America Gone Plastic 1

Running Head: AMERICA GONE PLASTIC

America Gone Plastic: How Does the United States Compare in Cosmetic Surgery?

Anne Christian Robertson

Glen Allen High School

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Introduction

Plastic surgery has become an increasingly popular and normalized topic in American

society. In 2017 alone, 17.5 million surgically and minimally invasive surgeries were performed in

the United States with an increasing emphasis on procedures such as breast augmentation,

liposuction, Botox, and soft tissue fillers. Much research has gone into questioning: what factors of

American society influence the prevalence of plastic surgery compared to the rest of the world?

History of Plastic Surgery

Although plastic surgery has become extremely prevalent and normalized in recent years,

research shows that plastic surgery originates as far as 16th century Europe in order to correct

syphilitic deformities. Michelle Smith, in her article, The Ugly History of Cosmetic Surgery,

outlines the long and often unknown history of cosmetic procedures. She states that along with

correcting syphilitic deformities, the roots of plastic surgery date back to “racialized ideas about

healthy and [socially] acceptable facial features” amidst racist societies, especially Europe and

America, having traditionally caucasian features were the strongest reasons to preform plastic

surgery, especially in the nose (Smith 2016). As time continued, Smith traces the evolution of

surgery from pedicle flap grafts to fashion new noses in the 1500’s, to the first anesthetic surgery

in 1846, to the first advertisement of plastic surgery in 1901 by Derma Featural Company, to

today’s extensive impact of cosmetic surgery. However, Smith notes that desired body types and

features have ebbed and flowed during time periods, and there is a close link between surgical

trends and the qualities valued as a culture. For example, in America smaller breasts used to be

more desirable and now larger breasts are, as noted by the rapid increase in breast augmentation.

America’s Social Standards and Cosmetic Surgery

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The United States of America leads the world in the highest number of procedures in the

world, with 17.5 million procedures in 2017 alone. In the article, Nip. Tuck. Or Else., Joel Stein

examines American societal and beauty standards as they relate to the enduring rise of cosmetic

procedures. In America, physical looks are heavily emphasized in society. As a study by

University of Texas economics professor Daniel Hamermesh found “workers with above-average

looks will make $230,000 more over their lifetime than people who are in the aesthetic bottom

seventh”, meaning that looks correlate with social acceptance and success in America (Stein 2015).

As time has progressed in America, and media has edited, enlarged, and smoothed out models,

beauty has become much more important in society, with TV shows airing such as Extreme

Makeover, a show about cosmetic surgery makeovers, leading to the normalization of plastic

surgery for women and men alike.

Social Media in America

The rise of social media and technology have impacted the amount of plastic surgery

procedures in America and other countries, as well as alter the way others perceive cosmetic

augmentation as it has become more common. Studies by JAMA Facial Plastic Surgery have found

that “taking selfies at a distance of about 12 inches from the face increases perceived nose size by

nearly 30%” leading researchers to warn against using selfies as guidance for plastic surgery

(Lieber 2018). According to Lieber

A 2018 poll conducted by the American Academy of Facial Plastic and Reconstructive
Surgeons [stated] 55% of surgeons reported having patients who said they were seeking
cosmetic procedures to improve their perceived appearance in selfies or other photos
posted on social media in 2017, up from 42% in 2016.

Since social media is so deeply engraved into our society, with platforms such as Instagram and

Snapchat who heavily emphasize selfies and physical looks, the fact that the perception of oneself

in a selfie is inherently distorted is extremely alarming. 218,924 of the 17.5 million cosmetic
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procedures in 2017 were nose-reshaping cosmetic surgeries, and the disconnection between a

patient’s perception of themself in a selfie is a factor that has led to this increase (Lieber 2018). In

her article, Snapchat Dysmorphia, Julia Brucculieri illuminates the issue of social media distortion

by highlighting the controversy of Snapchat filters as they relate to plastic surgery. In her article,

she discusses with several plastic surgeons how Snapchat filters have influenced their practices

with more patients using pictures of themselves with Snapchat filters for inspiration. Board-

certified plastic surgeon Dr. Michelle Yagoda stated that social media “is not changing the content

of our beauty standards, it’s just making images of it more widely available” which accounts for

the steady increase of plastic surgeon in America correlating with increased usage of social media.

