Body modification of one sort or another has always been practiced new technologies have opened up the possibility for radical change. This has meant that we can now change fundamental aspects of our bodies most obviously our biological sex, but also racial characteristics, signs of ageing and apparent physical imperfections.

Basically will be looking at what it means to want to radically alter the body to believe indeed that we have the 'wrong body'


CASE STUDY: NIP TUCK

Throughout the dissertation will be exploring the meanings acquired bythe body in modern, western societies. In doing so the dissertationwill examine the ways in which bodies are shaped, acted upon,represented and experienced.

Therefore explore various ways in which the body has been seen as anobject (the body we have), as a subject (the body we are) and as aproject (the body that we become) and will explore how these processesare intimately linked to regimes of power and knowledge.

For example, recent years have seen the increased prominence andsignificance of various 'body projects' - health and fitness, dieting,cosmetic surgery and body modification- along side a number ofcontemporary 'problems' associated with the body - new reproductivetechnologies, genetic engineering, cybernetics, etc.

As these examples show, the body in contemporary culture has become amalleable object crucial for the articulation of identities of 'race' ,gender, and sub cultural affiliation.

This dissertation will critically examine some of these contemporarytrends whilst simultaneously focusing on their social and historicalcontexts in order to give us a broader understanding of their meaningsand implications.


I. Introduction

Body modification has been practiced in a number of ways and for avariety of reasons since ancient times; it has existed on some levelfor thousands of years. Historical evidence suggests that red dyeextracted from hematite was used to paint the body as many as 20,000years ago. Archeological evidence proves that as many as 10,000 yearsago, parts of animal bones, animal teeth, and colorful stones were usedto decorate the body. Hair combs date back to nearly 5,000 years ago.Water served ancient peoples as mirrors until 4,500, when the firstmirror is believed to have been invented (Ehsan, 1999, 49-52).

Society has progressed since those early days. One need only turn onthe television or leaf through a magazine to be bombarded with allkinds of advertisements for body modification. Chemical treatments canstraighten hair and change skin tone and texture. Surgical procedurescan decrease or (more often) augment breast size. Penile implants claimto enhance sexual performance. Unwanted fat can be removed in anynumber ways, ranging from dietary changes to liposuction. Some signs ofageing can be temporarily reversed with injections of Botox; others canbe permanently altered, again through surgery.

Today in the western world, body modification is widely practiced inall classes of society. Often it is the result of societal pressure toachieve perfection. At times it is a ritual or rite of initiationwithin a group or social hierarchy. Less often, although this issteadily increasing, the body is modified to change its gender; this isdone through surgical procedures supplemented by hormonal and similarsupplementary treatments.

Women are considered the most frequent targets of this pressure toachieve somatic perfection, and therefore they are the most frequentpractitioners of body modification. However, this pressure affects menas well. This paper will examine four specific types of bodymodification: tattooing and scarification; piercing; diet and exercise;and aesthetic surgery.

Although these are by no means the only methods of body modification,they are among the most widespread and they cover a wide spectrum.Still, whether it takes the form of a minor dietary modification or anextreme makeover, it is clear that most individuals in the westernworld practice some sort of body modification. For this reason, it is apractice which merits close study and consideration. How far will someindividuals go in this pursuit for perfection? How much of this willsociety sanction? What are the implications for our future and that offuture generations? These are the questions to be explored throughoutthe course of this research.


Tattoos and Scarification

The word “tattoo” is derived from a Tahitian word meaning “to mark.”The act of tattooing is believed to be over ten thousand years old, andit has had a variety of uses throughout history. Tattoos have played animportant role in various tribal and cultural rituals. For example,ancient Greeks used them as part of a sophisticated espionage system.Romans used tattoos to clearly mark criminals and slaves. In Borneo,women would have symbols of special skills or talents tattooed on theirforearms, thus alerting potential marriage partners of theirmarketability.

Although tattooing has flourished consistently in many cultures, itspopularity in western civilization has fluctuated widely. After waningfor several centuries, it was reintroduced in the late seventeenthcentury, but it was not until the late eighteenth century that it onceagain became widespread, Even so, it often had negative associationsand tattooed individuals were mostly relegated to the fringes ofsociety, such as freak show oddities and carnival workers.

In the 20th century, the art of tattooing waxed and waned as societyrapidly changed with the proliferation of new and better technologies.By the late sixties it was still primarily an underground operation,often the provenance of biker groups and criminals. From the latetwentieth century until today, however, tattooing has enjoyed renewedpopularity as body decoration, and is seen in a much more positivelight, often as an art itself. In addition to the more traditional inktattoos, there are those caused by puncturing and/or burning the skin.In this process, known as scarification, scalpels or cauterizing toolsare applied to selected areas of the skin, and the resulting scartissue is the desired result.

Better technology has improved technique and ease of application forall kinds of tattooing; in addition, more sanitary conditions havelessened the risk of diseases such as hepatitis. These two points haveno doubt contributed to the revival and renewed respect for thepractice of tattooing. However, as it will be discussed, changes inattitudes toward the body have also played a part in its reawakenedpopularity.

Body piercing also has a long and varied history, dating back toancient times. There are mentions of body piercing in the Bible. Inaddition, it was a frequent practice of ancient Romans. Roman warriorsoften pierced their nipples, considering this to be a sign of strengthand masculinity; it was also a practical measure, a way of attachingcloaks to the body.

 Roman gladiators, who usually held the status of slaves, alsounderwent body-piercing, though as slaves they had little choice. Oftengladiators would be subjected to genital piercing, primarily throughthe head of the penis. This was partially a protective measure,allowing the ringed penile tip to be tied close to the body duringbattle, protecting it from injury. But it was also a territorialmeasure, since they were considered property of their owners. Placementof a larger ring through the penile tip could also prevent sex, makingit essentially a male chastity belt, to be removed at the discretion ofthe gladiator’s owner.

Aztec and Mayan Indians were known to have pierced their lips as partof religious ritual, believing this brought them closer to their god.They also pierced the septum, believing this gave them a fierce,intimidating appearance during battle. Aztecs and Mayans were also fondof lip labrets, which were often made of precious metals and servedhighly decorative purposes.

