I treat critical theory the way an evangelical preacher treats the Bible—as a set of texts that can help me figure out everything I need to know about the world around me. And yet sometimes, the world around me is so incomprehensible that I am left speechless.
Take the latest cosmetic surgery trend—awake surgery. You would think that after spending five years writing a book on cosmetic surgery, I could no longer be shocked by anything this industry has to offer. You would be wrong. Awake surgery is cosmetic surgery without general anesthesia. The patient is numbed, but not so numb that she doesn’t feel pain, often excruciating and torturous pain. One patient says she
couldn’t stop screaming. Lying on her side on a gurney, wearing only a bra and panties, she felt as if she were being stabbed again and again.
“Please stop! You’re hurting me!” she cried to her doctor. But the man performing the lipo, who turned out not to be the doctor but an assistant, told her to be quiet.
The boards that certify cosmetic surgery, like the American Society of Plastic Surgeons, think awake surgery is not a great idea because none of the surgeons doing it have a lot of training (usually two days) and because of the complications (including legal ones) that can arise.
But many of the surgeons performing awake surgery argue that it “empowers” women to make decisions, like what size breast implant they really want. According to Jeffrey C. Caruth, who performs awake breast implants at his office in Plano, Texas, his patients are “totally alert.” Because they’re awake, Dr. Caruth can stop midway through the operation and allow the patient to see her breasts stretched to a particular size, then usher in her partner or family and everyone makes the “decision” about size together.
“It’s actually a lot of fun; we play music and talk… They want to have input. When you go shopping, you don’t take something off the rack, throw it in the sack and go home. You try it on first… Women are picky. It’s like shopping for a new dress or a pair of shoes.”
But as “empowering” as shopping for breast implants while heavily sedated and cut open might be, the real driving force behind awake surgery is it’s a lot cheaper for the surgeon, since no anesthesiologist is necessary and the surgeon doesn’t even need to have hospital privileges or a surgical center to operate. The result—bargain-basement prices and some serious pain.
Cosmetic surgery is not well regulated. Any medical doctor can perform it, trained or not. A recent study in California found that 40 percent of those performing liposuction had no training whatsoever before entering the field. So clearly we need more state regulation of cosmetic surgery and commercial medicine generally. But that doesn’t really answer the question of why anyone would submit to what can only be described as torture?
When cosmetic surgery became a viable commercial enterprise a bit over a hundred years ago, it was in large part because surgeons had learned to put people out with gas. No one was willing to undergo surgery for purely cosmetic reasons unless the pain (and risk) could be minimized. Since then, these completely unnecessary surgeries have grown at a brisk rate to something like 12.5 million a year in the U.S.
But in 2011, as the requirements of the body project are ratcheted up to levels never before seen and the economic well-being of most Americans continues to decline, we are apparently willing to go under the knife without having the benefit of being asleep. This represents a relationship to the body—especially the female body and 91 percent of cosmetic surgery patients are women—that can only be described as alienated.
As Susan Bordo tells us in Unbearable Weight, the female body has for millennia been seen as out of control and in need of externally imposed limits. Whether it’s through self-induced starvation or cosmetic surgery, the unruly female body must be brought into line. If I think about awake procedures as the abjection of the female body within consumer capitalism brought to its logical conclusion, then I find comfort and solace in the holy cannon that is critical theory. But I can’t help but wonder if even the formidable powers of critical theory are insufficient to explain this kind of self-destruction.
(Photo: Orlan from her performance art/cosmetic surgery series)
8 Responses to Conscious During Cosmetic Surgery
trendisnotdestiny - January 20, 2011 at 11:45 am
Dear God, some notions are so beyond the pale of discourse that criticality is not enough to describe “the turn” our society has taken:
1) State & corporate interest merged(Public-private Partnership)
2) Hollowing out of social services (Camden, NJ)
3) Spying, Monitoring, and Data Mining Operations (see Wikileaks)
4) Massive Fraud & Plundering of Public Wealth
5) Environmental disasters, species dying in mass, fracking
6) High food costs, job losses and hyper-inflationary policies
7) Reneging on our promises (soc sec, pensions, healthcare)
8) Selling the idea that everything will be alright (propaganda)
9) A complicit class of consumeristic individualism
10)Drowning in technology, wars and bombarded by solicitations
11)Torture, Rendition, Selective Habeus Corpus rights
12)Supreme court’s decision of Citizens United case
The AWAKE (Mengele) approach staggers any fundamental belief in humanity. Taken in totality, it would be hard to argue that we are not in the middle of fascist turn. Civil liberties, concentrated monopolies of power and policies that reflect the small privilege minority at the expense of an increasingly indebted, out of work and miserable populace…. Chris Hedges talks about the Weimarization of society. Maybe what we are witnessing is more out in the open than we thought.
