The photo above is of my sister Connie Smith before cosmetic surgeons created fingers for her from skin on her thigh. Connie was interviewed for this article. Living in Orange County, California, inspired my interest in the topic; Connie’s embodied experience informed my thinking.
“Beauty often wins love. It just does,” write Karen Lee-Thorp and Cynthia Hicks in Why Beauty Matters. No wonder women, and, increasingly, men are willing to endure the pain and risk of elective cosmetic surgery to attain it. New York Times reporter Alex Kaczynski states it bluntly in her cosmetic surgery expose’ Beauty Junkies. “In the end it all comes down to sex. … We are looking for love. And we will accept lust.”
Few admit this with the aplomb of Cena Rasmussen. This former model readily confesses that her cosmetic surgery addiction was fueled primarily by the bliss of turning heads. By her own admission, Rasmussen has spent years looking in the mirror. More often than not, she has seen reason to improve the image that stares back at her. Rasmussen was twenty-seven years old when Palm Springs, CA, cosmetic surgeon Razi Mazaheri first sculpted her flesh. He was dating Rasmussen’s friend and she was envious of the friend’s evolving, surgically-enhanced appearance.
In one transformative day, Rasmussen had breast augmentation, rhinoplasty, cheek implants and an eye lift. The breast augmentation didn’t heal properly and had to be redone almost immediately. In fact, one-quarter to one-third of breast augmentations will require additional surgery, according to Kaczynski and the FDA.
For Rasmussen, aesthetic surgery would become a biannual ritual that continued for two decades. There were more rhinoplasties, breast surgeries and lifts—eyes, face, neck—and non-surgical procedures as well. The regimen ended with a hyalauronic acid peel in 1999 that burned the skin on her face so badly, she says it left her looking like a “freak of nature.” Since then, Rasmussen has sworn off Mazaheri and has had nothing but $4000 worth of laser treatments to reduce the scarring. Still, she remains undaunted and is planning another face lift—her third, or is it the fourth? She can’t recall.
Racing into the Future
Rasmussen may represent an extreme in the use, or what some might call abuse, of cosmetic surgery, but the trend has been growing exponentially. In 2006, according to the American Society for Aesthetic Plastic Surgeons, Americans spent just under $12.2 billion on 11.5 million surgical and non-surgical procedures.
That’s a 446 percent increase from 1997. Surgical procedures increased by 98 percent and non-surgical procedures by 747 percent. Liposuction, breast augmentation, eyelid surgery, abdominoplasty and breast reduction were the top surgical procedures in 2006, while Botox injections, hyalauronic acid, laser hair removal, microdermabrasion and laser skin resurfacing were the most popular non-surgical techniques.
Ninety-two percent of patients were women, but men had nearly one million procedures. Forty-seven percent of patients were aged 35-50, 22 percent were 19-34, and 25 percent were aged 51-64. Ethnic minorities made up 22 percent of the patient pool.
Sculpting flesh is just the latest in millennia of questionable beauty-enhancement practices. The use of mobile x-ray machines for hair removal early in the last century is another. By the 1930s, the technique seemed “firmly entrenched,” writes Teresa Riordin in Inventing Beauty. She says women appear to have been “either ignorant of the dangers or simply willing to ignore them, given the ease and effectiveness of the treatment.” Sound familiar?
According to Riordin, women have long been collaborators and profiteers in this business. From the mid-nineteenth to the mid-twentieth century, for example, women received one-third of all U.S. patents, but in the category of pre-surgical breast enhancement (“falsies”), nearly two-thirds of patent-holders were women.
So what is a Christian to think about elective cosmetic surgery? Is it a sin to get a nip and tuck? Depends on whom one asks. I asked a variety of professionals and lay people. Their answers are an eclectic brew.
Lilian Calles Barger, author of Eve’s Revenge, says the choice to have cosmetic surgery is not a free one. “If you tell me, ‘my mother had cosmetic surgery. She’s a very independent woman. She really loves God and she wants to do this, and this is her choice,’ I say, ‘This is not a free choice. This choice is under duress.” Barger describes the phenomena as “appalling,” “gut wrenching,” “fundamentally wrong,” “a failure of the imagination.”
