Monday, 10 June 2019

Culture and Context: A lifespan perspective on beauty

This month’s blog is a provocation. It is an invitation to, perhaps, imagine a different narrative about appearance and beauty…….not one that emphasizes consumerism or declares that everyone is beautiful or that attention to, or a focus on, appearance is trivial and beauty work is oppressive – an aspect of a patriarchal society. Of course, beauty work exists within the norms of a patriarchal society that, along with a consumerist edict, negatively impact notions of appearance and beauty, but that is only a partial telling of the story of human appearance. I am certainly not the first person to put forth this narrative – there are notable exceptions – Ribeiro,Hollows, Brand, Cahill, Craig, Gibson, Peiss. What follows, this blog, is based on research, interviews conducted with a diverse group of women and men from both the UK and the US. Coordinated Management of Meaning or CMM informed the interview process and grounded theory was used to analyse the data. The focus of the interviews was described as facial appearance or age and appearance “from the neck up.”

Faces are historical and cultural documents. How we chose to groom, style, make-up, or the many other ways we present ourselves through our appearance signals to the world who we are and how we would like to be seen. There is the larger context of culture and history. Taking it one step further, these choices are shaped by race, ethnicity, class, taste, and, of course, age, among other influences. Whether it is a bob or a comb-over, “tasteful” make-up application or “natural” bare skin,  gleaming whitened teeth, or a mouth barely visible through a beard, the image in the mirror is how and who we present ourselves to be to the world AND the image we craft for ourselves…… the ‘meness’ in the glass. My research showed a small sub-group {mostly men} who stated they didn’t care about appearance and almost never looked at themselves in a mirror. That, too, is a choice that belies cultural and historical notions about gender or morality or both.

Throughout history, morality, appearance, and the beautiful have been bound together and it most certainly continues today, from feminism to Christianity, with a fusion of notions of the natural as virtuous, along with strong value-laden ideas.

Some women and men spoke with me about tasteful cosmetic use as a moral imperative for older women. Straight men casting an eye on other older men passed judgement on their peers who spent, what was perceived as too much concern over their appearance. Gay men discussed gay and straight men who allowed themselves to get “scruffy.” Goodness, virtue, vanity and moral manliness are bound together with these attitudes.

At this juncture, I return to my opening remark – faces are historical and cultural documents. A focus on our appearance choices and/or enhancement of our appearance – what we perceive as making us more attractive – date back to earliest humans. Not only were we humans enhancing our appearance for our gods and each other, we were gazing at our own reflection. Early examples of mirror technology date back to 620 BCE with the discovery of highly polished obsidian found in Turkey. In ancient Egypt, polished reflective metal discs were used by women and men to groom themselves and apply cosmetics as seen in art from the region. Vanity? Or a profoundly embedded human interest in appearance and beauty? Something deeply bound to our sense of self? The philosopher, Elaine Scarry writes about the rootedness of beauty to our humanness. She asks, if we could be persuaded to stop looking at beautiful people, could that be extended to other sites of beauty – gardens, poems?

Do we carry this desire though our lifetimes? In older age and old age? Do we continue to look/see and present ourselves to be seen? And what becomes of the expression of beauty, the language of beauty in old age? Is it the current cultural tropes of the wizened exotic [read foreign] old person photographed staring into the middle distance – the penultimate image of the “natural.”? Or the tastefully enhanced looks of Helen Mirren? Can old people be beautiful and what does that mean? 

These questions are particularly relevant now as baby boomers have fully moved into old age. The experience of the cultural shifts of the sixties has had an abiding influence throughout the life of this generation, and it continues as they embody old age.  Baby boomers are also the recipients of the longevity revolution - making older people more visible through sheer numbers. This is coupled with a generation that values active and healthy lifestyles. As one research participant said, “Old people are no longer cosseted in the bosom of their families”; they are visible in almost every sphere of life from the mundane to the extraordinary. This visibility changes the range of the human landscape. Most especially, older people hold an awareness, a cognizance of each other. Older women look at each other, appraising but mostly appreciative. Men appraise each other with a competitive eye. Women and men see attractiveness, beauty in the opposite sex, regardless of sexual orientation. As the neuroscientist, Anjan Chaaterjee suggests, we are wired to seek pleasure in the sight of beauty.

With only a handful of exceptions, research participants answered that yes, old people can be beautiful……yes, it is facial features but participants were clear it was something beyond ‘good bones.’ Some of the words or phrases they used to define age and beauty were: luster, spark of life, radiance, glow, light and warmth, vitality, and presence were some of the ways people defined and discussed age and beauty…….It is a vividness.

