Discourse & Society

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The dream of a perfect body come true: Multimodality in cosmetic surgery

advertising
María Martínez Lirola and Jan Chovanec
Discourse Society 2012 23: 487
DOI: 10.1177/0957926512452970

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452970
2012
DAS23510.1177/0957926512452970Martínez Lirola and ChovanecDiscourse & Society

Article

Discourse & Society

23(5) 487­–507
The dream of a perfect body © The Author(s) 2012
Reprints and permission: sagepub.
come true:  Multimodality in co.uk/journalsPermissions.nav
DOI: 10.1177/0957926512452970
cosmetic surgery advertising das.sagepub.com

María Martínez Lirola

University of Alicante, Spain; University of South Africa (UNISA), South Africa

Jan Chovanec
Masaryk University, Czech Republic

Abstract
This article documents the operation of multimodal and rhetorical strategies in cosmetic surgery
leaflets, with a focus on the interplay between the verbal and visual channels. It describes how
advertising discourse exploits the image of an idealized female body in order to achieve its
economic goals. Recipients are targeted through the application of the prevalent ideology of
femininity, which in the Western context is increasingly dependent on patterns of consumption of
body-oriented products and services against the background of (male) expectations of the female
body ideal. It is argued that in this situation, which merges the private with the public and in which
women willingly participate in the self-perpetuating ideology of male-defined femininity, women
may, for various reasons, identify with the super-ideal sexualized images of women offered to
them, while indulging in a mixture of fantasy and reality and sharing in the guilty knowledge that
their own imperfect bodies need to be fixed. This article points out that such ideologies are very
effectively studied through their multimodal realizations, where the visual mode, in particular, can
non-verbally draw on and reproduce stereotyped representations.

Keywords
Advertising, cosmetic surgery, discourse, discourse analysis, gender, multimodality, sexism,
transitivity, visual grammar

Corresponding author:
María Martínez Lirola, Department of English Studies, University of Alicante, Ap. 99 E-030 80, Alicante,
Spain.
Email: maria.lirola@ua.es

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488 Discourse & Society 23(5)

Introduction
Cosmetic surgery is an invasive physical practice that people have recently been increas-
ingly willing to undergo with the intention of modifying their bodies. Inevitably, the
practice is embedded in extensive social discourse, which both constructs the need for
such a practice as well as legitimizes it. The discourse of (and about) cosmetic surgery,
which comes in highly diverse forms such as television makeover programmes, testimo-
nials in women’s magazines and advertising texts promoting the practice, to name just a
few, is typically highly persuasive. In this article, we focus on a set of advertising leaflets
that are used to communicate both explicit and implicit messages and meanings, reflect-
ing the underlying ideologies that are shared and promoted within society. We are par-
ticularly interested in how persuasion is achieved through the mutual combination of
verbal and visual means.
We live in a post-feminist period in which women’s studies look for new perspectives
in order to give answers to various questions that women and men are preoccupied with
and that go further than the traditional debate of being equal or being different. One such
question is the issue of how bodies are objectivized, that is treated as objects, and how
they become subject to (excessive) sexualization, in other words a sexualized representa-
tion. As argued by Jeffries (2007: 3–4):

The cultural imperative for women to look good remains strong and readers will therefore often
be in a relatively weak position in relation to the producers of the various ideologically-laden
messages about the female body, since they offer advice about the best way to improve looks
and attractiveness.

Inevitably, this situation is connected with power: women undergoing cosmetic sur-
gery may perceive themselves as agents of their physical change, while they, in fact, act
in concert with the prevailing ideology. The advertising leaflets not only draw on pre-
existing ideologies of female physical attractiveness and its central role in partnerships
and (sexual) relationships, but they also affirm and perpetuate such ideologies centring on
the Western ideal of female beauty, ‘an ideology of the body which emphasizes the stable,
youthful and clean [. . .] body over the real lived experience of women’ (Jeffries, 2007:
194). This perspective is in harmony with Fairclough’s ‘critical’ view of ideology, where
it is seen ‘as a modality of power [that] contrasts with various “descriptive” views of ide-
ology as positions, attitudes, beliefs, perspectives, etc. of social groups without reference
to relations of power and domination between such groups’ (Fairclough, 2003: 9).
The ideologies are naturalized: they appear as common sense, as ‘the way things are’.
The aim of (critical) discourse analysis then is to denaturalize the underlying ideologies,
in other words to show ‘how social structures determine properties of discourse, and how
discourse in turn determines social structures’ (Fairclough, 1995: 27). Uncovering the
workings of such naturalized ideologies is, in fact, one of the aims of emancipatory dis-
course (cf. Fairclough, 2007; Fairclough et al., 2007; Janks and Ivanic, 1992).
Since ideologies are produced (as well as reproduced) through various semiotic
modes, their operation needs to be documented not only on the textual level, but also
from the multimodal perspective. Modern communication increasingly requires people
to be visually (or multimodally) literate in order to understand the complexity of the

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Martínez Lirola and Chovanec 489

world mediated through signs (Jewitt, 2009; Kress, 2010a, 2010b; O’Halloran and Smith,
2011; Unsworth, 2010; Ventola and Moya Guijarro, 2009). Multimodality starts from the
position that all modes, like speech and writing, consist of sets of semiotic resources, that
is resources that people use in specific contexts in order to represent events and relations.
Multimodal critical analysis is particularly suited for explicating the operation of ideolo-
gies in advertising texts, since the construction and articulation of ‘common sense’ is often
not explicit, that is it relies on non-verbal communication and other semiotic modes.
The goal of this article is to deconstruct the representation of the female body in sev-
eral cosmetic surgery leaflets. Using a deductive approach inspired by multimodal criti-
cal discourse analysis, the article aims to find out how the ideology of the ‘ideal body’ is
mediated textually and visually, particularly in the case of advertising texts that strive to
directly persuade the recipients to undergo cosmetic surgery. While attention is paid to
the interplay between the various elements of visual grammar (prominence, frames,
information value, colour scheme), as well as the subject positions constructed for the
recipients through the visual mode, we are particularly interested in how the visual com-
ponent is interlinked with the textual component, how it projects the shared ideologies of
the sexualized female body and how its meaning potential can be made explicit through
discourse analysis.
Unlike other genres and discourses (such as women’s magazines), cosmetic surgery
advertising not only reproduces and reconstructs pre-existing ideologies, but also actively
uses them for its own economic purposes. The prevailing ideology under which public
female identity is perceived as being intrinsically connected with the physical appearance
of one’s body is thus interpreted here within the commercially motivated discourse that
contributes to the construction of the female body as an object that is both sexualized (i.e.
oriented towards men) and commodified (i.e. used instrumentally for generating profit).
The next section provides a brief overview of previous interdisciplinary research into
the phenomenon of cosmetic surgery in modern society. It is followed by a description of
the material used as data in this article and outlines the methodology adopted for analys-
ing the relevant advertising texts, paying special attention to multimodality and critical
discourse analysis. The results of the detailed analysis of two cosmetic surgery leaflets,
together with the discussion, appear in the next section, where we describe the main
visual and linguistic characteristics of the texts under analysis and explain how the two
modes create meaning. Finally, the last section sums up the main conclusions of the study.

