‘The poor have the right to be

beautiful’: cosmetic surgery in

neoliberal Brazil
Alexander Edm onds Macquarie University

Drawing on ethnographic fieldwork in hospitals that offer cosmetic surgery to the poor, this article
examines the causes of a rapid growth in plastic surgery rates in Brazil over the past two decades. It
argues that problems with diverse social origins manifest themselves as aesthetic defects, which are
diagnosed and treated by the beauty industry. But plastic surgery also incites the consumer desires of
people on the margins of the market economy and mobilizes a racialized ‘beauty myth’ (a key trope
in national identity) in marketing and clinical practice. Beauty practices offer a means to compete in a
neoliberal libidinal economy where anxieties surrounding new markets of work and sex mingle with
fantasies of social mobility, glamour, and modernity.

Only intellectuals like misery. The poor prefer luxury.

João Trinta, Carnivalesco, Carnival parade designer
The patients here have this philosophy of the masses: the beautiful live and the ugly die.
Dr Marcelo, chief of a plastic surgery ward at a Rio de Janeiro public hospital1

In the universe of beauty

In contrast to the calm and comfort of the private clinics where I begin my fieldwork,
Rio de Janeiro’s public hospitals have a hectic environment. Lines of patients sprawl
through the narrow corridors that serve as waiting rooms, while young residents in
surgery bustle past with stacks of medical files in their arms (Fig. 1). The patients,
mostly women and children, span the full range of colours celebrated in Brazil as the
hallmark of the povão, ‘the common people’. For some it is easy to tell what the
complaint is, as the residents say. A cleft palate, a chest burn, a mangled ear. But most
patients come for cosmetic surgery, what they call simply plástica.
On most days when I visit Santa Casa hospital, housed in an old convent in down-
town Rio, the patients are eager for their operations and there is an excited buzz in the
hallways. They have been waiting anywhere from a few months to several years. Strang-
ers strike up conversations about their breast surgeries or discreetly lift up their blouses
to compare results. Upstairs relatives crowd the corridors waiting to visit patients
recuperating in shared rooms, while a team of forty surgeons perform the full range of
cosmetic and reconstructive procedures. A Japanese television crew shoots a story one
day. On another, former residents come to pay their respects from Europe. In the midst

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Figure 1. Patients waiting to be attended at the plastic surgery ward of Santa Casa Hospital, Rio de
Janeiro. (Photo by author.)

of this daily routine the presence of an anthropologist will go mostly unnoticed, the
founder of the clinic, Dr Ivo Pitanguy, tells me, and leaves me free to wander the
hospital.
Vera, a woman in her forties, explains why she decided to have a breast reduction.
After having a child at age 20, her breasts enlarged. ‘I decided to take better care of
myself, né? I said to myself, “I deserve this, it’s my time now. If it’s something bothering
me, I have the total right to do it” ’.
Like many patients, Vera came to Santa Casa after seeing an interview on television
with Dr Pitanguy. When he founded the plastic surgery ward in 1962, it offered only
reconstructive procedures, and Pitanguy performed cosmetic operations in a private
clinic. The two clinics – one offering a luxury service, the other treating the victims of
industrial fires and car accidents – seemed to illustrate Brazil’s stark inequality. But
Pitanguy has said that ‘plastic surgery is not only for the rich. The poor have the right
to be beautiful’.
As the surgeons he trained open up new clinics around the country, demand for
plástica has been steadily rising. Santa Casa, which is funded in part by Catholic
charities, in part by the state health system, charges a small fee to cover anaesthesia and
medical materials for cosmetic patients. But there are also fully public hospitals in Rio
and around the country, supported by federal or municipal budgets, which offer
cosmetic surgery at no cost.2 And in the private sector, aggressive price-cutting and
credit plans offered by surgeons entering a saturated market have made plástica ‘inte-
gral to the roster of middle-class aspirations’ (Os exageros da plástica 2002). During the
1990s, the number of operations performed increased six-fold. In 2001, Brazil’s largest
news magazine Veja ran a story titled ‘Brazil, empire of the scalpel’, which claimed that
Brazil had displaced the United States as the world’s ‘champion’ of cosmetic surgery
(Brasil, império do bisturi 2001).3 As if to confirm the victory, a samba school honoured
Pitanguy in a 1999 Carnival allegory, titled ‘In the universe of beauty’. Brazil’s leading
surgeon led the procession from a perch on a float while hundreds danced to a samba
song that celebrated his work:

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Creating and modelling nature

The hands of the architect
Are in the universe of beauty
Giving men value with his chisel ...
Love take me so I will delight in
My narcissistic soul ...
The image and likeness of the Lord
Restored by the hands of the professor
The self-esteem in each ego awakens ...
Plastic beauty from subtlety to perfection
The light of heaven conducts his scalpel
Caprichosos sings Master Pitanguy.
‘No universo da beleza, Mestre Pitanguy’, performed by Caprichosos de Pilares Samba School, 1999

A shrinking state with a crumbling health system provides free plástica. A right to
beauty is celebrated in a country where human rights are disparaged as ‘privileges for
bandits’ (Caldeira 2000: 39). And perhaps not least, a tribute is paid to plástica during
Carnival – that beloved ‘folk opera’ of Bakhtinians and Brazilianists (myself included)
– when the long-suffering povão supposedly do not pay homage to elites but, for a
moment, take their place.
These juxtapositions make good news copy, and numerous articles on plástica have
appeared in Western media. The tone is one of outrage or amusement. The Brazilian
media, however, have been remarkably positive about the growth of plastic surgery.
Some stories cite the international reputation of Brazilian surgeons as a point of
national pride. Others view the growth of plástica as an indicator of economic health, a
flexing of Brazil’s consumer muscle. The fact that more Brazilians are having cosmetic
surgery, Veja reasoned, simply means that more Brazilians are becoming middle class
(Brasil, império do bisturi 2001).
But the growth of plástica cannot be explained as a product of economic prosperity.
Wealthier European countries have per capita cosmetic surgery rates only about a fifth
of Brazil’s (Brasil, império do bisturi 2001), and the so-called ‘democratization’ of
plástica occurred during a period of rising economic inequality in the 1980s and 1990s,
a period where the term ‘brazilianification’ became a synonym for ‘savage capitalism’
(Mello & Novais 1998). Why is demand for plastic surgery rising in one of the most
unequal societies in the world? How can beauty be offered as a ‘right’ in a cash-strapped
public health system? And why is there an operation called ‘correction of the Negroid
nose’ in a land known as a racial democracy?
Focusing primarily on the West and relying on textual and media materials, several
scholars have argued that beauty practices are an exercise in patriarchal power that
disciplines, normalizes, and medicalizes the female body (e.g. Bartky 1990; Bordo 1993;
Chernin 1981; Jeffreys 2005; Morgan 1991; Rankin 2005; Wolf 1991). I find it necessary to
modify this framework, however, in moving from the implicitly middle-class subjects
in these accounts, to patients who belong to the ‘popular classes’, who have a different
relationship to modernity, medicine, and consumer culture. In taking an anthropologi-
cal approach, I instead try to balance a ‘hermeneutics of suspicion’, which analyses the
structural factors feeding the beauty industry’s growth, with a ‘hermeneutics of
retrieval’ (Ricoeur 1970), which interprets local meanings across gaps of culture and
class (and, in my own case, gender, as plástica is a primarily feminine realm).
I argue that a range of problems with diverse social origins manifest themselves as
aesthetic defects, which are diagnosed and treated by the beauty industry. But with its

