2 for 1 at the surgeon’s office: The trivialization of cosmetic surgery

“Having no butt” had been a lifelong insecurity for Míriam Parralo. After years of saving, shortly before the pandemic began, she came up with the $8,000 she needed for a cosmetic operation to implant fat around her buttocks to make her bottom look bigger: “I was very excited, but I did something dumb and I regret it a lot.”

Her operation didn’t go as planned. They talked her into getting synthetic implants instead of fat, and now one of them does not stay in place. She feels deformed. A single working mother, she doesn’t have the money to file a lawsuit against the clinic or to undergo another surgery to fix the problem. “Before the surgery, I was hardly informed of anything. They told me the usual, that the implant could burst, but little else. Nothing to do with what happened,” she says.

In many low-cost clinics, it is salespeople, often with no health training, who explain the procedure to the patients (or rather, clients), of whom close to 85% are women. And patients who undergo an operation have no more than a brief encounter with the surgeon. This, together with aggressive sales promotions and a growing and massive exposure to unrealistic models of beauty, particularly through social media, is leading to a trivialization of cosmetic surgery, according to professionals, medical societies and experts.

“Some people think that this is like going to the hair salon, and don’t understand that complications may occur after surgery,” says plastic surgeon Diego Tomás Ivancich.

Surgeries gone wrong

Although surgical errors are not the norm, they are not completely unusual either, and the proliferation of low-cost clinics with medical professionals who are not specialized in plastic surgery, as well as the growing amount of procedures performed, is only increasing the number of errors. The International Society for Aesthetic Plastic Surgery (ISAPS) sees a rising trend in cosmetic surgeries for the coming years, after the pandemic brought the figures down in 2020. According to their latest report, United States, Brazil and Germany occupy the first three positions when it comes to plastic surgery.

Yolanda Cabrera, doctor in Audiovisual Communication and lecturer at Spain’s University of Valencia, explains that this may be due in part to the fact that “social media has aggravated the pressure of the tyranny of the image.” She explains “there is social overexposure and exhibitionism” on social media, which also hypersexualizes younger girls. This social pressure can lead to hasty decisions.

You get what you pay for

Surgeon Diego Tomás invites anyone who is planning to get cosmetic surgery to ask themselves what makes it so cheap: “There’s no such thing as a free lunch. They save on materials, on salaries, on facilities, don’t let the patient stay for enough time after the procedure, they have a single anesthetist for two simultaneous surgeries or perform several at the same time, something I would never do as it increases the risk of complications.”

Esther Pineda, doctor in Social Sciences and author of Bellas para morir. Estereotipos de género y violencia estética contra la mujer (or, Beautiful to die for: Gender stereotypes and aesthetic violence against women), elaborates: “The democratization and cheapening of plastic surgeries and other aesthetic procedures has contributed to their massification. It ceased to be a privilege of those with greater purchasing power in order to become available to any woman, even low-income women.” She alludes to 2 for 1, “bring a friend” special offers, packages that offer surgeries in countries where they are less expensive and that include airfare, hotel and surgery, deals where if you have two surgeries performed the same day the third one is free, social media raffles with surgeries as prizes and other similar practices.

Nonetheless, that is part of the commercial policy of some clinics. Francisco Menéndez Graiño, who has been a plastic surgeon for more than 40 years, laments that these centers are not managed by doctors, but by businessmen: “Ours is not a business, it’s a profession.”

Retouched skins, enlarged eyes, eternal youth: aesthetic violence

Clinical psychologist Aurora Gómez, expert in digital behaviors, explains that “what is normal [what we think is normal] is what we see most frequently.” What do teenagers see most often? “A lot of input through Instagram, a massive presence of those retouched skins, those enlarged eyes, that eternal youth.” That starts to become “normal” and “they start to alter the perception of their own body.”

Gómez talks about the “somatoform disorder” that can be produced by the continuous consumption of unreal beauty: “They generate an altered perception of themselves; there are no filters in the street, and the only way to achieve that perfect image is with surgery, in a society with a cult of beauty and the body from which a lot of money is made.”

That fits within what sociologist Esther Pineda defines as aesthetic violence: the set of narratives, representations and practices that exert pressure and forms of discrimination on women to force them to respond to the canon of beauty; social pressure that has physical and psychological consequences on women and that is based on four premises: sexism, gerontophobia, racism and fatphobia.

The demand for femininity, thinness, whiteness, and youth, has been maintained over time – explains Pineda – and the way in which aesthetic violence is exerted today has increased and become more widespread, due to the overexposure to the canon. At the same time, the opinions and judgments have multiplied: “Before, these comments could come from family members, friends, partners, study or work colleagues, but now our bodies are constantly exposed to the evaluation of endless people, known or not, through social media.”

As feminism grows and spreads, so do stereotypes and the omnipresence of aesthetic perfection. Pineda argues that “the questioning and problematization of aesthetic violence, plastic surgery, or the digital modification of the image does not mean that women’s freedom to choose over their bodies is being taken away or curtailed,” but that “they have enough information, that they know that there is nothing wrong with their bodies, that it is not an individual problem, as the beauty industry has led us to believe so that we can consume their products and services.”