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cases they may not stop wanting to modify their bodies. According to information in Brazilian popular magazines26 and the Sociedade Brasileira de Cirurgia Plastica, the trend towards bodymodification by cosmetic surgery at an early age is increasing dramatically. As a participant observer, I experienced some teenagers, both boys and girls who were suffering from obesity and who intended to reduce their weight by undergoing cosmetic surgery (liposuction and abdominoplasty), instead of, for example, trying out dieting or physical training. Discussion The cult of the body has become a mass phenomenon and taken on an important social dimension in an information society where norms and images are broadcast worldwide by the media. Self-realisation of the individual through body-modification (tattooing, piercing, cosmetic surgery, etc) proceeds, and for a growing number of people, the body is becoming the locus of self-expression and self-determination. According to one psychoanalyst: “Cosmetic surgery is deeply seductive because it speaks so directly to the fantasy of reinventing the self.”27 I question this assertion because it assumes that the self can only be reinvented by manipulating the body. Yet, as we have all been taught by our societies, culture, image and visibility are highly valued and play an important role in the formation of the self. Each individual wants to be visible and at the same time conform to social standards and norms, though of course there are exceptions. This being the case, it demonstrates very clearly the whole contradiction of cosmetic surgery: the wish for individual expression vs. the social pressure to conform to certain beauty standards. What did I learn in this research? I encountered individual motives on the part of patients and subjective explanations for their decisions and the behavioural models they followed. In describing these, I have tried to grasp their meanings in relation to wider cultural thinking and identity patterns. In the context of our interdisciplinary research, I hypothesised that normalisation of certain attitudes and values is taking place on a cultural, societal and individual level, where the kinds of body-modifications being carried out convey standardised ideas and images of an underlying social order. On the individual level, I found that the majority of women I interviewed wanted to “be normal”. Their wish to be normal was expressed more by modifying their bodies to adapt to social norms of beauty than by trying to express their individuality. Therefore, I argue, an internalisation of norms, values and ideals has taken place. Another thing I found important in the whole process of cosmetic surgery was the relationship between patient and plastic surgeon. In my interviews with patients, I noticed that it was of great importance for the patient’s well-being and contentment (even if complications occurred after the surgery) that during the whole process of decision-making, but also during the time after the operation, the surgeon acted as an empathic companion, as a friend, psychologist and therapist, in a way. Many plastic surgeons noted that their relationship with their patients was more than the common doctor–patient relationship. It was their duty to be available to their patients at almost any time, and sometimes they felt they had to take on the role of psychologists. Many of the key informants were very critical of what was happening to medical ethics in relation to cosmetic surgery. With the growth in a consumer culture, they saw ethics in medicine becoming more bendable and subject to the “law” of the market. For some, Brazil is just copying North American society. For others, Brazil’s bodyculture image in the eyes of the rest of the world is a false one; they believe the significance of the body is not nearly as important as “we” think. For them, Brazilian culture is characterised much more by its alegria, hospitalidade e criatividade ( joy, hospitality and creativity). It is not only at the historical-cultural and socio-political level that the phenomenon of cosmetic surgery in Brazil must be understood. Questions must be asked not only about the local situation but also its global significance. What demands further investigation are the consequences of cosmetic surgery for physical and mental health. The belief that both female genital mutilation and female genital cosmetic D Dorneles de Andrade / Reproductive Health Matters 2010;18(35):74–83 81 surgery are harmful practices for women’s psychological and physical health is a step towards a process of re-thinking and re-conceptualising individual, societal and cultural ideals and norms. Western society currently determines social standards and sets the rules for how specific (cultural) practices should be handled and understood morally. However, critical thinking and legislation (as one possible measure of such thinking) are needed which lead us to scrutinise bodymodification practices that can harm girls’ and women’s physical and mental health. These responses should be welcomed. Acknowledgements An early version of this paper was presented at the Cosmetic Cultures Conference, University of Leeds, 24–26 June 2009. The research was part of an interdisciplinary project with a team scholarship for dissertations. From the viewpoints of social/cultural anthropology, political science and psychology, respectively Elena
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