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powerful clinical and consumer visualization of the body, plástica also taps into the
aspirations of people on the margins of the market economy. Beauty practices offer a
means to compete in what I call a neoliberal libidinal economy where anxieties sur-
rounding new markets of work and sex mingle with fantasies of social mobility,
glamour, and modernity. At a time when plastic surgery is growing in developing
countries around the world, from Latin America to the Middle East and East Asia, the
Brazilian case, I hope, will offer insights into how new configurations of medicine,
therapy, and aesthetics are consumed in the peripheries of capitalism.

‘The self-esteem in each ego awakens’

Denise is a 17-year-old seeking a breast reduction and lift. She is moderately overweight,
wearing jeans that even by Rio standards seem painfully tight. Her shoulders are tense,
her arms folded over her chest. Dr Afonso tells her to lift up her t-shirt, but pauses to
ask a woman standing at the back of the room if she is her mother. (Minors cannot be
examined at the hospital without the presence of a guardian.)
‘Why?’ Denise responds to the doctor’s request, but then gives in without an answer,
pulling up her t-shirt halfway. Sensing her discomfort, Dr Afonso does not, as he
usually would, pinch the sides of her breasts to simulate the effect of the lifting
operation.
It’s a Friday morning at Santa Casa, the day of the plano cirúrgico, a pedagogical
discussion of technique led by a senior surgeon. Under a ceiling fan that ineffectually
stirs the humid air, residents sit in rows of tiny school desks. Patients are asked to expose
the relevant part of the body, while the residents take turns leading the examination. Dr
Afonso explains that Denise should wait until she has lost some weight in order to get
the optimal aesthetic result.
‘Wait?’ Denise interrupts him. ‘I’ve been waiting in line for three years’. The mother
seems embarrassed and tries to explain.
‘Doctor, it’s really hard. She has back pain’. She pauses, then adds helpfully, ‘Her
self-esteem is low’.
The surgeon turns back to Denise and adds, ‘Okay, we’ll do it. If you lose more
weight come back and we’ll do a touch-up (retoque)’. He applies his signature to her file.
After Denise has left the room he explains his reasoning to the residents.
‘She is not pretty, she has low self-esteem, and she’s poor. She has no access to
psychotherapy, to gyms, to nutritional guidance. And do you think she’s going to lose
weight? The reason we operate is not because of her back. Her principal illness is
poverty’.
It is doubtful Denise’s mother swayed the doctor since patients are rarely turned
away. But she did hit upon plástica’s key legitimating concept: autoestima or self-
esteem. As cosmetic surgery sought to establish itself as a medical practice in the United
States at the turn of the twentieth century, the central difficulty it faced was how to
define the disorder that it treated (Gilman 1999: 175-6; Haiken 1997: 91-130). Since a
botched operation harms an otherwise healthy patient, surgeons who practised aes-
thetic surgery risked breaking the Hippocratic oath. Early plastic surgeons denounced
‘beauty doctors’ as quacks. But after the First World War, surgeons realized that the
improved techniques developed while reconstructing the mutilated faces of soldiers
could successfully be applied for purely cosmetic purposes. All that stood in the way of
the widespread peacetime growth of the specialty was the discovery of a proper illness.

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The discovery was made not by medicine but by popular psychology. In the early
twentieth century, the notion that appearance is integrally linked to the psyche became
publicly accepted. Concepts such as the ‘inferiority complex’ helped make cosmetic
surgery acceptable by giving it a therapeutic rationale (Haiken 1997: 114-17). But in
Brazil, this therapeutic rationale has been pushed into new territory – in a sense, to its
logical conclusion – as it is deployed in Brazil’s public health system serving a popu-
lation described simply as carente, ‘needy’.
Over thirty-five years ago, Dr Claudio founded a plastic surgery ward at a municipal
hospital in Rio de Janeiro located at the foot of Mangueira shantytown, home to Rio’s
most famous samba school.
‘In the past,’ he told me, ‘the public health system only paid for reconstructive
surgery. And surgeons thought cosmetic operations were vanity. But plástica has psy-
chological effects, for the poor as well as the rich. We were able to show this and so it
was gradually accepted as having a social purpose. We operate on the poor who have the
chance to improve their appearance and it’s a necessity not a vanity’.
This reasoning, however, raises the question of why – if patients are suffering
psychologically – they should not be treated by psychologists? In fact, some surgeons do
agree that their patients could benefit from therapy or pharmaceuticals. Pitanguy
employs a psychologist at his clinic who gives all patients a pre-operative interview. But
while she believes that ‘the majority of patients are contra-indicated’, she rarely turns
them away so as not to ‘disappoint’ them. Other surgeons, those struggling to get a
toehold in a crowded market, appeal to the therapeutic rationale as a marketing tactic:
for example, through ads that promise to ‘raise your breasts and your self-esteem’. But
many surgeons I talked to also seem sincerely to believe that plástica is a form of ‘public
health’ to which the poor should have access.
‘Look, no surgeon would put in a prosthesis when there’s no need’, the Chief of
Plastic Surgery at a federal hospital told me. ‘There are women with a really fallen
ego. After four children, the breasts are so shrivelled and ugly ... there’s a psycho-
logical indication and so we authorize the surgery’. The surgeons’ sense of confidence
seems to be reinforced by the long lines they see every day at their clinics, by requests
for operations from the wives and relatives of their colleagues, by the fact that female
staff at hospitals, from nurses to coffee vendors, ‘all want operations’. Some patients
even revere their surgeons as artists or geniuses with ‘gifted hands’ – an association
exploited in ads that juxtapose before and after pictures with images of works
of art.
But while Pitanguy acknowledges that ‘there is a lot of art in our field’, he argues that
ultimately plastic surgery is ‘normative’: ‘I cannot – like a Picasso – have three breasts
or whatever. But inside our limitations we can do many things’. Pitanguy, however, does
feel it necessary to warn his less experienced colleagues to be wary of an ‘excess of
self-confidence’. He calls this the ‘Pygmalion complex’, in which ‘the surgeon-artist
repeats the drama of the sculptor, and falls blindly in love with his work’ (Pitanguy 1992:
271). The surgeon falls in love, not with the patient, but rather with the physical form
he creates – a condition that ‘blinds’ him to the patient’s real complaint. More common
than the Pygmalion complex is a kind of patient reaction that surgeons compare to
psychoanalytic transference and projection. The spectre of the complaining patient
haunts plástica more than other medical specialties because defects are psychologically
invested. Post-operative reactions range from depression and crises of regret to eupho-
ria, exaggerated gratitude, and sexual invitations to the surgeon (Pitanguy 1992: 271).

