Making the body beautiful : a cultural history of aesthetic surgery

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Nose reconstructions have been common in India for centuries. South Korea, Brazil, and Israel have become international centers for procedures ranging from eyelid restructuring to buttock lifts and tummy tucks. Argentina has the highest rate of silicone implants in the world. Around the globe, aesthetic surgery has become a cultural and medical fixture. Sander Gilman seeks to explain why by presenting the first systematic world history and cultural theory of aesthetic surgery. Touching on subjects as diverse as getting a "nose job" as a sweet-sixteen birthday present and the removal of male breasts in seventh-century Alexandria, Gilman argues that aesthetic surgery has such universal appeal because it helps people to "pass," to be seen as a member of a group with which they want to or need to identify.

Gilman begins by addressing basic questions about the history of aesthetic surgery. What surgical procedures have been performed? Which are considered aesthetic and why? Who are the patients? What is the place of aesthetic surgery in modern culture? He then turns his attention to that focus of countless human anxieties: the nose. Gilman discusses how people have reshaped their noses to repair the ravages of war and disease (principally syphilis), to match prevailing ideas of beauty, and to avoid association with negative images of the "Jew," the "Irish," the "Oriental," or the "Black." He examines how we have used aesthetic surgery on almost every conceivable part of the body to try to pass as younger, stronger, thinner, and more erotic. Gilman also explores some of the extremes of surgery as personal transformation, discussing transgender surgery, adult circumcision and foreskin restoration, the enhancement of dueling scars, and even a performance artist who had herself altered to resemble the Mona Lisa.

The book draws on an extraordinary range of sources. Gilman is as comfortable discussing Nietzsche, Yeats, and Darwin as he is grisly medical details, Michael Jackson, and Barbra Streisand's decision to keep her own nose. The book contains dozens of arresting images of people before, during, and after surgery. This is a profound, provocative, and engaging study of how humans have sought to change their lives by transforming their bodies.

Reviews (6)

Publisher's Weekly Review

An intriguing inquiry into how aesthetic surgery has evolved into a major area of modern medicine, this book combines cultural perspectives on the body beautiful with a medical chronology. Gilman (Creating Beauty to Cure the Soul, etc.), who teaches human biology at the University of Chicago, focuses extensively on the nose as the original site of aesthetic procedures. He simultaneously explores "the basic motivation for aesthetic surgeryÄthe desire to `pass,'" starting with 16th-century surgery to rebuild the noses of syphilitics "so they would be less visible in their society"Äand its cultural implications. Early debate centered on whether surgery restored function or merely catered to human vanity. The "hierarchy of races" created by some scientists in the 18th century inspired procedures to create "American noses out of Irish pug noses," while "the origin of the `correction' of the black nose is masked within medical literature [because] no reputable surgeon wanted to be seen as facilitating crossing the color bar." Gilman discusses political uses of aesthetic surgery, such as that of the Nazis to achieve the Aryan ideal, the transformation of former Klan Grand Wizard David Duke into what one commentator called "a blond, blow-dried replica of a young Robert Redford," transsexual surgery to permit "restoration of the relationship between the inner and outer selves" and aesthetic surgery as a fountain of youth. His fast-paced narrative blends cultural criticism with discussion of medical techniques and ethics in a thoughtful study that should appeal to both a lay and professional readership. Photos not seen by PW. (May) (c) Copyright PWxyz, LLC. All rights reserved

Kirkus Review

From rebuilding syphilis-ravaged noses in the 1600s to the current rage for breast sculpting, this is an enlightening consideration of how aesthetic surgery arises from and is shaped by cultural concerns of the age. University of Chicago professor Gilman (The Jew's Body, not reviewed; Smart Jews: The Construction of the Image of Jewish Superior Intelligence, 1996) clearly differentiates aesthetic from other types of plastic surgery: reconstructive, for instance, restores function, while ``the name aesthetic surgery seems to be a label for those procedures which society at any given time sees as unnecessary, as non-medical, as a sign of vanity''. He identifies the roots of such procedures in the syphilis epidemic of the 15th century. The disease caused the nose to collapse in on the face, so the first nose re-sculptings were devised to repair the obvious marker and stigma of having syphilis. Gilman goes on to look at ``The Racial Nose'' (Jewish, Irish, Asian, and black): there was a notion of 18th and early 19th century anthropology that Jewish and black noses indicated a 'primitive' character. Similarly, he traces changes in the significance ofo the breast; at the turn of this century, large breasts were considered 'primitive,' small breasts were considered 'modern'; only after WWII, he notes, did breast augmentation surgery overtake breast reductions. Gilman also considers how the ideal profile has changed with the ages, and how the treatment of war injuries has influenced aesthetic surgery. Gilman is not trying for a comprehensive survey of the field'rather, he follows certain threads through history with the goal'fully accomplished'of awakening readers' interest. A scholarly, if quirky, look that serves as a history of our notions about the body and the significance of its parts.

