Hektoen International

A Journal of Medical Humanities

Ethics, feminism, and cosmetic surgery

Unaiza Waheed

Illustration of a woman's face divided into different colors
Illustration by author

In Reshaping the Female Body, Kathy Davis expresses surprise when a feminist friend announces she is considering breast augmentation surgery: “[She] was very critical of the sufferings women have to endure because their bodies do not meet the normative requirements of feminine beauty,” yet she still felt pressure to seek cosmetic surgery for herself.1 Davis believes cosmetic surgery to be an act of submission or weakness, whereas others would argue it is an act of independence and free-will. Descriptions such as “weak” and “liberating” create the illusion of war, perhaps one between the sexes.

The body is the connection between the mind and the external world: it shapes the way we present ourselves and affects our interactions with others. Cosmetic surgery, which alters the body for aesthetic appeal, can be a source of empowerment for women. However, body dysmorphia underpins some women’s decisions to seek cosmetic surgery. Since most cosmetic procedures are performed on women, this issue bears examination from a feminist perspective.

In “My Body is My Art,” Davis presents an account of women who have undergone cosmetic procedures, explaining that “cosmetic surgery . . . was an intervention in identity. It enabled them to reduce the distance between the internal and external so that others could see them as they saw themselves.”1 However, Davis also interviewed women who were so disconcerted with their physical appearance that it was interfering with their quality of life. Fixated on a particular physical trait, managing daily life became difficult. At some point a fixed or overwhelming insecurity may point to a diagnosis of body dysmorphic disorder (BDD), which is treated with psychological therapy. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies BDD under “Obsessive Compulsive and Related Disorders.” Those seeking cosmetic surgery under the UK National Health System are routinely screened for this disorder and unable to receive surgical treatment if the perception of their appearance is so skewed that they are unlikely to be pleased with the results. However, private healthcare professionals are not under the same obligations to screen their patients for BDD, which raises a key ethical concern. Cosmetic surgery is not a cure for people with this psychological diagnosis, yet these procedures are available to them privately. Davis speaks to the effects of this disorder, stating that these women were not seeking a more beautiful body, but just wanted an ordinary one.1

Some women seek cosmetic surgery as a way to use their bodies as a source of power. Kathryn Morgan interviewed a woman who stated, “I’ve gotten my breasts augmented. I can use it as a tax write-off.”2 In her point of view, surgery enabled her to advance in her career. Some may find this to be unethical; others argue that this has enabled her to feel more optimistic about herself and the future, allowing her to make decisions for herself freely.

Women are not forced to undergo cosmetic procedures, but there are external factors that influence their decisions. Media exerts a tremendous influence on women to look a certain way that is culturally accepted as “beautiful.” Sandra Bartky explores the ways that women are under an insidious form of control by examining Foucault’s Theory of the Panopticon. A panopticon was a form of prison architecture proposed by Jeremy Bentham in the late eighteenth century where a central surveillance tower could patrol aisles of cells, so that prisoners would believe they were being surveyed even when no one was in the tower. Foucault described this concept as the internalization of norms, and Bartky extends this analogy to women in today’s society who are subjected to policing not only through the male gaze but through their own internalized gaze. Cosmetic surgery may be seen as a tool of male domination; the standards of beauty that are set by males are practiced by females.3 If women modify their bodies in order to live up to male standards, dominated by the expectations of a patriarchal society as a surveillance instrument, then beauty standards are no longer an aesthetic interest but an instrument of power, making the concept of free will in cosmetic surgery something of a delusion. But if this is a delusion that helps a woman bear her life more easily, is it really a problem?

While cosmetic surgery does not necessarily pose a physical harm to individuals, if it perpetuates a feeling of inadequacy, a danger arises. Cosmetic industries have a vested interest in promoting women’s self-conscious need to remedy their flaws. Marketing interests thus promote the degradation of women, limiting their actions and forcing them, subliminally, into an inferior role. This point is illustrated by women seeking cosmetic surgery in order to feel more powerful.

Since the media characteristically promotes only one form of beauty, in a woman’s search for identity, “choice” is significantly affected by the society she lives in. This is why most women look for a particular shape for their rhinoplasty, and opt for breast augmentation rather than reduction. The argument changes from one of choice to one of conformity. Whether a woman wants her body to be more beautiful, or wants to be ordinary and fit in, the “norm” is at stake in both situations. The modified woman becomes the norm and the natural becomes the deviant. Modern surgical practice has catalyzed the dangers of a society that normalizes the unnatural.

On the other hand, surgery as a feminist tool can be liberating and empowering, as explored by the French body modification artist Orlan. She has used “surgery not to better [herself] or become a younger version of [herself], but to work on the concept of image and surgery the other way around.6 Orlan has cosmetically enhanced her forehead with two horns in an attempt to question beauty norms and expectations. She has defined her actions as out of the ordinary and “abnormal,” which perhaps also represents the unrealistic ability for most women to achieve this in a society. Morgan has characterized Orlan’s art as “utopian,” and Davis defines it as “a utopian revisioning of a future where women re-appropriate cosmetic surgery” for themselves.2

Cosmetic surgery may be viewed as a means of empowerment, liberation, and personal contentment; or as a sign of personal weakness and societal oppression. And for women with undiagnosed BDD seeking cosmetic surgery, appropriate psychological treatment is more ethical than surgery. While modern plastic surgery was developed in the First World War as a means to treat facial injuries, surgeons later realized that the same techniques could be used to transform healthy but subjectively unattractive noses into more culturally acceptable specimens. Plastic surgery still continues to help the wounded and the malformed, but excessive amounts of energy and money have been injected into upgrading the healthy. Ethically, where should science draw the line?5


  1. Davis, K., 2013. Reshaping The Female Body. Hoboken: Taylor and Francis.
  2. Artnet.com. 2020. ORLAN | Artnet. [online] Available at: <http://www.artnet.com/artists/orlan/> [Accessed 6 May 2020].
  3. Jaggar, A., n.d. Living With Contradictions.
  4. Bartky, S., 1990. Femininity And Domination. New York: Routledge.
  5. Ranciére, J., 2003. The Politics Of Aesthetics. London: Bloomsbury.
  6. Harari, Y., 2018. Homo Deus. New York: Harper Perennial.

UNAIZA WAHEED will soon graduate from the University of Exeter, UK with a medical degree, having already obtained her intercalated bachelor’s in Medical Science, Neuroscience. She has a particular interest in studying the brain and mind, and hopes to pursue an academic medical career in the near future.

Summer 2020



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