Cross-posted from The Global Sociology Blog.

I have already discussed sociologist Anthony Elliott's Book, Making the Cut: How Cosmetic Surgery is Transforming our Lives when it was reviewed in a newspaper. I have since read the book in its entirety. Below is my full review.

"In the new economy nothing is more sexy than surgery. From Botox to lipo to tummy tucks and mini-facelifts, the number of cosmetic surgery operations undertaken around the globe has soared recently, as consumers spend more and more on themselves in the search for sex appeal and artificial beauty. In a society in which celebrity is divine, information technology rules, new ways of working predominate and people increasingly judge each other on first impressions, cosmetic enhancements of the body have become all the rage." (7)

In other words, for Elliott, we have entered the era of the cosmetic surgical culture, a subset of the makeover culture that also includes fashion, fitness and all sorts of therapies. His book is dedicated to examining the social causes and consequences of this cultural shift in the global context, both in terms of the social production of identity at the micro-level and at the global level of shift in the structure of work at the macro-level.

Specifically, he identifies three social forces that operate both at the cultural and the structural levels that brought about the cosmetic surgical culture:

1. Obsession with celebrity bodies, and especially body parts as well as the flourishing of makeover shows.
2. Consumerism whereby buying beauty and changing one's body according to cultural demands becomes part of life for certain social classes. In this context, artificially "enhancing" one's body becomes an essential part of a "successful life." This consumerism also contributes to the promotion of what Elliott calls an acquisitive individualism concerned / consumed with buying more stuff including better / bigger / younger / enhanced body parts.
3. The new economy of global capitalism and its ever more rapid pace of social change, which has involved employment adaptability and flexibility. As Elliott puts it,

"My argument is that the new economy spawned by globalization intrudes traumatically in the emotional lives of people - with many scrambling to adjust to today's routine corporate redundancies. (...) The dramatic changes now occurring in the global electronic economy and on the ways in which corporate layoffs, downsizings and offshorings are affecting people's sense of identity, life and work. (...) Many have reacted to this sense of social dislocation and economic insecurity - what I term today's pervasive sense of ambient fear - by turning to forms of extreme reinvention in general and cosmetic surgical culture in particular. Many are calculating that a freshly purchased face-lift or suctioning of fat through liposuction is the best route to improved live, careers and relationships." (9)

In this sense, the cosmetic surgical culture is an individual response to a social-structural issue (C. Wright Mills, anyone?), that is, the pressures of corporate life and the global economy. In the context of general economic insecurity, even for social classes that not so long ago considered themselves secure (after all, the 1980s layoffs affected mostly industrial workers, but, as conventional wisdom went, it is just an upgrading of the economy. Once the labor structure moves away from union-heavy industrial labor towards a more education service-trained workforce, then, everything will be fine... because brown people will never be able to do the educated, technological jobs of the service economy... how did that turn out?).

In the cosmetic surgical culture, the personal / subjective responds to the structural / objective. As the global conditions trickle down to individual societies and ultimately to individuals, they generate uncertainties (and Elliott does not mention the risk society but I think this theory is relevant here) regarding work, relationships and life in general to which the cosmetic surgical culture is a response.

Elliott studied the subject through a variety of methods: interviews with cosmetic surgeons, cosmetic surgery patients as well as media reports and studies. He also provides a basic statistical overview of the enormous increase in cosmetic surgery procedures that has taken place in many, mostly but not exclusively, Western countries (the Asian tigers are catching up in that department as well, especially for the upwardly mobile, newly-enriched upper classes).

He also overviews the economics of it, after all cosmetic surgery is big business ($15 to $20 billion a year just for the United States) offering a variety of procedures for every part of the body, from the most common non-invasive procedures all the way to labia rejuvenation (in which the vagina is snipped and re-sculpted). And even though, in the United States, 90% of cosmetic surgery patients are women but the number of men going under the knife is growing.

