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a footnote she remarks that the terms “health” and “illness” are related to and formed by one’s culture and are therefore not sufficiently understandable with our Western biomedical model of the body. A healthy body is for Ensel a body “without organic and functional disorder”. 18 D Dorneles de Andrade / Reproductive Health Matters 2010;18(35):74–83 76 find out if these dichotomous perspectives were culturally constructed or if there might exist some kind of “global” norms. This paper, reporting part of my research, focuses on three main issues: • What motivates people’s decision to modify their own bodies and what arguments do they give for doing this? What were the subjectively perceived advantages and disadvantages of cosmetic surgery in relation to the person’s status in society and economic factors? • Is female genital cosmetic surgery being practised in Brazil? What are the main reasons for having this type of surgery? Who is having it? What do the surgeons think are the main indications for it and the main risks? • How do plastic surgeons view cosmetic surgery on adolescents aged 14 to18, in relation to questions of professional ethics and whether informed choice on the part of patients is possible at such a young age? In all of these, I was interested in the extent to which the decision to go for cosmetic surgery could be regarded as an act of self-determination. Methodology and participants The field research took place from January to November 2008 in Rio de Janeiro. Qualitative methods of data collection and evaluation were used: ethnographic approaches included participant observation in private medical offices, beauty clinics and hospitals, and one public hospital, accompanied by the writing of memos and field notes. Semi-structured interviews were carried out with 12 plastic surgeons (ten men and two women), 15 women patients of cosmetic surgery (ages 26 to 73), three women considering cosmetic surgery (ages 35 to 59), and ten experts from the fields of psychology and psychotherapy, sociology, gynaecology and anthropology (nine women and one man), who acted as key informants. The 15 women patients were in the pre- or post-operative phase. Their surgeries primarily consisted of breast augmentation or reduction, liposuction, abdominoplasty, surgeries on the face, or hair transplantation. I met five of the women in a private surgeon’s office or clinic, and the rest in the public hospital’s plastic surgery department, Enfermeria 38 in Santa Casa de Misericórdia, founded by Brazil’s most famous plastic surgeon, Ivo Pitanguy.* Through the interviews, I hoped to obtain the perspectives of those most closely associated with cosmetic surgery. Through participant observation, I aimed to get a better understanding of Brazilian, and especially carioca, ways of handling the body and related cultural traits. This research This research is towards my PhD dissertation. Academic mentoring and supervision in Brazil was provided by the department of psychology at the Pontificada Universidade Católica de Rio de Janeiro, which enabled me to establish contact with practising plastic surgeons and other academic experts. I followed the “snowball principle” throughout the research to find the kinds of people I wanted to meet. The interviews were conducted either in private medical offices/ clinics or in privacy in a room in the public hospital. Informed consent was obtained from all participants. A tape recorder was used during the interviews, notes were written immediately after the interview and transcriptions were made either in Portuguese or English. For evaluation of the interviews, a coding list was generated based on common themes that arose, and these themes were systematically organised according to the objectives. Data analysis is still in progress. A semi-structured interview manual was used with the women, including demographic information like marital status (eight women were married, three divorced, three single and one a widow), and profession. The main questions covered type of cosmetic surgery, the moment of decision for the surgery, motivation and expectations from the procedure, satisfaction with themselves and their bodies before and after the surgery (as appropriate), how they perceived their relationship with the surgeon, and the reactions of partners, husband and other family members. With the three women who had not yet decided, I had informal conversations about why they were considering surgery, their expectations and hopes from it, and why they had not yet made the decision. Their openness in responding to my questions helped me as a researcher to understand this phenomenon from a local point of view. A problem-centred interview manual was used with the plastic surgeons. I asked about their *What is special about this public hospital is that it receives a mix of state and charity funds. D Dorneles de Andrade / Reproductive Health Matters 2010;18(35):74–83 77 motivations in becoming plastic surgeons, possible risks of cosmetic surgery, their relationship to the patients, ethical issues regarding cosmetic surgery for adolescents, demand for and possible risks of female genital cosmetic surgery, their subjective view of beauty and what they liked most in their profession. Lastly, I asked the key informants how they interpreted body-
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