During medieval times the art of body piercing lost favor, regainingpopularity during the Renaissance period. It enjoyed unprecedentedpopularity during the Victorian Era, due to the sexual pleasures it wasknown to enhance.

Until recently, body-piercing, like tattooing, was primarily associatedwith fringe groups in western society. However, today it no longerexists solely in the realm of punk rock and fetish scenes. Nose-,nipple-, and navel- piercing is now common in contemporary westernsociety, alongside the more traditional pierced ears and the lessvisible genital piercings.

Diet and exercise—often used together—are another form of bodymodification. The diet industry is huge in western countries. Appetitesuppressants, both prescription and over-the-counter types, areextremely popular. Fad diets such as the South Beach Diet or the AtkinsProgram attract and retain large numbers of followers. Health clubs andgyms are another large part of this industry, selling memberships whichpromise buyers a new way of life and a fit—and thin—future. To membersof a society who desire this more than anything else, it is not a hardsell.

 Excessive dieting can lead to life-threatening eating disorders. Theprimary disorders are anorexia nervosa and bulimia, and they primarilyafflict women, mostly in their teens and twenties. Although “anorexia”itself literally means “loss of appetite,” this disease often has moreto do with a denial of appetite rather than loss of desire for food.

Its sufferers will go for extended periods of time without eating, orwill eat just the barest amounts of food, in an effort to become and/orremain thin. The most tragic aspect of anorexia is that often thesufferer loses a sense of her own body, refusing to acknowledge thatshe has gone way beyond “thin”—anorexics are often emaciated.

Bulimia is a disorder which is characterized by ingestions of largeamounts of food—binging—followed by a period of purging, to rid thebody of the unwanted calories. Purging may be achieved by vomiting,either self-induced or through chemicals such as syrup of Ipecac.Excessive laxative use is also associated with this disorder. Oftenbulimics will have a low-to-normal body weight as compared toanorexics, but sufferers of both disorders face similar health problemsdue to electrolyte imbalance, nutritional deficiencies, and relatedcomplications.

Susan Bordo sees eating disorders as complex, multi-layered disordersin which the sufferer sees her body as alien, as a threat to control,as an enemy. She also sees it as a gender/power issue and a protestagainst the confines of femininity.

 Exercise, on the other hand, can be seen as a way of activelyasserting control instead of passively denying oneself. It can beargued that exercise is taken by some for the sake of exercise, butthere is no doubt that it is also an activity that is undertaken tocombat corporeal excesses and to exert control over the body.

Some forms of exercise—for example, body-building and weight-lifting,can also be a form of exerting control without the concomitantexistence of an eating disorder, and are more commonly undertaken bymen, though women are involved in this as well.

Surgical modification can be called many names, among them: plasticsurgery; reconstructive surgery; or, as Sander Gilman prefers to referto it: aesthetic surgery. Indeed, this type of surgery includes a widevariety of procedures, from surgically correcting a birth deform suchas a cleft palate, to disfigurements due to accident or injury...orfrom a subtle removal of “crows’ lines” or other signs of age, to moredramatic adjustments to a too-large nose or an unacceptably sharp chin.The most extreme result of this type of surgery involves gendermodification.

Surgical body modification is different from most other forms in thatit generally implies a level of secrecy that the others do not. Theprocedure and the recuperation period that follows both take placebehind closed doors, sometimes even in foreign lands. Furthermore, thereappearance of the individual after the procedure is not accompaniedby any sort of fanfare; there is an implicit assumption that theindividual has always appeared thus, or if the change is dramatic, thatit is not to be spoken of.

Discussions of surgical body modification in this paper will focusprimarily on elective surgery undertaken for purely cosmetic purposes,so that it may be explored and assessed as part of the larger societaltrend towards achievement of physical perfection at any cost.

Sander Gilman’s comprehensive body of research is well worth exploring,particularly two of his books: Creating Beauty to Cure the Soul: Raceand Psychology in the Shaping of Aesthetic Surgery, and Making the BodyBeautiful: A Cultural History of Aesthetic Surgery. His works provide abroad and thorough base for any study of body modification, though hisprimary focus is on surgical enhancements.

Yet while Gilman thoroughly addresses the subject of aesthetic surgery,the focus is on the surgery itself, as well as upon the need for it andwhat that need signifies. Discussion of the body itself is limited inGilman’s work; it is seen only in terms of its potential for surgicalalteration. In addition, other types of body modification—such aspiercing, tattoos, weight-loss regimens, exercise—are only brieflycovered in his work. While he speculates on the significance ofaesthetic surgery thoughtfully and articulately, his ideas do not gobeyond surgical issues (though, to be fair, they do not pretend to; heis very clear about the scope and limitations of his research).

For broader looks at the concept of the body and the various modes ofmodification now prevalent in society, we can turn to otherresearchers. Much of the current literature seeks to approach theconcept of the body from a different angle, focusing on the bodyitself. Interestingly enough, many of these researchers findsignificance in the fact that focus on the body seems to be missing inmuch of the earlier literature, or, if not missing, submerged.

Bryan Turner begins his book The Body and Society by immediatelyintroducing the duality of the body, opening with what is at once aseemingly simple yet very complex statement: “There is an obvious andprominent fact about human beings: they have bodies and they are bodies(Turner 1996, 37). He goes on to point out that despite this veryobvious fact, there is a seeming lack of information about the body insociology; he explains that beyond a wealth of historical andmathematical data, there is really no actual investigation of the bodyin and of itself—or, rather, that this information is there, but deeplyencoded: “in writing about sociology’s neglect of the body, it may bemore exact to refer to this negligence as submergence rather thanabsence, since the body in sociological theory has had a furtive,secret history rather than no history at all (Turner 1996, 63).