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Such reactions prove that surgical incisions do not just alter the face, but ‘go beneath the
skin, touching the psyche too’ (Pitanguy 1983: 8).
But while they are wary of the ‘scalpel slave’ – the patient addicted to surgery – most
surgeons tend to believe that plástica is simply the most effective ‘therapy’. Thus a plastic
surgeon joked, ‘What is the difference between a psychoanalyst and a plastic surgeon?
The psychoanalyst knows everything but changes nothing. The plastic surgeon knows
nothing but changes everything’. Moreover, surgeons point out, psychoanalysis has
limited efficacy with working-class patients. But the suffering that plástica cures is,
unlike neurosis, distributed across classes. As Dr Herbert put it, ‘Faced with an aesthetic
defect, the poor suffer as much as the rich’.

‘Giving men value with his chisel’

Perhaps Denise experienced the same suffering that Rogéria did, a teenager whose
parents paid a private Ipanema clinic about $5,000 for an identical operation. But if we
accept for a moment that these patients have been healed, we might still ask how they
came to have a defect in the first place. In the absence of physical pain, what motivates
patients to confront the bureaucracy of public hospitals, wait on lines along with the
disfigured, endure a painful period of recuperation, and undergo the risk of com-
plications and even death?
One answer, as we have seen, is low self-esteem. But Dr Afonso also voiced a minority
opinion: ‘Her principal illness is poverty’. The comment indicates that the psychological
suffering that plástica heals has roots in larger social problems. When President
Cardoso was inaugurated in 1995 he announced ‘the end of the Vargas era’. His claim
was that the policy of modernization as defined by the populist leader in the 1940s and
1950s could no longer serve as a guiding vision of national development (Reis 2000:
178). Whether a new incarnation of modernization will emerge – or what new forms of
polity will take its place – remains to be seen. During this time of transition undergone
by Brazil, many have argued that the emergence of new rights has coexisted with a split
in citizenship between the ‘market-able’ and those surviving on the margins of the
formal economy (Biehl 2001: 105; 2005).
While the human rights movement has grown in Brazil, there has also been an
increase in violence and in police terror, and a partial privatization of security (Caldeira
2000). In the area of health care, the split between private and public sectors of different
quality has deepened, even as the new democratic state ambitiously provided a univer-
sal right to health care (Biehl 1999: 54-7).4 Thus the right to health care, like many social
rights in Brazil, is based on a public-private division that reproduces the larger
inequalities of the market economy. With the shrinkage of the state and an influx of
foreign goods, others have argued that citizenship is increasingly defined in the sphere
of consumer culture (Canclini 2001; O’Dougherty 2002). If Brazil is Belíndia, as an
economist put it, half-Belgium, half-India, then its two sides are drifting further apart.
In this time of uncertainty, diverse social anxieties emerge as symptoms in the beauty
industry’s psychological and medical discourses. And so while surgeons believe the
aesthetic defect is located in the patient’s psyche, and imply that they are treating
a psychosomatic disorder, I argue that the aesthetic defect is also ‘sociosomatic’
(Kleinman & Becker 1998: 292): produced by connections between mind, body, and
society.
Receptionists, elevator operators, maids, cooks, hotel staff, vendors, telemarketers,
events promoters, English teachers, and secretaries. This list of commonly encountered

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patient occupations points to three related social trends in Brazil: the rise of female
employment, the feminization of the working class, and the growth of the service sector
(Ribeiro & Scalon 2001: 3). Service work places a special emphasis on the appearance of
the worker, who faces direct contact with the customer. Traits such as youth and sexual
allure can ‘add value’ to the service interaction, while colour continues to act as a bar to
some job categories (Fry 2005: 267-9; Hasenbalg & Silva 1999). The boa aparência (‘good
appearance’) unofficially required by many service jobs is a euphemism for white.5
Colour is a provisional classification in Brazil, subject to adjustment – hence the saying
‘money lightens’. By the same logic, subtle cosmetic changes may nudge a job-hunter a
little closer to a boa aparência. These conditions present fertile ground for anxieties
about appearance.
Aline is a 24-year-old breast implant candidate who lives in a working-class area in
Rio’s North Zone. After seeing an ad, she went with a friend to a cheap private clinic
close to home. At 3,000 reais, the surgery would still have been a large ‘sacrifice’. Her
friend backed out and decided to buy a car instead. But then Aline decided to try Santa
Casa because she heard that it ‘was a good deal’.
‘The breast is a thing that bothers me. It’s something for my work because they really
demand a good appearance. I pass through a selection each day, and the better I am ...
I’ll have a return on that’.
Aline works at product promotions and events, distributing paper cups of Gatorade
at bars near Rio’s South Zone beaches. The job pays well, about 20 dollars a day, but
work is irregular. She has been doing it for five years, hoping to save enough money for
college.
‘Lots of girls apply to the company and we’re selected by the body and appearance
... I want to improve myself. After the breasts, I’ll do a lipo on the saddlebags and “little
tires” ’.
‘Will you earn more money?’
‘I think so. No one’s going to hire someone who will ruin the image of the product.
They hire the best they can get. And in any case, it will boost my self-esteem’.
References to work and the wider social world punctuate discussions of the decision
to have plastic surgery. Some worry about being fired, others hope to break into a new
job market. Nancí is to have rhinoplasty after losing a job because, she says, her nose is
‘too ugly’. She is surprised when I ask her why she wants to have an operation, as if it
were obvious that she needed it.
‘It’s very flat’, she points to her nose. ‘I want to make it finer, turn it up’. During the
operation – unsupervised as it turns out – the residents disagree about the surgical
indication.
‘There isn’t much indication’, Dr Hermano says,‘because it’s a very Negroid nose, it’s
her type. There’s not much we can do’.
But his colleague argues, ‘Her nose is very ugly. Not even Pitanguy could make that
a pretty nose. But we can do something and it bothers her a lot so I think there’s an
indication’. In the end they can agree their job is to please the patient.
Plástica has been ‘democratized’ not only via the public health system but in the
private sector as well. After years of hyperinflation the 1994 Plano Real expanded access
to consumer credit. Plástica financing plans began to target what one company called
the ‘long line of secretaries, office assistants, and maids ... waiting for cosmetic surgery
at public hospitals’. Other consumers formed plástica consórcios – associations that use
a lottery to enable members to make large purchases, traditionally cars or higher

