1970s. Since the field of cosmetic surgery was making several advances during a time when technical and medical advances were increasingly more frequent and exciting, it was something that was depicted as futuristic. Magazines saw this as an opportunity to promote it further by telling its readers that in order to follow the trend of being ‘futuristic’, they should educate themselves and undergo cosmetic surgery. An article called “How we’ll be living in 25 Years” written in 1967 predicted that “total surgical rejuvenation may become part of Everywoman’s normal routine.” 25 Notice here that the wording specifically says every woman, not everyone. This means that men were automatically left out of the narrative of cosmetic surgery and women were faced with increasing pressures to conform to beauty standards. The cosmetic surgery industry was gaining a firmer hold on the beauty industry as it completely turned its focus to women. It makes sense that this article was written in 1967, which is when many people had great interest in futuristic things, especially with science and technology in the era of the ‘Great Space Race’ when these subjects were put to the test. Many thought that traveling to the moon was such a foreign and impossible idea. However, if that was possible, what else could be possible? Flying cars? Robot kitchens? Embryos made in little tubes? The list goes on. The idea of cosmetic surgery as being something that already was within grasp 25 Mildred Istona, “HOW WE'LL BE LIVING IN 25 YEARS,” Chatelaine, January, 1967, 22. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/how-well-beliving-25-years/docview/1715376147/se-2. 22 made the reach for the future even more tangible. Who wouldn’t want to take advantage of these new and exciting innovations? Keeping up with trends is something that defines today’s generation. From hairstyles, clothing, and all aspects of appearance, including ever-changing trends in cosmetic surgery which emerge and are widely popularized. Things such as lip injections, the ‘Brazilian butt lift’, Botox facial injections, cryotherapy, liposuction, tummy-tucks, and other procedures are advertised as what is “new” and “desirable”. It seems hard to keep track of all of these trends in altering facial and body features. Different body shapes come and go in style, putting the pressure on women to be ever-vigilant in upkeeping their appearance. Although some may argue that magazines don’t put pressure on changing one’s body today like was seen from these primary sources, women still face the same pressures in other forms all around them that tell them they will never be enough. In order to further persuade women to keep up with the trends and advancements of cosmetic surgery, magazines used another method of ethos to sway their readers. This was done by including plastic surgeons in their articles, columns, Q&A’s and more. Editors figured that one of the best ways to convince women who are tinkering on the edge of if they will pursue a surgery or not is to reassure them with the words of an experienced surgeon who knows better than anyone how to answer questions on cosmetic surgery. This proved to be quite effective 23 because as one can imagine, a surgeon in this non-necessary and elective field of medicine would be cautious to say anything too damaging against their chosen trade, which sustained their livelihood. For example, a 1981 issue of Ladies Home Journal is a good example of an instance where “crucial questions” are answered by a “noted surgeon” in a female magazine. This is done in order “to help you decide” whether or not to get cosmetic surgery. The surgeon answered logistical questions such as how long the surgery is, if eyelifts are part of face-lifts (they almost always were), what anesthetic is used, if scars are used, and more.26 The consultation of cosmetic surgeons for special articles was very commonplace in this time period. They were used to write ‘updates’ for magazine audiences such as Cosmopolitan, Town & Country, and Ladies' Home Journal, to answer any and all questions in the best light that could be managed. 27 If the article didn’t at least include a direct question and answer model, writers would often at least disclose that plastic surgeons were consulted by the writer. 28 This worked to ensure that the readers felt confident in the sources of the magazine and can be a trustworthy fountain of information. A woman considering cosmetic surgery would be slow to accept advice for someone unqualified in terms of medical knowledge and practice. Regardless, either the editors couldn’t stop publishing this content or the readers seemingly couldn’t get enough of these updates, because they never stopped coming. 26 Harriet la Barre and Daniel L. Weiner, “The Truth about Facelifts,” Ladies' Home Journal, June, 1981, 32. 27 Maxine Abrams, “Cosmo's Update on Plastic Surgery,” Cosmopolitan, December, 1981, 212. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/cosmos-updateon-plastic-surgery/docview/1826455760/se-2 28 “WHAT ABOUT A FACE LIFT?,” Cosmopolitan, October, 1976, 106. 24 The accompanying photo for this article, inserted above, is worth analyzing. A woman removes a mask, which is made from her pre-cosmetic surgery face, to reveal her real and true face, which is full of youth and free from signs of aging. It is deeply metaphorical as a reflection of how doctors and magazines wanted women to see themselves. Only after a cosmetic procedure would they be able to reveal who they really are. Cosmetic surgeons were ultimately glorified for the ‘state of art’ work that they did. They were revered for being able to ‘cure’ something that was always understood to be incurable: aging. Now, as innovators of this new science and knowledge of medical procedures, they are the key sources of information when questions related to cosmetic surgery arise. In another question panel with 12 plastic surgeons in Town & Country, “A Thinking Woman’s Guide to Cosmetic Surgery” ends the preface to the Q&A with “Plastic surgeons differ from other doctors. They do not maintain or save life; they alter the quality of a patient’s life to make it more worth living.” 29 This source, which is from 1981, is interesting for a few different reasons. Firstly, the part of the title that says, “A Thinking Woman’s Guide” is a bit irksome to me. This tells me that this is not only an article for women, which is obvious, but only for those who have the ability to reason, reckon, and contemplate for themselves. It is fair to say that any woman would want to be regarded as a “thinking woman”. What the article has done with the title alone is reel in every woman who considers themself to be knowledgeable in any capacity, which was 29 Shay McConnell, “A Thinking Woman's Guide to Cosmetic Surgery,” Town & Country, January, 1981, 88. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/thinkingwomans-guide-cosmetic-surgery/docview/2155680199/se-2 25 basically every woman holding that magazine. No woman wanted to be left out of the narrative that she was capable and intelligent. Secondly, this article so clearly exalts plastic surgeons as people that selflessly do what they do in order to make women' s lives “more worth living” by giving them their new sense of youth. They could be heroes of the emergency department or of the labor and delivery wing, but they chose to help the quiet sufferers of natural aging and wrinkles and make a true difference in the lives of women across the United States. These men, cosmetic surgeons, are the true heroes. Luckily, if one didn’t have a point of contact with a plastic surgeon, readers could easily find one by checking the long list of surgeons that hugs the edge of the article. Everything was laid out in a considerably convenient fashion to make it easy to proceed with the process of fixing everything a reader didn’t like about herself. Fundamentally, magazines manipulated the ethos of a person with a medical degree to encourage cosmetic surgery. It is just another ploy against women to get them to succumb to the pressures that are only put on them. A final argument for the case of magazine influence on cosmetic surgery is perhaps one of the most powerful. By printing the words from ordinary women who attest to the life-changing results of cosmetic surgery, magazines spread the credibility of the practice like wildfire. Testimonials are a sure way to advertise virtually any product or thing while gaining validity. Cosmetic surgery is a weighted decision, one that is often permanent. If one can get a firm testimony from someone who has lived the experience that person is contemplating taking a part of, it has the power to totally dissuade or persuade you, even if the testimony comes from a stranger. 