Joanne Entwistle cites Turner several times in her own work, though herperspective is clearly focused on the significance of clothing andfashion. In “The Dressed Body,” she addresses, as the title of heressay suggests, the symbolic meaning of clothing. She points out thatthere is an abundance of straightforward description concerning theparticulars of style: colors, hemlines, cut, accessories—but thisrarely goes beyond details of style. There is very little literaturethat looks at the very subtle and complex relationship between the bodyand clothing. Since social norms demand that bodies must (almost)always be dressed, she finds this lack telling: “dress is fundamentalto micro social order and the exposure of naked flesh is, potentiallyat least, disruptive of social order” (Entwistle 2001, 33-34).

In fact, Entwistle, like many of her contemporaries, views the body asan entity in and of itself, asserting that “we experience our bodies asseparate from others and increasingly we identify with our bodies ascontainers of our identities and places of personal expression.(Entwistle 2000, 138).

Chris Shilling echoes both Turner and Entwistle about the seeming lackof focus on the body itself. However, Shilling points out that this isnow changing, and that academic interest in the body itself is steadilygrowing: “the sociology of the body has emerged as a distinct area ofstudy, and it has even been suggested that the body should serve as anorganizing principle for sociology (Shilling 1993, 1).

As for what has brought about this new and much-needed shift inperspective, Shilling and others agree that it seems based on conflict.It is perhaps Shilling who best describes the paradox at the core ofthis change: “We now have the means to exert an unprecedented degree ofcontrol over bodies, yet we are also living in an age which has throwninto radical doubt our knowledge of what bodies are and how we shouldcontrol them (Shilling 1993, 3). This paradox is a recurring theme inthe literature, both in the writings about the body as well as themultitudinous passages about the various procedures to which it issubjected to in today’s world.

There is, however, a general consensus that surgery is the mostdramatic form of body modification—in particular, cosmetic surgery(Gilman consistently refers to it as “aesthetic surgery,” which seems amuch softer and much more positive term). Cosmetic surgery for most ofthese researchers includes any kind of surgical enhancement that isperformed solely for aesthetic ends, although the definition of“aesthetic” can vary widely.

Other types of surgeries are considered as well, including thoseinvolving gender modification. However, most of the literature studiedfor this paper has tended to focus on the more mainstream applicationsof aesthetic surgery. Transsexual operations, and the many issuestherein, are acknowledged by virtually all researchers, but they arenot explored in any depth in the sources considered for this paper.Considering the many procedural and ethical issues involved intransgender procedures, this is not surprising. It is a rapidlychanging surgical sub-specialty, and one with wide-ranging sociologicaland psychological issues, none of which can be adequately dealt with ina footnote to a more general piece of research.

Indeed, the body seems to have become a thing separate from the self, acontinual work-in-progress with a growing number of options and“enhancements” to choose from. The theme of body-as-object is echoedthroughout the current sociological literature and in other disciplinesas well. Speaking of the body as art, Lea Vergine posits that

The body is being used as an art language by an ever greater number ofcontemporary painters and sculptors....It always involves, for examplea loss of personal identity, a refusal to allow the sense of reality toinvade and control the sphere of the emotions, and a romantic rebellionagainst dependence upon both people and things (Vergine 2000, 1).

Entwistle explores the relationship between the body and societalpressures, asserting that there are “two bodies: the physical body andthe social body” (2001, 37). To understand the role of dress, shefurther notes, “requires adopting an approach which acknowledges thebody as a social entity and dress as the outcome of both social factorsand individual actions” (2001, 48).

Entwistle explains that in contemporary culture, the body has becomethe “site of identity”: “We experience our bodies as separate fromothers and increasingly we identify with our bodies as containers ofour identities and places of personal expression” (Entwistle 2000,138). However, when we consider that society pressures us to achieve asingle, consistent ideal of perfection, it seems a contradiction toaccept the concept of body as a vehicle for personal expression. Whatpersonal expression is there in sameness?

Vergine reconciles this seeming contradiction by perceiving the body as a vehicle for art and language:

The use of the body as a language has returned to the scene of theworld around us in new and different forms, and it speaks throughaltered declinations....By way of tattoos, piercings, and citations oftribalism. Through manipulations of its organs. The instrument thatspeaks and communicates without the word, or sounds, or drawings. Thebody as a vehicle, once again, for declaring opposition to the dominantculture, but also of desperate conformism. (Vergine 2001, 289).

Shilling explores the concept of the body as machine, particularly inthe world of sports: “The ‘body as machine’ is not merely a medicalimage, however; one of the areas in which the body is most commonlyperceived and treated in this way is in the sphere of sport” (Shilling1993, 37). He explains that the vocabulary used in the field of sportsserves to depersonalize the body, to transform it into an object whosesole purpose is optimum performance: “the body has come to be seen ‘asa means to an end...a factor of output and production…as a machine withthe job of producing the maximum work and energy’ (Shilling 1993, 37).

Turner also addresses the concept of body mutilation as an attempt toassert control in a chaotic world, relating it back to Christianity. Hedescribes the body as “a genuine object of a sociology of knowledge.”(Turner 1996, 64). He explains that the Western world customarilytreats the body as “the seat of unreason, passion and desire,” and goeson to discuss the battle of the flesh with the spirit: “flesh was thesymbol of moral corruption which threatened the order of the world: theflesh had to be subdued by disciplines, especially by the regimen ofdiet and abstinence” (Turner 1996, 64).

The concept of chaos is another recurrent theme in recent discourse onbody modification. Entwistle sees fashion as one way in whichindividuals attempt to assert control over the ever-increasing chaos oftoday’s world” “If nakedness is unruly and disruptive, this would seemto indicate that dress is a fundamental aspect of micro social order”she asserts (2001, 35).

This is echoed by Armando Favazza in Bodies Under Siege:Self-mutilation and Body Modification in Culture and Psychiatry. “Chaosis the greatest threat to the stability of the universe,” he writes(1996, 231). He goes on to explain how we need social stability toco-exist, that it gives us the framework for appropriate sexualbehavior, the ability to recognize and negotiate among various socialhierarchies, and the tools necessary to successfully make thetransition from childhood into mature adulthood. “The alteration ordestruction of body tissue” asserts Favazza, “helps to establishcontrol of things and to preserve the social order” (1996, 231).