“The body is not just a hunk of meat,” she insists. “The body is significant in Christianity. The Bible talks about how we are to offer our bodies as living sacrifices to God. The question is what are we offering our bodies up to when we do that?” Her conclusion is that we’re offering them up to “false beauty and to cultural norms that we should be challenging,” but adds, “so that is where you can be compassionate, because you can understand that sin is not the sinner by themselves. It is collaborative, communal, reinforced. We support each other in this.”
Barger’s claim was born out in interviews with several cosmetic surgery patients. In nearly every interview, individual choice was held out as a trump card, but all the women made their decisions within the context of relationships both personal and professional.
Therapeutic and Spiritual Perspectives
A disconnect between body and Spirit emerged in the reasoning of two patients who said body sculpting decisions are spiritually insignificant. “I don’t think it is a spiritual issue in any way,” says Rasmussen. “I personally believe that when we die, we’re going to have a glorified body that’s not going to be physical in any way. So what does the Lord care what we do to our skin?” Rasmussen explains that she both saved for her procedures and tithed faithfully throughout the exercise of her habit.
A fifty-something patient who asked not to be identified has had eye lid surgery, a chin implant, a mini-face lift and Botox. She says that as she struggled with the idea of tampering with the body God gave her, she sensed Him saying, “My beloved, you’re beautiful. You don’t need to do this.” She doesn’t believe, however, that tuning out the voice of God was sin. What matters, according to this patient, is “where your heart is.”
Cissy Brady-Rogers is a Pasadena therapist who has had a mastectomy, but no reconstruction after breast cancer years ago. She says that our culture “sets women up to feel shame about our bodies.” Body shame originates at home where children are not taught what to do with developing bodies and sexual impulses. It is then reinforced in school and through the larger culture. This coincides with what Brady-Rogers calls “disembodiment”—the phenomenon by which a subject looks into the mirror and sees that he or she does not measure up to cultural ideals and then comes to view their body as an object in need of repair rather than simply “me.” She says those considering aesthetic surgery would do well to heal the cause of their discontent (shame) rather than treating symptoms surgically.
Sociologist Philip Rieff talked about this disembodiment as “the triumph of the therapeutic” in his landmark 1960s book of the same name. It is a view of self as patient to be cured that he believed had replaced religion as the defining cultural narrative. He wrote, “That a sense of well-being has become the end, rather than a by-product of striving after some superior communal end, announced a fundamental change in focus in the entire cast of our culture—toward a human condition about which there will be nothing further to say in terms of the old style of despair and hope.”
For Christians walking out faithful body stewardship in defiance of this fundamental change, Brady-Rogers (who holds a Master of Divinity degree along with her other credentials) offers another narrative. She says patient-consumers are trying to figure out how to save themselves, just like the Galatians were, and in the process are biting and devouring one another by increasing the social pressure on all of us to conform to false ideals. “There is always going to be some law, some culturally offered avenue to save ourselves, to make ourselves okay, to fix what’s not working.” What Paul said is that it’s not going to work. Christ is the only one who can save us. “We are free to have plastic surgery. There is not a biblical law that says, ‘Thou shalt not have plastic surgery or drive a BMW,’ but what the Scripture says is: do not use your freedom as an opportunity for self-indulgence, but through love serve one another.”
For a woman contemplating aesthetic surgery, she advises, “I would like her to have a group of soul sisters who could support one another in becoming who they are in Christ, and support her in a process of discernment about that decision, not as solo journey. That may be part of the problem; too many women are making these decisions in isolation from other women.”
Idols and their Denouncing Prophets
Although the pursuit of beauty and the power it wields are timeless, a plethora of television makeover shows has normalized the triumph of both the therapeutic and the pornographic. Affluence and materialism, improved surgical techniques and doctors fleeing managed care realities for a cash business have all kept the engine humming along in the direction of more medical intervention to tame unwieldy flesh, according to Kaczynski.