Literature review
It is a truism that women and men are not represented in the media in the same way.
Probably the most significant function served by the presence of the female body in the
media is that of a media call/advertisement (Abril Vargas, 2007; Bringas López, 2010;
Gibson, 2006; Goodman and Walsh-Childers, 2004; Jeffries, 2007; Martínez Lirola,
2010a; Núñez Puente and Establier Pérez, 2008). The concentration on female bodies
has the consequence that women’s intellectual capabilities are backgrounded – arguably
in conformity with the androcentric and patriarchal demands of society (Conboy, 2007;
Irigaray, 1982; López Díez, 2008; Martínez Lirola, 2010b; Núñez Puente, 2003).

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490 Discourse & Society 23(5)

While the focus on the physical representation of female bodies is particularly marked
in texts whose intended audiences are predominantly male, this situation also occurs in
those types of text that are oriented primarily to women (e.g. women’s magazines, con-
sumer advertising for women’s products, etc.). In these genres, the female body is a fre-
quent subject of diverse discourses and practices that are crucial for constructing the very
concept of female identity. Women are thus symbolically defined not only through their
awareness of the body ideal and preoccupation with their own bodies, but also through
their exposure to and participation in the myriad physical and symbolic practices associ-
ated with bodies (fashion, cosmetics, exercise, diet, etc.). This constitutes them as a
hypothetical community – a ‘synthetic sisterhood’ (Talbot, 1995), whose members share
such ideologies as the consumer orientation to their own bodies.
As established in previous research, media representations of cosmetic surgery pre-
sent operations as quick and easy solutions to change the body and feel better, without
focusing much attention on risk and recovery time (Adams, 2010; Pitts-Taylor, 2007). In
this sense, the body becomes an object that can be improved to accomplish the beauty
canon established by society, i.e. the body can be easily modified and body practices can
be characterized as ‘body-as-enterprise’ (Maguire, 2002: 454). In Adams’ words (2010:
757): ‘The body is modified through a variety of consumable options, intertwining
individual and class identities through the exercise of consumer choice.’
It is necessary to account for the social context in which cosmetic surgery and its
media representations co-exist. In this sense, it is essential ‘to demonstrate that what we
understand by “the body” or “the language” is very largely dictated by norms and con-
ventions that belong not to the nature of the body/language itself, but to the context in
which they find themselves’ (Jeffries, 2007: xii). This means that our perception of these
concepts is affected by the normative ideologies that are typically unquestioned,
common-sense assumptions about ‘the way things are’.
Cosmetic surgery needs to be seen as an important social practice because it merges
the attention given to the body by an individual person with the values and priorities of
the consumer society. In other words, it offers the possibility of moving closer to the
idealized image of one’s body and meeting the cultural expectations of beauty. As Hesse-
Biber (2007: 97) notes, ‘surgery as self-improvement is an interesting option, even a
mandate, with an expanding market’. Consequently, human beings, especially women,
tend to use body work through cosmetic surgery to achieve some social or personal goal
(Adams, 2009). Some women, feeling that they do not fit into society unless they obey
certain aesthetic canons, may go as far as to risk their lives in plastic surgery in order to
adapt their bodies to such socially pre-established patterns. As Polonijo and Carpiano
(2008: 468) point out, cosmetic surgery tends to be presented as ‘a normal practice for
maintaining perfection, solving one’s beauty qualms, and being more attractive to men’.
Some international studies have analysed the main psychological reasons that cause
people to have cosmetic surgery (Delinsky, 2005; Henderson-King and Brooks, 2009;
Markey and Markey, 2009; Mirivel, 2008; Nabi, 2009; Slevec and Tiggemann, 2010): to
feel better about one’s body, to have greater opportunities for advancement in the job
market, to please a partner, to follow the media’s ideal image, to affirm one’s femininity,
to improve one’s self-esteem, to overcome the anxiety of ageing, etc. The main reasons
for undergoing plastic surgery are social, physical and psychological, although fashion
and peer pressure cannot be discounted either. It is also important to note that cosmetic

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Martínez Lirola and Chovanec 491

surgery is ‘used to alter “normal” and physically healthy bodies’, thus being ‘distinct
from reconstructive surgery, which aims to fix body disfigurement’ (Polonijo and
Carpiano, 2008: 464). This is a paradox, since medically normal bodies are presented as
being in need of some treatment in order to correspond to some externally defined norm
of perfection. Consequently, as Gillespie (1996: 83) argues, cosmetic surgery ‘encour-
ages women to experience their bodies as pathology and reinforces unrealistic ideals’.
Gillespie also says that ‘this may lead to disharmony and dissatisfaction [. . .] and make
body pre-occupation normal feminine behaviour’.
Relatively less attention has been paid to the representation of cosmetic surgery in the
media. Some research has focused on the effects of media (especially television) expo-
sure on their audiences (e.g. Slevec and Tiggemann, 2010). Other studies have analysed
the impact of media content on viewers’ body image and body perception in reality TV
makeover programmes (e.g. Nabi, 2009).
As regards print publications, Polonijo and Carpiano (2008) have dealt with repre-
sentations of cosmetic surgery and emotional health in women’s magazines. Adopting a
psychological perspective as well, they identify, among other things, several recurrent
themes that characterize the content of women’s magazines and that are also relevant
from the discourse perspective: the medicalization of the female body, the presentation
of men as beauty experts, risk perception, and cosmetic surgery as beneficial for
emotional health.
However, none of these studies pays systematic attention to the importance of the dis-
course used in order to persuade people, mainly women, to have plastic surgery. A notable
exception is Jeffries (2007), who provides a systematic account of the textual construction
of the female body in women’s magazines written in English. The analysis, carried out
from the perspective of feminist critical discourse analysis, pays attention, among other
things, to cosmetic surgery, though it limits itself to the textual dimension only.
The present article, developing the initial findings presented in Martínez Lirola
(2009), thus extends the academic debate on cosmetic surgery by studying the discursive
dimension, applying the perspectives of multimodal analysis and critical discourse anal-
ysis in order to reveal how language and visuals are combined in advertising messages to
persuade recipients.