Favazza sees self-mutilation as an attempt on the part of theself-mutilator to control the chaotic world around him or her. He alsopoints out that self-mutilation is often culturally sanctioned. Whetheror not a practice falls under the category of “mutilation,” accordingto Favazza, depends on whether or not there is a change to oreradication of body tissue. Clearly tattooing, scarification,body-piercing and surgery meet this criterion.

This focus on the body is particularly significant, as Shilling pointsout, questioning why, “at a time when our health is threatenedincreasingly by global dangers, we are exhorted ever more to takeindividual responsibility for our bodies by engaging in strictself-care regimes” (Shilling 1993, 5). As he and other researcherspoint out, our inability to control outer chaos seems to have resultedin our focusing on our bodies as disparate parts of our selves and ofour universe: this is one small way we can assert control, or at leastfeel as though we are.

Surgical modification can be called many names, among them: plasticsurgery; reconstructive surgery; or, as Sander Gilman prefers to referto it: aesthetic surgery. Indeed, this type of surgery includes a widevariety of procedures, from surgically correcting a birth deform suchas a cleft palate, to disfigurements due to accident or injury...orfrom a subtle removal of “crows’ lines” or other signs of age, to moredramatic adjustments to a too-large nose or an unacceptably sharp chin.The most extreme result of this type of surgery involves gendermodification.

One point that should be reiterated here is that surgical bodymodification is unique. It is different from most other forms in thatit generally implies a level of secrecy that the others do not. Boththe procedure and the recuperation period that follows both take placebehind closed doors, sometimes even in foreign lands. Furthermore, thereappearance of the individual after the procedure is not accompaniedby any sort of fanfare; there is an implicit assumption that theindividual has always appeared thus, or if the change is dramatic, thatit is not to be spoken of.

Sander Gilman offers the most comprehensive history of aestheticsurgery, along with a broad and varied perspective. In his booksCreating Beauty to Cure the Soul: Race and Psychology in the Shaping ofAesthetic Surgery, and Making the Body Beautiful: A Cultural History ofAesthetic Surgery, he addresses the complex reasons behind the growthof aesthetic surgery, and explores its significance and complexity. Inthe first volume, he clearly focuses on it primarily as a form ofpsychotherapy. The second work is rich in historical detail andthoroughly traces the development of aesthetic surgery from itsearliest days to modern times.

Gilman follows the development of aesthetic surgery over the course ofthe nineteenth century, and notes that during this time “the idea thatone: could cure the illness of the character or of the psyche throughthe altering of the body is introduced within specific ideas of what isbeautiful or ugly (1998, 7).

He also asserts that the lessening of the stigma of mental illness isdirectly related to the fact that in today’s society, the view ofaesthetic surgery as a type of psychotherapy is gradually becomingaccepted. According to Gilman, “psychotherapy and aesthetic surgery areclosely intertwined in terms of their explanatory models” (1998, 11).

He explains that the lessening of the stigma of mental illness hasresulted in healthier attitudes towards psychotherapeutic interventionas well as a growing acceptance of aesthetic surgery, and he discussesthe issue from a variety of viewpoints: the patient, the physician,society at large. Addressing the concept that “happiness” is theprimary motivation that spurs individuals to pursue this avenue ofchange, he is careful to study the various definitions people offer for“happiness” and discusses these within the larger societal context.“Aesthetic surgeons operate on the body to heal the psyche,” assertsGilman. “Being unhappy is identified in Western culture with beingsick. In our estimation only the physician can truly ‘cure’ our spiritsand our souls’ “(1998, 25).

According to Gilman, it was during the Enlightenment that the conceptof happiness ceased to be one of a collective morality. During thisperiod, he writes, “the hygiene of the body became the hygiene of thespirit and that of the state” (1999, 21).

Today, he asserts, the “pursuit of happiness” is no longer a collectivegoal but an individual desire” (1998, 27). This equating of unhappinesswith pain is a concept that began to be formulated in the second halfof the nineteenth century, and is closely tied to social and culturalattitudes toward the body and the blurring of the distinction between“somatic and mental pain,” as he phrases it.

Indeed, it is remarkable how often aesthetic surgeons cite “happiness”as the goal of the surgery. “Happiness” for aesthetic surgeons is autilitarian notion of happiness, like that espoused by John StuartMill, who placed the idea of happiness within the definition ofindividual autonomy... Happiness, the central goal of aestheticsurgery, is defined in terms of the autonomy of the individual totransform him- or herself (Gilman 1999, 18).

In Making the Body Beautiful: A Cultural History of Aesthetic Surgery,he states that “body imagery follows the lines of political andcultural power,” and he offers a clear, in-depth history of aestheticsurgery in the western world, carefully noting its connection tosocial, political and technological changes (Gilman 1999, 105).

He also carefully traces the history of aesthetic surgery, explainingits strong affiliation with syphilis. Apparently, one of the results ofa syphilitic infection was damage to the nose, and that attempts tosurgically reconstruct the nose were therefore strongly andinextricably tied to venereal disease and the concomitant loosemorality. The association made between nose surgery and syphilis was sodeeply ingrained that it continued to taint aesthetic nose surgery formany years: “The rise of aesthetic surgery at the end of the sixteenthcentury is rooted in the appearance of epidemic syphilis. Syphilis wasa highly stigmatizing disease from its initial appearance at the closeof the fifteenth century” (Gilman 1999, 10).

Gilman also discusses the impact of important historical events on thedevelopment of surgery in general and on reconstructive surgery inparticular; he describes the effect of the American and FrenchRevolution and the American Civil War on body image and on the role ofaesthetic surgery in restructuring it. Significant changes in aestheticsurgery took place following the upheaval that resulted from thesepolitical revolutions. In a society thus destabilized after years ofrepression, radical changes in thinking occurred, including changingconcepts of the body: “It is not that the reconstructed body wasinvented at the end of the nineteenth century,” explains Gilman, “butrather that questions about the ability of the individual to betransformed, which had been articulated as social or political in thecontext of the state, came to be defined as biological and medical”(1999, 19).