Dr. Essig, do we have a cost for this type of surgery? Any marketing materials?
record - January 20, 2011 at 12:35 pm
I’m stunned by this article. However, I also find myself running down the list of culturally normalized mutilations across a variety of societies. Many of us have seen ethnographic photographs of subcutaneous implants, genital mutilations etc. and I admit to being bothered by these non western practices, but Western standards of beauty are clearly changing, evidenced by the proliferation of relatively harmless tattoos and piercings. That said, brutality and self-loathing seem unusually present, and I’m tempted to pathologize this phenomenon in the West. I’m happy to receive instruction.
mrtall - January 21, 2011 at 1:11 am
Your first and last sentences are a telling testimony to critical theory’s worth in explaining the human condition.
splendido - January 24, 2011 at 7:50 am
After the birth of our third child, 21 years ago, my wife and I agreed that a certain part of my male body was unruly and needed to be controlled, so I underwent a vasectomy.
At my request, my doctor set up a series of mirrors so that I could watch the operation “awake.”
How does that fit into your paradigm?
hhopf - January 24, 2011 at 2:12 pm
Splendido, I imagine you were not in excruciating pain, since the vasectomy is routinely done under local anesthesia, and good pain control is the norm. Also, there is a purpose to your vasectomy– preventing pregnancy– beyond reshaping your body (indeed, no one knows you had a vasectomy unless you tell them). Even when breast augmentation is done under general anesthesia, most women experience severe pain postoperatively. What’s most remarkable to me is that these women are agreeing to having the procedure done under local anesthesia– the pain (even thought presumably they don’t really understand the degree of pain) is worth it. I’ve never been able to understand the lure of cosmetic surgery– risking death to improve your appearance makes no sense to me. And the risk of death from cosmetic surgery is much higher than for most surgery because of the lack of qualifications of providers.
ellenhunt - January 24, 2011 at 2:50 pm
The idea of undergoing liposuction under local is astonishing. On the torso, it is impossible to produce local anesthesia throughout. It can be done from the waist down with a spinal block. But that should be done by a qualified physician.
Breasts can be anesthetized with local, but not tissues very close by unless done by a skilled anesthesiologist. It’s actually harder to do that well than it is to do conventional anesthesia.
I’m appalled. This smacks of garage surgery. This is what you expect from people without medical degrees of any kind. To listen to a patient screaming and tell them to be quiet is just sadism and that guy should have is license taken away.
trendisnotdestiny - January 24, 2011 at 4:48 pm
“And the risk of death from cosmetic surgery is much higher than for most surgery because of the lack of qualifications of providers.”
As Huffington Post reports that a famous adult actress has died from her sixth breast augmentation surgery (reasons are unknown according to the article, but I thought of this thread when I read it)…
http://www.huffingtonpost.com/2011/01/24/sexy-cora-dead-carolin-berger-pictures_n_812936.html
This is where specific offenders should be called to account for their market-bred reductionism and astonishing lack of human presence….
the_health_culture - January 27, 2011 at 2:41 am
Great article. I will definitely read your new book, American Plastic. I especially appreciate your recognition of the impact of neoliberal ideas on matters of health.
There was just an article in the Guardian on how the UK reacts differently to offering cosmetic surgery on credit — “Plastic surgery companies under fire for tempting people into unneeded surgery” (http://bit.ly/gHxngf).
Re: Being alienated from the body and the comment that mentions self-loathing. On the DVD of the TV series Nip/Tuck, creator Ryan Murphy states quite explicitly that his purpose was to portray cosmetic surgery as the externalization of self-hatred. I don’t think that’s what viewers come away with, but it’s interesting that he said it.