Data and methodology

The research was carried out by collecting cosmetic surgery leaflets handed out to
passers-by in the streets of Alicante (Spain) by the Spanish cosmetic surgery clinic
Dorsia during the years 2007 to 2009. This clinic was selected because it engages in
aggressive publicity and performs among the highest numbers of cosmetic operations in
Spain. In this sense, the study follows a deductive approach, that is we expected to find
that the adverts treated women differently from men and used female bodies as an
inducement to persuade women to have plastic surgery. This research will explain how
that happens in visual and linguistic terms.
Altogether, we collected 20 leaflets. In 19 out of the 20 leaflets, there is a young white
woman who is shown as the main protagonist. The woman normally appears in a seduc-
tive position and is accompanied by a man (see e.g. text 2, in which the position of the
man and his gesture indicates that he owns the woman). This confirms that femininity is
often visually defined with respect to men.

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492 Discourse & Society 23(5)

The main part of this article offers an analysis of the major linguistic and visual char-
acteristics of two out of the 20 texts collected. The two texts have been selected for
analysis in this article because they are representative of the way in which images of
women are treated in this type of text, that is with few clothes on and with substantial
parts of their bodies revealed.
Images of women are the most salient visual element in all 20 texts analysed. They are
most prominent in size, most frequently (14 times) appearing on the left, which is the
place of known information. They are on the right, the most important part of the leaflet,
in three texts and in the centre in another three. The colour chosen for the women’s
clothes is pink in 50% of the texts; in the rest of the data, women wear green, red or white
clothing. All the women and men represented in the visuals are white and young, which
indicates the characteristics of the main intended audience of these texts. Women in the
images either wear very few clothes or their blouses or dresses tend to partially reveal
their breasts through the low neckline.
As is common with other visual representations of women, the private sphere, repre-
sented by one’s (almost naked) body and openly displayed sexuality, is shared in the
public sphere with mass audiences – in this case, the thousands of passers-by who collect
the leaflets and other advertising materials. In Preciado’s words (2010: 75),
the public nakedness as social and political category, as legal or moral transgression, but also
as entertainment, is a recent invention. Only modernity has used feminist nakedness until
transforming it in a practice at the same time codified and considered in terms of money/
commercialised.1
The method used to analyse the data is visual grammar as a tool for deconstructing the
ways in which the texts are created. The material is considered from the perspective of
multimodal analysis (Jewitt, 2009; Kress, 2010b; Kress and Van Leeuwen, 2006; Van
Leeuwen, 2005, 2011) that stems from the tradition of critical discourse analysis (cf.
Fairclough, 1989, 1992, 2007), particularly with respect to the link between discourses
and underlying ideologies.
These approaches are particularly suited to the description and explanation of adver-
tising texts, since they help to reveal how various semiotic modes are used purposefully
to have certain desired effects on the recipients and how they build on underlying
knowledge structures and ideologies. Hence the necessity of a multimodal approach to
advertising that explores the interplay between various semiotic modes without privi-
leging either the verbal or the visual aspect of the message, as is sometimes done. Guy
Cook, for instance, states in his almost programmatic call, ‘advertising, unlike analysis,
operates in all modes and media at once, and must be treated accordingly’ (2001: 44).
Therefore, the next section consists of presenting the analysis and results of two
multimodal texts used by the cosmetic clinic Dorsia in order to advertise its services.

Multimodal analysis of two Spanish cosmetic surgery

leaflets and discussion
The following subsections describe the main visual and linguistic characteristics of the
leaflets in order to deconstruct and understand the hidden and explicit meanings in the
multimodal texts produced by Dorsia. These leaflets are produced in order to persuade

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Martínez Lirola and Chovanec 493

women to use cosmetic surgery so that they modify their bodies and adapt them to the
canons of beauty created by society (even though, as pointed out above, the ultimate goal
is economic in nature, i.e. to generate profit through marketing and selling a service to
consumers).
The analysis approaches the deconstruction of texts through the written and visual
characteristics of the data as a way of understanding social behaviour and social practice
(Cook, 2001; Martinec and Van Leeuwen, 2009). As Blackledge (2009: 4) makes clear:
‘Social life can be seen as networks of diverse social practices, including economic,
political, cultural, familiar practices and so on. Social practices are more-or-less stable
forms of social activity which always, or almost always, include discourse.’
With respect to plastic surgery, these social practices motivate people – who may feel
that their bodies do not conform to the norm or the established canon – to undergo a
physical alteration, in other words to modify their bodies according to the socially estab-
lished ‘must be’, albeit with the risk of suffering unwanted consequences, including – in
extreme cases – the loss of life.

Visual characteristics
The visual elements involved in the construction of meanings can be elucidated with the
help of visual grammar, which explains them in terms of prominence, frames and infor-
mation value. The analysis of the data with respect to those categories is followed by a
discussion of the symbolic significance of the choice of colour, and supplemented with a
consideration of the role of gaze in constructing subject positions for the recipients.

Prominence, frames, information value.  Regarding the main visual characteristics, let us
first briefly discuss the elements of prominence, frames and information value (Kress
and Van Leeuwen, 2006). One of the most important elements for the composition of
these texts,2 in which image and written text are combined, is prominence, which is
understood as the result of the interaction of several factors (such as choice of colour,
placement/location and image/letter size) and concerns especially the size of the image
in comparison with the written text. It is evident that in the data analysed, the woman is
the predominant element because – although cosmetic surgery is also offered to men –
women are the priority public (Preciado, 2008: 147).
The composition of multimodal texts also pays attention to frames. These point out
whether the elements present in the text are placed together or not. In text 1, the images
of people that surround the protagonist are placed in frames and their size is smaller than
the woman who appears in the centre of the text. In text 2, the frame is not marked.
The third main characteristic of the composition of multimodal texts is information
value. This concerns the dimensions of visual space, that is how the spatial organization
is arranged along three components: left/right; ideal/real; and centre/margins (Kress and
Van Leeuwen, 2006: 197). As regards the left/right arrangement of information in texts,
new information, usually, comes on the right and known information on the left. In text
1, however, new information consists of the woman who is placed in the centre; while in
text 2, new information appears on the right, which implies that emphasis is laid on the
man and the woman’s breasts.