Later developments, such as globalization, have had a huge impact onaesthetic surgery. For reasons of privacy, availability, and/or cost,many people will travel to foreign surgery sites. Since they oftenspend considerable amounts of time in these locations, they often endup bolstering the economy as tourists, hence spurring an entirely newand thriving industry of medical tourism. Gilman describes medicaltourism as a thriving business due to the widespread and increasingpopularity of elective aesthetic surgery.

“You can become someone new and better by altering the body,” Gilmantells us as he plunges into a lengthy examination of the role bodymodification has played in society. He begins by discussing theassimilation of foreigners into society, and the steps to which peoplewill go to achieve the goal of “fitting in” or “passing” for somethingthey are not: “the transformation of the individual, such as theimmigrant, into a healthy member of the new polis” (Gilman 1999, 20).

According to Gilman, happiness may be sought through aesthetic surgerybecause it offers individuals the opportunity to redefine themselves.Categories of inclusion and exclusion, whether tacit or broadlydelineated, impact strongly on societal hierarchies. “Happiness in thisinstance exists in crossing the boundary separating one category fromanother,” explains Gilman. “It is rooted in the necessary creation ofarbitrary demarcations between the perceived reality of the self andthe ideal category into which one desires to move” (Gilman 1999, 22).

The categories are defined so that there is no question about whichcategory is most beneficial. Of course, the advantages of eachconstructed category are subject to change as society changes. Theideal is to be to move from the negative category to the positivecategory; the “catch” is that categories are subject to frequentchange.

Gilman and other researchers refer to “the discourse of ‘passing.’”This discourse came into existence during the racially chargednineteenth century, and is, according to Gilman, “the very wellspringof aesthetic surgery.”

Citing the research of sociologist Max Weber, Gilman discusses theconcept of validity and acceptance, which are only gained when one isrecognized and accepted by the prevailing social group: “validitythrough group consensus.” In this light, Gilman posits, we can see“passing” as a type of “silent validation” (Gilman 1999, 26).

In Customizing the Body: The Art and Culture of Tattooing, ClintonSanders writes that “in western societies body sculpting to attainbeauty or to avoid identification with disvalued groups is a commonpractice” (Sanders 1989, 7). He then goes on to describe the many waysin which people try to merge into the desired social group. Kinky hairis chemically straightened, while “ethnic” noses are permanentlyreshaped through plastic surgery. Less invasive procedures are dietarychanges and exercise routines, which will reduce or increase bodymeasurements in keeping with the style of the time.

Richard Dyer echoes and expands on this in White. He discusses the useof skin lighteners on black skin, pointing out that “a black person whouses lighteners does not succeed in passing him or herself off as amember of another race” (Dyer 1997, 50). He compares this to tanning,which is the reverse, but points out that the two are very different.The aim of chemical lighteners by blacks is to “pass” themselves off asmembers of a different race, or of a different hierarchy within theirgiven race. This is a much different goal and not one which is soughtthrough tanning.

Dyer also points out that the ultimate goal of the process oflightening the skin is, as noted earlier, to “pass,” and that there isno greater ridicule than when this fails: “the failure to achieve thisaim is a source of ridicule...” He also discusses the pop icon MichaelJackson, whose changing skin tone has given rise to rumors over theyears. Notes Dyer: “Few things have delighted the white press as muchas the disfigurement of Michael Jackson’s face through what have beensupposed to be his attempts to become white (Dyer 1997, 50). “In theUnited States, there was an explosion of hair straightening and skinlightening among African Americans at the beginning of the twentiethcentury,” Gilman adds (1999, 111).

Gilman, Dyer and others spend a great deal of time discussing the nose.No other body organ seems to have caused so much anguish nor receivedso much attention throughout the course of the development of aestheticsurgery. Its initial and unfortunate association with syphilis accordedthis organ a significant amount of power as a social marker, much ofwhich was unmerited.

Gilman explains that “the difference of the too-short nose is a racialdifference and racial differences” in the nineteenth century were seenas “signs of character” (Gilman 1999, 85). Furthermore, he explainsthat in the eighteenth and nineteenth centuries the noses of. “theblack and the Jew” were thought to be “signs of their ‘primitive’nature.” He relates this back to syphilis: “this was primarily becausethe too-flat nose came to be associated with the inherited syphiliticnose” (Gilman 1999, 85).

In the late nineteenth century there arose the new problem of the “pug”nose, which was associated with Irish ethnicity rather than withsyphilis. Thus aesthetic surgery began to evolve into a way to “createnew Americans out of the noses of Irish immigrants” (Gilman 1999, 91).“Their new noses did not mask the sexual sins of their parents,”explains Gilman, “but the fact that their parents came from elsewhere,in the case of the pug nose, from lreland” (Gilman 1999, 91).

When political and cultural climates change, body imagery is soon tofollow. This was clearly seen in Vietnam. After American troops leftthe country, notes Gilman

a detailed physiognomic study determined the relative facial dimensionsof the Vietnamese so as to provide an adequate, non-Westernizing modelfor the relationship among the features, including the form and shapeof the eyes, for aesthetic surgeons. This was clearly in response tothe explosion in aesthetic surgery, which remade the faces and breastsof the women of Vietnam into ‘Western’ faces and bodies (Gilman 1999,105).

In a similar vein, Asian-American women came to thought as having a“‘blank’ look that is equated in American society with ‘dullness,passivity, and lack of emotion.’” To remedy this, explains Gilman,aesthetic surgery again came into play. Asian-American women began tohave their eyelids restructured to match more accepted Caucasianfeatures. They also had their noses restructured, specifically byhaving the bridges heightened and the tips made less prominent.“Whether black, Irish, or Asian, the nose that is too small or too flathas been altered by the aesthetic surgeon because of its “otherness” inrelation to Western ideals, writes Gilman (1999, 117).

The anxiety associated with the Jewish nose began to be matched at thebeginning of the twentieth century by yet another anxiety about thepenis. “The nose and its surgical repair seemed a natural analogy tomyths about Jewish sexuality, which haunted the medical literature ofEurope. Jewish sexuality, as represented by the practice of infant malecircumcision, became the touchstone for the belief that Jewish socialpractices were the cause of the biological differences of the Jew.(Gilman 199, 137).