Other Countries’ Social Standards and Cosmetic Surgery

Although America has the highest number of procedures in the world, South Korea has the

highest rate of plastic surgery per capita, which is greatly accounted for in their societal norms and

culture. In the article, About Face: Why is South Korea the World’s Plastic-Surgery Capital?,

Patricia Marx discusses Korean society and social standards and how they influence the prevalence

of cosmetic procedures. She discusses how there are “full length mirrors in subway stations”, ads

for plastic surgery on every surface, and that job applicants must attach a picture in their

applications (Marx 2015). Marx even states that “a typical high-school graduation gift for a Korean

teenager is either a nose job or a blepharoplasty” (Marx 2015). She discusses the plethora of

factors that influence the big emphasis on plastic surgery, such as incremental theory and

Confucianism. She also discusses with Eunkook Suh, a psychology professor at Yonsei University

who states that “in contrast to Western cultures, the external aspects of self (your social status,

clothes, gestures, and appearance) versus the inner aspects (thoughts and feelings) matter more [in

South Korea]” (Marx 2015). South Korea’s plastic surgery is different from America’s based on
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their social standards and definitions of beauty. While Americans value big breasts and butts,

Korean society values “baby faces” and double-eyelid surgery (Marx 2015).

Implications

As plastic surgery becomes more prevalent and normalized in America and in countries all

over the world, there are are several implications that need to be assessed and considered. In the

article, Children’s Bodies, Parent’s Choice, Susan Gilbert discusses underage cosmetic surgery in

teenagers, and parental encouragement of teenage plastic surgery. In October of 2008, “the state of

Queensland in Australia made it illegal for teenagers under eighteen to have cosmetic surgery” due

to the extreme amount of children undergoing cosmetic surgeries (Gilbert 2009). She lists several

statistics about teenage plastic surgery, such as in the United States in 2007 “almost 8,000 girls

under eighteen had breast augmentation” and about “205,119 teenagers under eighteen and

younger had cosmetic interventions” (Gilbert 2009). Her article delves into the topic of monitoring

plastic surgery especially for young patients.

Another implication of plastic surgery is the psychological impacts on patients. In the

article, Psychiatric Issue in Cosmetic Plastic Surgery, Ericksen and Billick consider several

aspects of plastic surgery such as patient satisfaction, self-image, and patient screening. The article

states that the “patients aware of realistic and unrealistic expectations of surgery were most

satisfied” with the outcome of their surgery, which is important to the cosmetic world in order to

ensure a fulfilled patient (Ericksen & Billick 2012). Ericksen and Billick also delve into patients

with low levels of satisfaction. They have found that body dysmorphic disorder, crisis, or a loss of

identity are strong indicators of a patient who will report low satisfaction with plastic surgery.

Since plastic surgery is extremely prevalent in America and continually on the rise, Ericksen and
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Billick state that “psychiatric screening of patients considering cosmetic surgery is helpful to the

plastic surgeon in optimizing patient satisfaction and outcome” (Ericksen & Billick 2012).

Conclusion

Research around plastic surgery in America and countries around the world is relatively

new and continuously changing as more and more people decide to go under the knife. Different

societies have different cultures and standards that influence the high or low amount of plastic

surgery, yet as seen by history, people have always wanted to be an idealized version of

themselves. While plastic surgery wasn’t as impactful in older times, beauty products claiming to

change the body have always existed, and plastic surgery gives a new outlet for patients to change

their bodies to their personal likings. Research on societies and plastic surgery needs to be

furthered in order to accurately depict a variety of countries, their standards, and their cosmetics.

There are several concerns with plastic surgery, such as the impact of social media, psychological

implications, and underage teenage procedures, however most patients report high levels of

satisfaction, and plastic surgery is a means to increase self-confidence in America and around the

world.
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References

Brucculieri, J. (2018). Snapchat dysmorphia points to a troubling new trend in plastic surgery.

Huffington Post.

Eriksen, W., Billick, S. (2012). Psychiatric issues in cosmetic plastic surgery. Psychiatr Q, 83,

343-352.

Gilbert, S. (2009). Children’s bodies, parent’s choice. Hastings Center Report. 14-15.

Lieber, M. (2018). Selfies make your nose look 30% bigger, study says. CNN Wire.

Marx, P. (2015). About face: why is South Korea the world’s plastic-surgery capital? The New

Yorker.

Smith, M. (2016). The ugly history of cosmetic surgery. Independent.

Stein, J. (2015). Nip. tuck. or else. Time. 42-48.