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Anger and Forgiveness"Are You There Alone?"10 Good Questions about Life and DeathA Casebook of Ethical Challenges in NeuropsychologyA Companion to BioethicsA Companion to BioethicsA Companion to GenethicsA Companion to GenethicsA Companion to Muslim EthicsA Cooperative SpeciesA Critique of the Moral Defense of VegetarianismA Delicate BalanceA Fragile LifeA Life for a LifeA Life-Centered Approach to BioethicsA Matter of SecurityA Mirror Is for ReflectionA Mirror Is for ReflectionA Natural History of Human MoralityA Philosophical DiseaseA Practical Guide to Clinical Ethics ConsultingA Question of TrustA Sentimentalist Theory of the MindA Short Stay in SwitzerlandA Tapestry of ValuesA Very Bad WizardA World Without ValuesAction and ResponsibilityAction Theory, Rationality and CompulsionActs of ConscienceAddiction and ResponsibilityAddiction NeuroethicsAdvance Directives in Mental HealthAfter HarmAftermathAgainst AutonomyAgainst BioethicsAgainst HealthAgainst MarriageAgainst Moral 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Challenged ProfessionsEthicsEthicsEthicsEthics and AnimalsEthics and ScienceEthics and the A PrioriEthics and the Discovery of the UnconsciousEthics and the Metaphysics of MedicineEthics at the CinemaEthics at the End of LifeEthics Case Book of the American Psychoanalytic AssociationEthics Done RightEthics ExpertiseEthics for EveryoneEthics for PsychologistsEthics for the New MillenniumEthics in CyberspaceEthics in Everyday PlacesEthics in Health CareEthics In Health Services ManagementEthics in Mental Health ResearchEthics in PracticeEthics in PsychiatryEthics in PsychologyEthics in Psychotherapy and CounselingEthics of PsychiatryEthics without OntologyEthics, Culture, and PsychiatryEthics, Sexual Orientation, and Choices about ChildrenEvaluating the Science and Ethics of Research on HumansEvilEvil GenesEvil in Modern ThoughtEvil in Modern ThoughtEvolution, Gender, and RapeEvolutionary Ethics and Contemporary BiologyEvolutionary Psychology and ViolenceEvolved MoralityExperiments in 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AmericaOxford Handbook of Psychiatric EthicsOxford Studies in Normative EthicsOxford Studies in Normative Ethics, Volume 7Oxford Textbook of Philosophy of PsychiatryPassionate DeliberationPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perfecting VirtuePersonal AutonomyPersonal Autonomy in SocietyPersonal Identity and EthicsPersonalities on the PlatePersonhood and Health CarePersons, Humanity, and the Definition of DeathPerspectives On Health And Human RightsPharmaceutical FreedomPharmacracyPharmageddonPhilosophy and This Actual WorldPhilosophy of BiologyPhilosophy of Technology: The Technological ConditionPhysician-Assisted DyingPicturing DisabilityPilgrim at Tinker CreekPlaying God?Playing God?Political EmotionsPornlandPowerful MedicinesPractical Autonomy and BioethicsPractical EthicsPractical Ethics for PsychologistsPractical RulesPragmatic BioethicsPragmatic BioethicsPragmatic NeuroethicsPraise and BlamePreferences and Well-BeingPrimates and PhilosophersPro-Life, 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How Much?Why Some Things Should Not Be for SaleWisdom, Intuition and EthicsWithout ConscienceWomen and Borderline Personality DisorderWomen and MadnessWondergenesWould You Kill the Fat Man?Wrestling with Behavioral GeneticsWriting About PatientsYou Must Be DreamingYour Genetic DestinyYour Inner FishYouth Offending and Youth Justice Yuck!