Today in the U.S. and other western nations, body modification iswidely practiced in all classes of society. Often body modification isthe result of societal pressure for perfection.

It can be seen, however, that the precise social significance of thebody has definitely begun to shift. Shilling notes that in the past,the body was defined by national government, but that recentlywomen—and men—have begun to “reclaim” their bodies, and to assess theirself-identities in new and different ways (Shilling 1993, 30). Alongwith this, however, there is the development of a new technology, onewhich offers a range of surgical enhancements that have until now beenthe stuff of science fiction. Thus arises the paradox: we can remoldand redesign our bodies, can surgically manipulate them into anythingwe want them to be—however, we are not quite sure what it is we wantthem to be.

In addition to the confusion of our own self-identity issues, there aresocial and demographic changes in western society which cannot beignored. The elderly population is now larger than ever before: thereare more of us, and we are living longer. The needs of the elderly willno doubt impact societal attitudes and affect the way we look atourselves as humans and as individuals.

Methods of categorization have been shifting as we seek to redefine sexand gender, nature and culture, biology and society. Boundaries havebegun to blend and merge, and resulting confusion is even moreproblematic. Change is both constant and rapid, welcomed and feared.The need to exert control over our bodies seems stronger than ever, yetit is accompanied by a crisis in their meaning.

Additional considerations are advances in such areas as transplantsurgery. These exacerbate our uncertainty about the body by threateningcollapse the boundaries upon which we have come to rely. The line whichseparates body from technology has begun to shift, leading to issues oflegal and political importance. “The idea that the body is the locationof anti-social desire is thus not a physiological fact but a culturalconstruct which has significant political implications” (Turner 1996,65).

It has also been suggested that this excessive dependence on reality,coupled with the obsessive need to control our bodies, is one way inwhich we respond to a chaotic world. Huge global issues menace ourfutures, and we react to this by looking inward, but in the mostsuperficial of ways.

The concept of chaos is another recurrent theme in recent discourse onbody modification. We have seen that fashion is one way in whichindividuals attempt to assert control over the ever-increasing chaos oftoday’s world. As Entwistle posits, “if nakedness is unruly anddisruptive, this would seem to indicate that dress is a fundamentalaspect of micro social order (Entwistle 2001

Symmetry, too, became a consideration, as seen by the growth of dentalaesthetics during this period. Even, symmetrical teeth became thestandard form, and to display a perfect smile was a strong socialasset. “No greater marker for happiness can be found in Western culturethan the smile (Gilman 1999, 153).

With the passage of time, the demands placed on aesthetic surgery grewand became more complex: it was no longer enough just to “pass.” Whatmattered now was to “pass” into that particular group of society thatwas tacitly understand to be erotically desirable. It seems that aboutthis time there was much conjecture about the shape and size of thefemale body. Take, for example, the buttocks:

The buttocks have ever-changing symbolic value. They are associatedwith the organs of reproduction, with the aperture of excretion, aswell as with the mechanism of locomotion through discussions of gait.They never represent themselves (Gilman 1999, 215).

Various “ethnographic studies” were undertaken of the femalebody—primarily by men, of course. One of these ethnographers wasHermann Heinrich Ploss, whose extensive writing on the female anatomygets quite detailed. He and others wrote pages and pages about thesubtleties of breast shape and size, categorizing them according torace, ethnicity, and of course, the prevailing erotic standards of thetime. One authority on the subject described the breasts of “white” and“yellow” races as virginally compact, while those of the “black” racewere thought to resemble a “goat’s udder” (Gilman 1999). Even themeasurements of the areola are described as having been determined byrace.

It is no surprise, then, to learn that about this time the breastbecame the frequent object of the surgeon’s scalpel. Augmentation cameinto vogue. There seems to have been little argument about theimportance or value—or even the safety—of surgically increasing femalebreast size. Rather, the issue became a controversy of what materialsshould be used to achieve this (Gilman 1999, 248).

Men, though with less frequency, also seek out aesthetic surgery, andthis is on the increase. “Judging by the increasing rates at which theyare having aesthetic procedures, men, too, are susceptible to the fearthat without the help of aesthetic surgery they will be condemned tolive in the wrong body (Gilman 1999, 257).

The length to which individuals will go in the pursuit of perfection isperhaps best exemplified by popular television shows such as “ExtremeMakeover,” “The Swan,” I Want a Famous Face,” and “Nip/Tuck.” “ExtremeMakeover,” “The Swan,” and “I Want a Famous Face” all fall under thecategory of “reality”—unscripted, true-to-life television. Each ofthese shows is aimed at changing the lives of individuals by changingtheir physical appearance.

“Extreme Makeover” follows the progression of individuals who areselected to be completely made over, including plastic surgery. Thisincludes, but is not limited to: rhinoplasty (nose reconstruction);breast augmentation or reduction; liposuction; lasik surgery (whichsurgically corrects vision and eliminates the need for glasses and/orcontact lenses); cosmetic dentistry (including teeth whitening,straightening, and implant technology); diet; wardrobe; and of course,makeup.

The show starts off by asking contestants—male and female—to state thethings they most dislike about their bodies. After this they arewhisked off to have these blemishes removed or improved, hidden orenhanced.

Unspoken, but understood, is this: that this new outward self willimprove their lives. No one doubts this. No one even questions it—thisis how deeply etched it is on the American psyche. Indeed, it is thesame in much of western civilization: we are never good enough; thereis always room for improvement; a nip here, a tuck there, and voila:perfection, happiness, success! The effect this message is having onyounger generations, who make up the majority of this show’s audience,is truly frightening.

MTV’s “I Want a Famous Face” is an even more disturbing variation onthis theme. In this show, contestants will do just about anything tophysically resemble their favorite celebrities. It is a sad and emptypremise for a show—even sadder when one considers the young andimpressionable individuals who are most likely to be watching. Whatkind of messages can they be getting from a television show thatencourages people to physically reconstruct themselves in the image ofpop icons?

