A 'Philosophy' of Plastic Surgery in Brazil - NYTimes.com - 0 views
opinionator.blogs.nytimes.com/...a-necessary-vanity
beauty aesthetics art rights self-image surgery power
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Is beauty a right, which, like education or health care, should be realized with the help of public institutions and expertise?
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For years he has performed charity surgeries for the poor. More radically, some of his students offer free cosmetic operations in the nation’s public health system.
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I asked her why she wanted to have the surgery. “I didn’t put in an implant to exhibit myself, but to feel better. It wasn’t a simple vanity, but a . . . necessary vanity. Surgery improves a woman’s auto-estima.”
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He argues that the real object of healing is not the body, but the mind. A plastic surgeon is a “psychologist with a scalpel in his hand.” This idea led Pitanguy to argue for the “union” of cosmetic and reconstructive procedures. In both types of surgery beauty and mental healing subtly mingle, he claims, and both benefit health.
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“What is the difference between a plastic surgeon and a psychoanalyst? The psychoanalyst knows everything but changes nothing. The plastic surgeon knows nothing but changes everything.”
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Plastic surgery gained legitimacy in the early 20th century by limiting itself to reconstructive operations. The “beauty doctor” was a term of derision. But as techniques improved they were used for cosmetic improvements. Missing, however, was a valid diagnosis. Concepts like psychoanalyst Alfred Adler’s inferiority complex — and later low self-esteem — provided a missing link.
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Victorians saw a cleft palate as a defect that built character. For us it hinders self-realization and merits corrective surgery. This shift reflects a new attitude towards appearance and mental health: the notion that at least some defects cause unfair suffering and social stigma is now widely accepted. But Brazilian surgeons take this reasoning a step further. Cosmetic surgery is a consumer service in most of the world. In Brazil it is becoming, as Ester put it, a “necessary vanity.”
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Pitanguy, whose patients often have mixed African, indigenous and European ancestry, stresses that aesthetic ideals vary by epoch and ethnicity. What matters are not objective notions of beauty, but how the patient feels. As his colleague says, the job of the plastic surgeon is to simply “follow desires.”
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Patients are on average younger than they were 20 years ago. They often request minor changes to become, as one surgeon said, “more perfect.”
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The growth of plastic surgery thus reflects a new way of working not only on the suffering mind, but also on the erotic body. Unlike fashion’s embrace of playful dissimulation and seduction, this beauty practice instead insists on correcting precisely measured flaws. Plastic surgery may contribute to a biologized view of sex where pleasure and fantasy matter less than the anatomical “truth” of the bare body.
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It is not coincidental that Brazil has not only high rates of plastic surgery, but also Cesarean sections (70 percent of deliveries in some private hospitals), tubal ligations, and other surgeries for women. Some women see elective surgeries as part of a modern standard of care, more or less routine for the middle class, but only sporadically available to the poor.
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When a good life is defined through the ability to buy goods then rights may be reinterpreted to mean not equality before the law, but equality in the market.
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Beauty is unfair: the attractive enjoy privileges and powers gained without merit. As such it can offend egalitarian values. Yet while attractiveness is a quality “awarded” to those who don’t morally deserve it, it can also grant power to those excluded from other systems of privilege. It is a kind of “double negative”: a form of power that is unfairly distributed but which can disturb other unfair hierarchies. For this reason it may have democratic appeal. In poor urban areas beauty often has a similar importance for girls as soccer (or basketball) does for boys: it promises an almost magical attainment of recognition, wealth or power.
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For many consumers attractiveness is essential to economic and sexual competition, social visibility, and mental well being. This “value” of appearance may be especially clear for those excluded from other means of social ascent. For the poor beauty is often a form of capital that can be exchanged for other benefits, however small, transient, or unconducive to collective change.