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BOOK REVIEW | winter 2003

Do the eyes have it?
Flesh Wounds: The Culture of Cosmetic Surgery
By Virginia L. Blum
University of California Press

Ms. Winter 2003

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It’s official: The cultural obsession with plastic surgery has migrated from Hollywood to the mainstream, middle-class culture. We are a makeover-mad world, argues Virginia L. Blum in Flesh Wounds: The Culture of Cosmetic Surgery, and we need to face it. And face it Blum does—and then some—in this investigation of how so many of us have become happy to go under the knife in order to look like someone else and, just as important, what that has done to our individual sense of self-identity.

Interweaving social science, psychological analysis, personal reflection and pop culture, Blum pieces together a sharply observed picture, and colors it with scraps of notes taken during the surgeries she has observed and interviews she has conducted with 39 surgeons and 11 patients. Along the way, she addresses the politics of beauty: how women, because we have allowed ourselves historically to play the object, are the perfect consumers of the cosmetic surgery industry. And she explores the dichotomy of beauty: on the one hand the democracy implicit in the notion that with surgery everyone can be beautiful, on the other the tyrannical insistence that we all strive to look the same and to maintain that sameness.

Flesh Wounds CoverBlum’s ultimate aim, however, is to tie the swell of cosmetic surgery in America’s mainstream to the culture’s wholesale obsession with celebrity. “The deepest wish associated with cosmetic surgery is that it might make one movie-star gorgeous,” she writes. “This is not grandiosity. … This is because of the ‘Hollywood effect’ of making attractive women seem and feel unlovely next to superhuman beauty.” And ultimately, she applies the evergreen human dilemma of mind and body to her subject, asking how, when our sense of self comes so much from the skin’s surface, could surgery not change who we are?

A professor of literature at the University of Kentucky, Blum here employs a perspective that melds academic analysis with personal experience. Sometimes that approach works—as when she uses the story of her own botched first nose job—imposed on her as a teen by her mother—as a framework for discussing what she considers the often coercive relationship between male surgeons and female patients. And Blum’s own experience clearly galvanizes her ruthlessly honest accounts of the breast augmentations, rhinoplasties and face-lifts she witnessed during her research.

But at other times, Blum’s arguments meander and even contradict one another. She asks why women pursue beauty, for example, and comes to the dubious conclusion that we do so because we have been taught that beauty is an end in itself rather than a means to life’s privileges. If that’s so, then why in a separate chapter does she posit that women are taught that beauty is the key to life’s successes?

Throughout the book, Blum identifies the pipelines supplying the culture of cosmetic surgery: the greed of surgeons; our fantasies of a new, culturally sanctioned body; the widespread belief that an altered appearance will change our lives. But she focuses far less on our own culpability—for example, those women, famous or otherwise, who have surgery but refuse to admit it. To such infighting, Blum offers a vague prescription for an ongoing dialogue: “We accuse each other of submitting to the culture of appearances or providing the wrong role models, making each other feel bad/guilty, and even by criticism,” she writes. “The debate is predictable, yet also necessary even in its predictability, because we do need to at least account for our practices, if only in the name of leaning toward an understanding of what drives our social experiences.”