And more and more, plastic surgery is viewed by both surgeons and patients as an investment in the future, a way of keeping one's major asset in the new global and flexible economy: one's youthful look. Looking tired, showing one's advancing age does not play well in the new labor market. Experience no longer matters as much as it used to. However, what matters is being flexible, being able to embrace change positively (Who moved my cheese!!). One is more likely to convey such notions through surgically enhanced looks. After, we all know since Goffman, that impression management is a crucial interactional dynamic.

Celebrity Culture

This is the first social force at work in the rise of the surgical cosmetic culture. Here is how Elliott puts it:

"The conduit of celebrity arises from massive institutional changes throughout the West, involving a wholesale shift from industrial manufacture to a post-industrial economy orientated to the finance, service and communications sectors. As the economy becomes cultural, ever more dependent on media, images and public relations, so personal identity comes under the spotlight and open to revision. The new economy, in which the globalization of media looms large, celebrates both technological culture and the power of new technologies to reshape links between society, the body and the self. The current cultural obsession with artificially enhanced beauty is reflective of this, and nowhere more so than in the attention that popular culture lavishes upon celebrity." (51)

And so, we end up with TV shows, gossip rags and TMZ constantly and relentlessly scrutinizing celebrity bodies for signs of surgery or signs of imperfections that surely would require surgery. This celebrity obsession trickles down to the common mortals through extreme makeover shows, like the Swan where the narrative is that the surgeries alter not only the body but also the identity of the person undergoing them.

In these shows, women (as they are mostly women) are identified in terms of defective body parts to be surgically fixed or enhanced. But how do these shows last over weeks? Because they revolve around a narrative that associates bodily defects with a variety of psychological ailments, unhappiness or low self-esteem. So, the surgeries will not only fix the defective body parts, they will restore an identity for all to see.

There is another aspect to celebrity culture that Elliott underlines: the difference between celebrity and fame, especially the shift from the latter to the former. He associates fame with a particular talent, artistic originality or creativity where what he calls the democratization of public renown requires no such characteristics. Celebrity can come without talent, originality or creativity. And whereas talent requires authenticity, celebrity, on the contrary, can be emptied of content. This has been especially the case with the rise of reality and contest TV shows that catapulted certain individuals to celebrity in the obvious absence of any authentic talent attached. The obtention of celebrity status is part of such democratizing trend.

And similarly, celebrities can be reduced to body parts as many surgeons interviewed by Elliott report seeing potential patients who want so-and-so's nose or lips or whatever. In 2004, according to the Independent, the most desirable noses, for instance, were, for women Nicole Kidman's, Reese Witherspoon's and Diane Lane's. For men, it was Ben Affleck's, Edward Burns's and Jude Law's. The survey also listed other body parts as well (60-61).

Of course, one cannot mention celebrity culture without mentioning the issue of age and ageing. By providing the aging body with artificial plasticity, that is, an artificial way to renew itself, then, surgical cosmetic culture promotes a different relationship between body and society, especially in terms of public perceptions of aging. This is why it is not surprising to see the connection between celebrity and the surgical cosmetic culture trickling all the way down to teenagers, especially adolescent girls, seeking to dismember their inherited self and reconstruct it more in conformity with the standards of celebrity culture.

Consumerism

Elliott borrows from one of my favorite sociologists, Zygmunt Bauman, from his book, Liquid Life:

"Consumer society rests its case on the promise to satisfy human desires in a way no other could do or dream of doing. The promise of satisfaction remains seductive, however, only so long as the desire stays ungratified; more importantly, so long as there is a suspicion that the desire has not been truly and fully gratified. Setting the targets low, assuring easy access to the goods that meet the target, as well as a belief in objective limits to 'genuine' and 'realistic' desires - that would sound the death knell of consumer society, consumer industry and consumer markets. It is the non -satisfaction of desires, and a firm and perpetual belief that each act to satisfy them leaves much to be desired and can be bettered, that are the fly-wheels of the consumer-targeted economy." (84)

For this to work, products have to be devalued rapidly after they are put on the market and replaced by newer ones. The same goes for plastic surgery. In a consumerist culture, people cannot be "fixed" once and for all. New procedures are being introduced all the time, marketed and advertised, less invasive, quicker to be administered and quicker to heal (as of course, all indications of painful recoveries are evacuated from the narrative). New enhancements have to be offered to replace and "upgrade" the previous procedures. It never ends. One procedure leads to another and has to be supplemented by other products.

