Volume 78/Number 4
Fall 1998
Tennessee Alumnus
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Fine Lines
Elizabeth Haiken's book, Venus Envy, traces the history of cosmetic surgery.
By S. Yvonne Loveday
Dr. Elizabeth Haiken, UTK associate professor of history, doesn't have what she calls a perky little nose, but she has a father who kept a picture of her, in profile, on his desk because the photo "showed strength," and a mother who wouldn't buy Barbie dolls for her four daughters because they were bad role models.
("She said they were too unrealistic in terms of the image of women they presented.")
It was in this protective and nurturing atmosphere that Haiken formed her opinions about the world and about herself. Her parents raised her and her sisters to be "spunky" as well as "elegant and interesting."
Perhaps this is why Haiken's healthy and well-reasoned voice in her book, Venus Envy: A History of Cosmetic Surgery, has caught the attention of so many people. Published by the Johns Hopkins University Press, Venus Envy takes a look at the ways culture and medicine intersect and change each other. Cosmetic surgery, she says, lies at the nexus of medicine and consumer culture.
"When I started researching this topic, I had a pretty negative image of plastic surgeons," Haiken says. "I really thought I would end up blaming them. Yet, it's just amazing how much public demand has driven this from the very beginning.
"Where does all this demand come from? It actually all doesn't come from the surgeons. It comes from culture."
The Way We Were
Haiken begins her study by comparing the noses of Fanny Brice and Barbra Streisand.
"In 1923, Americans clamored for an explanation of why Fanny Brice, beloved vaudeville actress, successful comedienne, and star of Florenz Ziegfeld's new Follies, had bobbed her nose. Forty years later when Barbra Streisand emerged on the national scene–ironically, her first significant role was as Brice in the musical Funny Girl–Americans wanted to know why she had not," Haiken writes.
What caused this change of perception? Plastic, or cosmetic, surgery had become accepted and, for entertainers at least, even expected. The specialty is now one of the largest and fastest-growing medical specialties in the United States, Haiken says. According to the American Society of Plastic and Reconstructive Surgeons Inc., between 1982 and 1992 the number of people who approved of plastic surgery increased by 50 percent. In 1948, fewer than 300 board-certified plastic surgeons were in practice; today the number is more than 4,000. Between 1990 and 1993, the total number of cosmetic surgical procedures increased by 37 percent, with liposuction the top cosmetic choice of American women in 1993, and hair transplants for men.
Sanity, Not Vanity
Plastic surgeons returning from World War I had made revolutionary advances in reconstructing the faces of injured soldiers. At the time, however, plastic surgery for minor cosmetic imperfections was considered vain and outrageously foolish, the kind of thing only movie stars did.
Viennese psychologist Alfred Adler unwittingly pushed cosmetic surgery into the mainstream with his much ballyhooed theory of the inferiority complex. Through it, he -effectively bridged the gap between the practice of plastic surgery and the American consciousness.
"Patients who developed inferiority complexes because of physical defects would find their economic status adversely affected because those suffering from such complexes were unable to present themselves with the confidence necessary to ensure success in a competitive world," Haiken writes.
If cosmetic surgery could help solve a medical problem, the public was more willing to embrace it, Haiken says.
In their readiness to label certain nose shapes and types as deformities, surgeons helped to cement not just standards of beauty, but standards of normality and acceptability in American minds, she says.
Increasing numbers of Americans came to believe looks were crucial to social and economic success. So much so, that by 1927, leading Girl Scout booster and beauty expert/editor -Hazel Rawson Cades told young girls, -"Being good looking is no longer optional. . . . There is no place in the world for women who are not."
The search for the "perfect" face was set in motion. The "squashed-tip" nose of the '40s and the "scooped-out-bridge" pug nose of the '60s were side effects of surgeons' emphasis on homogeneity. By the mid-1980s American ideals of beauty emphasized a more natural, ethnic image, says Haiken. The push now is to enhance, rather than change, existing features.
Nothing New Under the Sun
Intertwined with Haiken's look at the culture of beauty is a well-researched history of cosmetic surgery. In the early 1920s, the debate raged between the "beauty" surgeon, who performed any surgery at any time for money, and the "bona fide" plastic surgeon, who was willing to operate only when the deformity was sufficient to justify it. Commercialism became a litmus test, of sorts, Haiken says. Many devastating surgical "experiments" performed by "flagrant charlatans" were the direct result of the public's demand for beauty.
Physicians in the 1920s injected paraffin into women's faces to smooth out wrinkles and fine lines, not realizing its long-term results, she says. Paraffin seemed like a miracle cure. Surgeons could inject it anywhere and mold it easily.
"Then people started going out in the sun. The paraffin melted and moved around," she says. Surgeons abandoned the practice in horror as more and more procedures failed. The same happened in the 1960s, when Americans injected liquid silicone into their faces and other places.
"It was a disaster. It moved around. It rotted. The side effects were terrible," Haiken says.
Silicone, after injection, tended to migrate, turning up in lymph nodes and other areas of the body; it also formed lumps that could mask (and prevent early detection of) breast cancer. At worst, then, silicone injections could result in amputation.
A series of lawsuits against physicians and against the companies that manufactured silicone stand as a testament to what Haiken terms "the injection debacle" (whether or not silicone breast implants will be proven dangerous remains to be seen, say -researchers).
Today's surgeons inject collagen and the newest "miracle" into their clients' wrinkled faces: Botox, derived from the same bacteria that causes botulism, or food poisoning.
"Botox is a nerve poison, essentially," Haiken says. "It freezes the muscles so that you can't move them, so you don't get wrinkles."
Whether with paraffin, silicone, or Botox, people continue to pursue youth and beauty.
"As a historian, I really try to stay away from the phrase, 'There's nothing new under the sun,'" says Haiken. "It's so trite. And yet doing this book, I thought, there's really nothing new here."
Here's Lookin' At You
The world watched as Humphrey Bogart's "new" face was revealed in the 1947 movie Dark Passage. In 1973, we watched Elizabeth Taylor in Ash Wednesday as a woman who was sure a facelift would help her hold a straying husband. We've watched as pop star Michael Jackson "looks less like his pre-surgery self and more like Elizabeth Taylor than either patients or surgeons in previous generations would have believed possible," says Haiken.
"I think television and movies have had a huge impact," she says. "After the second World War, I noticed the wording changed. People would say, 'so-and-so looks good for 50.' And I thought, 'how does anybody learn what 50 looks like?'
"Before television and magazines, before this endless parade of images that we're more and more inundated with from the day we're born, 50 looked like your grandmother or the neighbor down the street. Are Goldie Hawn and Angie Dickinson really what 50 looks like now?"
Haiken, a native of Northern California, came to UTK as an assistant history professor in 1995. She is the recipient of UTK's 1998 Angie Warren Perkins Award, given to a female faculty member who has demonstrated excellence in teaching and scholarship. Her book, Venus Envy, has been given rave reviews here and abroad by both scholars and non-scholars.Top of Page
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