Under the Knife

In a patriarchal society, how far will women go to get men’s attention and approval? How much of their own flesh will they sacrifice, how much of their daughters’ flesh?

In some countries and at various times, these sacrifices have included the crippling procedure known as foot binding; female genital mutilation: surgically removing lower ribs to create a narrower waist; neck rings that weaken the muscles, damage the collar bones, and prevent the wearer from bending to take a drink; corsets that restrict breathing; and pointy-toed shoes that induce bunions and hammertoes.

Millions of Asian women—an estimated 1.3 million in 2017 alone—have had eyelid surgery to look “more Western.” Black women have resorted to skin lightening creams and hair straightening compounds that burned their scalps, but at least these procedures are reversible, as the hair and skin grow back.

Now women in the United States and elsewhere are flocking to submit themselves to another form of physical mutilation, and paying thousands of dollars for the privilege. This is the Brazilian butt lift, described in two recent articles in The New York Times, one dated August 19, 2021 and the other May 11, 2022. The operation involves suctioning fat—essentially dead fat—from the abdomen or other body parts and injecting it into the butt. The object is to increase buttock size, making the woman more attractive to men. If you have a strong stomach, check out the photos in the May 11 article. Facebook’s artificial intelligence decided that they were sex-oriented and wouldn’t let me include them in this post. They even banned me for days for trying.

However, there are many downsides to this procedure. The butt lift has the highest mortality rate of any plastic surgery, one to two deaths in every 6,000 patients. If the doctor mistakenly injects the fat into the gluteal muscle, it can travel via the inferior vena cava to the heart or lungs, obstructing blood flow and causing immediate death. Some of the doctors who run low-cost, high-volume butt-lift clinics were never trained as plastic surgeons—and some of them aren’t even MDs. Recovery from this surgery is excruciatingly painful. One woman said it was worse than childbirth. For two weeks afterward, the patient can’t sit down or lie on her back to sleep. And nobody knows the long-term effects of this procedure.

Yet despite the pain and the risk of death, demand is booming. A total of 40,320 butt lifts were done in 2020, and 61,387 in 2021. Those numbers, also, are only for such procedures done in the United States and reported by the society for board-certified plastic surgeons.

Women also shell out big bucks for breast augmentation. Like butt lifts, they may be done by transferring fat from other parts of the body. They may also be done with implants, which come with additional risks, including scarring, contracture (51.7%), infection (35.4%), and rupture (31.2%) or migration of the device. These will likely require additional surgery. A common risk is breast implant illness, resulting in chronic fatigue, joint pain, and/or cognitive difficulties. So the patient gets stupider but has bigger boobs–for some guys, this would be a feature, not a bug. The most serious risk is anaplastic large-cell lymphoma, occurring in one out of 450 patients. HealthLine considers this last complication rare–but if you’re the lucky victim, you’re in for chemotherapy, radiation, and a significantly increased chance of early death.

If you thought female genital mutilation only happens in the Third World, consider labioplasty and “designer vagina” surgeries. According to the National Center for Health Research, the number of procedures increased 262% in 6 years, from 3,521 in 2012 to 12,756 in 2018. “The American Society for Aesthetic Plastic Surgery (ASAPS) reported 12,756 labiaplasty surgeries in 2018, costing more than $53 million.” Women give various reasons for paying some surgeon (usually male) to take a knife to their genitals, from wanting heightened pleasure to wanting more youthful appearing genitals to pressure from their partners.

As every woman knows, in a patriarchal society we are judged first by our looks. An article about a female political candidate making a speech will often comment primarily on her appearance and clothes. Think of Hillary Clinton’s pants suits. Our looks will enable us to get a job, get a promotion, get a man who will support us and our children, or keep the man when we’re getting old and worried that he might be casting his eye on a younger model.

The first time I heard about plastic surgery was at age 12, when I was hospitalized for an emergency appendectomy and shared a room with a woman who had just had a nose job. She was in quite a bit of pain. Though I myself was recovering from surgery, I did what I could to help her—brought her a cup of water, or rang for her nurse.

Later I learned that many of my female cousins had had nose jobs. The idea was to look less Jewish, to fit the white American standard of beauty. When I came out to my mother, she offered to pay for a nose job, hoping that it would make men desire me and induce me to go straight.

To be clear, I’m not opposed to plastic surgery per se. For someone born with cleft palate or other malformations, or who has been injured in an accident or had breast cancer, or whose unusually large breasts are actually disabling, going under the knife may be the best or even the only option.

The rest of us have other options, though these are always constrained by social and economic conditions. Women undergo these painful, expensive, and medically unnecessary procedures to snag a job or a husband with a good job, in a society controlled by men. Advertising and marketing campaigns shape our choices. Movies, TV, advertising, and the internet tell us what we must look like to catch that meal ticket. And the patients are almost all women—we purchase 92% of cosmetic surgeries, men buy only eight percent.

Meanwhile the medical industry, like the pharmaceutical industry, reaps enormous profits. Americans spent over $8.7 billion on plastic surgery during the first six months of 2021, and the annual total will likely double that figure.

Butt lifts are horrifying enough. In my opinion, though, the procedure that should get a gold medal for misogyny is one I heard about decades ago. I can’t find the original newspaper article, written before we all had computers and access to the internet, but I can’t forget it either. A plastic surgeon in the Midwest had devised a method to relocate the clitoris to inside the vagina, so as to allow a woman to climax from intercourse alone. The man didn’t need to do anything extra, just pleasure himself the way he always had. And if the woman didn’t come, she could lie about it to please him, the way subjugated women always have.

Fortunately, I never heard of any other surgeons adopting this technique. Perhaps it didn’t work all that well, and perhaps the quack subsequently had his license pulled. One can only hope.

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