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education. Surgeons appear on talk shows such as Before and After, perform free plastic
surgery on models or beauty contestants (Fig. 2), or take out ads in glossy monthlies
with names like Plástica & Beauty and Plástica & You. Though patients view such
publications as educational, they are, in fact, a kind of print infomercial where stories
on the latest medical technologies mingle with images of celebrities, plastic surgeons in
tuxedos, and miraculous before and after images.
Such marketing exuberance is hardly unique to Brazil. But I argue that while the
beauty industry is clearly global, as a consumer phenomenon it should be understood
in relation to specific dynamics of consumption and status in Brazil. In the post-war
period, Brazil underwent the wrenching transformations of accelerated capitalist devel-
opment. In a few decades, a backwards coffee economy grew into a consumer society
with the ninth largest GDP in the world. During this period of giddy economic growth,
Brazil also created one of the largest and most sophisticated media networks in the
developing world (Mello & Novais 1998). Established with the support of the military
dictatorship, the Globo network defined its programming mission as ‘presenting an
image of a populace moving together toward modernity, glamour, and a materially
enriched, upwardly mobile lifestyle’ (Kottak 1990: 37). Nearly twenty years after the fall
of the dictatorship, the middle class remains a minority in Brazil, at less than a fifth
of the population, though Globo’s vision – elaborated in export-quality dramas –
dominates national airwaves. This situation is one in which consumption is both
symbolically central and beyond the reach of many.
In this context, public hospitals and cheap private clinics can promise not only
bodily change, but also the allure of First World modernity and glamour. Marilene
arrives at her consultation holding up a picture of Sharon Stone torn from a magazine.
‘I want to be plásticafied’, Luanda declares. Slang terms such as turbinada and siliconada
evoke qualities such as streamlined and smooth, while ads promote ‘moderno’ beauty
procedures. Many surgeons are alarmed by patients who ‘lack the culture to understand
that plastic surgery is a serious medical procedure’. Dona Firmina, who fled a life of

Figure 2. ‘Miss Siliconada’, winner of the highly publicized 2001 Miss Brasil contest. This
contestant’s multiple plastic surgery operations were the focus of media coverage of the event.
(Photo by author.)

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rural poverty in the interior of Minas Gerais to work as a maid in Rio, and now, at 58,
sells snacks at the beach, ‘never had time for school’. She had been to a hospital only
once in her life, to give birth to her daughter, until she decided to have a facelift at Santa
Casa: ‘My face was awful because I was in the sun so much’.6 In principle these patients
are contra-indicated because they misunderstand the benefits and limitations of
surgery or, like Aline and Nancí, hope through plástica to ‘get somewhere in society’,
in the words of one psychologist employed by Santa Casa. They approach plástica
instrumentally – in the belief it will confer social mobility, erotic powers, or actual
physiological rejuvenation. But while such patients betray an imperfect grasp of the
therapeutic purpose of plástica, they understand perfectly well the market value of
appearance. Beauty then can become a ‘right’ during a neoliberal regime where rights
are re-interpreted as access to goods and the antidote to social exclusion is imagined as
market participation.‘If a girl from Ipanema can have a $5,000 breast job’, a shantytown
resident said, ‘then I have the right too’.

‘Plastic beauty, from subtlety to perfection’

Brazil’s beauty culture illustrates Freud’s (1961: 58-63) idea that nationalism is fuelled by
a ‘narcissism of minor differences’, but in ways, of course, that he never intended.
Physical beauty, along with samba and soccer, is a cliché of Brazil. As a tropicalist
fantasy of Northerners it runs through five centuries of Brazilian history, from the
letters of Portuguese sailors describing the ardent Indians who greeted their ships to the
brochures of the online sex tourism business. But in the twentieth century, corporeal
beauty became a trope in the ongoing political and cultural re-imagination of racial
mixture (mestiçagem) as crucial to modern Brazilian identity (Parker 1991).7 As a
liposuction patient put it, ‘Our country is a country of pretty people. This miscegena-
tion here gives us a different tone I think’.
In contrast to the multicultural model of racial difference found in many contem-
porary Western societies, and to an older segregationist logic with its fears of racial
contamination, in Brazil eroticized and aestheticized hybridity has been a key symbol in
elaborations of national identity. Inspired by the new anthropological views of culture
and race he learned while studying with Franz Boas, in the 1930s Brazilian historian
Gilberto Freyre (1956) successfully attacked scientific racism in Brazil, and created a
new nationalist image of Brazil as a unique ‘tropical civilization’ founded in mixture.
Freyre’s place in Brazilian thought, and the ‘myth of racial democracy’8 that his work
helped create, have been much debated (Fry 2000; Goldstein 2003; Vianna 1999). I
highlight here a lesser-known aspect of his work: Freyre believed that racial mixing has
not only moral and cultural benefits, but aesthetic ones as well. He claimed that
inter-racial unions in Brazil’s slave plantations led to a gradual improvement in the
appearance of the population, ‘as if miscegenation were accomplished through anthro-
pologically eugenic and aesthetic experiments’ (Freyre 1986: 61). These experiments
created racially mixed female beauty as a national patrimony. He praised, for example,
the brown, rounded bundas (‘bottoms’) portrayed by Brazilian modernist painters such
as Emiliano Di Cavalcanti as a subversive attack on Europe’s Apollonian aesthetic
values. And he urged Brazilians to embrace morenidade (brownness) as a kind of moral,
creative, and aesthetic condition that could harmonize social differences. For example,
he advocated sun tanning because the new ‘ritual’, like miscegenation itself, would
democratically darken Brazilians, helping to create a ‘meta-race’ (1986: 116).9 Freyre in

