Beauty and Body Modification

Martin Donohoe, MD, FACP

Disclosures

April 19, 2006

In This Article

Introduction

Since ancient times, human beings have attempted to modify their physical appearances to conform to cultural ideals of beauty. Many characteristics of human appearance are also considered to be evolutionary adaptations for survival of the human species. Beauty, size, and muscularity advertise one's health and fertility. The ancient Greek ideal equated symmetry with beauty,[1] and more recent scientific studies have shown that symmetry is still valued in both male and female faces. The "ideal woman" is said to have a small chin, delicate jaws, full lips, a small nose, high cheek bones, large and widely spaced eyes, and a waist-to-hip ratio of 0.7. The "ideal man" is taller, with a waist-to-hip ratio of 0.9, and rugged features such as a dominant, rectangular face and chin; deep-set eyes; and a heavy brow, suggesting a strong supply of testosterone.[2]

As Christine Rosen points out, physical appearance has also been linked to moral worth.[3] Those considered good-looking are more likely to get married, be hired, get paid more, and be promoted sooner. Height is associated with income and leadership positions. Strangers are more likely to assist good-looking people in distress. The pretty/handsome are less likely to be reported, caught, accused, or punished for minor and major crimes. On the other hand, attractiveness is recognized as a special gift, and its misuse is not easily tolerated.

Today, women and men of many cultures diet, exercise, apply cosmetics, and undergo a bewildering array of surgical procedures to achieve a desired look. Yet, many techniques of body manipulation have had profound health effects on the individuals practicing them. Moreover, some have been cultural practices designed to control the female sex, even when willingly accepted by women. Others, such as female genital mutilation, again often accepted by women, involve the abrogation of women's right to bodily integrity and sexual fulfillment.[4]

Most interventions have been practiced by women, rather than men, who, as a result of their more privileged position in society, have been able to rely more upon their intellectual, political, and military feats to achieve respectability and to woo prospective mates. Ageism has also historically disproportionately discriminated against women. Whereas older men have been seen as distinguished and sophisticated, women who have completed their childbearing years are more often considered "past their prime" and older women have been the greatest consumers of cosmetic procedures. However, this is changing in American culture particularly, in which "youthfulness" dominates the popular cultural discourse on beauty, and older men comprise an increasingly larger proportion of the cosmetic surgery market.[3]

"Youthfulness is a...desirable commodity, as Americans in the corporate world are learning. A February 2004 report in the Wall Street Journal described a recent survey by ExecuNet that asked senior-level corporate executives about attitudes toward aging. The result found that "82 percent consider age bias a 'serious problem,' up from 78 percent three years ago. And 94 percent of these respondents, who were mostly in their 40s and 50s, said they thought age 'had cost them a shot at a particular job.' Many executives -- male and female -- are turning to cosmetic surgery to help them stay competitive."[3]

This article takes a brief historical look at some of the modifications people (mostly women) have undertaken to try to achieve particular ideals of beauty, and then focuses on some currently fashionable modifications -- namely cosmetics, tanning, body piercing, and botulinum toxin (BOTOX) and dermal fillers. Future articles will consider cosmetic surgery and female genital mutilation.

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