This invitation, this provocation asks you readers to consider attention to appearance in the context of culture and history; to reconsider or set aside the moral underpinnings attached to a critique of appearance and the wish for attractiveness and beauty; to question that article of faith that older people, especially old women are invisible. Old people can be and are beautiful. I have so many rich quotes from participants, it was difficult to choose one to end; this from Maggie:

I’m not talking about the front page of Vogue. I mean there are some wonderful models, you know, in their eighties who are still in Vogue and that is about looking good and glamorous and selling clothes – that’s not really what I am talking about. The beauty of how you are with people, how generous a spirit you are coupled with, yes, a love – an engagement with the world.   

Beauty is there: on radiant faces, eyes that shine, and an appearance that leads the viewer to gaze upon a luster, a vivid being.

Dr Naomi Woodspring was a Research Fellow, University of the West of England as part of the Bristol Ageing Better project and is currently a Visiting Fellow. She is also a Fellow at the Schumacher Institute. Since completing her PhD in 2014 she has published two books – Baby Boomers, Time and Ageing Bodies and Baby Boomers, Age and Beauty

References
Brand, Z. P. (2000). Beauty matters. Bloomingdale, IN: Indiana University Press
Cahill, A. J. (2003). Feminist Pleasures and feminine beautification. Hypatia, 18(4), 42-64
Chaaterjee, A. (2014). The aesthetic brain: How we evolved to desire beauty and enjoy art. Oxford: Oxford University Press
Craig, M. L. (2006). Race, beauty, and a tangled knot of a guilty pleasure. Feminist Theory, 7(2), 159-177
Gibson, C. P. (2013). “To care for her beauty, to dress up, is a kind of work”: Simone de Beauvoir, fashion, and feminism. WSQ: Women’s Studies Quarterly, 41(1 & 2), 197-201
Hollows, J. (2006). Feminism, femininity, and popular culture. Manchester: Manchester University Press
Ribeiro, A. (2011). Facing Beauty: Painted women and cosmetic art. London: Yale University Press
Scarry, E. (2000). On beauty and being just. London: Gerald Duckworth
Wilson, E. (2005). Adorned in dreams: Fashion and modernity (3rd ed.). UK: I. B. Taurus & Co., LTD.

Tuesday, 28 May 2019

Cosmetic Surgery Tourism: Self-Improvement in a Risky World

Why risk cosmetic surgery? Why risk infection, pain, possibility of life-long complications, just to look prettier? All surgery is dangerous but facelifts aren’t the same as (say) knee replacements that enhance our lives in obvious ways; with knee replacements we weigh up the risks versus the benefits and decide the risks are worth it. And choosing to have cosmetic surgery abroad, adding a foreign country into the mix, that’s just madness!

Contrary to popular opinion, ‘unnecessary’ cosmetic surgery may improve life as much as a ‘necessary’ knee replacement. Of the 100+ recipients of cosmetic surgery tourism that Ruth Holliday, David Bell and I interviewed, observed, and travelled with for our forthcoming book Beautyscapes: mapping cosmetic surgery tourism (MUP, 2019),  all had carefully weighed risk against benefit. They told us that they hoped cosmetic surgery would give them better opportunities at work, in romance, in day to day living. Further, they sought cosmetic surgery abroad, taking an additional risk in order to access services that were too expensive at home. We call them patient-consumers

Sociologists Ulrich Beck (1992) and Anthony Giddens (1990) argue that the current period of ‘Reflexive Modernity’ not only produces ‘goods’ but also many threatening and risky ‘bads’. The management of these risks is part of living in a ‘Risk Society’.  This intertwines with neoliberal cultures that urge us all to ‘take control’, to ‘do something’ to improve our lives and become our ‘true selves’. In neoliberal cultures individuals learn to calculate risk; to manage it in order to be the best we can be (because we’re worth it). Risk is thus made into an individualised, responsibilised choice. This partly explains how risk is managed in relation to cosmetic surgery tourism. 