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494 Discourse & Society 23(5)

Text 1.  Dorsia Clínicas de Estética (Dorsia, Cosmetic Surgery Clinics).

When talking about information value, it is also important to look at what is consid-
ered ideal or real, that is what appears at the top and the bottom of the text. The top part
of the page is normally more important and coincides with the ideal. In the data, we find
Dorsia’s logo/slogan at the very top: Dorsia, Clínicas de Estética (‘Dorsia, Cosmetic
Surgery Clinics’) (text 1) and Medicina y cirugía estética – Medicina antienvejecimiento
(‘Medicine and anti-ageing surgery’) (text 2). The placement of this information at the
top of the texts has the purpose of presenting cosmetic surgery as a type of surgery that
is health-oriented. The perception of cosmetic surgery within the medical frame, in fact,
serves to legitimize the practice and potentially increases its persuasive appeal, since the
recipients may become convinced of the necessity to undergo the relevant ‘treatments’.3
On the other hand, the bottom of the page normally has information that is perceived in
visual grammar as ‘real’. In the data, this is where the bigger parts of human bodies

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Martínez Lirola and Chovanec 495

Text 2.  Seducción Dorsia. No te resistas (‘Dorsia Seduction. Do not resist yourself’).

appear – it is also the place where ‘action’ is going on: the woman in text 1 plays with the
strap on her underwear, while the man in text 2 passionately kisses the woman’s breasts.
Finally, information value also pays attention to the part of the message that appears
in the centre and the margins. The centre normally coincides with the nucleus of the
information. That is where, in text 1, the main image appears and where the woman’s
chest is located. In text 2, the offers made by Dorsia are found in the centre – they are
printed diagonally across the woman’s chest and seem to originate in the man’s mouth.
The marketing offers are conveyed through verbal text that is visually arranged into lines
that dynamically emanate, almost in a phallic shape, from the man, going across the
woman’s body towards her face and mouth, possibly being sexually suggestive.
In contrast to text 1, the visual arrangement of text 2 is very dynamic: the woman’s
pose and the diagonally placed text constitute a trajectory that connects the woman’s
ecstatic face with the man’s face positioned on her breasts, with the cleavage being the
focal point of the entire leaflet. The breasts, located in the new and ideal section of the
page and also mentioned verbally in one of the diagonal textual lines (cf. Aumenta de
pecho – ‘increase your chest’), thus appear to be the visual clue to this leaflet, providing

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496 Discourse & Society 23(5)

the link between such concepts as ‘breast improvement through surgery’, ‘attractiveness
for men’, ‘female satisfaction’, ‘sexual gratification’, etc.
In this connection, the central role of breasts in text 1 should also be mentioned: the man
is shown as if contemplating the woman’s bulging breasts, while there is the ambiguous
phrase pecho a la carta (‘chest on the card/menu’) right next to her body. Since the phrase
a la carta can be read as ‘on the menu’, the woman (or a part of her anatomy) is metaphori-
cally likened to a dish. From the perspective of the cognitive metaphor theory (Kövecses,
2000, 2010; Lakoff and Johnson, 1980), two domains are mapped onto each other, yielding
the metaphor WOMAN IS A DISH. This introduces an additional dimension to the verbo-
visual composition of the leaflet, in which the female body becomes the locus in which both
men and women participate: women as offering themselves and men as consuming women.
In general, less important information tends to appear in the margins. Thus, for
instance, in some of the adverts (see texts 1 and 2), Dorsia includes the official registra-
tion number of its medical practice in the left-hand margin since that information is not
very relevant for readers. However, in text 1, the little images in the margins are of some
significance. One image shows the naked body of a muscular young man from the waist
up. He is shown from below in a perspective that conventionally assigns authority to the
person depicted (cf. the general conventions of cinematic discourse). The fact that view-
ers are invited to consider the naked man’s body from the level of his waist also puts the
viewer in a subservient, potentially sexually loaded position.
Taken from the same perspective, the other image in the same margin shows a deper-
sonalized female body from the waist down, exposing the perfect shape of her buttocks.
What is offered for visual consideration here is merely a torso of the woman rather than
a complete person. The visual representation essentially reduces the woman to a mere
body part – one that tends to be seen as aesthetically ‘problematic’ (cf. Jeffries, 2007: 18).
At the same time, the two images in the margins are related: both are clipped, that is
showing incomplete bodies, and both are taken from the same low perspective. If full
bodies were to be shown in the photographs placed exactly in these two locations, they
would, in fact, overlap, superimposing the woman’s head – face down – on the man’s
crotch in a sexually highly suggestive scene.

Colour scheme.  Colour is an important element in visual analysis and it is necessary to

explore the way in which society uses it (Van Leeuwen, 2011: 1). As Pastoreau has said
(2008: 16): ‘Colour is defined first of all as a social phenomenon. It is society that
“makes” the colour, that gives it its definitions and meanings, that constructs its codes
and values, that organizes its customs and determines its stakes.’
In the texts analysed, the colours chosen for the women’s clothes are green (text 1) and
red (text 2). Heller (2004) points out that green is, among others, the colour of fertility,
hope and the bourgeoisie. The swimming costume of the woman in text 1 is green and
her posture is provocative. The associations of green with health, nature, freshness, youth,
purity and cleanliness cannot be discounted either. In the medical frame (here triggered
by the name of the practice – cosmetic surgery), the colour green may assume a symbolic
meaning, namely that of a problem removed (be the problem real or self-perceived) and
health reinstated. In multimodal terms, green may correspond to the discursive move of
‘solution’ in the problem/solution pattern commonly found in advertising texts.