"Beauty opens doors, seals marriages, disrupts dynasties, prompts war... No matter how intellectually evolved we are, and no matter how primitive and vaguely immoral it sounds, beauty matters" (Kuzcynski:104-5). This ambivalent sentiment laces Kuczynski's engrossing and surprisingly balanced account of the burgeoning business of elective cosmetic surgery. A journalist and patient, as well as an insightful social observer, she examines not only the wide array of cosmetic enhancements available -- from Botox injections to vaginal reshaping -- but also the marketing and the motives inspiring their use. The text is brisk and exceptionally clear. It expertly inter-weaves a well-researched array of statistics amid both interviews with patients and practitioners, and sharp social commentary. The book addresses a variety of contentious issues, including the safety and regulation of various procedures, and the occasionally head-line grabbing excesses they engender, excesses indulged in by practitioners greedy for money or fame, and patients greedy for beauty -- "superlative narcissists," or "beauty junkies," she calls the latter. At its core, however, it explores the spectacular growth of cosmetic surgery as an industry, and what its clients are willing to pay -- in time, in money, in pain, and in risk -- for the enhancements it promises.
In evaluating the many motives of patients, she identifies among them fear of aging, social competition, appearance discrimination in employment, and a desire to fit into one's social surroundings, as, for instance, in surgical modifications that aim to eradicate traces of ethnic identity. Despite her misgivings about the latter procedures in particular, she consistently returns to two broader themes: the propriety of surgical procedures, with all their attendant risks, that serve no definitive therapeutic needs, and the difficulty of then identifying any medical limit to the scope of such enhancement procedures. Unlike many critics of cosmetic surgery, however, she does not merely facilely lament a human inability to accept what nature gave us. To the contrary, she recognizes beauty's siren song across time and culture, and accepts that beauty might matter on more than a superficial level. Even more strikingly, and again, unlike many critics in this venue, she takes to task only the most ardent pursuers of beauty at any cost, the "beauty addicts" whose insatiable appetite for enhancements, she suggests, may prove ultimately self-destructive.
Despite the book's title, moreover, Kuczynski is admirably restrained in criticizing such individuals for their pursuits. She decries instead what she depicts as a cultural drive to see cosmetic surgery less as a therapeutic means of "curing deformity," and more as a means of "curing ugliness" (Kuzcynski:72). She maintains, for example, that therapeutic plastic surgery was initially developed primarily to treat war injuries, and was only later turned to serve explicitly non-therapeutic aims. Even here, however, she opposes less a growing willingness to recast natural variations in human appearance as deformities meriting surgical correction, than a tendency to narrow the range of desirable traits. She does point out the apparent irony of enhancing one's self- esteem by making oneself look more like a particular social ideal. Yet her more subtle concern is that beauty itself might be rendered "mundane," an object to be surgically engineered. Here, she cites the work of one researcher who sought to discover the geometry of the beautiful face, and to provide a template from which cosmetic surgeons might then work. On this front, she notes that while she was largely skeptical of his project, she still wished to see how her face would compare to the mathematical ideal that he extrapolated. Throughout the book, she very effectively couples the information she presents with her own experiences with cosmetic surgery, evaluating whether her own pursuits qualify her as a beauty junky.
To the author's great credit, however, she very candidly acknowledges that her own misgivings about cosmetic surgery need not apply to others. She engages neither in political argument, nor in policy making, nor even in persuasion. Her book aims, rather, to provide insight into an industry for which she plausibly predicts staggering growth over the next few decades. In allowing the patients and practitioners and marketers of cosmetic surgery to speak for themselves, she provides a fascinating read for a general audience. For those unfamiliar with elective cosmetic surgery, she offers a point of entry into a world of exotic procedures -- like the toe shortening undergone by those seeking to wear designer shoes. Again to its credit, considering its audience and apparent intent, the book never claims to resolve the ambiguity of the opening quote cited above. It instead very accurately depicts a deep cultural confusion about the value of beauty and the scope of vanity. We hear daily that beauty is only skin deep, yet stew daily in a culture that screams the exact opposite. Is elective cosmetic surgery a vain pursuit, a practical career investment, a noble effort to make the most of what nature gave us, or something else entirely? Anyone curious to answer that question would be well served to read this informative and provocative book.
© 2008 Lisa Bellantoni
Lisa Bellantoni, PhD, Philosophy Department, Albright College, PA
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