Different individuals and groups understand and calculate risk differently (Douglas 1992) and people are differently positioned in terms of risk–benefit calculations. When we asked a room full of academics at a conference if they would improve their appearance with a wave of a magic wand, the vast majority—men and women—said yes. But very few said yes when the improvement relied on surgery. Most middle-class and tertiary-educated subjects enjoy sources of cultural and financial capital separate from their appearance, and thus for them the risks of cosmetic surgery outweigh the benefits (this is mitigated somewhat by gender, since women are currently still judged more on their looks than men, especially when women’s looks are integral to their income—either from employment or spouses). However, for those with less cultural capital and fewer other sources of value, the risk of cosmetic surgery can become worth taking. If one’s body is already commodified for the labour market then one’s aim may well be to add value to it or at least to limit negative evaluations or devaluations. For example, we interviewed two Australian prison guards having facelifts in Malaysia who felt they were no longer able to do their jobs properly because they looked like ‘grannies’.

Cosmetic surgery tourism patient-consumers attempt to know and manage risk. They take on this responsibility themselves, spending considerable time and effort researching and learning about clinics, surgeons, agents, destinations, flights, accommodation, aftercare, compression garments, breast implants, when and how much to exercise after surgery, etc. In fact, managing risk is a significant new form of labour that patient-consumers perform. In cosmetic surgery tourism, risk is individualised and is carried by the patient who chooses where to travel, what treatments to undergo, which surgeons and agents to use. In public health, as Annemarie Mol (2008) notes, risk is managed by the institution and embodied by the figure of the (often paternalistic and unchallengeable) doctor (‘the doctor knows best’). Cosmetic surgery tourists can use their ‘consumer power’ to avoid the potential abuses of this approach, but this comes with the cost of shouldering the work of managing risk personally. 


The cosmetic surgery tourists we worked with were responsible consumers who, for example, tried to avoid debt. Their surgeries were often funded by windfalls or long-awaited inheritances and compensations. Jess, who travelled from the UK to Poland, told us:

I thought about it for about a year. A year, seriously. I had a consultation here, in the UK, but it would have worked out really expensive and they wanted to give me a loan, so it would have put me in debt. This way I could save for six months and get it done and not be in any debt.

Patient-consumers are aware of the criticisms leveled against them for having surgery and for travelling abroad. But we found they were far from frivolous or flighty. All had researched surgeons and destinations thoroughly (not easy because qualifications are multifarious and independent registers of successful operations don’t exist). All were savvy about how websites can be deceptive, for example with rival clinics posting negative anonymous reviews. Thus, they were more likely to rely upon word-of-mouth recommendations. Social media sites were therefore crucial, providing direct access to other patients. Patient-consumers know that choosing the right clinic, surgeon, recovery place etc is vital because cosmetic surgery is largely under-regulated: they know that there is little legal recourse in their own countries, let alone across national borders, if things go wrong.

If complications develop at home, there are social sanctions for accessing the NHS. Popular opinion is that the NHS shouldn’t be responsible for people’s foolish decisions; that in some way cosmetic surgery tourists with complications have brought them on themselves. But note how profoundly gendered this attitude is: would the adventurous young man who rode a motorbike without a helmet in Bangkok, crashed, and needed NHS care on his return to the UK be scorned or told he was wasting taxpayers’ money? And yet people (about two thirds of the patient-consumers we interviewed were women) who seek surgery to improve their work, social and romantic prospects—to become better neoliberal citizens—are thought unworthy. Cosmetic surgery tourists are very aware of being considered a ‘burden on the NHS’ and their practices before, during and after surgery revealed they felt responsibility for this and sought to minimise its impact.

The ‘consumption’ of cosmetic surgery is part of the neoliberal imperative to constantly strive for self-improvement. But this is full of choices and risks. Patient-consumers bear the weight of this responsibility, and they are the ones who are blamed if things go wrong.

Meredith Jones is a Reader in Gender and Media Studies at Brunel University London. She is a feminist scholar specialising in theories of the body and is one of the pioneers of social and cultural research around cosmetic surgery. Her books and articles, especially ‘Skintight: An Anatomy of Cosmetic Surgery’ (Berg, 2008) in the area are widely cited. Meredith's latest major publication (with Ruth Holliday and David Bell) is 'Beautyscapes: mapping cosmetic surgery tourism' (MUP, 2019) based on data collected as part of the project Sun, Sea, Sand and Silicone). She is currently working on a monograph: ‘Velvet Gloves: A Cultural Anatomy of the Vulva

References:
Beck, U. (1992) Risk Society: Towards a New Modernity, London: Sage.
Douglas, M. (1992) Risk and Blame: Essays in Cultural Theory, London: Routledge. 
Giddens, A. (1990) The Consequences of Modernity, Cambridge: Polity Press.
Mol, A. (2008) The Logic of Care: Health and the Problem of Patient Choice, London:Routledge.