Flesh Wounds: The Culture of Cosmetic Surgery

Flesh Wounds: The Culture of Cosmetic Surgery. By Virginia L. Blum. (Berkeley: University of California Press, 2003. Pp. x + 356, acknowledgments, photographs, notes, bibliography, index. $29.95 cloth, $19.95 paper) Blum has written a provocative and thoughtful exploration of contemporary American interest in cosmetic surgery and its influence on identity. Her analysis is scholarly, but with a personal tone that is neither tangential nor overly confessional. She asserts that three cultural phenomena have profoundly shaped the experience of American life in the twentieth century: celebrity culture, psychoanalysis, and plastic surgery. Blum skillfully weaves these three threads together to develop an innovative picture of how identity is increasingly rooted in two-dimensional images. Her analysis includes examination of selected literature (including Frankenstein, of course) and films in which plastic surgery is key to transformation of identity, as well as interviews with several plastic surgeons and observations of surgeries. Regrettably, she provides little background about the interviews or how candidates were identified and selected for interviews, and no indication of an interview protocol. Blum briefly and knowledgeably rehearses some truisms of contemporary feminist theory-such as the way feminine identity is shaped by the male gaze so that woman becomes both an object and a subject to herself-to develop her thesis. She recognizes that it is widely assumed that people-especially women-are influenced to change their appearance by omnipresent images of impossible-to-achieve beauty. But Blum rejects the claim that surgery is on a continuum with other forms of body modification such as chemical hair straightening or curling, tooth bleaching, and starvation diets; among other criticisms, she notes that these practices have a comparatively low risk of fatality. Blum regards the acceptance of risk of death in exchange for beauty as indicative of the degree to which we identify with the two-dimensional. Blum focuses on the narrowing distinction between the human and the two-dimensional in our cultural definition of beauty and its pursuit. "We are immersed in visual culture to the degree that we become its embodied effects," making the specific content of the image thus less important than the general yearning for identification with the image per se. Cosmetic surgery ultimately transforms the patient's image as much as it transforms her body, as beauty comes to be defined as photogenicity. This identification with media images ultimately puts us at risk for "a lifetime of transformational identifications" because images are inherently changeable, two-dimensional, and technologically constituted. Blum notes, however, that critical demands for "more realistic" media images are ineffectual: "To imagine that there are people who could change the images if they wanted to is to misunderstand the embeddedness of the image producers in a cultural machinery that they don't run but instead merely service. …