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Martínez Lirola and Chovanec 497

As regards red in text 2, this colour represents passion, from love to hate, danger, etc.
(cf. Heller, 2004). The colour red is also linked to seduction, which fits perfectly with the
woman’s posture and correlates with the verbal text that explicitly mentions the concept
of ‘seduction’. The colour scheme is thus representative of what may informally be
called ‘red-hot passion’.
As Kress and Van Leeuwen (2002: 347) and Van Leeuwen (2011: 16) note, the col-
ours that create multimodal texts can be used to highlight certain characteristics of the
people represented. In this sense, the combination of red and black in the woman’s visage
in text 2 underlies our perception of her in harmony with the common Western stereotype
of a sexually attractive and available woman. Interestingly, some visual signs may seem
to be counter to such meanings, such as the rather prominent glasses that the woman is
shown wearing. In some contexts, such glasses may signify a woman’s sexual inacces-
sibility (or inactivity) and general lack of beauty or physical attractiveness. This visual
stereotypization is in stark contrast to the overall red-and-black colour scheme of her
body and clothing – lips and nails made up in red, red blouse and black bra – and other
visual signs, such as her loose and free-flowing hair, which all communicate the contrary
meaning.
What might seem a conflict between the conventional meanings of signs and colours,
however, may actually fit the purpose of this advertising text. While the woman is visu-
ally presented as ambiguous, being simultaneously visually unattractive (cf. her glasses)
and sexually provocative (cf. the red-and-black colour scheme), this representation can
be interpreted as encapsulating the pre-surgery and post-surgery situations. Thus, the
pre-surgery fear of one’s perceived physical unattractiveness is supplemented by the
self-confidence of a changed woman, whose beauty and feelings of self-worth are con-
firmed by her romance with a member of the opposite sex. The surgery offered by Dorsia
may help women to overcome obstacles to attracting a man.

The body as representation and interaction: Gaze and subject positions.  In addition to what
has already been mentioned above about the mutual relationship of the male and female
bodies in terms of their placement and interaction, several related issues need to be
briefly discussed. These include, in particular, the visual representation of actions in text
2 and the interaction between the image and the viewer in text 1 that obtains as a result
of the woman’s gaze.
In terms of prominence, the leaflets undeniably focus on the female body, which
occupies the largest space and appears in the foreground. Yet, in both texts analysed here,
men are present: in text 1, the man covers a relatively small space on the left, that is the
place for less important information. In text 2, only the man’s head is shown; he thus
occupies a much smaller space. While the focus is on the woman, a part of the man’s
body is also present in the foreground.
While the interaction between the male and female bodies is only implicit and open to
the viewer’s inferences in text 1, in text 2 both bodies are shown in motion, which gives
vividness and dynamism to the composition. In a symbolic sense, physical activity is a
highly positive quality, particularly in the (pseudo) medical frame. This is so because it
provides the target recipients with a possibility of identifying with the trouble-free, active
persons depicted in the illustration. They are not static – they do things. And, more

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498 Discourse & Society 23(5)

specifically, they are actively using their sexuality. This is so despite the fact that the
woman is visually presented as a passive recipient of the man’s actions, in other words the
image, in fact, visually constructs a predication that could roughly be expressed as ‘a man
seduces a woman’ or ‘a man makes love to a woman’ (cf. also the analysis of semantic roles
in the next section).
What is crucial in the texts is how they construct subject positions for viewers, that is
to what extent they draw viewers into a seemingly direct interaction with the individuals
shown in the leaflets. Thus, in text 1, the woman exposes almost all her body; her skin is
very dark and her attractive body is wet and shiny. She looks directly at the readers,
requesting an answer; her gaze is inviting. The woman’s gaze establishes a contact with
viewers in what is known as a ‘demand’ image. As Unsworth (2010: 285), following
Kress and Van Leeuwen (2006), points out:

[A] demand image has the gaze of one or more represented participants directed to the viewer
and hence ‘demands’ some kind of response in terms of the viewer entering into some kind of
pseudo-interactive relation with the represented participant; an ‘offer’ does not have the gaze of
any represented participant directed to the viewer and hence provides a portrayal for the
viewer’s contemplation.

From a multimodal perspective, the issue of subject positions constructed for recipients
through visual means is significant because such positions may contribute to the formation
of the recipients’ preferred interpretations. Thus, in text 1, the woman’s demand image with
respect to the viewer is complemented by her body language – the posture is inviting and
she is shown playing with the strap on her bikini in a rather provocative and flirtatious way.
In text 2, the woman is inclined towards the back, with the man holding her; she wears
glasses and her mouth is half-open; her skin is very pale and she has a nice/attractive
body. The facial expression of this woman shows that – although she is passive – she
is enjoying herself and is experiencing pleasure. She does not look at readers; her
interaction is just with the man who is kissing her breasts; he looks at her.
While the woman’s gaze in text 1 establishes a direct contact with the recipients and
is interpreted as a ‘demand’, the visual rhetoric in text 2 is different, and a different sub-
ject position is constructed for the recipients. Here, viewers are merely onlookers, not
directly participating in the scene (through the ‘naturalist’ visual mode) but perceiving it,
as if more objectively, from the outside (through the ‘realist’ mode; cf. Graddol, 1994:
140). The recipients are thus placed in the position of voyeurs, observing a couple in an
intimate and passionate moment of their private relationship.
For recipients currently outside of heterosexual relationships or in relationships with
little romance and passion, the image may trigger – as advertising images often do – an
identification or the desire to identify with the person (woman) depicted. Cosmetic sur-
gery then offers itself as a means of achieving the goal. By subconsciously comparing
their unexciting relationships with the heated passion in the image, combined with the
function of the advert to convince people to undergo cosmetic surgery, women may be
led to the belief that their current unsatisfactory situation is the result of their own (physi-
cal) defects which can be rectified by means of cosmetic surgery. In a sense, exposure to
an image like the one in text 2 may enhance feelings of personal failure and self-blame,

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Martínez Lirola and Chovanec 499

as well as stimulate the desire to identify with the individual depicted in the image (either
as a way of ‘re-kindling one’s own stale relationship’, ‘being romantically ravished by a
man’ or, less specifically, merely ‘being attractive’). Cosmetic surgery is a way in which
the metaphorical transformation of an individual reader into the supermodel shown in the
image may be achieved in actual reality: it is a dream come true.4
So far, subject positions have not been linked to the gender identity of the recipients.
While the targeted recipients of the practice of cosmetic surgery are unquestionably
women (on whose bodies the surgery is performed), audiences for the advertising mes-
sage may, regardless of the intended recipients, be mixed. Where the advertising leaflets
are received by women, the visuals may enhance their inner feelings of physical inade-
quacy and trigger their desire to improve their bodies surgically, that is in harmony with
the ideology of the beautiful body ideal. It is probably not unlikely that the recipients
may also be male, who may be urged by the same ideology to, for instance, procure cos-
metic surgery for the benefit of their female partners. In that way, the message for them
would be ‘this is the woman you can have’, rather than ‘this is the woman you can be’,
as in the case of female recipients. This reasoning seems to be supported by the demand
gaze of the woman in text 1 and the way she plays – rather invitingly – with her under-
wear. While women may wish to identify with the body ideal that the lady represents,
men may be attracted by the sexually laden promise that her ideal body holds for them.
In addition to the above-mentioned, there are some visual and graphological elements,
such as the size and font of letters, that stand at the intersection between the visual and
verbal characteristics of multimodal texts. However, their consideration is not crucial for
the purposes of this study because they do not contribute significantly to the construction
of meaning in the data analysed. The next section therefore shifts attention to the main
linguistic characteristics in order to understand the multimodal text as a unity of visual
and linguistic material.