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effect re-envisioned the relationship between morenidade and modernidade, so that

brownness becomes not a barrier to modernity, but its sensual and democratic
realization.10
Freyre’s work helps identify what I call a nationalist and populist ‘beauty myth’,
which is celebrated in popular culture and deployed by the beauty industry. Paula, 25,
is a single mum with a full-time job in telemarketing. She lives with her 5-year-old
daughter and mother in a working-class area in the North Zone. At first she tells me
that a breast lift and liposuction are her first plástica. But later she reveals that she had
once had liquid silicone injected into her buttocks in a beauty parlour in order to ‘fit the
Brazilian padrão (pattern or standard)’.
Liquid silicone – an industrial oil that is injected directly into the body’s tissues – is
considered to be an unsafe practice (as opposed to silicone implants), and has been
banned by the government. It is currently used mainly by male transvestites. But in the
1990s and before it was also used by women such as Paula, some of whom now come to
public hospitals to have the substance surgically removed from their bodies. Both
women and transvestites use silicone to shape the body according to a national corpo-
real ideal, described as ‘large hips, thighs, and buttocks, a narrow waist, with little
attention to breast size’ (Hanchard 1999: 78; Kulick 1998: 233).11 This ideal is used by
media and marketing materials to provoke demand for particular beauty practices. A
Globo news programme, for example, featured a woman who had decided to ‘trade her
bottom, on the thin side, which God gave her, for another that a plastic surgeon
moulded according to the national preference’. And plastic surgeons advocate certain
types of operations, such as the buttocks implant, that are ‘rare in other parts of the
world’. As plástica has been democratized, there has been an increase in operations that
‘contour’ the body as opposed to ‘rejuvenating’ the face. In 2004, 77 per cent of cosmetic
surgeries were performed on the body, while the average age of the patient has sharply
dropped, from 50 in 1980 to 35 in 2000 (Brasil, império do bisturi 2001; SBCP 2005). In
some instances surgeons explicitly link body-contouring operations, such as ‘lipo-
sculpture’, which redistributes fat from the waist to the hips and buttocks, to African-
European racial mixing, which a surgeon claimed has ‘blessed women with small
waists’.
The Brazilian padrão, however, is not always racialized, or rather there is a slippage
between the national-cultural notion of a ‘preference’ and a racial-biological notion of
a ‘type’. Like mestiçagem itself, this padrão implicitly encompasses all colours, even
whites, who are mostly ‘mixed’ in any event, according to Freyre (as descendants of
Iberian colonizers marked by the cultural and physical inheritance of the Moors). Some
operations, such as breast surgeries, for example, can be linked to national but not
racial identity. Until the 1990s, the most popular breast surgeries were reductions
and lifts, some of which make minute changes (which nevertheless can leave large
scars), creating improvements that can only be ‘seen’ through the lens of the national
preference.12
I have argued that a racialized ‘beauty myth’ – elaborated in diverse spheres of
national culture – incites demand for cosmetic practices. But the idealization of hybrid-
ity also co-exists with historically entrenched aesthetic hierarchies, which are inscribed
on the body through cosmetic practices. And so while mestiçagem is celebrated in
expressions of aesthetic patriotism, surgical practices point to a more complex rela-
tionship between cosmetic practices and racial inequalities. Eugenia Kaw (1993) has
argued that cosmetic surgery on perceived racial traits in the US reinforces negative

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stereotypes about racial minorities. But in Brazil – with its idealization of hybridity and
history of inter-racial mixing – there are different cultural links made between pheno-
typic traits and imputed membership in racial groups. Brazil has been described as
having a flexible system of colour classification that recognizes phenotypic differences
along a continuum rather than race as defined by origin (Fry 2005). Some surgeons
argue that this folk taxonomy and Brazil’s history of ‘miscegenation’ increase demand
for surgeries that ‘correct racial features’ because racial identities are more fluidly
defined. ‘The black Brazilian is more miscegenated than the black American’, Dr
Marcelo told me. ‘And so he has more inclination to improve the nose, diminish the
width, refine the tip. In the United States the black person wants to maintain his own
characteristics so he doesn’t do much nasal surgery there’. Dr Marcelo’s comments
suggest that more fluid ‘racial’ or colour identifications have facilitated a view of
rhinoplasty as ‘beautification’ rather than racial change. And in fact some candidates for
this procedure, such as Vilmar, a 46 year old with light, reddish skin, do not identify as
negra, black.
‘I have one black grandparent, one Italian’, she told me.
‘And the others?’
‘Don’t know. But my nose took after (puxou) the black one. Everyone else in the
family has a thin (afinado) nose, but I have one like hers, this nose of a little pig’. Her
comments reflect a popular view of family inheritance as a kind of aesthetic lottery,
where relatives exhibit different permutations of racial features, skin colour, and hair
type, leading sometimes to ‘ugly combinations’, as a surgeon put it. Farid Hakme,
former president of the Brazilian Society of Plastic Surgery, argued that due to the ‘mix
and match of different races ... the nose sometimes doesn’t match the mouth or the
buttocks don’t match the legs’ (quoted in Gilman 1999: 225). This view echoes earlier
concern among the Brazilian elite about racial mixing, though now the problem is not
physical and moral degeneracy, but aesthetic defects. The logic behind such operations
aims at a merging of the extreme of ‘unmixed’ race into the national norm of mixture.
The goal seems to be not to pass as white, but to join Freyre’s ‘meta-race’, where racial
identities as such are dissolved. Of course, patients do not put it in these words. They
say they simply want to look ‘prettier’, although they blame Indian or African ancestry
for features that need improvement. When pressed, however, surgeons readily admit
that patients ‘always want to move the nose in the direction of Europe, not Africa’, and
in fact officially term the procedure ‘correction of the Negroid nose’. Beauty practices
show that Freyre’s vision of ‘triumphant brownness’ has not, in fact, entirely displaced
an earlier ideology: embranquiamento, ‘whitening’. In the early twentieth century,
eugenicists hoped that the people could be lightened by European immigration and
inter-racial marriage (Skidmore 1974). Plástica suggests how this dream has been trans-
formed from a collective project of social hygiene that would allow Brazil to enter the
ranks of civilized nations into a private practice aiming at self-improvement.
Brazil, then, has an aesthetic imaginary rooted in its particular history of racial
mixing and nation-building that classifies and values appearance in distinct ways.
Miscegenation can be praised for its aesthetic products, but also blamed for creating
disharmonies. The racially mixed female body can be celebrated as national patrimony,
while facial features and hair perceived as negro are stigmatized. On the other hand,
brown or very dark skin is considered to be less of a racial indicator, and in any event
is often aesthetically valued in a country where sun tanning is a cross-class national
pastime (Winddance Twine 1998). Brazil’s beauty myth, based in mestiçagem, contrasts

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with North American multicultural models of beauty that stress not one national norm
but a plurality of distinct racial types, in which authenticity is linked not to national
but racial identity. In both cases, however, these contrasting principles of ‘racial vision
and division’ (Bourdieu & Wacquant 1999: 44) co-exist with aesthetic hierarchies that
mirror larger inequalities.
Anthropologists have argued that the remarkably diverse forms of body modifica-
tion that they have encountered must be understood not as exotic forms of mutilation,
or simply beautifying, but as practices with roots in interlocking social spheres. Plástica
is of course different from many ‘tribal’ practices of body modification in that it is part
of an international medical specialty. Nevertheless, one of the reasons why the beauty
industry has been ‘democratized’ so rapidly in a developing country is that it has been
indigenized. The encounter between global media and medicine and a distinctive logic
of aesthetics and race in Brazil has produced a localized form of the beauty industry
capable of mobilizing both national meanings of beauty and racial hierarchies to incite
demand for its services.