26 Take one letter written by a female reader to Good Housekeeping in 1978.30 “At age 36, I had the wrinkles and bags removed from around my eyes by a very competent surgeon. I love my ‘rested look’. It has given me the extra confidence I needed to meet the public on my job.” This is an accurate example of how magazines included the words of other women, who seem relatable and average, into the fairytale portrayal of cosmetic surgery. It is validating for women who feel insecure about particular features they have because there are other women, just like them, who decided to dive head-in to changing the things that they didn’t like. In the simplest of terms, it is empowering. However, it is important to see the other side of the coin. When magazines publish testimonials of cosmetically altered women, it also gives women the chance to compare themselves in a harmful light. One might think, ‘If she had that transformation, then what am I waiting for?’ This is something that is seen today in social media and digital advertisements. Products are put into the hands of ‘influencers’ with massive followings, which can be millions of people, to promote a product based off of an often made up narrative of how it has benefited them. While one difference here is that these influencers are paid, it has a similar psychology as any product put into the hands of a real person who can attest to the reliability of a product. This is just another way that the magazine uses ethos to convince their female leaders that there is almost only good that will come from surgery. Concluding thoughts on the magazines of the 1960s-1980s heavy contribution to the pressures of women to receive cosmetic surgery has left me with pivotal questions and points of discussion that may have inferred answers based on what is known about 30 "Cosmetic Surgery," Good Housekeeping, June, 1978, 1. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/cosmetic-surge ry/docview/1886996066/se-2. 27 the nature of the industry. One would ask, what good did it do if the female-based magazines got cosmetic surgery because of the influence from the magazine? One would assume that it had something to do with the importance of the magazine to stay ‘in the know’ and able to provide its readers with the most current information in the light speed world of changing fashions and trends. Magazines served as a vital source during the era before the internet as a way for women to know the coming trends in order to evolve gracefully with the times rather than being out of touch. It was the responsibility of the magazine to dutifully inform their readers in the unwanted event that they search elsewhere for the information they desire. Did cosmetic surgeons incentivize the magazine editors to include regular articles on their medical practices? While there is no solid evidence of whether they did, it can be inferred that as a relatively new medical practice that stood to attract people who cared greatly about their appearance, plastic surgeons would naturally go to the strongest sources they could find to attract customers/patients in the quickest way possible. During this time, men in America didn’t have similar magazines with recurring articles on beauty like women have had since the dawn of magazines. One of the most similar men’s magazines, Men’s Health, didn’t debut until 1987, several decades behind most traditional women’s magazines that still run today. Undoubtedly, it was decided that the most fitting place for the cosmetic surgery industry to advertise would be in the realm of beauty and like-minded spaces that reflect on self-image. So, while cosmetic surgery wasn’t invented for the ‘plight’ of women, a series of circumstances naturally led the industry to have a huge bias towards targeting women due partially to the availability of marketing resources of cosmetic surgeons. Magazines ran wild with the possibilities of 28 consumerism by marketing it to women and girls of all ages, manipulating photographs, and making it a new expectation for women. In the end, it was a win-win for both the magazine and the surgeons as cosmetic surgery evolved to become something that was seen only as a female practice. News, Media, and Culture in the 1960s to 1980s There is much to be said about the fact that men’s magazines didn’t have similar pressures to alter their appearance in such a drastic manner in the 1960s-1980s. This was a turning point in time when America was undergoing social transformations. Crucial American experiences linked with the WWII baby boomer population and passages of civil rights acts declaring discrimination based on sex to be unlawful helps us to understand a little bit about the culture contributing to the divide between men and women in a consumerist context. While magazines paint a clear picture of how cosmetic surgery was primarily marketed to women, it takes contextual investigation to understand how a similar phenomenon occurred outside in the realm of news, other media, and the general culture of sexism in the home, workplace, and other parts of society that contribute to the understanding of how this industry was unfairly projected on women instead of men. The 20th century beheld a new era where women were told their appearances, particularly their faces, was their most important quality for success. This was not always the case, but thanks to new forms of global connectivity, everyone then had more access than before to how people looked thanks to photographs, movies, magazines, and more. With the changing landscape of social culture, there were shifts in related social sectors such as in the workplace and in the sphere of the home, which lead to an intense culture 29 of self-improvement. Commonplace America saw women in the 20th century not exclusively at home, as some might assume, but often working outside of to support their family in one way or another. Historically, this work was almost never always paid in wages equal to men. Unless one was very privileged, families typically had a dualincome household. Women had to compete not only with their performance in the workplace, but also with their appearances. Expectations were higher for them, with many positions requiring them to have their hair and makeup looked a specific way. These expectations were strict and commonly led to extreme measures that were taken by working women. One article from 1981 states, “Not long ago, a facelift was a movie star’s or socialite’s secret. Today, however, with increasing numbers of women competing in the job market and a nationwide trend toward self-improvement, more and more people are choosing to have a few years subtracted via surgery.” 31 This demonstrates the attitude that women had to compete using all of the resources available to them to improve their looks in order to succeed in their careers. Another quote also from 1981, yet from a different source, says, “a new generation of women in their middle years is rejecting growing gracefully wrinkled, and taking a more competitive stance towards sexuality, fitness, and careers.”32 These sources denote that by the 1980s, it was common for women to elect or at least seriously consider cosmetic surgery in favor of desirable positions in the workplace to enhance their success and their lives in general. As one might imagine, this was applicable in several fields of work. Whether it was corporate, retail, office, or service- 31 Harriet la Barre and Daniel L. Weiner, “The Truth about Facelifts,” Ladies' Home Journal, June, 1981, 32. 32 Shay McConnell, “A Thinking Woman's Guide to Cosmetic Surgery,” Town & Country, January, 1981. 88. 