In a 2004 New Atlantis article, “The Democratization of Beauty,” Christine Rosen wrote, “Cosmetic surgery … feeds our envy of those who embody nature’s most powerful but fleeting charms—youth, strength, beauty, and fertility. Its supporters praise its ability to change lives and its critics denounce it as the expression of our society’s worst impulses.”
As Christians reach for the charm, it’s these worst impulses that Hans Madueme, M.D., a fellow at the Center for Bioethics and Human Dignity, insist pose the greatest danger.
He calls the trend “deeply depressing” and says it’s one more area of American materialism that shocks his African family when they visit. The intuitive “yuk” reaction some Christians have towardaesthetic surgery is instructive, says Madueme. It tells us where the culture is moving, and reveals our loves, desires, idols and lusts. He suggests three “functional idols” that come into play with aesthetic surgery: youth, beauty and money. Consumers idolize youth and beauty, while medical providers exploit patients “inordinate desires” as a function of money idolatry.
Gary Churchill, a suburban Chicago facial plastic surgeon and aesthetic patient, offers a different perspective. He believes God directed him to a career that overwhelmingly consists of making women look and feel younger and more beautiful. Churchill was deeply offended when a fellow churchgoer suggested his work is incompatible with his faith. He takes a minimalist approach to surgery that leaves patients looking “refreshed” rather than altered.
Scot Rae, a bioethecist at Talbot School of Theology in La Mirada, CA, had an up-close and personal introduction to the world of cosmetic surgery when his wife Sally was having breast reconstruction after a double mastectomy. Although Rae was shocked to see young women in the surgeon’s office perusing catalogues that advertised buttocks implants, he strikes a middle ground.
Rae says Christians must see medical technology through a proper theological lense. He says God embedded his wisdom into creation through general revelation and that technology is “one of the primary ways that human beings unlock and apply God’s wisdom in the continuing quest to subdue the earth.” Rae allows that this quest was complicated after the fall, but says the three Ds—death, disease, and decay—were brought into the world by sin, and, as such, are legitimate targets for alleviation through technological means.
Like Madueme, Rae believes our intuitions are helpful, but sometimes in need of re-education. “They give us sort of yellow lights, but not necessarily red or green.” He offers a three-fold grid for evaluating aesthetic surgery. First, he says,” We are not our bodies, but we don’t devalue the body.” Second, “Medical technology, in general, to help alleviate the entrance of the effects of sin is a part of God’s common grace. And I think you can make a very good case that aging is a consequence of sin.” Third, “There’s a dynamic interaction between the soul and the body. So that’s why I think it makes sense that both men and women who have a change in their bodily appearance can feel better about themselves, and vice versa.” He concludes, “I think the bottom line is that you get principles and parameters out of Scripture and those form the fence around the field in which there’s freedom to make decisions.” If his eyelids were to droop in ten years, Rae says he would consider a nip and tuck.
Marketing toward Insecurity
To those who suggest that cosmetic surgery is marketed toward women’s insecurity, Ray Anderson, senior professor of theology and ministry at Fuller Theological Seminary in Pasadena, CA responds, “We need to look at it much more realistically, that it’s on a continuum. It’s on the same continuum as other aspects of embodied cultural life that effect our self-image….The solution to that [marketing towards women’s’ insecurity] is not to demonize an industry, but it is to revitalize the soul, the self in such a way that one is free to make use of products, services, opportunities within responsibility without having to be branded in ones own mind at least to be capitulating to that culture. We have to be strong enough so that Christian women now need to be socialized in the Christian community in such a way that they are able to make good choices with regard to products and opportunities to enhance their appearance and self-esteem within their culture.”