‘Creating and modelling nature’

Walking into the waiting room of a plastic surgery ward, one has the impression of
entering a distinctly feminine realm, and those patients who have either not yet learned
or reject the therapeutic language of the specialty describe their operations as simply
uma coisa da mulher, a woman’s thing.13 In public hospitals, male cosmetic patients,
aside from a few borderline reconstructive cases – boys with ‘donkey ears’ or enlarged
breasts – are particularly rare.14 Plástica is also gendered in its association with female
life-cycle events: puberty, pregnancy, breast feeding, and menopause.15 Motherhood,
for example, is blamed for thickened waists, ‘dead flesh’, Caesarean scars, and bellies and
breasts that are ‘fallen,’ ‘flaccid’, or ‘shrivelled like an old passion fruit’. Plástica can be
said to medicalize the female body in that it constructs real or imagined bodily changes
due to ageing and childbirth as ‘deformities’ requiring surgery. Diagnoses in clinical
language and images do not necessarily create a negative body image, but the language
and expert eye of the professional give dissatisfaction a powerful objectivity.
But plástica does not only work through a negative logic of pathologization and
rejection of deformities. I argue that both the body and medicine exist in a libidinal
economy in which positive incitement is particularly effective in stimulating demand.
Surgeons claim that they are merely ‘following the desire of the patient’. Such desires are
mobilized, however, not only by the beauty myth, as I have argued, but also by the
mystique of modern medicine, new expansive notions of health, and broad changes in
sexual and social relationships.
While there are few defenders of cosmetic surgery (outside its own marketing
apparatus), those who have taken a view sympathetic to real or imagined stigma
experienced by cosmetic surgery patients have stressed that patients are motivated by
what is after all a human desire: to fit into a social group. Sander Gilman (1999: 21-6),
for example, develops an interpretation of plastic surgery as a means of ‘passing’ –
enabling stigmatized people (originally syphilitics who received skin grafts to rebuild
their damaged noses) to pass as normal. Kathy Davis similarly argues that Dutch
cosmetic surgery patients whom she interviewed ‘do not have cosmetic surgery because
they want to be more beautiful ... but to become ordinary, normal, or just like everyone
else’ (1995: 161).

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In Brazil, many patients do aim to correct traits that they believe make them fall
outside norms. But as we saw in the last section, a growing number of operations aim
to make patients look not average but sexier. While many patients say they undergo
surgery to raise self-esteem, others such as Sheila claim that after their operations, ‘Men
are hot for us more, they have more sexual appetite, né?’ Surgeons are encountering
more patients who ‘have beautiful bodies but seek out multiple operations to achieve
more perfect forms’, as Dr Luciana said. The redundant ‘more perfect’ suggests that for
some plástica is not a one-time passage into normality, but a never-ending pursuit
of incremental improvement. Plástica tends to cluster in networks of female relatives
and friends, creating a kind of hothouse environment with an intensely com-
petitive and mimetic body aesthetics. This kind of perfectionist self-tooling can be
compared to what João Biehl (2001: 120), in the context of AIDS testing in Brazil, calls
‘technoneurosis’.
In conditions of scarcity, a hunger for modern consumer and technological wonders
can produce medical and corporeal fetishism. I use the metaphor of fetishism here to
describe a mingling of economic and psychological processes, the embrace of hi-tech
medical and cosmetic services, and the division of the body into eroticized and
pathologized fragments. In clinical practice and the surgical imagination of patients,
plástica is linked to a broad range of medical and cosmetic procedures that manage
reproductive health and sexuality. ObGyns and other specialists refer patients to plastic
surgeons (Goldenberg 2004). Tubal ligations are combined with cosmetic procedures
to ‘take advantage’ of the anaesthesia – or are performed for free when linked to a
Caesarean delivery in the public health system (both surgeries, like plastic surgery,
occur at very high rates in Brazil [Béhague, Victora & Barros 2002]). And Caesareans,
like plástica, may be chosen for ‘sexual-aesthetic’ motives. Maria Carranza points to a
‘popular belief ’ that a Caesarean birth is ‘capable of preserving the vaginal anatomy of
the woman, while a vaginal birth would produce distensions making sexual relations
more difficult’ (1994: 113).16 But though patients associate plástica with other ‘female
surgeries’, they also distinguish it as being uniquely beneficial to self-esteem, capable of
making ‘the libido rise to the head’. As Maria José put it: ‘After pregnancy and breast
feeding, after Caesareans, mastectomies, we feel old, ugly. In truth, it’s because women
have difficulty living out their own sexuality. As if after becoming a mother, the role of
woman becomes secondary’.17 And so Maria José urges other women to have cosmetic
surgery, because after the sacrifices of motherhood, ‘plástica is good for the self ’.
Plástica, then, is not an isolated consumer service, but rather is part of an emerging field
of ‘aesthetic medicine’ (medicina estética) that offers an array of medical, therapeutic,
and cosmetic tools for the pursuit of an expansive notion of health (Edmonds 2003:
127-90).
This field is emerging during a time of rapid change in the social organization of
sexual and affective relationships. Since the legalization of divorce in 1977, steadily
rising divorce rates have made new domestic arrangements more common: single
mothers like Sheila living with their single daughters and dating at the same time
(Castells 1997; Figueira 1996). The right to sex as well as the duty to manage sexual allure
have been legitimated for new groups of women: the middle-aged, the divorced, the
adolescent (Bassenezi 1996; Goldenberg 2004). Plástica rates on teenagers have grown
particularly fast, reaching 21 percent in 2004 (SBCP 2005). ‘Sex after 40’ has become a
topic in the media, while figures such as the ‘menopausal playboy’ have entered into the
cultural imagination. More generally religious and moral discourses surrounding sex