The stalling the visibility of the aging process becomes a never-ending battle to be fought with the latest technological means.

"Cosmetic surgical culture provokes the very anxiety it seeks to quell. Security for the body means fending off every sign of ageing or maturity, and such defensive measures are principally undertaken through consuming surgical culture. (...) As such, the consumer of cosmetic surgical culture emerges both as victor and failure, winner and loser." (90-93)

And at the very same time that consumerism promotes autonomy and freedom of choice while of course, being the anti-thesis of autonomy. Consumerism = restlessness.

Global Realities

At the intersection of globalization and consumerism, we find surgical tourism (as part of the pleasure periphery). The globally mobile (the real elite of global times) get to uproot and fly halfway around the world for cosmetic surgery as a luxury vacation package where the non-globally mobile (the stuck lower classes of global times) get to serve them. Those who can afford it can effectively abolish time and space and can treat the semi-periphery as a privatized 'recuperative space' as Elliott puts it.

In the current global labor market, it pays to look good and youthful. The corporate self that is required displays vitality and energy in an aging society. As Elliott describes it, in the global labor market,

"There can be no falling back on traditional ideas of 'careers' or 'jobs-for-life', both of which are eroding before our eyes. Work identities today, for the most part, are built out of active processes of remaking and reconstruction. If the new economy promises high-tech jobs with stock options, short-term contracts and creative working environments, it also inaugurates unprecedented levels of outsourcing, lay-offs, age discrimination and job insecurity." (115)

This is the end of the long-term labor culture, at least for employees. Track records or experience become less valued than assets (like vitality and energy - or at least looking like one has them - along with flexibility and a positive attitude towards change and a capacity to reinvent oneself).

"There are important new links between the speed and dynamism of processes of intensive globalization on the one hand and the popular explosion of interest in the makeover industries and cosmetic surgical culture on the other."

And of course, new communication and information technologies are at the heart of this process. With the compression of time and space (no, the world is not flat), individuals, especially those who are anchored in geographical localities, are seen as dispensable and disposable. This is a process that Richard Sennett covered well in his short books, The Corrosion of Character, and The Culture of the New Capitalism:

"What matters is flexibility - the plastic, reshaped sense of self that these new institutional forms of the global economy at once produce and demand. (...) The fast, short-term, techy culture is unleashing a new paradigm of self-making. In a world of short-term contracts, endless downsizings, just-in-time deliveries and multiple careers, the capacity to change and reinvent oneself has become fundamental. A faith in flexibility, plasticity and incessant reinvention - all this means that we are no longer judged on what we have done and achieved; we're now judged on our flexibility, on our readiness for personal makeover." (122)

Now, there is already an extensive body of sociological research that shows how this has wreaked havoc on relationships, personal and professional. On the one hand, the neo-liberal embrace this new corporate credo of endless renewal, burning bridges and starting over, while the social conservatives deplore our lack of commitments to personal relationships (something they either misleadingly or dishosnestly support with the latest statistics of divorce and dissolutions). These two groups excel at creating double binds.

And in the constant of drive for the privatization of all things social, don't expect societies to provide solutions for these structural dilemmas. All the responsibilities will rest on the shoulders of individuals. No more salvation by society, as Bauman once stated.

And so, the ultimate form of renewal, of course, is cosmetic surgery. The procedures are the individual solutions to a socially-generated conundrum (can't help getting older) that individuals find as they navigate the celebrity and the consumerist cultures, while dealing with the globally-generated labor conditions.

This is a very interesting book to be read in conjunction with the other ones mentioned (any book by Bauman or Sennett is worth anyone's time). It should also be read in conjunction Elliott's other book (along with Charles Lemert), The New Individualism: The Emotional Costs of Globalization. There is some jargon used in the book and a couple of sections I skimmed because they did not really interest me, but overall, I find the global labor argument fairly powerful, based on my other readings on the subject.