Linguistic characteristics
Although the most prominent parts of the texts are the images, it is also necessary to refer
to the verbal characteristics found in the texts since they complement and enhance the
visual aspect of the advertising messages. The aim of the present section is twofold:
to provide a textual description of the verbal component in the data analysed, and to
offer an explanation of a transitivity pattern that extends from the textual to the visual
component of the text.

Stylistic and textual description.  The choice of words and syntactic structures in the data
is motivated by the underlying conative function of the leaflets. Highly positive evalu-
ative expressions and instructional phrases, combined with some of the argumentative
strategies, are thus inevitably shared with other kinds of advertising discourse (cf. Cook,
2001). Thus in text 1, apart from the caption Dorsia, Clínicas de Estética (‘Dorsia,
Cosmetic Surgery Clinics’) at the top of the leaflet, there is a vector between the pro-
tagonist’s neck and the statement Máxima seguridad al mejor precio. ¿Qué más se
puede pedir? (‘The highest security at the best price. What else can we ask for?’). The
adjectives máxima and mejor (‘highest’ and ‘best’), together with the rhetorical

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500 Discourse & Society 23(5)

question, are used to highlight the fact that this clinic is a safe one.5 The heading of text
2 is Seducción Dorsia. No te resistas (‘Dorsia seduction. Do not resist yourself’). The
first part of the statement establishes the existence of a special type of seduction called
Dorsia, while the second part is a negative imperative used in order to persuade
readers.
The main linguistic resources used by Dorsia are emphatic expressions, exclamations
and repetitions. The main collocations and emphatic expressions used in order to indicate
overemphasis in both texts are: rabiosa actualidad (‘furious present’), club Dorsia
(‘Dorsia’s club’) and pecho a la carta (‘breast à la carte’) (text 1), and Medicina antien-
vejecimiento (‘anti-ageing medicine’) (text 2). Text 1 uses different exclamation marks:
in the first two examples, we find exclamation marks only at the end:6 (gratuitos!!!, a tu
gusto!) (‘free!!!, as you wish!’), and in the last example there are exclamation marks both
at the beginning and at the end (¡y más de 500 tratamientos para el deleite de tu cuerpo!)
(‘and more than 500 treatments for the delight of your body’). In addition, the adjective
mejor (‘best’) is repeated in this text: mejor precio (‘the best price’), mejores profesion-
ales (‘the best professionals’); and figures are highlighted: más de 20 tipos de implantes
(‘more than 20 types of implants’), más de 500 tratamientos (‘more than 500 treat-
ments’), más de 10000 pacientes (‘more than 10000 patients’). In text 1, there are differ-
ent verbal forms: one imperative (elige tus tratamientos gratuitos!!!) (‘choose your free
treatments’), two infinitives (pedir and encontrar) (‘ask for’ and ‘find’) and one present
(confirman) (‘confirm’). In text 2, there is a lack of verbs in the treatments offered. There
is just one verb in the imperative: No te resistas (‘Do not resist yourself’).
As the examples of the verbal component of the leaflets indicate, several common
techniques are used for persuasion: the price argument (mejor precio), a free gift (gratui-
tos), the rhetoric of numbers/quantification (más de 10000 pacientes), appeal to the staff’s
professionalism (mejores profesionales), appeal to join the community (club Dorsia),
evocation of the medical frame (tratamientos), etc. This discursively persuades the recip-
ients that cosmetic surgery is both affordable and safe, thus alleviating their potential
fears (máxima seguridad al mejor precio). Indeed, the only obstacles are the women
themselves and their indecision (No te resistas) to do what others have done before (club
Dorsia). The advertisement also subtly plays on one’s inner fears of ageing and the related
loss of physical attractiveness (medicina antienvejecimiento). In this sense, it draws on
the ‘guilty knowledge’ shared by women (cf. Bringas López, 2010; Talbot, 1995).

Verbo-visual coherence and transitivity structure.  Also noteworthy are aspects of verbo-
visual coherence, that is, the internal links that obtain between the various components
of the multimodal text. The most prominent of these is the element of ‘seduction’, which
is important for the interpretation of text 2. The verbal element in the caption (Seducción
Dorsia) coheres with the sexually loaded content of the image, showing a man kissing
the woman’s bosom. The expression ‘seduction’ is, formally, a nominalization, which
has an underlying cognitive structure that can be essentially translated into the transitiv-
ity pattern of the clause in the sense of Hallidayian linguistics (Halliday, 1985, 1994;
Halliday and Matthiessen, 2004; see also Fowler, 1991 and Richardson, 2007 for appli-
cations of this model). This means that the nominalization ‘seduction’ condenses a verbal
predication, in other words it is a surface transformation of an underlying clause struc-
ture of the pattern shown in Figure 1.