Things get even more bizarre with “The Swan.” This show seems to be themost vicious variation on an already-sad theme: the contestants areindividuals who have been altered in every way possible. Thebefore-and-after version of the individual contestant means nothinghere: it’s not about anyone’s “personal best,” but rather about thefinal product. Message: you are only as good as your plastic surgeon.Or: your plastic surgeon is only as good as the material s/he had towork with—namely: you. Again, all of this is subject to the constantlyvacillating norms of society.

It is significant to point out that these “reality shows” are not basedin reality at all. There is nothing realistic about an individual beingdrastically altered through artificial techniques, then miraculouslyand seamlessly re-integrated into mainstream life.

This so-called “reality” costs hundreds of thousands of dollars,although the “lucky” contestant doesn’t have to foot the bill.Furthermore, this transformation process trumps all else: whatever lifethe “lucky” contestant has led up to this point is now forever altered,for better or for worse.

Of course, those of us watching the show will be convinced—as long aswe want to be convinced—that all this change is for the better. We haveno concern about costs. We will gloss over health risks. We willbelieve, if we want to believe, that this fresh new person, who is nownot only blemish-free, but beautiful, is living a life of perfection.

Which makes us ready for “Nip/Tuck,” which is not a reality show, but is perhaps more lifelike than many reality shows.

“Nip/Tuck” is set, rather fittingly, in Miami, Florida, a popularvacation site with a somewhat plastic reputation. The series followsthe weekly exploits of two plastic surgeons as they minister to theneeds of patients in their search for physical perfection and thepresumed happiness this will bring.

A typical episode of the show opens with an innocent-sounding request:“tell me what you don’t like about yourself”—this fits quite nicelyinto Gilman’s assertion that aesthetic surgery is the newpsychotherapy.

“What don’t you like about yourself?” The repetition of this openingreinforces to the audience the fact that there is something “wrong”with all of us; that this “wrong” thing can be surgically removed,improved, enlarged, or reshaped—through surgical procedures.

The show features two main characters, Doctors Sean McNamara (DylanWalsh) and Christian Troy (Julian McMahon), who function as a sort ofgood doctor/bad doctor team, not unlike the good cop/bad cop pairingsso familiar to us from crime shows. In an arguably lame attempt to castplastic surgery in a positive light, one of the doctors expresses aninterest in doing pro bono work for victims of crime, in this case thevictims of a serial rapist who is known by the suggestive andhorrifying moniker, “The Carver.”

That rape and mutilation are indeed violent, heinous crimes, no onewill dispute. However, the suggestion that aesthetic surgery—even as itmasquerades under the lofty aegis of pro bono work—will erase thedamage done by such an act is completely misleading. To anyone who hasever been the victim of rape and/or disfigurement, it is callous andinsensitive.

 It is clearly evident that these programs do educate watchers aboutsome aspects of cosmetic surgery. Though often under-played, the veryreal aspect of surgical risk is always present. At the other end of thespectrum are the horror stories of those who skipped a step or two, orwho skimped on the cost and opted for a plastic surgeon who was not“board-certified,” only to have their dreams of a perfection dashed,but to have their natural looks, however imperfect, only worsened.

Again, what is left unsaid: board-certified surgeons are only justthat: board-certified. In this gamble with beauty, there are noguarantees.

Some plastic surgeons bemoan the fact that shows like “Nip/Tuck”denigrate their professional status, portraying them as nothing morethan “glorified beauticians”; however, most seem unperturbed by thecomparison—and why should they, when their services are moresought-after than ever?

Most practitioners agree, though, that the complex, multi-dimensionalapproach that any truly good surgical procedure must encompass, iseither lacking or glaringly glossed over in the TV versions. Oftenthere is a team of professionals—surgeons, anesthesiologists, recoveryspecialists—involved every step of the way. In addition, there areconcerned and often confused family members waiting in the wings,worrying about their loved ones, wondering what all this change willmean in their relationships. This does not often make for pleasantviewing—and certainly will not appease an audience that is geared upfor a quick-fix, fantasy tale.

So-called “reality-shows” often end up giving wrong impressions: changedoes not happen overnight; in addition, change is not always what onemight expect, and even if it is, that does not necessarily guaranteehappiness.

One certain result of “Nip/Tuck” is that—for better or for worse—it hashelped to lessen the stigma of plastic surgery. The profession itselfhas been given a “nip/tuck”—though whether this is a blessing or acurse remains to be seen.

Dr. Robert Norman begins his essay on “Nip/Tuck” by summarizingNathaniel Hawthorne’s story “The Birthmark.” The story is about aphysician with a perfectionist personality who decides to operate onhis beautiful wife to remove her one imperfection: a birthmark. Shegoes along, ostensibly to please him—she herself doesn’t seem botheredby this single blemish, which is a small, faint facial scar—but she isbothered by the fact that it bothers him.

During the course of the operation, she dies. This, concludes Norman,is a clear message that “nature, in all its randomness, can only bechanged or altered at a price.”

If there is one point that has been made abundantly clear during thecourse of research for this paper, it is this: in the arena of bodymodification, there has been exponential change. Huge leaps have beenmade in the last century, and in the last few decades, those leaps haveundergone phenomenal expansion. This in itself is significant.

As we have seen, society has progressed since early days. Bodymodification is at one end of the continuum. It is ubiquitous. It isexciting and also frightening. Discussions of surgical bodymodification in this paper have focused primarily on elective surgeryundertaken for purely cosmetic purposes, so that it may be explored andassessed as part of the larger societal trend towards achievement ofphysical perfection at any cost.

One need only turn on the television or leaf through a magazine to bebombarded with all kinds of advertisements for body modification.Chemical treatments can straighten hair and change skin tone andtexture. Surgical procedures can decrease or (more often) augmentbreast size. Penile implants claim to enhance sexual performance.Unwanted fat can be removed in any number ways, ranging from dietarychanges to liposuction. Some signs of ageing can be temporarilyreversed with injections of Botox; others can be permanently altered,again through surgery.