30 related fields, women then and even now are expected to maintain an appearance that is unequal to the expectation held to men. Never have men been required to wear makeup for a professional white-collar position. Men and women in the same position, for example a retail salesperson, had different expectations for dress and appearance. It seems that men were applauded for wearing a suit, having a shaved face, and combed hair. Women, on the other hand, were scrutinized from head to toe. Tights, heels, skirts, makeup including blush, mascara, eyebrow filler, lipstick, and foundation, and hair that was in place without a wisp. It’s obvious that the expectations are not the same between men and women, then and even now, which contributed to the eventual expectation that women should consider cosmetic surgery in order to stay relevant and competitive in the workplace. Never mind the heavy costs they already pay to maintain their appearance. What is a few more thousand dollars? Intertwined with the beauty standard and the workplace is the spirit of selfimprovement. America is notable for their traditional culture of self-improvement to be the best one can be and thrive in this capitalist society. As a country whose remarkable economy is built from immigrants, a heavy emphasis on hard work, in sacrifice of a healthy work-life balance, is called for in order to succeed in having the life that one wants. This translates to appearing in every way they can to be the self-made man or woman that they so desperately aspire to be- everything is a competition. The self-made man has always been ingrained in American culture, it always has a way of finding its way back into the core beliefs and values in America. 33 When it comes to the topic of Edward J. Balleisen, Navigating Failure. Luther Hartwell Hodges Series on Business, Society, and the State. Chapel Hill: University of North Carolina Press, 2001. 33 31 self-improvement and adhering to the beauty standard, “The line that separated cosmetic surgery from other forms of self-improvement and self-culture became more difficult to draw.”34 As the historian, Beth Haiken, has argued, the culture of self-improvement and beauty became almost completely inseparable and boundaries dissolved to be nonexistent. One would be slow to question motives of cosmetic surgery, especially if it is done in the spirit of ‘self-improvement’, which America applauds. Women are told that the older they get, the less attractive they are. While men are not treated in a similarly pathetic manner. Reflecting on the quote from earlier which said the “saddest moment in the day often comes in the morning when we first look in the mirror,”35 one can imagine how damaging the message sent to women is that what the world cares most about them is their face and how they appear. Their ‘face value’ is one of their most notable values, which is not a narrative that is subjected to men in the same way. How is this contributing to the culture that women are the ones who must maintain their appearance in every social sphere in a way that men don’t? The larger problem at hand is, of course, the uneven sexist expectations held to men and women. These standards were much stronger 50 years ago compared to today. However, by recognizing the contextual environment in which women worked and lived in, it can be understood how the cosmetic industry and male gaze inserted itself into the female sphere and forced itself upon it. This reinforced a universal ‘beauty standard’ for women across the United States, which has curious origins itself. 34 Beth Haiken, Venus Envy, (John Hopkins University Press, 2000), 101. Dicker and Syracuse, “LOOKING BETTER, FEELING LIKE A MILLION: A Report on Plastic Surgery Today,” 36. 35 32 The ‘beauty standard’ has evolved over about the last 100 years as a concept and an idea. Before the 1900s, beauty was considered an innate quality rendered by values and virtues of a woman rather than physical attributes36. Many still recognize the beauty inside an individual who is caring, compassionate, kind, and intelligent, but beauty is now considered mostly to be an external concept. Haiken recognizes a pivotal turn in this new American ideation with the emergence of the first Miss America beauty pageant in 1921.37 This new emphasis on beauty coincides with the emergence of the American Board of Plastic Surgery, setting the foundation for a beauty standard for women in a new climate in America that fixated on female appearance. Persisting into the 1960s through the 1980s, this beauty standard only gets more intense as it is steadily funneled to female consumers. Perhaps this is a result of the changing role of women in the workplace, but nonetheless, it is women who are targeted because of the American fixation on beautiful women. Men do not have pageants like women do, especially in 1921. Today, there are body building contests such as, “Mister Global, '' and “Man of the World'', but many of those started recently, in the 21st century. What does this tell us about the culture of beauty, which was forced on women in the workplace, at home, and everywhere they went? It only reinforces the notion that women were kept in their respective gender roles further by upholding standards for how they should look, think, and behave. So, what even is the beauty standard and who determines it? From what images magazines published, it can be assumed that the ‘ideal image’ was almost always generated from a young Anglo-Saxon face with light complementary coloring and 36 Ellen Furlough and Victoria De Grazia, The Sex of Things : Gender and Consumption in Historical Perspective, (Los Angeles: University of California Press, 1996), 313. 37 Beth Haiken, Venus Envy, (John Hopkins University Press, 2000), 101. 33 smooth skin. The accompanying image from 1971 is a silhouette of a woman that has the “ideal image” with specific procedures to eradicate aging such as blepharoplasty to tighten the eyes and rhinoplasty to correct the nose.38 This is one example of what the ‘ideal woman’ American women should strive to look like. Blatant racism is obviously marketed through pictures of women that are marketed as the perfect image due to the fact that the majority are white and lacking any type of diversity. In the next section, it will be discussed how surgeons even pushed white racial features to correct non-white facial structures. This is a common theme throughout the beauty industry with lack of support for non-white women. An example is lack of correct shades of face makeup for varying tones and colors of skin. Makeup in the cosmetic industry was made and designed for women. Makeup wasn’t a new concept in the 20th century, though it grew rapidly with the expansion of salons and new products. Its reputation and role in women’s lives and society changed drastically over a short period of time. Visibly noticeable makeup evolved from 38 Advertisement: Cosmetic Surgery. Town & Country, July, 1971, 23. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/advertisementcosmetic-surgery/docview/2137422910/se-2 34 correlated with “deception and alterity” in the 19th century, to “integral to self-expression and the belief that identity was a purchasable style” by the 1930s. 39 With this change in attitude surrounding cosmetics, marketing for products became more fruitful. With good feedback from its customers and marketing to the right target, a product has the potential to make millions. Madam C.J. Walker was the first American female self-made millionaire by making hair products for black women in the early 20th century. As an African American woman herself, she was able to market the products she made as someone who could attest to its effectiveness on thinning hair and baldness. Her marketing strategies that targeted African American women made her extremely wealthy. This is an example of how the culture surrounding beauty shifted in America thanks to the availability of products. It is not a negative thing that female entrepreneurs were able to make money in this industry, it only shows how women became more attuned with their appearance as they were told they should buy products to fix their imperfections, making this industry boom even more. It has become more and more common over the last 100 years for women, especially celebrities, to create their own line of beauty products and make fortunes. By releasing their own brands and lines of products once they realize they can make more money selling lip gloss to their music than making popular music. For example, one can go to Sephora today and see makeup lines from Gen-Z and Millennial celebrities like Addison Rae, Selena Gomez, Rihanna, and Kylie Jenner. These women gained their fame from song making, acting, and even dancing in front of their phone camera. However, 39 Ellen Furlough and Victoria De Grazia, The Sex of Things : Gender and Consumption in Historical Perspective, (Los Angeles: University of California Press, 1996), 313. 