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Martínez Lirola and Chovanec 501

Thus, the concept of ‘seduction’ inevitably involves two participants, the semantic
agent and the semantic patient. While the former is the doer of the action, the latter
receives (or, in semantic terms, ‘suffers’) the action performed by the former. The man in
the image is shown in an active pose (kissing the woman’s body), while the woman is pas-
sive – she is visually presented as the semantic patient (recipient) of the man’s amorous
actions. The image thus enacts the underlying transitivity structure through visual means.
The image plays with meanings related to the cultural understanding of the concept of
heterosexual seduction. Western society typically assigns a different value to it depending
on the nature of the seduction. With more or less open seduction, male seducers tend to
be seen as somewhat negative, aiming at their own sexual gratification and, possibly,
sexual exploitation of women. Female seducers tend to be seen in a similarly negative
way, particularly where promiscuity is implied (though the perception of men as sexually
exploited victims is much weaker in this negative seduction scenario). However, in a more
subtle way, seduction is also considered as an appreciable skill, closely related to one’s
physical attractiveness and ability to find a suitable partner. There is a wide folk knowl-
edge of methods whereby women are allowed to initiate their own ‘seduction’ by men,
that is they can have themselves seduced yet not appear as the seducer (thus retaining their
non-promiscuous reputation), and still achieve their own gratification. That appears to be
one of the meanings with which the image in text 2 is possibly playing (cf. Figure 2).
Given the verbal element, however, there is another level of play involved: the seduction
mentioned in the title is, in fact, self-focused. By urging No te resistas (‘Do not resist your-
self’), the slogan introduces the concept of ‘resistance’, which tends to be connected with
seduction: the advances of the seducer should, to a certain extent, be resisted (particularly
where the seducer is male). The slogan, however, presents a semantically deviant proposi-
tion because it cautions against ‘resisting oneself’ – it thus merges the seducer and the
person seduced into one (see Figure 3). By implication, the recipient of the message can
interpret this to mean that the only obstacle (e.g. to romance, cosmetic surgery, beauty, an
attractive relationship, etc.) is the woman herself. In a sense, a woman should thus ‘seduce’
herself to cosmetic surgery (or be seduced by the Dorsia clinic), so that she could, eventu-
ally, let herself be seduced by an attractive-looking man. Being eventually seduced by the

X seduces Y
(agent – action – patient)

Figure 1. Transitivity pattern for ‘seduction’.

Y allows X to seduce Y
(agent 1 – action 1 – patient 1/agent 2 – action 2 – patient 2)

Figure 2. Transitivity pattern for ‘letting oneself be seduced’.

Y does not resist Y

patient – action – agent

Figure 3. The deviant transitivity pattern for self-caused, Dorsia-style seduction: ‘No te resistas’.

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502 Discourse & Society 23(5)

man – as shown in the image – becomes a confirmation of the positive effect of the wom-
an’s physical transformation achieved by means of cosmetic surgery.
The ‘seduction’ frame, which is introduced through the nominalization in the text and
visually represented by the image, should also be read in conjunction with other aspects
of the multi modal unity of the text, such as those related to the woman’s visage. As
pointed out above, the glasses she wears may operate as a symbol, representing the
woman, in terms of a cultural stereotype, as lacking in beauty or being sexually inacces-
sible (or inactive), although the colour of her clothing and make-up point to the opposite
reading. The image then functions as an invitation to (female) recipients to release their
pent-up sexuality: they will become irresistible and explode in passion just like the
woman in the picture – as long as they undergo ‘treatment’ at the clinic advertised.
It is clear that what lies at the very core of the complex system of various semantic
roles appearing in such condensed and embedded propositions, as shown in this section,
is once again the female body. The body is the vehicle through which one’s physical
improvement can be achieved and a positive change in one’s life anticipated. Success is
eventually confirmed by the body’s sexual attractiveness. Within the framework of that
ideology, the pre-surgery (i.e. ‘imperfect’) body is also where real or hypothetical faults
can be located, and thus, the body may be considered as a potential source of blame for
various deficiencies in life: lack of romance, self-confidence, etc.
As shown in the two texts, the visual representations of the women in these leaflets
are used as a means of persuading other women to obtain comparable bodies: the images
set up an example to be followed and a model to be striven for.

Conclusions
The phenomenon of cosmetic surgery fits into a broader cultural norm that requires
women to define their femininity through the consumption of particular products and
kinds of practice, such as clothing, fashion accessories, cosmetics products, methods of
relaxation, etc., in which women willingly participate as consumers.
Based on analysis of the data, there appear to be several discursive moves that under-
lie the multimodal construction of the need for cosmetic surgery and that draw on preva-
lent ideologies of femininity: the perceived imperfection of the female body; the need for
body improvement as a universal solution to one’s problems; and the merging of such
relatively unrelated domains as beauty, health and sex, which are presented as lying at
the core of female identity.
It has been pointed out that a part of feminine identity consists of the belief that
women’s bodies are imperfect and constantly need to be fixed and improved (Jeffries,
2007; Smith, 1988; Talbot, 1995). While knowledge of such bodily imperfections is
assumed to be generally acknowledged, it is also understood that these imperfections
need to be hidden from others, especially men, since, as argued by Talbot (1995: 162), it
is ‘in consumption and in relationship with men’ that feminine identity is achieved.
The consumption of cosmetic surgery services is offered as a solution to one’s internal
fears of failure to approximate the beauty ideal presented to and shared by the public.
Cosmetic surgery promises to obtain perfect post-surgery bodies that are sexually attrac-
tive and thus satisfactory not only to women, but also to men. The discourse then oper-
ates with the classic rhetorical structure of problem–solution (cf. Hoey, 1983; Winter,

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Martínez Lirola and Chovanec 503