Doody's Book Review

In this book the author chronologically and thematically traces the history of aesthetic surgery from the Renaissance to the new millennium. Aesthetic surgery is used as a lens through which to look at the contested and transgressive meanings associated with surgically induced bodily transformations. Central to the author's argument is the belief that the body can be (and is) read culturally. For the author, the body represents a site that continually acts on and is acted upon by culture; hence, the physical markers of a healthy body are in constant states of transformation. His objective is to locate the underlying racial and ethical subtexts that have shaped aesthetic surgery, and he succeeds with remarkable clarity and nuance. This is an important book to read for students who are interested in practicing aesthetic surgery. Practicing surgeons also will find the author's insights into the elective nature of aesthetic surgery as well as his sensitivity to the unique relationship between aesthetic surgeon and patient/client quite revealing. By choosing to have aesthetic surgery, for example, one both announces his or her autonomy while simultaneously abdicating it to the surgeon. Although medical professionals will certainly find the study useful, the author also wants to reach an audience of historians who are interested in the intersection between medicine, modernity, and world history. By showing the possibility of making comparisons between European and Indian medicine, he cogently argues that medicine can be a useful category of analysis in world history. The author's analysis of the ability of aesthetic surgery to allow one to "pass" -- to become (in)visible, seen but not seen -- is perhaps the most compelling aspect of the book. This desire can represent a challenge to authority in that aesthetic surgery allows one to cross seemingly impassable boundaries such as race and gender. Yet the author argues that the desire to change one's body represents the realization of an Enlightenment promise, made possible by modern medicine, that humans have the autonomous right to remake themselves in ways that they find fulfilling. Most impressive is the fact that, while the underlying methodology that holds the study together is incredibly sophisticated, the author maintains a lively prose that is elegant, subtle, and very readable. David Johnson(University of California Irvine). Copyright 2001, Doody Publishing

Booklist Review

Just what is the difference between aesthetic surgery and restorative surgery? Gilman explores many aspects of that question. He focuses on the nose as an object of surgery because it is the most visible element of the human body and has so many psychological, religious, and personal aspects. Can the surgical remodeling of the nose change a person's character? Should such an operation be performed if the surgeon believes the patient's vanity is the major motive? How does a particular patient at a particular time view his or her eyes, ears, breasts, and buttocks, or his penis? Gilman explores all these matters in terms of surgical possibilities, medical and political philosophies, and the individual's desires, both spoken and hidden. So doing, he produces a fascinating combination of text and illustration and of literary, medical, and scientific information. A thoughtful history by an author who knows his material well and has a sympathetic understanding of human beings as well as a lively sense of humor. --William Beatty

Choice Review

In Making the Body Beautiful, Gilman develops a theme found in his recently published Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery (CH, May'99): that aesthetic surgery comes from and simultaneously serves medical, psychological, and cultural needs, which are commonly expressed as the need individuals feel to "pass" in a culture from which they also feel alienated. As far back as the late Renaissance, for example, the desire to improve a scarred nose--either from warfare or congenital syphilis--spurred the development of cosmetic or aesthetic surgery. In the late 19th and throughout the 20th century, racial assimilation, the amelioration of sexual dysmorphia, or the restoration of youthfulness have been among the goals of such surgery. Gilman's research is thorough, his analysis thoughtful, and the presentation thought-provoking. Also, his gift for seeing connections amid diverse cultural and political strains makes his work much more than simply an antiquarian medical history of the topic, i.e., problems and procedures. Ample illustrations; extensive bibliography. General readers; upper-division undergraduates through professionals. T. P. Gariepy; Stonehill College

Library Journal Review

Gilman, a distinguished professor of human biology at the University of Chicago, has drawn on a rich variety of sourcessurgical texts as well as literature, art, and filmto trace the history and the cultural meaning of aesthetic surgery. His story begins with the Renaissance, when the focus on the human ability to transform the self and the world created the distinction between reconstructive and aesthetic surgery. In addition to undoing the ravages of disease, Gilman identifies other motives for aesthetic surgery: matching cultural ideals of beauty, repairing the impact of war-related injuries, and appearing youthful or erotic. Most disturbing are Gilmans wide-ranging examples of how aesthetic surgery has been used to correct signs of racial difference. Gilman brings his story to the present, discussing liposuction, breast enlargement and reduction, and transsexual surgery. He also gives examples from non-Western regions, reflecting the globalization of European American standards of beauty. A fascinating and provocative book that should appeal to scholars and informed general readers alike. Highly recommended.Marie Marmo Mullaney, Caldwell Coll., NJ (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

List of Illustrations	p. ix
Preface	p. xvii
Chapter 1 Judging by Appearances	p. 3
What Is Aesthetic Surgery?	p. 3
Why Is It Aesthetic Surgery?	p. 8
Remaking the Self	p. 16
"Passing"	p. 21
Criminal Bodies	p. 26
Gender Questions	p. 31
"Before and After"	p. 36
Chapter 2 Victory over Disease	p. 42
Amy and the Princess	p. 42
The Syphilitic Nose	p. 49
The Strange Case of Tristram Shandy	p. 60
Renaissance Noses	p. 66
A Cure from the Colonies	p. 73
Chapter 3 The Racial Nose	p. 85
Enlightenment Noses	p. 85
The Jewish Nose	p. 88
Irish Noses	p. 91
"Oriental" Noses-and Eyes	p. 98
Black into White ill
Chapter 4 Marks of Honor and Dishonor	p. 119
Character Inscribed on the Face	p. 119
Too-Jewish Ears and Noses	p. 124
The Telltale Foreskin	p. 137
Greek Ideals	p. 144
Chapter 5 Noses at War	p. 157
Fixing Shattered Faces	p. 157
Patriotic Noses and Weimar Surgery	p. 169
Nazi Noses	p. 177
Chapter 6 Assimilation in the Promised Lands	p. 186
Helping Jews Become Americans	p. 186
The Israeli Experience	p. 199
The Importance of Being Barbra	p. 202
Chapter 7 After the Nose	p. 206
Erotic Bodies	p. 206
Buttocks Have Meaning	p. 210
Big Breasts and Bellies	p. 218
Small Breasts--No Breasts?	p. 237
Chapter 8 The Wrong Body	p. 258
Men with Breasts	p. 258
Transsexual Surgery	p. 268
The First Cut Is the Deepest	p. 288
Chapter 9 Dreams of Youth and Beauty	p. 295
Beauty and Age	p. 295
Post-Aesthetic Bodies	p. 319
Conclusion: "Passing" as Human	p. 329
Notes	p. 335
Index	p. 385

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