35 these are some of the wealthiest young women in America. Rihanna is the wealthiest female musician in the world, worth somewhere around $1.7 Billion thanks to her clothing and makeup lines.40 The power lies not so much with the product as it does with the marketing and the face behind the product. The makeup and cosmetic surgery industries fall directly under the influence of the beauty standard. Celebrities, workplace, and self-improvement are all studied in order to understand the climate that women find themselves in when it comes to the pressures they face to look a certain way. Makeup is not a bad thing, but it contributes to the magical air of transformation from one’s natural features, which often is how beauty is rated and defined. Advertisements can often be misleading and serve as a gateway to thinking about how a woman will start thinking about what society says they need to change about their appearance, leading them to surgical solutions. Cosmetic surgery’s influence from the viewpoint of the media can’t be complete without mentioning the strong sway of celebrities. Celebrities vary from musical artists, movie stars, athletes, politicians, and more. Particularly before the birth of the internet and social media, celebrities served as public figures who entertained the masses, dazzled the commoner with their impossible looks and style, and were a figment of one’s imagination. They seemed to exist only halfway in reality- a life so glamorous will always seemingly remain out of reach for everyone else. Movie stars were, and still are, adored by Americans. Popular actors and actresses wielded great power to persuade their followers to think a certain way or align their beliefs with a certain opinion or conviction 40 Madeline Berg, “Fenty’s Fortune: Rihanna is officially a Billionaire,” Forbes, accessed November 11, 2022. https://www.forbes.com/sites/maddieberg/2021/08/04/fentys-fortunerihanna-is-now-officially-a-billionaire/?sh=55697c8c7c96 36 when it came to appearances. This thought pattern often appealed to the male gaze by conforming to female sexualization and stereotyping. Actress Marie Windsor broke quiet with her Cosmopolitan interview in 1959. “What Plastic Surgery Does for the Stars” highlights Windsor’s unfortunate situation, being “plagued with sinister roles because of her nose.” 41 In order to help her plight, she decided to go under the knife for help. In the images below, her before and after photos were included in the article. While there is a difference between the two noses on Windsor, it is not astronomical. While this is a subjective analysis, the “lump” seems to be nearly nonexistent. The article made it clear to emphasize the point that because Windsor was able to get the help she needed and desired, she was able to get new roles and continue to have a successful career. The same message being sent to readers could be repeated almost word per word. They want women to see that since celebrities are open about cosmetic surgery, it must be a good and beneficial thing. Celebrities were willing to alter their faces in order to grow their fame. This doesn’t make them any less admirable, but perhaps even more admirable for their dedication to their careers and appearances. It is important to discuss that men got cosmetic surgery then and still today. Their rates of procedures were drastically lower than women because of marketing, types of 41 Lawrence Galton, “What Plastic Surgery does for the Stars,” Cosmopolitan, November, 1959, 22. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/what-plasticsurgery-does-stars/docview/1999138570/se-2 37 procedures available, and general public acceptance. Men, especially celebrities, who underwent cosmetic surgery did so under wraps. They denied undergoing procedures, probably to avoid embarrassment. “Men everywhere, denied any knowledge of the subject (cosmetic surgery) whatsoever- they’re all doing it, and they’re glad.” 42 This is likely because as public figures, they didn’t want to risk being associated with femininity at the risk of their masculinity. Men weren’t supposed to go to the extent that women did to upkeep their looks. Celebrities, men and women, drew attention to the practice of cosmetic surgery, but in different ways. Since they were constantly in the spotlight, the public was quick to scrutinize or praise newly altered faces when they saw one, naturally drawing attention to the practice of cosmetic surgery. Because celebrities were some of the time’s greatest ‘influencers’, they could be used by up-and-coming cosmetic surgeons to promote the new capability of medicine to erase age and achieve the ultimate goals of beauty. As explained by Haiken, cosmetic surgeons had to rely on outside forces to gain credibility as real and legitimate surgeons due to the vain nature of the medical practice. 43 Many would agree that female celebrities were used, perhaps even exploited, by cosmetic surgeons. They were made to be a beacon of beauty and were the expectation that other women should aspire to be, combining both philosophies of the ‘male gaze’ and the ‘medical gaze’ as these women were created to become beacons and standards of beauty by the hand of medical professionals. Since artificial looks were impossible to come by naturally, it was just another unrealistic face for women to compare themselves to. 42 Nancy Smith Bate, “WHO'S DOING IT,” Town & Country, May, 1974, 1. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/whosdoing/docview/2155688823/se-2 43 Beth Haiken, Venus Envy, 11. 38 Today’s generation has legions of social media influencers, the Kardashian family, and other women who are in front of the camera for different reasons besides acting. While these are examples of popular people many Americans follow closely, the 20th didn’t hyper-fixate on seemingly ordinary people who were commercialized for simply being who they were. A better example of that time period might be members of royal families. Royal families still exist today, but are not the hyper-fixation of all. They still have great sway with the public, just like they always have. This Cosmopolitan article on Italian Princess Luciana Pignatelli does much to expel any negative connotations against the practice of plastic surgery. Pignatelli looks remarkably beautiful and also not very aged, which is either thanks to genetics or her operations. “Like most women, I have always been afraid of wrinkles and lines. My approach is to get at them before they really dig in.”44 This primary source is included to reiterate that cosmetic surgery was truly marketed for every woman. It was not underneath female celebrities of all variations, including royals, to sing its praises. Including the fact that surgeons would oftentimes use celebrities to promote their own interests, respective opinions might be altered as the true dynamics are revealed to show how they really were. 44 Luciana Pignatelli and Jeanne Molli, “A ROYAL BEAUTY REVEALS: HOW SIMPLE SURGERY CAN REJUVENATE YOUR FACE,” Cosmopolitan, July, 1971, 38. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/royal-beautyreveals-how-simple-surgery-can/docview/1816841205/se-2 39 It is important to grasp the culture surrounding beauty to understand how the cosmetic surgery industry was able to permeate so deeply into it and justify its means of marketing its product which was not just risky physically, but also mentally. The media along with all social sectors reinforced the beauty standard on women and advertised cosmetic surgery as something that all women should plan on pursuing. If celebrities were doing it, so should all women, because who wouldn’t want to live like a celebrity? Cosmetic surgery done on men and male celebrities wasn’t talked about, for reasons that will be discussed in the next section, and was even frowned upon by medical professionals. As a medical practice that was founded while aiding men recovering from war wounds, it has taken a very surprising turn as an industry whose patients are mostly female. Taking the evidence into account, is not a coincidence, but a result of the society which valued women not for what they could do, but for how they looked. Medical Journals: Cosmetic Surgeons and their fixation on Female Patients All of the analyzed primary sources and discussions surrounding cosmetic surgery thus far have arrows pointing to the creators of the industry, which of course is the cosmetic surgeons themselves. By analyzing medical journals from the 1960s to the 1980s, the perspective and intentions of medical doctors and surgeons in the cosmetic surgery industry will become more clear. Their ideal patient, methods, and contributions towards the targeting of women will be made abundantly clear through the images and words that they use. This argument is important because it connects the themes highlighted in magazines, advertisements, general media, and even celebrities together under the empire of