Surgery Junkies: Wellness and Pathology in Cosmetic Culture

Chapter 5: The Surgery Junkie as Legal Subject

5 The Surgery Junkie as Legal Subject When cosmetic surgery is linked to mental disorder, it becomes a social problem, raising a significant set of worries for medical decision making and the public. Possible scenarios of surgical excess and addicted or obsessed patients trouble cosmetic surgeons, psychiatrists , critics of cosmetic surgery, and others. Given the frequency of malpractice suits in American medicine, one of the social institutions where such scenarios will inevitably play out is the courtroom. Such a story unfolded in the New York State courts in recent years. A woman named Lynn G. underwent surgeries of the face, neck, breasts, abdomen , and legs, seeing her cosmetic surgeon a total of more than fifty times over six years. She later regretted the operations. In Lynn G. v Hugo, she claimed that her surgeon , Dr. Norman Hugo, ought to have realized that she was unreasonably obsessed with cosmetic surgery and, in fact, had Body Dysmorphic Disorder. The case raises many troubling questions, a number of which were debated in media coverage of the case. Should a patient be able to sue her surgeon for performing surgery she has elected? To 128 what extent should a doctor question the normalcy of his or her patients’ desires for multiple surgeries? Does it matter if his or her patient had been under psychiatric treatment for depression? If the patient was a surgery addict, how would that impact the medical standard of care? Whose responsibility is it to check surgical excess, and to diagnose Body Dysmorphia? The case itself is an anticlimax: it ends in summary judgment for the defendant—prevented from going to trial—and offers few answers to the broader questions it provokes. But Lynn G. is interesting because, among other things, it is one of the first entrances of the surgery addict into the courtroom, indicating the potential of the diagnosis to organize legal and medical decision making about cosmetic surgery, as well as what kinds of social and media responses a court case about a cosmetic surgery addict might raise. In addition, I see the conundrums and paradoxes the case presents as shaped partly by what Foucault calls the hermeneutics of the self—the drive to establish the truth of the subject. From the perspective of the judges and lawyers, whether or not there were triable issues in the case was the legal question at hand. But the case can be read beyond the narrow grounds on which it was decided, because the court records acknowledge broader questions about cosmetic surgeons and patients. After presenting the events of the case, I describe a range of possible constructions of the surgery addict as a legal subject that one can imagine from reading the various court opinions of Lynn G. I find instances where the patient might be perceived variously as a rational consumer, a narcissist, or a mentally ill victim. I see these constructions as forms of subjectivation resonant with widely held but disparate ideas about cosmetic surgery patients. The debates over the subjectivity of Lynn G. Surgery Junkie as Legal Subject 129 in the court opinions effect a powerful interrogation of the subject that reflects the broader hermeneutics of the self of cosmetic surgery culture. Lynn G. v Hugo Lynn G. was a middle-aged woman living in New York City. Dr. Norman Hugo was a prominent plastic surgeon in Manhattan, chief of plastic surgery at ColumbiaPresbyterian Hospital in the early 1990s, and a past president of the American Society of Plastic Surgeons. Lynn met Dr. Hugo when she was in her early forties, after she brought her daughter into his office for a rhinoplasty. Having already had some cosmetic surgery performed by other surgeons, including rhinoplasty, she saw Dr. Hugo more than fifty times over the next six years for various procedures, including periodic fat injections to the face, blepharoplasty (eyelid surgery), several liposuctions of the face, eyebrow tattooing, and skin growth removals (including the removal of lesions, skin tags, papillomas, and keratoses). Eventually, in February of 1993, Lynn G. also underwent liposuction of the abdomen, thighs, knees, and flanks as well as a bilateral mastopexy (breast lift). After reporting dissatisfaction with the results of the liposuction, Lynn G. underwent another operation nine months later, this time a full abdominoplasty, along with liposuction of the inner thighs. Mrs. G., as she is referred to in some of the court documents , had been dissatisfied...