To the extent that beauty ideals are internalized, women themselves are likely to see beauty work as a personal preference and to feel badly about themselves when they do not quite meet the standard. Women reg­ularly report an ideal body image that is thinner, lighter, taller, more mus­cular, with larger breasts and longer hair compared with their actual phys­ical characteristics (Jacobi & Cash, 1994). In fact girls and women are encouraged to experiment with various looks and body manipulations very much as if they themselves were objects. Although cosmetic surgery is the primary culprit—and clearly the most potentially dangerous— dysfunctional eating, tattooing, and body piercing also are forms of body manipulation.

Approximately 2 million cosmetic procedures are performed annually in the United States. Not only do these figures represent a significant in­crease over the past decade, but they also represent an increase in proce­dures being performed on younger and younger clients. For example, more than a third of face-lift patients are age 50 or younger (Hamilton & Wein – garden, 1998). Cosmetic surgery fosters the notion that being unattractive is a form of pathology (Morgan, 1994). It has been suggested that cosmetic surgery exists to cure women of their ugliness, despite the fact that ugliness is not a biological disease, but rather a socially created disease (Wolf, 1991). By creating and then claiming to cure women’s flawed appearance, the medical profession plays a significant role in controlling women and ben­efits from advising what to do to their bodies in order to combat flaws that have been socially constructed.

Because Western ideas of sexuality are projected onto women’s breasts, various means of shaping and enlarging breasts have become com­mon. Surgical breast implants were first marketed in the 1960s and have long been a means for acquiring the ideal body shape. Complications from these procedures include rupture and shrinking scar tissue around the im­plants that can result in a painful hardening of the breast. Implants also may limit the effectiveness of standard techniques used to screen for breast cancer. Implants filled with silicone gel have been the subject of class action suits involving 400,000 women claiming a variety of connective tissue diseases and immune disorders. Nevertheless, we continue as a so­ciety to view breast size as an important marker of sex appeal and beauty.

New technologies have expanded the range and degree of invasive­ness possible in the pursuit of beauty. Liposuction (the surgical vacuuming of subcutaneous fat) is now one of the most common procedures. New techniques break up fat cells with ultrasound and suction with a smaller cannula than used in earlier methods that allow for removing pounds as well as reshaping the body. The fact that complications can include blood clots in the lung, vein collapse, shock, permanent nerve injury, skin dis­coloration, and increased lumpiness of skin has not kept liposuction from becoming an extremely popular procedure (Springer, 1996). Other proce­dures, costing thousands of dollars, involve the injection of collagen to minimize facial wrinkles. What women are getting is probably more ap­propriately called “psychosurgery” (Chisholm, 1996), considering the most important impact is on how women think and feel about how they look, and the real objective is a psychological comfort.

Cosmetic surgery is only the modem day approach to women’s im­perfections. In the Victorian era, treatment for women’s pathology focused directly on their sex organs, with doctors performing clitoridectomies, hys­terectomies, and ovariectomies in order to cure women of their mental illness (Ussher, 1989). Today, women have been convinced that what is wrong with them is how they look, so the knife that once removed our great grandmothers’ ovaries now removes the excess cartilage from our noses, cellulite from our thighs, and wrinkles from our faces. The locus of the pathology has shifted, but the assumption is the same: Women’s bodies are to blame for their inadequacies. Tragically, this message is aimed not only at women, but also at girls.