plastic surgery. The medical side of the argument against cosmetic surgery is perhaps one of the most surprising, due to the fact that most people don’t 40 typically credit surgeons as one of the main culprits that funneled women into the system of cosmetic alterations. Most people 40-50 years ago, and still today, put great trust in medical providers with their opinions, knowledge, and expertise in an almost authoritarian manner. The “Medical Gaze,” which has already been discussed, summarizes how medical doctors fit into the system of diagnosing conditions without really looking at their patient.45 With the help of accredited medical schools, multiple exams, and practicing hours, doctors have come a long way from the time of medical quackery when they could not be trusted to diagnose conditions and save one’s life. However, doctors in the 1960s-1980s were still imperfect and often biased in the treatment they gave men and women and even discriminated in the treatment they gave others. The manner which surgeons and doctors wrote in published medical journals from this time period is a key part to understanding how, through their tone, implications, and expressions, the consumption and marketing of cosmetic medical services was driven upwards. Heavy focus on one sex could’ve been done without even realizing it, but there was certainly a gist of subconscious sexism throughout cosmetic medical journals, which ultimately set the stage for the future consumers in the industry. Medical journals displayed images of patients as part of their case studies, drawings, writings of their methods, and conclusions based on the results from their patients. The demographic of the patient evolved from the 1960s to 1980s, but most often in these cosmetic medical journals, patients pictured were mostly female. For example, in “The Senile Eyelid,” 45 Michel Foucault, The Birth of the Clinic : an Archaeology of Medical Perception, (New York : Pantheon Books, 1973). 41 Doctors drew a diagram using a female to model the eyelid surgery in 1967. 46 As a disclaimer, this surgery was most often performed for cosmetic reasons, but it is also done in medically necessary cases where drooping eyelids interfere with vision, which doesn’t coincide with the cosmetic context in which this research paper is focused. For this specific medical journal, they could’ve used a male depiction or even better, a gender-neutral one, but they specifically chose a woman for the drawing. Adding to their biased preference of women for this eyelid procedure, they only published cases of before and after photos of female patients who underwent this surgery, whose pictures are inserted below.47 By looking closely at these three before and after photos, some interesting patterns emerge, which is seen in other medical journals as well. By comparing the before and after appearances, it’s noticeable that their eyelids aren’t the only thing that look different. For all three women, they are wearing makeup in their after photo, but not in their before photo. Their eyebrows are filled in and darkened, their mascara is applied, and eyeshadow is used liberally. The 46 Stevens E. González-Ulloa M, “The Senile Eyelid: Aesthetic Correction,” Arch Ophthalmol. 1967;78(3):365–368. 47 Stevens E González-Ulloa M, “The Senile Eyelid: Aesthetic Correction.” 42 third woman is missing the mole on her nose, which was either blurred out, surgically removed, or covered some other way. Their expressions are different too. Before photographs have angry and even empty stares while after photographs have sultry and mysterious looks. These after photographs, in combination with the makeup, give an exciting aura to their new look. Additions, besides the cosmetic surgery, was common to have in medical journals when displaying the transformation of patients. This illuminated the life-altering benefits of cosmetic surgery. It gave women a new lease on their lives and was supposed to make them feel sexy and desirable again. In the 1950s and early 1960s when cosmetic surgery wasn’t accepted as only a female enterprise, it was more common to see men in these medical journals. With time and the shift of preference to target female patients, those men become fewer and fewer. This leads one to wonder if that shift was merely coincidental or intentional. It may be inferred that multiple surgeries were created for females, not just breast augmentations, but also facelifts, tummy tucks, and more. An example of a “Brow lift operation” in 1975 shows the difference in the before and after photo of a woman who underwent the procedure. 48 Upon closer inspection, one can see that her eyebrows are penciled in, she is wearing lipstick, and the lighting is much more friendly in the “after” photo compared to the first. 48 Mark Rafaty, F, Richard L Goode, Willard E Fee, “The Brow-Lift Operation”, Arch Otolaryngol, 1975;101(8):467–468. 43 She is portrayed in a totally different way that is another example of how women were portrayed in line with the beauty standard of the time after the procedure was completed. Some sources denote that there was a clear bias against men being approved of undergoing cosmetic surgery. In an interview with unnamed plastic surgeons and a psychologist published in a magazine issue from 1966, one doctor said “many men who seek a nose job or face lift may have serious psychological problems, associated with repressed homosexuality or other schizoid psychological tendencies.” 49 Not only do we see the polarity in perception towards men and women during this time period, but we get a peek into how men were treated when it came to cosmetic surgery. In this same article, a doctor explained why women might get cosmetic surgery, “she may want to start a new life-her children are grown up, her function in the home is completed. Another reason is boredom. It’s something to do, especially among the rich.” This speaks volumes to the context in which this article is written. Life for women in the 1960s and how they were perceived was much different than in 2022. In the following paragraphs, a surgeon even goes so far to say that the husband must be part of the decision if his wife is to get plastic surgery, “if they’re not getting along too well and the husband disapproves of plastic surgery, this can aggravate an already poor situation. Besides, he has certain rights.” This seems very offensive to the woman, who seems to not be in control of her own bodily choices when her husband’s opinion is just as important. It seems like no matter your sex, you were never going to be treated equally. This illustrates the beginning of the cosmetic Pamela Jones, "Experts Analyze COSMETIC SURGERY," Town & Country, 02, 1966, 78-79, https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/expert s-analyze-cosmetic-surgery/docview/2126837103/se-2. 49 44 surgery industry and how it truly started as something catered towards women as a way to control them and build an industry worth billions of dollars off of insecurities. Medical doctors who published professional journals based on their research clearly had to be careful in their wording because it was going to be read by other professionals. Therefore, they were straightforward about the terms they used in order to deliver the information and techniques they had practiced to other practicing professionals. One thought provoking thing to note was the difference between ‘necessity’ and ‘elective’ when it came to cosmetic surgery journals. In earlier publications, they were careful to use the word “necessity”, because it was known then as it is now, that aesthetic surgery is an elective operation and not necessary to save one’s life. However, later into the 1970s and 1980s, surgeons felt at liberty to refer to procedures as ‘necessary corrections.’ This is due to the increased confidence in the legitimacy of their practice as a relatively new branch of medicine, which was supported by paying customer patients. They had gained credibility by the medical community at this point, and were basically protected to take advantage of what wording they liked in their publications. While an exchange of a simple word doesn’t seem like a big deal, it actually makes a big difference in the scheme of encouraging cosmetic surgeons to convince their consultation patients to go under the knife. If their mindset is one that thinks the surgery is necessary to the patient, then they will tip the patient towards agreeing to the procedure. One published source from 1973, called “Thoughtful Nasal Tip Surgery”, is an interesting analysis on all the different nose tips a patient might have that need 45 correcting.50 Once the nose was identified, 5 nose tip shapes were listed ranging from the “Bulbous Tip” to the “Hook Tip”, it was explained how it would be corrected. The requirement for fixing these noses shows the mindset held by cosmetic surgeons that there was, in fact, a right and wrong way for a person to look. In another compelling source called “Chin Implants with a Newer Plastic Compound” doctor Maury L. Parkes, M.D., writes about the importance of the relationship between the chin profile and the nose profile.51 The term “nasal deformity” is used for noses that are sloped downwards or slightly too big. They argue for the importance of chin augmentations, with or without rhinoplasty, which “is necessary in producing an aesthetically satisfying profile.” Parkes uses real before and after photos of patients, in which 3 out of 4 were women, and diagrams to show the importance of what is necessary to achieve a satisfactory and pleasing profile. Note that in this publication, doctors used the term “necessary” when discussing the methods of a desired outcome, which was defined as a face that adhered to the drawing above. The before and after profiles of one of the patients in this medical journal clearly followed the expectations of the drawing to produce a “satisfying profile.” Her face underwent both a rhinoplasty and 50 TW Smith, “Thoughtful Nasal Tip Surgery,” Arch Otolaryngol, 1973;97(3):244–246. doi:10.1001/archotol.1973.00780010252003 51 ML Parkes, “Chin Implants with a Newer Plastic Compound,” Arch Otolaryngol, 1962;75(5):429–436. doi:10.1001/archotol.1962.00740040440010 46 a chin implantation. These were the standards and expectations set by not the patient, but the cosmetic surgeons. What does the tone of expression through words, pictures, and phrasing in professionally published medical journals tell us about the influence of beauty culture and what effect it has made on women as consumers of aesthetic and cosmetic surgery? One can infer that plastic surgeons fed the narrative that women needed plastic surgery either because they wholeheartedly believed in and supported the beauty standard, or because they profited most off of women. Either way, it had the same effect of luring women to fix what they were told ‘needed’ to be fixed. It shouldn’t go without saying that a lot of surgeons took time to get to know their patients, as many doctors and surgeons do today in their practice. This is necessary for all medical doctors when dealing with patients and requires patience and sensitivity. “The cosmetic surgeon must search his own psyche as to his reaction to vain, nervous, apprehensive, and at times, aggressive patients, since it is from these categories that many people electively come for cosmetic surgery.” 52 Many surgeons carried a good conscience with themselves and didn’t care about power or influence. They could’ve operated on those that came to them, which happened to mostly be women. However, elective procedures are an expensive out-of-pocket expense that is not covered by insurance, leaving patients with bills costing thousands. Since this is the case, one would imagine that a cosmetic surgeon would be doing all they could to advertise their procedures, skills, and services, in order to make a living. 52 TW Smith, “The Selection of Patients for Rhinoplasty,” Arch Otolaryngol, 1971;94(1):56–58. doi:10.1001/archotol.1971.00770070092010 47 In order to keep the revenue streaming, new procedures had to be popular and of interest to the target audience for aesthetic surgery. Discussed earlier was how many of the new surgeries were catered towards changes that could be made to the female appearance. The cosmetic surgery industry had to work fast in order to keep up in order to guard the interest of the women. This was evident in different innovative surgeries that were designed specifically for women. It can be seen how many procedures were inspired from the booming makeup and general cosmetic industry. By making further ties between these two sister industries, it can be further explained why the odds were stacked even further against women since men did not have an even remotely similar industry like the makeup empire. What would be the reaction of women if they were told they should undergo a few procedures in order to make permanent what they try to achieve every day with cosmetics? It was apparently a brilliant idea that still works today. Lip liner and lipstick was used to change the shape of a woman’s lips, so lip filler and surgical alterations were used to make that more permanent. Eyeliner and mascara were used to change the shape of the eyelid and make eyes look bigger, so blepharoplasties became the mainstream to make the dream of bigger eyes a reality. Contouring makeup used to define cheekbones, jawlines, and noses could be replaced with rhinoplasties, facelifts, and injections of filler in the right places to solve all of those issues. While many women then and now can say that they are happy with how they look following cosmetic surgery, the hyper fixation of following the trends of makeup to create a more permanent and convenient solution led to techniques and practices that were not always so safe. The outcome was not always a 48 fairytale for those women who were told their dream surgery was going to ease their daily makeup routine. Cosmetic surgeons regularly experimented with carcinogenic fillers and implantations. Since many procedures were emerging and without many case studies, they were often done at the risk of the patients, who were harmed in the process. Injectable silicone, once used commonly for the face, breasts, and other soft-tissue augmentation, is no longer acceptable today. “Injectable Silicone for Facial Soft-Tissue Augmentation” was an article published in 1986 about the success of medical-grade injectable silicone.53 The first line says, “Preserving youth and enhancing beauty are the two main goals of cosmetic surgery.” This sounds very superficial, but it is their main objective they wanted their patients to know. The study highlights how they had followed, for the previous 20 years, 235 patients who collectively received 2,811 injections of silicone to the face. The most popular procedure done in this study was the cheek-lip groove, which took an average of 6 treatments per patient to obtain the desired result. This study emphasized the importance of injection technique of silicone in order to avoid bad reactions or “silicone lakes, drifting, and other complications”. 54 This tells me that they knew the danger of silicone and its tendency to react poorly when used for augmentation and cosmetic procedures, but they published their ‘findings’ anyway, giving way to other doctors to use the same materials on their patients. Even though they weren’t fully aware of implications, they proceeded to operate readily on willing patients in good conscience. This was likely done in order to increase the stream of patients 53 RC Webster, JM Gaunt, US Hamdan, NS Fuleihan, RC Smith, “Injectable Silicone for Facial Soft-Tissue Augmentation,” Arch Otolaryngol Head Neck Surg. 1986;112(3):290–296. doi:10.1001/archotol.1986.03780030054011 54 “Injectable Silicone for Facial Soft-Tissue Augmentation”, pg 296. 49 coming into the doctor’s office. Injectable silicone was used for a few decades as a means to alter features of an individual before it was banned by the FDA. 55 Implantations were similar to silicone injections in the fact that it was a foreign substance inserted in a body for the goal of body modifications. Chin implantations, for example, were done in both male and female patients, but even more popular was breast augmentation through implantation. This was only done exclusively for female identifying patients. The evolution of what breast implantations were made of is another example of how harmful substances used by cosmetic surgeons have negatively impacted trusting patients. In a 1957 study called “Implantation of Plastics in the Breast,” Lieut. Col. Harold F Hamit, warned his readers of the dangers of complications and infections from breast implants and generally advised against them. 56 Because there was a lack of research done on implant materials, all surgeons should have been cautious of the carcinogens introduced to the body through plastic implantations. He cited a case of a 22 white woman who underwent “breast-plasty” and had two sponges placed behind her breasts. After about one year, she started having leakage, open sores, and pain, resulting in two subsequent hospital stays to remove the sponges and resolve the complications. The original plastic surgeon supposedly remained unaware of the complications because they were taken care of by someone else. It is ghastly to think that sponges were put inside a person's body for the goal of body modification. Since this source is from the late 1950s, it might make sense that the medical knowledge and technology surrounding 55 “The FDA Warns Against Injectable SIlicone and Dermal Fillers for Large-Scale Body Contouring and Enhancement,” U.S. Food and Drug, accessed October 10, 2022. https://www.fda.gov/consumers/consumer-updates/fda-warns-against-injectable-silicone-anddermal-fillers-large-scale-body-contouring-and-enhancement 56 HF Hamit, “Implantation of Plastics in the Breast: Complications in a Case,” AMA Arch Surg. 1957;75(2):224–229. doi:10.1001/archsurg.1957.01280140062010 50 cosmetic surgery wasn’t as advanced compared to 20 years after that. Perhaps even more interesting about this source is that the woman got the implants in 1954 after her male gynecologist told her that her “breasts were somewhat underdeveloped” and talked her into “having them built up with plastic material”. 