American Plastic

The riveting story of how cosmetic surgery and plastic money melted together to create a subprime mortgage crisis of the body Plastic surgery has become "the answer" for many Americans, and inAmerican Plasticsociologist Laurie Essig explores how we arrived at this particular solution. Over the last decade there has been a 465 percent increase in cosmetic work, and we now spend over $12 billion annually on procedures like liposuction, face-lifts, tummy tucks, and boob jobs. In this fascinating book, Essig argues that this transformation is the result of massive shifts in both our cultureandour economy-a perfect storm of greed, desire, and technology. Plastic is crucial to who we are as Americans, Essig observes. We not only pioneered plastic money but lead the world in our willingness to use it. Itrs"s estimated that 30 percent of plastic surgery patients earn less than $30,000 a year; another 41 percent earn less than $60,000. And since the average cost of cosmetic work is $8,000, a staggering 85 percent of patients assume debt to get work done. Using plastic surgery as a lens on better understanding our society, Essig shows how access to credit, medical advances, and the pressures from an image- and youth-obsessed culture have led to an unprecedented desire to "fix" ourselves.

Laurie Essig is assistant professor of sociology at Middlebury College and has written for publications ranging from Legal Affairs and Salon to the Chronicle of Higher Education. She lives in Burlington, Vermont, and Montreal.

Cosmetic Surgery and Sex

By the 1920s, Americans were obsessed with the actress Fanny Brice’s nose job. The mixture of sex and race in Brice’s career is impossible to fully separate, since it was her Jewishness that made her “funny” (as immortalized by Barbra Streisand in Funny Girl ), but it was the fact that Brice wanted to look “beautiful”—which is to say fully female and white—that made her undergo a nose job in 1923.33 Since then, the bodies that we want to imitate are not just two-dimensional and therefore unreal, but surgically altered before they’re even photographed. We now imitate bodies that never existed. Through prestigious imitation, plastic surgery has spread from being a necessity for matinee idols to a necessity for the rest of us, as we are all trapped in a two-dimensional visual culture that rewards bodies that look good on-screen. Because women were the first shoppers and continue to dominate consumption, accounting for about 80 percent of all purchases, they were also the most obvious audience for advertisers.34 Advertising taught women—and then men—to want to look like bodies that cannot exist “in nature.”
 
So it was that being a woman in the twentieth century often required not just cosmetics, but cosmetic surgery. Both the first professional meeting of plastic surgeons and the first Miss America pageant were held in the late summer of 1921 because both wanted the same thing: clearly gendered, classed and raced beauties.35 The obsession with the female body continued to dominate cosmetic surgery throughout the century. The Depression came and went, but it did nothing to slow the growth of the cosmetics industry aimed almost exclusively at women.36 Cosmetic surgery continued to spread, reaching the upper middle classes in addition to the rich and famous.
 
World War II left a longing for large breasts in its wake, a longing that fed a growing practice in breast augmentation. Why Americans suddenly became obsessed with large breasts is an interesting question. Some theorize that it was the deprivation of the two wars and the Depression that caused a desire for women who looked full and abundant. Others theorize that it was the “foundation garment” industry that first invented the bra in the 1930s, with its cup sizes that required all women to fit into them or feel like a misfit. Surely 1950s anxiety over producing a “normal” girl, which increasingly fed into young girls’ desires for large breasts, shaped this obsession with “the sweater girl.”37
 
The year 1959 proved to be a watershed year for cosmetic surgery, since that was when Barbie was introduced to the American toy market and an entire generation of young girls A short history of plastic 17 grew up worshiping a form impossible to achieve without surgical intervention. As M. G. Lord points out in her biography of Barbie:
 
In Barbie’s early years, Mattel struggled to make its doll look like a real-life movie star. Today, however, real-life celebrities— as well as common folk—are emulating her. The postsurgical Dolly Parton looks like the postsurgical Ivana Trump looks like the postsurgical Michael Jackson looks like the postsurgical Joan Rivers looks like . . . Barbie.”38
 
Women and even young girls became increasingly obsessed with having large breasts. “We must, we must, we must improve our busts” was chanted over and over again as a fervent prayer for C cups. Psychiatry named distress over small breasts “a significant problem.”39 Popular magazines and beauty advice books also “worried” about the size of women’s breasts.40 A variety of advertisements and articles offered breasts as a means of escaping the confinement of women’s postwar roles. For instance, the Maidenform “I Dream . . .” campaign, introduced in 1949, was the first advertising campaign to feature a woman in her underwear. The ads had women “dream” they went to Paris or won a political election or even just went shopping in their Maidenform bras. The Maidenform “Dream” campaign is “a classic example of wish-fulfillment psychology, as the fantasy situations of the ads fed women’s hunger for independence, romance, personal achievement, and even power and influence.”41
 
Ever anxious to please the public, plastic surgeons began experimenting with breast augmentation. Earlier surgeons had tried paraffin and fat injections, but the results were not good, and often deadly. In the early 1950s plastic surgeons tried medical- grade sponge implants. The sponges made the breasts look a bit like the padded bras that were also popular. The sponges didn’t really work, since they tended to harden and were often impossible to remove because surrounding tissue usually filled in and embedded the porous sponges. Increasingly, doctors and patients turned to silicone injections directly into the breasts, a highly dangerous practice that was allowed to continue for decades. By the early 1960s, the silicone implant had been invented, as well as early attempts at saline sacs that could be filled to capacity once inside the woman’s breasts. Although hardly perfect—for instance, the ridges usually could be felt through the skin—these implants were more or less stable, possibly safe, and, unlike earlier implants, did not result in disfigurement and scarring if they needed to be removed.42