Today in the western world, body modification is widely practiced inall classes of society. Often it is the result of societal pressure toachieve perfection. At times it is a ritual or rite of initiationwithin a group or social hierarchy. Less often, although this issteadily increasing, the body is modified to change its gender; this isdone through surgical procedures supplemented by hormonal and similarsupplementary treatments.

Women are considered the most frequent targets of this pressure toachieve somatic perfection, and therefore they are the most frequentpractitioners of body modification. However, this pressure affects menas well. This paper will examine four specific types of bodymodification: tattooing and scarification; piercing; diet and exercise;and aesthetic surgery.

Although these are by no means the only methods of body modification,they are among the most widespread and they cover a wide spectrum.Still, whether it takes the form of a minor dietary modification or anextreme makeover, it is clear that most individuals in the westernworld practice some sort of body modification. For this reason, it is apractice which merits close study and consideration. How far will someindividuals go in this pursuit for perfection? How much of this willsociety sanction? What are the implications for our future and that offuture generations? These are the questions to be explored throughoutthe course of this research.

This paper has focused on four specific areas of body modification:tattoos and scarification; piercing; diet and exercise; and finally,surgical enhancement. Initially the spectrum I had hoped to cover wasmuch wider, and would have included sex-change procedures. However,gender mutation is no longer a minor subset of body modification; it israpidly becoming a discipline of its own, and it needs to be addressedas such.

As shown earlier, body modification has existed in various forms forthousands of years—some argue that “decorating” or enhancing the bodyis a normal and natural act; others assert that this “normal” and“natural” act has grown to unreasonable and unacceptable levels.

Society has made rapid progress since the early days, when crudehematite extractions and animal fragments served as makeup and jewelry.Television commercials and magazine advertisements continually bombardus with suggestions for body modification on a number of levels.Chemical treatments can straighten hair and change skin tone andtexture. Surgical procedures can decrease or (more often) augmentbreast size. Penile implants claim to enhance sexual performance;unwanted fat can be removed in any number ways, ranging from dietarychanges to liposuction. Some signs of ageing can be temporarilyreversed with injections of poison [Botox]; others can be permanentlyaltered, again through surgery.

Today in the U.S. and other western nations, body modification iswidely practiced in all classes of society. Often body modification isthe result of societal pressure for perfection. It can be seen,however, that the precise social significance of the body hasdefinitely begun to shift. Shilling notes that in the past, the bodywas defined by national government, but that recently women—andmen—have begun to “reclaim” their bodies, and to assess theirself-identities in new and different ways (Shilling 1993, 30). Alongwith this, however, there is the development of a new technology, onewhich offers a range of surgical enhancements that have until now beenthe stuff of science fiction. Thus arises the paradox: we can remoldand redesign our bodies, can surgically manipulate them into anythingwe want them to be—however, we are not quite sure what it is we wantthem to be.

In addition to the confusion of our own self-identity issues, there aresocial and demographic changes in western society which cannot beignored. The elderly population is now larger than ever before: thereare more of us, and we are living longer. The needs of the elderly willno doubt impact societal attitudes and affect the way we look atourselves as humans and as individuals.

Methods of categorization have been shifting as we seek to redefine sexand gender, nature and culture, biology and society. Boundaries havebegun to blend and merge, and resulting confusion is even moreproblematic. Change is both constant and rapid, welcomed and feared.The need to exert control over our bodies seems stronger than ever, yetit is accompanied by a crisis in their meaning.

Additional considerations are advances in such areas as transplantsurgery. These exacerbate our uncertainty about the body by threateningcollapse the boundaries upon which we have come to rely. The line whichseparates body from technology has begun to shift, leading to issues oflegal and political importance. “The idea that the body is the locationof anti-social desire is thus not a physiological fact but a culturalconstruct which has significant political implications” (Turner 1996,65).

It has also been suggested that this excessive dependence on reality,coupled with the obsessive need to control our bodies, is one way inwhich we respond to a chaotic world. Huge global issues menace ourfutures, and we react to this by looking inward, but in the mostsuperficial of ways.

The concept of chaos is another recurrent theme in recent discourse onbody modification. We have seen that fashion is one way in whichindividuals attempt to assert control over the ever-increasing chaos oftoday’s world. As Entwistle posits, “if nakedness is unruly anddisruptive, this would seem to indicate that dress is a fundamentalaspect of micro social order (Entwistle 2001, 35).

This has been echoed by Armando Favazza: “Chaos is the greatest threatto the stability of the universe,” he asserts (1996, 231). He goes onto explain how we need social stability to co-exist, that it gives usthe framework for appropriate sexual behavior, the ability to recognizeand negotiate among various social hierarchies, and the tools necessaryto successfully make the transition from childhood into matureadulthood. “The alteration or destruction of body tissue” assertsFavazza, “helps to establish control of things and to preserve thesocial order” (1996, 231). This may seem overly dramatic to some, butdrastic times call for drastic measures.

Perhaps the most dramatic consideration here is that in light of thethreat of huge global dangers, our refusal to acknowledge and addressthem is a fundamental failing that may have disastrous and irreparableconsequences: “at a time when our health is threatened increasingly byglobal dangers, we are exhorted ever more to take individualresponsibility for our bodies by engaging in strict self-care regimes(Shilling 1993, 5).

As he and other researchers point out, our inability to control outerchaos seems to have resulted in our focusing on our bodies as disparateparts of our selves and of our universe: this is one small way we canassert control, or at least feel as though we are.

 In Section VII, number 87, the last aphorism of Hippocrates, hewrites, “Those diseases which medicines do not cure, iron cures; thosewhich iron cannot cure, fire cures; and those which fire cannot cure,are to be reckoned wholly incurable.” We must tread carefully in thisdangerous new world of technology.

According to Sander Gilman

To become someone else or to become a better version of ourselves inthe eyes of the world is something we all want. Whether we do it withornaments such as jewelry or through the wide range of physicalalterations from hair dressing to tattoos to body piercing, we respondto the demand of seeing and being seen...in a world in which we arejudged by how we appear, the belief that we can change our appearanceis liberating” (Gilman 1999, 3).

The price we pay for that liberation remains to be seen.