Anderson’s son-in-law Gregory Evans is chief of aesthetic and plastic surgery at UC Irvine Medical Center in Orange, CA. His practice is equally divided between corrective and aesthetic surgery. Evans says, “We all as physicians help people, but our area of the field is really trying to focus more on quality of life issues. … So one day a hand, another a cleft lip, breast reconstruction, injecting Botox around the eyelid—so we’re involved in the whole facet of a person.” Evans acknowledges the potential for exploitation, but offered a four page code of ethics from the American Society of Plastic Surgeons as evidence that his board is serious about combating unethical advertising practices fueled by greed.
The only board certifications Kaczynski trusts are those offered by the American Board of Plastic Surgery and the American Board of Medical Specialties.
Anne Brattli is an aesthetician and salon owner in Sarasota, Florida. Brattli found out the hard way that not all board certifications are equal. Ignorant of uneven licensing practices in the industry, she briefly went to work for Kurt Dangl, a practitioner who was later featured on 20/20 and in Beauty Junkies for his part in the death of a breast augmentation patient whose anesthesia was administered by an unlicensed “nurse.”
Brattli says Dangl offered free surgeries to employees after four months of employment. At first she considered a tummy tuck or liposuction. But after witnessing the grisly realities of the operating room (which were visible from the break room where employees ate their lunch), Dangl’s arrogance and myriad grotesque complications, she changed her mind. Eventually she learned that Dangl’s primary training had been in dentistry and took an early and permanent maternity leave.
Brattli has been examining women’s faces under a high-powered microscope for a decade. She identifies a nagging problem with medically enhanced beauty. “When you’re talking to someone who’s had Botox and they smile at you, they don’t look sincere and you can’t put a finger on it, but it’s because they’re smiling at you with their mouth and not with their eyes. When you get a person who smiles with their eyes and their mouth, you feel like they’re genuine. With Botox, it doesn’t matter if they’re genuine. It just never reaches their eyes.”
“Sooner or later a person that resorts to some artificial way of delaying aging or overcoming some perceived abnormality is going to have to deal with the fact that you’re going to have to live with what you’ve got,” concedes Anderson, who, at 80-years-old, is still dying his hair and beard dark brown.
Wisdom from Tarnished Humanity
Some women, like Connie Smith, never have had a choice about the bodies they inhabit. Smith was born with multiple birth defects [her term of choice]: congenital constricting bands that cut off most of her fingers at or below the knuckles, a clubbed foot and webbed toes. With sponsorship from March of Dimes, cosmetic surgeons created digits that have served her well for more than 40 years. Perhaps it is women like her, Brady-Rogers and Sally Rae who have the most to teach us about living within our imperfect, aging bodies.
Smith is a homemaker and is divorced from her husband. Facing the idea of mid-life dating and re-entry into the job market, she has no plans for medical enhancement. She feels the same cultural pressures that others do, but says when she feels good about other areas of her life—particularly her relationships with God, family and friends—her birth defects don’t bother her or others. “When I’m feeling good, I project an air of confidence, she says, “My hands are the last things on someone’s mind; they are looking at my face or my body, or they are listening to my words. My hands are irrelevant. When I project insecurity, I feel like some people treat me like I’m invisible. They’re looking at me in a different way.”
Rieff and Kaczynski may be correct that the therapeutic and the pornographic have triumphed. The theologians may be correct that technology can be either used responsibly or abused in a Christian context as it alleviates the effects of the fall. Feminists and therapists may be correct that the industry exploits women’s greatest insecurities and culturally induced shame. But there’s also something uniquely American and Protestant in the wholesale rush to embrace medical enhancement.
David Brooks describes this strain of perfectionism in American life in his book On Paradise Drive. He writes, “Unlike some other bourgeois nations, we are also a transcendent nation infused with everyday utopianism,” a utopianism that “lures us beyond the prosaic world” and “gives us a distinct conception of time, so we often find ourselves on some technological frontier,” Of these ever-expanding frontiers, Brooks duly notes that we occasionally look back on them with regret.
As medically altered faces and bodies become more commonplace, will the era of Botox and DD breast implants be one we regret? Will the dangerous excesses be abandoned as x-ray hair removal machines were? One can only hope.
*Note: I have not updated the information in this piece. Source affiliations and cosmetic surgery stats may have changed.