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are being supplanted by therapeutic, medical, and consumer ones (Parker 1991). In this
new social environment, cosmetic surgery can be a means to ‘remain competitive’. ‘In
the past’, Paula said, ‘a 40-year-old woman felt old and ugly. And she was traded for a
younger one. But not these days. A 40 year old is in the market competing with a 20 year
old because of the technology of plastic surgery. She can stretch [her skin], do a lift, put
in silicone, do a lipo, and become as good as a 20 year old’.
In arguing for the therapeutic effects of plástica, a surgeon told me that it aimed at
a more expansive state of health: ‘Our strongest argument went like this. The World
Health Organization said many years ago that health is a state of physical, social, and
mental well-being, not simply the absence of illness. You have to reach health by being
happy’. Plástica, however, pushes the ‘positivity’ of this conception of health in direc-
tions never imagined by public health professionals. Instead of being negatively defined
as the absence of disease, health becomes a more amorphous state of aesthetic and
sexual as well as physical, social, and mental well-being that can be actively – and
continuously – cultivated. Plástica, then, can be seen as one technology among many in
a sexual republic where citizenship requires participation in a consumer lifestyle, the
medical management of sexuality and reproduction, and an aesthetic tinkering with
the body for therapeutic ends.
Several scholars have shown how biomedicine can act as a form of politics by other
means. But in some contexts a disarticulation of medicine from state governance is also
occurring. In travelling the enormous social distance from the elite to the povão
(common people), medical beauty practices are shaped by diverse anxieties, expecta-
tions, and fantasies into a novel experimental practice. And so from its unique position
on the borders of proper medicine, plástica not only medicalizes the body but also in a
sense ‘de-medicalizes’ itself. Of course, cosmetic surgery is a medical specialty like any
other in that its practitioners follow professional norms, and are indeed trained in the
same techniques used in reconstructive surgery. But as plástica becomes infused with
the frustrated desires of patients, the competitive logic of markets, the imagery of a
nationalist beauty myth, and the medical and consumer fetishisms of popular culture,
the question arises as to whether it is ‘medicine’ in any recognizable form, though it
continues to benefit from the prestige of this perhaps largest of all modern systems of
expert knowledge.

Beauty and capital

Is the popularization of plástica another example of the povão misbehaving, or not
behaving the way intellectuals would like them to? There is a long history of this in
Brazil. Recently both the Liberation Theology and black consciousness movements
have had to confront the reality that they are losing converts to apolitical Pentecostal
churches (Lehmann 1996). And after decades of a military dictatorship, the newly
enfranchised povão elected a telegenic and corrupt populist. Does the right to beauty
constitute another form of alienation?
In their analyses of the cultural and psychological ramifications of capitalist devel-
opment, Gilles Deleuze and Georg Simmel emphasize the increasing fungibility and
circulation of different forms of capital. Drawing on Marx, Deleuze calls the world
economy a ‘universal cosmopolitan energy which overflows every restriction and bond’
(1993: 236). Simmel argues in a similar vein that money levels traditional distinctions:
through generalized transactions it draws attention to the ‘relativistic character of
existence’ (1990 [1907]: 512). In earlier stages of capitalism, such fungibility aided the

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rise of the bourgeoisie, enabling the conversion of capital into social position. In late
capitalism, this process might be said to be extended to the body as it is brought into
relations of exchange in the markets of production and reproduction, work and sex.
I argue that the same processes of capitalist development that are undermining older
forms of authority, including a paternalistic state and some formal patriarchal struc-
tures, are also paving the way for the expansion of beauty culture. The weakening of
moral restrictions on cosmetics, legal constraints on women’s economic activity, and
the social regulation of female sexuality ‘free’ the body – but also insert it in the market.
Aspirations rise with flows of cosmopolitan culture. The growing importance of body
capital incites fantasies of social ascent. And so in a sense, beauty mirrors the ambigu-
ous emancipatory power of capital itself: it challenges traditional hierarchies, but
exposes the ‘liberated’ body to the new hazards of generalized exchange. I have argued
here that the mingling of sexual, labour, and medical markets facilitates the projection
of social anxieties onto the body as aesthetic defects, but also stimulates desires for
social mobility and medical consumption. While some disciplinary moral discourses
and practices governing the female body have diminished within this libidinal
economy, older gender ideologies persist, not least of which is the nationalist beauty
myth, which is inscribed on the body by this localized form of the global beauty
industry.
But analysis of the structures that are fuelling demand for the beauty industry must
be balanced by a hermeneutics of retrieval that interprets local meanings. For workers
and consumers on the margins of the market economy, beauty, then, does not simply
encode social hierarchies, it can also threaten to upset them. The point is recognized,
oddly enough, in Pierre Bourdieu’s rigorous analysis of the class body. Bourdieu makes
a conspicuous exception in his work, however, for physical beauty, which he calls ‘fatally
attractive’ because it threatens other hierarchies, and sometimes ‘denies the high and
mighty the bodily attributes of their position, such as height or beauty’ (1984: 193).
Beauty, then, is an unfair hierarchy, but one which can disturb other unfair hierarchies.
The class meanings of beauty become prominent in elaborations of the beauty myth
in ‘popular culture’: a term which I use to refer not only to the commercial mass media
(Williams 1983: 238), but also, following Latin American usage, to ‘the (common)
people’, where the people are creators of an authentic national culture. The erotic and
aesthetic ideal of morenidade (brownness) can be embraced as a tactic (de Certeau
2002) by the people, who embody authentic brasilidade in their capacity to seduce and
provoke the elite. This is a trope that recurs in different spheres of both popular and
elite culture: ‘the maliciously innocent’ nudes painted by Brazilian modernists (Freyre
1986: 63); fables of mulata slaves who sexually dominate the master; fantasies of escap-
ing the poverty of a shantytown by seducing an older man (Goldstein 2003: 108); stories
of women from humble origins who through samba skills – and recently considerable
amounts of plástica – make themselves into pop icons.
And so even as it encodes some social hierarchies, beauty may have a kind of
democratic appeal, perhaps especially during a time when authoritarian structures are
losing their legitimacy while opportunities for social mobility remain limited. In such
a situation beauty can function for girls as soccer does for boys. While boys living in
poverty often dream of becoming professional athletes, many girls in poor communi-
ties have the equally impossible dream of becoming a fashion model. (NGOs and
private instructors have responded by offering courses in modelling aimed at shanty-
town residents.) In both social fantasies, the invisibility of poverty is best negated by

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media visibility. When access to education is limited, the body – relative to the mind –
becomes a more important basis for identity as well as a source of power. This theme
is often portrayed in the dominant popular genre in Latin America, melodrama, in
stories about passion that crosses class lines. While the rich girl may have all the
advantages, the poor girl’s beauty (or, more rarely, the boy’s masculine appeal) is so
strong that it threatens class barriers. Heroines in melodrama and fairy tales are
invariably attractive. Perhaps this is because beauty can influence the rich and power-
ful, becoming – like the samba parade – a popular form of hope.