57 According to the woman, she was seeing the doctor for a gynecology issue, not for matters of how her breasts appeared. Putting this into context leads us into the next point of discussion of how male doctors and surgeons reinforced the beauty standard just as much as everyone else, if not more. The jurisdiction the male gaze had on the cosmetic surgery industry is undeniable and helps to explain why most of the patients were and still are female. Most doctors and surgeons in America during this period of time were male. This is due to varying gender reinforcements of where women were accepted in the workplace and what access they had to higher education. Discrimination in the workplace based on sex wasn’t made illegal in the United States until the legislature surrounding the events of 1964 and the Civil Rights Act. Statistics of specific demographics on cosmetic surgery patients from this time are difficult to find, but the most recent statistics from the American Society of Plastic Surgeon statistics report tell us that about 90% of cosmetic surgery patients are female.58 It can be assumed that percentage was similar, if not higher, in the focused time period of the 1960s-1980s. What does the relationship between a majority of male doctors and a majority of female patients tell us about the power dynamic between the all-knowing doctor and the vulnerable patient? The medical gaze and the male gaze both come into play here. If a woman went in for a gynecological 57 “Injectable Silicone for Facial Soft-Tissue Augmentation,” pg 296. “Plastic Surgery Statistics,” American Society of Plastic Surgeons, accessed October 10, 2022. https://www.plasticsurgery.org/news/plastic-surgery-statistics 58 51 exam where she was likely naked and being inspected on an uncomfortable table by a male doctor, why did he, the doctor, think it was appropriate at that time to comment on her breasts apart from checking for lumps or other malignancies and tell her that they were somewhat underdeveloped and needed to have them enlarged with plastic and sponges? In this specific scenario, it appears that the doctor abused his role as health provider and convinced the 22-year-old woman, who wasn’t at the appointment for anything other than a regular exam, to undergo surgery for his own benefit. The argument made here isn’t that male doctors are incapable or bad people, but that there is a point to be made that men were the ones performing and inventing surgeries that enforced female beauty standards and expectations. All of the sources used from medical journals have almost exclusively male names. In a 1982 journal called “Midforehead Incisions in Treatment of the Aging Face59,” women are the only portrayed sex, yet again, and it is written by two male doctors. In the journal, the two doctors describe how to diagnose conditions of aging, namely wrinkles and fine lines, in order to apply the necessary procedures in order to help the patient regain their youthful appearance. In the image to 59 HG Brennan and FM Rafaty, “Midforehead Incisions in Treatment of the Aging Face,” Arch Otolaryngol, 1982;108(11):732–734. doi:10.1001/archotol.1982.00790590054015 52 the left, two women are compared against one another. One is the ideal “youthful” face, and the other is the “aged” undesirable example of a face. Whoever decided what was the ‘ideal face', these surgeons recognized that it was a marketable tool to sell to women to appeal to their desire to gain greater social or economic position by adhering to the beauty standard made by someone else. Returning once more to Lieut. Col. Harold F Hamit, he wrote that female breast implants are done for “(1) the relief of psychic disturbances, actual or potential, presumably caused by possession of hypoplastic breasts; (2) the increase of breast mass for other reasons, e.g., social or economic, or (3) combinations of (1) or (2).” It has already been discussed how women were pressured to increase their economic and social position through permanent cosmetic alteration, which men weren’t expected to do. However, the words “psychic disturbances'' is an attention-grabbing phrase, which is very strong and wouldn’t be used in this situation today. Perhaps this term didn’t have the magnitude of negative connotations that it does now, but it is still a statement nonetheless. Was it a belief during this time that women could heal “psychic disturbances'' by undergoing cosmetic surgeries? Certainly, this could lead into another topic for research entirely on its own, but allow that question to illustrate one of many unexplored connections that strengthened the monopoly the cosmetic surgery industry had made in the female world. In culmination, medical journals give an intimate insight to the thoughts and beliefs held by practicing cosmetic surgeons during the focused timeframe. The wording in professional journals was quite different from the content analyzed in magazines. This was obviously done for the sake of professionalism in the context of the publisher and the 53 reader. Although the wording and phrasing were different from one another, it is easy to conclude that the rest of the world didn’t think so differently from the doctors and surgeons with great credentials and reliability. They viewed women the same way: as people worthy for their appearance and a potential consumer of a new and expensive product that would leave them coming back for more. Cosmetic surgeons were salesmen dressed in white lab coats. COUNTERARGUMENTS Throughout the arguments made about how the cosmetic surgery industry evolved, there are valid counter arguments and points of discussions that can be made to offset said arguments. Many of these are centered around the contradicting thoughts and beliefs of different people. For example, there are many women who didn’t like their experience with cosmetic surgery and perhaps even regretted their decision. Magazines often didn’t publicize poor experiences related to the cosmetic surgery industry because it went against what they usually preached. However, there are some examples found of when an article was published that condoned cosmetic surgery or questioned it, such as an article published in Woman’s Day in 1980 called “Is Plastic Surgery Being Oversold?”60 This specific article reviews one woman’s experience of gathering consultations from several cosmetic surgeons about her nose. Many surgeons told her she needed surgery and others told her to save her money. She was very surprised at the lack of tact some doctors had to not warn her of the risks of a major surgery. “If a doctor, who is both a man and an expert, agrees that your nose should be fixed, you don’t question 60 Judith Jobin, “Is PLASTIC SURGERY being Oversold?: ONE WOMAN'S EXPERIENCE,” Woman's Day, Mar 11, 1980, 42. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/is-plasticsurgery-being-oversold/docview/1818415244/se-2 54 it.”61 This woman’s experience is one where she decided against surgery as a result of her multiple consultations. It could’ve gone differently had she not been cautious, which is something that many women began to realize. Not all women were submissive to the industry. Every man and woman should be able to express themselves however they would like and to look however they want. Whether that be through art, music, work, photography, makeup, and surgery. The point of this paper is not trying to illustrate the compliance of women and depicting them as incapable of nonconformity. It is about articulating their environment, which is completely unique from men’s during the time period when cosmetic surgery was growing and evolving at a rapid pace as a legitimate medical business. Women, more often than not, had to face constant pressures telling them to look different, younger, and prettier, even by extreme means of permanent alteration. Naturally, this contributed to an entire slew of insecurities, body dysmorphia, and other image disorders, which wasn’t always a direct result from the cosmetic surgery industry. This was a self-photograph on gelatin silver print by a French artist named Sophie Calle, born in Paris, 1953. It is called The Plastic Surgery and was taken in 2000.62 This was found at the Metropolitan Museum of Art and is one of only a few objects there that has anything to do with plastic and cosmetic surgery. The fact that there aren’t many objects, photos, or any other museum-quality things of the 61 62 Judith Jobin, Woman’s Day, pg 124. Sophie Calle, The Plastic Surgery, 2000. https://www.metmuseum.org/art/collection/search/284116 55 last century to be found is testament to the fact that the topic of plastic surgery is still ‘taboo’ for a large portion of society. Not enough time has passed for us to reflect on particular practices and sentiments that transpired in many families- such as what Calle described when her grandparents urged her to get plastic surgery at 14 years old. This would have been in 1967 if Calle was born in 1953. Even more interesting and suggestive is the suicide of her would-be plastic surgeon just two days before her operation. One cannot make complete assumptions to why the surgeon took his life, but Calle makes the allusion to the crippling immorality the surgeon felt when coming to the realization of what his medical practice had become: altering the natural appearances of 14-yearold girls. This artist chose to speak up about things that are wrong and that have gone too far with society and the cosmetic world. This piece of art ties into the last point, which focuses on the surgeons themselves. Not all surgeons were malicious, greedy, and selfish. Certainly, there were practicing doctors that didn’t like how the industry was evolving and did what they could to correct trends that they saw developing. This is evident in the experiences told in Woman’s Day about the handful of doctors who advised against surgery to the Army doctor Hamit, who warned surgeons against breast implantations. An interesting debate opened up in 1998 between several doctors about the “Morality of Cosmetic Surgery for 56 Aging.”63 Many doctors argued in defense of cosmetic surgery, and some argued against it. This occurred a decade or so past this paper’s focused timeframe of research, but it is clear that many doctors felt that there were factors of right and wrong to the practice of cosmetic surgery. This doesn’t mean that they always acted on their impressions or inward beliefs, because nothing was strongly said or done to stop the boom of the industry for decades. Based on findings from this research, it becomes clear why the cosmetic surgery industry has developed to become the way it is today. In every city, one can find a plethora of cosmetic surgery offices. Billboards advertising things such as “Life is short, buy the lips,” permeate suburban communities all across America. 64 It has grown in such a manner that it cannot be escaped. Circling back to the first statistic presented in the introduction, it is clear that the ratio between men and women persists into today in extreme imbalance of number of procedures. This is a setback for all women, because it is feeding several millions of dollars to a corporation that profits off of insecurities and the reinforcement of the beauty standard. Cosmetic surgery wasn’t popularized because of women’s needs and desires, but because of the impulses and agendas of those who benefited most from it, which was the surgeons, the magazines, the media, and those who see women through the ‘male gaze’ as objects that should look a certain way rather than accept who they are. Pioneers of cosmetic surgery could’ve chosen to keep going down the path of making aesthetic alterations of the body a more universal product. However, they decided 63 EW Ringel, “The Morality of Cosmetic Surgery for Aging,” Arch Dermatol. 1998;134(4):427– 431. doi:10.1001/archderm.134.4.427 64 Beauty Lab Laser, https://beautylablaser.com/ 57 to target women through several different fronts and completely reversed the industry from what it originally was. As a result, women were harmed from dangerous medical practices, underwent major out-of-pocket procedures they didn’t need, and created a generation of women who believed their universal fate of growing old was shameful and undesirable. In many cultures, it is a privilege to grow old and be able to reflect one’s years on their skin. In others, plastic surgery is expected of all women, even young girls. Obsession with cosmetic surgery is not unique to America, which is something worthy of additional research and study. This paper focused on women’s experience in America, which is an example of how a country ruined the magical gift of aging with its obsession for profit at the expense of its women. 58 BIBLIOGRAPHY Abrams, Maxine. “Cosmo's Update on Plastic Surgery.” Cosmopolitan, December, 1981, 212. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/cosmo s-update-on-plastic-surgery/docview/1826455760/se-2 “Plastic Surgery Statistics Report.” American Society of Plastic Surgeons. https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgerystatistics-full-report-2020.pdf Balleisen, Edward J. Navigating Failure. Luther Hartwell Hodges Series on Business, Society, and the State. Chapel Hill: University of North Carolina Press, 2001. Barre, Harriet and Weiner, Daniel L., “The Truth about Facelifts.” Ladies' Home Journal, June, 1981, 32. 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Parkes, ML. “Chin Implants with a Newer Plastic Compound.” Arch Otolaryngology, 1962;75(5):429–436. doi:10.1001/archotol.1962.00740040440010 Pignatelli, Luciana and Molli, Jeanne. “A ROYAL BEAUTY REVEALS: HOW SIMPLE SURGERY CAN REJUVENATE YOUR FACE.” Cosmopolitan, July, 1971, 38. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/royalbeauty-reveals-how-simple-surgery-can/docview/1816841205/se-2 Peiss, Kathy. Hope in a Jar: The Making of America’s Beauty Culture. New York: Metropolitan Books, 1998. Porter, Sylvia.“Q our Daughter Feels Her Nose is Too Big, so we're Planning to Give Her the ‘Nose Job’ She Wants.” Ladies' Home Journal, July, 1982, 144. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/q-ourdaughter-feels-her-nose-is-too-big-so-were/docview/1879238134/se-2 Rafaty, F. Mark, Goode, Richard L, Fee, Willard E. “The Brow-Lift Operation.” in Arch Otolaryngology, 1975;101(8):467–468. Ringel, EW. “The Morality of Cosmetic Surgery for Aging.” Arch Dermatol. 1998;134(4):427– 431. doi:10.1001/archderm.134.4.427 Santis, Mallen de. “HOW TO BE UPLIFTED ALL OVER.” Cosmopolitan, May, 1976, 226. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/howbe-uplifted-all-over/docview/1851624856/se-2 61 Scott, Eve. “Staying Well: Plain Facts about Plastic Surgery.” Seventeen, April, 1980, 34. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/stayin g-well-plain-facts-about-plastic-surgery/docview/1855835469/se-2 Smith Bate, Nancy. “WHO'S DOING IT.” Town & Country, May, 1974, 1. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/whosdoing/docview/2155688823/se-2 Smith, TW. “Thoughtful Nasal Tip Surgery.” Arch Otolaryngology, 1973;97(3):244–246. doi:10.1001/archotol.1973.00780010252003 “Why experts say Norway’s retouched photo law won’t help fight body image issues.” The Washington Post, Published July 8, 2021. https://www.washingtonpost.com/lifestyle/wellness/photo-edit-social-medianorway/2021/07/08/f30d59ca-df2c-11eb-ae31-6b7c5c34f0d6_story.html Webster, RC, Gaunt, JM, Hamdan, US, Fuleihan, NS, and Smith, RC. “Injectable Silicone for Facial Soft-Tissue Augmentation.” Arch Otolaryngology Head Neck Surg. 1986;112(3):290–296. doi:10.1001/archotol.1986.03780030054011 Wysor, Bettie. "NEW BEAUTY DIVIDENDS: COSMETIC SURGERY COSMETIC DENTISTRY." Town & Country, February, 1969, 68-69, 129, 131, 133-134. https://login.ezproxy.lib.utah.edu/login?url=https://www.proquest.com/magazines/newbeauty-div idends/docview/2137419333/se-2. 62 Name of Candidate: Brooklynn Segura Jensen Date of Submission: April 18, 2023