D. Tube or knife?

Moisturizer or mascara might lure with possibility of transforming, but plastic surgery promises better. In spite of being costly and often overlooked medical procedure, the industry has grown drastically in the past 30 years. The trend began in the 1980s with a campaign to improve public awareness and perception. To make procedures more “user-friendly,” linguistics changed from plastic to cosmetic surgery.1 And to lure clients in, beauty problems needed to be constructed.

In early marketing, the American Society of Plastic and Reconstructive Surgeons referred to small breasts as a “disease,” causing a “total lack of well-being”.2 Doctors offered finance plans and credit for prospective patients. Marketing campaigns were widespread, offering everything from a better self-esteem to an improved career. Fashion magazines ran articles with advice on surgery and true-life stories of bigger bust sizes and subsequently better lives. In Ladies' Home Journal, a respectable magazine aimed at middle-aged women, the reader could learn about three generations of women in a family who touted the results of face lift, breast augmentation and nose job.3

Advertising was very effective. Women of the middle class – not just the expected wealthy – jumped into the game. They took out loans and second mortgages to pay their bills. And the marketing strategies of course always diminished the risks. Early breast implants of the 1980s had the highest surgery failure rate.Liposuction, promoted as “the revolutionary technique for reduction of fat without dieting” often caused painful infections and even a worsening of the “cellulite problem.” Women died from these surgeries, although resultant deaths were not always correctly reported because families were ashamed of chalking up death to a “vanity procedure”. There were many side effects early on: damaged facial nerves; breast implants which solidified and moved into armpits; scarring and loss of feeling. Studies are still being done on long-term effects on the body, with possible connections to cancer and arthritis.4

Plastic surgery has become safer over the years. Websites boast of less invasive techniques. One plastic surgery center writes that “Cosmetic surgery should be viewed as a long term investment in yourself and your future”.5 In the U.S., which ranks #1 in plastic surgery procedures, it has also become more smoothly packaged, better advertised and more accepted in the main-stream. In current news, the Miss California Pageant admitted to funding the breast implants of recent Miss USA runner-up Carrie Prejean. "We assisted when Carrie came to us and voiced the interest in having the procedure done...We want to put her in the best possible confidence in order to present herself in the best possible light on a national stage," the co-Director said in an interview.6

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Surgeon Anthony Berlet boasts that “Liposuction can...be used to fine-tune the sculpture of human flesh back into a woman who is no longer just surviving but now “living”.8 Another plastic surgeon muses that having breast augmentation “complements a woman's natural curve...Women who have breast augmentation have a fuller shape that not only is pleasing aesthetically but also makes it easier to fit into clothing and improves self-confidence”.9 The fastest growing trend in cosmetic surgery in the U.S. today is in vulva augmentation, so women can now have “designer vaginas.”10 Botox is reported to be the most popular procedure. From 2000 - 2005, the number of Botox injections increased from 1.1 to 3.3 million injections. 11

Billboards tempt women with attainable solutions to those difficult problems like facial lines, cellulite and aging skin. To fix such problems, our above model could chose liposuction, Botox or a photofacial, for example.

There is a growth worldwide in cosmetic surgery tourism, as perspective clients from Western countries travel abroad for better prices, possibilities of combination procedures, and more discretion. One woman traveled from the UK to India for an extreme makeover, a trend that in combining various procedures that has risen dramatically.12 Frommer's travel website offers a laundry list for surgery seekers: South Africa, Brazil, Jamaica, Venezuela, Costa Rica, Thailand and the Philippines all offer great packages of surgery clinics and tourist attractions.13