Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery & Making the Body Beautiful: A Cultural History of Aesthetic Surgery

Creating Beauty to Cure the Soul: Race and Psychology in the Shaping of Aesthetic Surgery by Sander L. Gilman. Duke University Press, 179 pp., $21.95 (paper). Making the Body Beautiful: A Cultural History of Aesthetic Surgery by Sander L. Gilman. Princeton University Press, 396 pp., $16.95 (paper). In these two complementary volumes, cultural historian Gilman tells a timely, yet previously largely untold tale. According to American statistics, in 1992 more than 78,000 women had surgery to improve the shape of their breasts, while more than 100,000 had liposuction. A combination of technology and psychology, bolstered by marketing and financial resources, has produced these astonishing results. The story begins with three aspects of 19th-century history: concepts of race, the disfigurements of syphilis, and the invention of anesthesia. By presenting the complex interaction of ideas, social relations, technology, psychiatry (and the madness of doctors as well as patients), the author makes a valuable contributi on to our understanding of our times.

Anesthesia made surgery more widely acceptable, introducing its use to enhance appearance, to remodel the face and the body, beyond reconstruction, previously limited to repairing extreme deformities caused by disease, birth defect, or injury. It became possible to have one's appearance changed to fit a desired self-image. Such ideal images involved notions of "racial" stereotypes, which encouraged disfavored types to seek means of "passing": Irish "saddle noses" and "Jewish" (but curiously not "Roman") noses, could be reshaped. Personal appearance could be enhanced to promote self-esteem as well as the esteem of others. Notions of a relationship between the appearance of the body and the psyche were widespread among surgeons as well as psychiatrists. The size and shape of a man's nose was believed to be connected to his sexual (and "racial") identity. (Shades of Freud's friend Wilhelm Fliess--and of the art of Melanesia!)

The second volume covers a broader scope and presents a more detailed picture. Illustrated with numerous photographs and contemporary caricatures, it also includes more technical material. Other, newer themes are discussed. Transgender surgeries allow more radical transformations: the patient seeks to have nature's "mistake" corrected, to have the sexual body that corresponds to the individual's sense of self.

Technology has become an extension of cosmetics, facilitating conformity to an ideal culturally and socially dominant type, an ideal whose internalization is encourged by media and models. Perfection, however, is elusive, and models change. Eye operations have found a place in Japan and China. In the United States, "race" has declined as a motive for aesthetic surgery. Instead, in a youth-obsessed society, "youth" has become more salient, for men as well as women. Yet youth is brief, and addiction to aesthetic surgery becomes a secondary psychiatric problem.

It is fascinating to discover the interactions of the various strands that make up this story, where medicine and technology become tools and agents of broader themes that in turn highlight the central concerns of a society at a given time.

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COPYRIGHT 2008 Gale, Cengage Learning