NOTES
I am grateful to the Social Science Research Council and Princeton University for funding this research.
The Museu Nacional in Rio de Janeiro, Princeton’s Woodrow Wilson Society of Fellows, and a Woodrow
Wilson Postdoctoral Fellowship at UCLA’s Center for Modern Studies also provided financial and institu-
tional support for this project. I would also like to thank the JRAI reviewers and editorial staff as well as many
friends and colleagues who have provided invaluable comments: Vincanne Adams, Kirsten Bell, Niko Besnier,
João Biehl, James Boon, Peter Fry, Mirian Goldenberg, Chris Huston, Joana Lima dos Santos, Kirsty McClure,
Pál Nyíri, Vince Pecora, Kalpana Ram, Cristina Rocha, Thomas Strong, Gilberto Velho, Hermano Vianna, and
Lisa Wynn.
1
I use pseudonyms for all patients and surgeons except those interviewed in an official capacity (e.g. as
director of a hospital ward) or quoted in the media.
2
Santa Casa charges patients having cosmetic procedures a fee that covers the cost of medical materials (in
2003 about R$1,700 for most operations) while reconstructive operations are free. At fully public hospitals,
where I also conducted fieldwork, there are no fees for cosmetic operations (though some patients still prefer
to go to Santa Casa due to differences in waiting times or because they are drawn by Pitanguy’s name).
Pedagogical techniques, hospital procedures, and patient demographics at Santa Casa are similar to those at
public hospitals and so I generally include it in the category of public hospital.
3
Brazil subsequently lost its top place in the ranking to the United States. A survey of 3,200 women in ten
countries found that 54 per cent of Brazilians (compared to 30 per cent of Americans) had ‘considered having
cosmetic surgery’, the highest of the countries surveyed and more than double the average (Etcoff, Orbach,
Scott & D’Agostino 2004). A Brazilian study in 1988 found that a fifth of women in São Paulo had had plastic
surgery (O feitiço do corpo ideal 1998). In 2004, 616,287 plastic surgery operations were performed, of which
59 per cent were cosmetic (SBCP 2005). With a reputation for quality surgeons and cheap prices, Brazil has
also become one of the world’s top destinations for the growing business of cosmetic surgery tourism.
4
Faveret and Oliveira (1990) describe this situation of a two-tiered health care system as a kind of
‘excluding universalism’ in which the elite and the middle class are excluded from the constitutional right to
publicly provided health care (in Biehl 1999: 55).
5
Though it is now illegal to require a boa aparência in a job announcement, I often heard service workers
speak of how colour bars continue to be enforced in informal ways.
6
Surgeons are also responsible for poorly informed patients. During her fifteen visits to the hospital, Dona
Firmina was never told about scars, risks, or what aesthetic result she could expect.
7
For this reason, I prefer to use the emic word ‘beauty’ (beleza) rather than the more neutral ‘appearance’,
as a colleague suggested.
8
The term – often used in scholarly and public discussions of racism in Brazil over the past four decades
– was probably first introduced by sociologist Florestan Fernandes (1965: 205).
9
Patrícia Farias (2002) argues that this cultural logic is deployed among contemporary beach-goers in Rio
de Janeiro.
10
There is a long history of black social movements that have in various ways challenged the encompassing
paradigm of mestiçagem and fostered a pan-black identity (Andrews 1991). A more recent ‘black is beautiful’
movement has emphasized the aesthetic valorization of blackness, not mixture. The emphasis on aesthetics
as a basis of ‘self-esteem’ among some black activists and consumers has raised concerns among some
activists, however, that an aestheticitized black identity would simply reflect North American identity in a
‘neoliberal mirror’ (Sodré 1999: 256; see also Fry 2005).
11
The concept of beauty as national patrimony is highly gendered in Brazil. The image of the male body
as athletic, graceful, but also playfully dangerous (represented in the samba dancer, the soccer player, and
capoeira player, for example) is, however, also a key symbol in brasilidade.

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12
More recently, the reaction to the sudden popularity of silicone breast implants reveals how the female
body is discussed in a national register. In the United States, implants provoked an ongoing debate about their
safety and led to the largest class action lawsuit in American history against a silicone manufacturer. In Brazil,
implants elicited instead a controversy over whether yet another aspect of Brazilian culture was losing ground
to American fashions.
13
The surgeon-patient interaction is also gendered, as senior surgeons are typically male, though rising
numbers of women are now entering plastic surgery residency programmes.
14
Sixty-nine per cent of all plastic surgery operations are performed on women, but this percentage would
be higher if reconstructive operations were excluded (SBCP 2005).
15
For example, the minimum age for surgery is calculated by counting back years from the first menstrual
period. While there is almost no upper age limit to surgery, menopause is perceived by some patients as an
acceleration of ageing that can be reversed through surgery.
16
Plástica & Beleza reports on a rise in ‘intimate plásticas’, claiming that ‘cosmetic surgery on the genitals
... offers the modern woman the freedom to improve her performance’ (Cirurgia plástica íntima 2000-1).
17
Maria José’s comments are taken from an interview in a plastic surgery guide (Ribeiro & Aboudib 1997:
148-52).

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« Les pauvres ont le droit d’être beaux » : chirurgie esthétique dans le

Brésil néolibéral

Résumé

En s’inspirant d’un travail de terrain ethnographique dans les hôpitaux proposant de la chirurgie esthé-
tique accessible aux revenus modestes, l’auteur étudie les causes de la diffusion rapide de la chirurgie
esthétique au Brésil sur les vingt dernières années. Il avance que les problèmes liés à la diversité des origines
sociales se manifestent sous la forme de défauts esthétiques, qui sont diagnostiqués et traités par l’industrie
de la beauté. La chirurgie esthétique suscite cependant aussi les désirs de consommation de la part des
citoyens qui se trouvent en marge de l’économie de marché et fait intervenir dans le marketing et la
pratique médicale un « mythe de la beauté » racialisé qui est un grand thème récurrent de l’identité
nationale. Les chirurgiens esthétiques offrent un moyen de devenir compétitifs dans une économie
néolibérale de la libido, où les angoisses liées aux nouveaux marchés du travail et du sexe se mêlent aux
fantasmes de mobilité sociale, de séduction et de modernité.

Alexander Edmonds is Lecturer in the Department of Anthropology at Macquarie University in Sydney,

Australia. He has conducted extensive ethnographic fieldwork in urban Brazil and is currently writing a book
on Brazil’s culture of beauty. He has a particular interest in understanding the intersection of race, sex, and
markets in capitalist peripheries.

Department of Anthropology, Macquarie University, NSW 2109, Australia. alexander.edmonds@mq.edu.au

Journal of the Royal Anthropological Institute (N.S.) 13, 363-381

© Royal Anthropological Institute 2007