1986). While the psychological motivations are rarely specified in cosmetic surgery
advertising, the discourse does localize the problem within certain body parts (such as by
naming them or presenting them visually), even though the precise nature of the problem
is often left implicit and constitutes the shared assumptions between the recipients (cf.
Jeffries, 2007 on such implicit meanings in women’s magazines).
Significant with respect to the persuasive potential is the subtle recontextualization of cos-
metic surgery from an aesthetic activity to the medical frame. Such an essentially metaphorical
transfer occurs when a natural physical condition – be it real or perceived – comes to be viewed
as a medical problem that requires a medical solution. This may subtly lead to the conviction
that cosmetic surgery is, in fact, an unavoidable necessity – the evocation of the medical frame
works to justify the practice. The exploitation of the medical frame has been noticed by other
scholars as well, such as Polonijo and Carpiano (2008: 467), who argue that ‘[b]y presenting
medical professionals as experts on beauty, appearance is defined in a manner consistent with
a medicalization framework – as a problem in need of medical treatment’.
Cosmetic surgery, then, is a modern practice located in the context of the ideology of
female beauty and the ideal (and idealized) image of the female body, as perpetuated in
Western society across centuries of verbal and visual traditions. Here, the female body is
crucial in accomplishing the beauty canons established by the patriarchal system, urging
women to be beautiful and accepted by society.
It appears not accidental that the cosmetic surgery leaflets analysed depict young, slim
and beautiful women. Since the primary target recipients of the advertisements are female,
images of ideal-looking women may serve them as a model towards which their bodies
could (and should) aspire. Almost paradoxically, although women are the recipients of the
adverts, they tend to be represented almost as sexual objects. The female body stands at
the centre of various intersecting interests: the surgically enhanced body is (1) the key to
women’s self-esteem, self-confidence and physical perfection, (2) the target of male
voyeuristic desire and (3) the medium through which cosmetic surgery providers are able
to generate their profit. As pointed out by Polonijo and Carpiano (2008: 468), ‘cosmetic
surgery is legitimated as a means of attracting men’, while media representations of the
practice are based on the ‘notion that women’s bodies are for men’s viewing pleasure’.
The analysis of how the different linguistic and visual meanings are combined in the
texts presented in the previous section allows us to talk about the female body being
treated as an object: the body is used as an advertising call; it is a body idolized as
a carrier of fertility, created according to masculine desires, which are the ideas high-
lighted in the social and cultural context in which these texts are framed. In this way, what
is highlighted in the analysed texts is the aesthetic role of women: they are represented as
decorative objects, that is in this case they are used to promote Dorsia’s cosmetic clinics.
In other words, what we see in the adverts is a calculated, strategic use of (female)
near-nakedness that is as much oriented to women, that is the intended recipients of the
advertising message, as to men, with respect to whom the sexualized stereotype of femi-
nine beauty is defined. From a critical discourse perspective, it is crucial that the female
body is commodified: it is linked to the economic interests of the advertisers and becomes
the vehicle through which the need to buy a service is communicated with implicit refer-
ence to pre-existing ideologies and discourse. The body is not displayed merely in order
to display nudity publicly for male voyeuristic enjoyment and gratification, for example,
but is used as a vehicle for achieving some ulterior (e.g. economic) motive.

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504 Discourse & Society 23(5)

The analysed texts contribute to the construction of femininity and sexual identity
because cosmetic clinics are elements of biopower that define the binary system of gen-
der and establish an image of women based on the beauty of their bodies. Consequently,
the analysed data perpetuate the cult of the body and the necessity of maintaining the
body’s youthfulness through cosmetic surgery. As a close visual analysis of the images
reveals, femininity is defined with reference to men and has a strong sexual basis. ‘Being
a woman’ means being visually attractive and (hetero)sexually active. Not surprisingly,
cosmetic surgery projects itself as essential in assisting women to obtain perfect, ideal
bodies that are idealistically deemed to provide the gateway to better self-confidence,
passionate relationships and longed-for love.
Funding
This research received no specific grant from any funding agency in the public, commercial or
not-for-profit sectors.

Notes
1. The text in the original is: ‘El desnudo público como categoría social y política, como trans-
gresión legal o moral, pero también como espectáculo, es una invención reciente. Sólo la mod-
ernidad ha utilizado el desnudo femenino hasta transformarlo en una práctica al mismo tiempo
codificada y mercantilizable.’ (Translation by authors.)
2. The expression ‘text’ is used here to mean the multimodal unity of various semiotic codes (i.e.
the verbal and the visual modes in this case) that constitute the objects analysed, that is to say
the cosmetic surgery leaflets as advertising artefacts.
3. The medical frame is already present in the phrase ‘cosmetic surgery’ itself: the word ‘surgery’
implies the necessity of treating a medical problem, while the adjective ‘cosmetic’ highlights
the mostly aesthetic purpose of this practice, in other words its orientation to external appear-
ance. The phrase thus contains an internal semantic contrast because it merges the otherwise
incompatible practices of ‘beautifying the body’ (i.e. cosmetics) and ‘reinstating a healthy med-
ical condition’ (i.e. medicine).
4. It has been suggested that motivations to undergo cosmetic surgery include a person’s low self-
esteem, low self-confidence and insecurity. After surgery, women have been found to report such
positive emotional health benefits as ‘self-confidence, self-esteem, general feelings of happi-
ness, and the ability to attract a romantic partner’ (Polonijo and Carpiano, 2008: 467).
5. In her discussion of women’s magazines, Jeffries (2007: 122) mentions that stories on cosmetic
surgery often mention – and sometimes rather graphically describe – possible health complica-
tions. However, she notes that such scaremongering is linked to the commercial interests of
clinics because the articles typically ‘promote particular clinics as being within the realm of
the responsible’. In the data analysed here, the advertisers acknowledge the risks – since the
recipients can be expected to harbour certain concerns about possible negative health effects
– but, at the same time, try to minimize them. Significantly, the security argument is also linked
with an economic argument (‘at the best price’).
6. Spanish uses one exclamation mark at the beginning and one at the end of the word or sentence
highlighted. The adoption of the non-Spanish convention may be an attempt to instill the text
with the positive value of ‘global’ (i.e. non-local) culture and also a way of giving the text a
sense of spoken discourse. Piller (2010: 100), based on Barrett (2006), mentions in passing the
opposite phenomenon, that is the adoption of Spanish conventions of punctuation and the use
of what she calls Mock Spanish to connote positive socio-cultural stereotypes in the context of
an Anglo-owned Mexican restaurant in Texas.

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Martínez Lirola and Chovanec 505

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Author biographies
María Martínez Lirola is Professor of the Department of English at the University of Alicante,
Spain and Research Fellow, Department of Lingustics, University of South Africa (UNISA), South
Africa. Her main areas of research are critical discourse analysis, systemic functional linguistics
and applied linguistics. She has published more than 70 papers and seven books, such as Main
Processes of Thematization and Postponement in English (Peter Lang, 2009). She has been a visit-
ing scholar in different universities such as: UNISA (Pretoria, 2012), the University of Anahuac
Mayad (Mérida, Mexico, 2008), the University of Kwazulu-Natal (Pietermaritzburg, South Africa,
2006) and Macquarie University (Sydney, Australia, 2005). She has presented papers in
international congresses all over the world.

Jan Chovanec is Assistant Professor in the Department of English and American Studies at the
Faculty of Arts, Masaryk University in Brno, Czech Republic, where he teaches courses in media
discourse analysis, language and law and sociolinguistics. His research interests include the inter-
active nature of discourse in media contexts, the representation of social actors, face and politeness
in interpersonal encounters, and discriminatory discourse. He has recently focused on dialogism
and humour in the discourse of live text commentary. He co-edited the book Language and
Humour in the Media (with Isabel Ermida, Cambridge Scholars Publishing, 2012).

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