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Modern Miracles: The Development of Cosmetic Prosthetics
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6 Modern Miracles The Development of Cosmetic Prosthetics Elizabeth Haiken IMAGINE AN ARCHEOLOGIC AL dig some centuries in the future focused on medical practices of past times, a time when the term “primitive ” is even more out of fashion than it is today. The dig site? One of the many cosmetic surgery centers that sprinkled the North American landscape in the late years of the twentieth century. A core sample taken from the refuse pile reveals layer after layer of scientific and technological innovation. On top is Gore-Tex, that miracle fiber of “explornography,” then, a layer of Teflon and several layers of silicone solids, underlain by a thick layer of still-viscous gel. Beneath these are several strata of what looks like compressed sponge of varying density and consistency. Below this is a frightening hodgepodge: “glass balls, terylene wool, ox cartilage.”1 At the very bottom is a thick layer of what looks like beeswax, embedded in which are chips of ivory, beef bone, and “quite a variety of foreign materials . . . bits of braided silk, bits of silk floss, particles of celluloid, gutta percha, [and] vegetable ivory.”2 That a core sample—even an imaginary one—should suggest an increasingly synthetic environment is no surprise. Any landfill excavation , layer by layer, would similarly reveal the plastic (r)evolution that has fundamentally shaped the last one hundred years. What is striking about this sample are the shreds of human fat and flesh that have been preserved in paraffin and petrified sponge and liquid plastic—or (less so) what these materials have in common, which is that they have all been used to augment or reshape human flesh. 171 A prosthetic is generally defined as something created to replace a part of the body that has been removed, and by this definition the term “cosmetic prosthetic,” in addition to being something of a tongue twister, is a misnomer. While an ivory or (later) latex or (still later) silicone strut needed to rebuild a nose destroyed by fire may, by this definition , be termed a prosthesis (as might a foam rubber– or silicone- or saline-filled breast implant needed to reconstruct a breast removed because of cancer), an implant designed and selected to create what did not exist in the first place (whether cheekbone, chin, pectoral, calf, buttock , or breast) cannot, strictly speaking, be called prosthetic. Over the course of the twentieth century, however, “strictly speaking ” has become increasingly difficult for practitioners as well as patients . The category of need, which once seemed self-evident (as well as strictly physical), became more difficult to define as psychological thinking was added to the mix. Furthermore, technological innovation has produced many more choices: an accident victim may “need” a prosthetic hand that enables him or her to grasp and manipulate objects , but does that hand “need” to be lifelike? Many of us can accept a breast cancer survivor’s “need” for breast reconstruction, even with full knowledge of the fact that accepting this “need” pushes us closer to acknowledging all “needs” as valid. In the borderland between need and desire in which cosmetic surgery, as a practice and as a phenomenon, developed, the line between what is and what ought to be—that is, between the real and the imagined self—faded away, and the term “cosmetic prosthetic” began to make instinctive sense. And in the quest for the perfect prosthetic substance—one that could be easily inserted, injected , or implanted, that would not react or extrude itself or deteriorate or morph into something rich and strange, that would mimic (in texture , in movement, and in psychological effect) the “real thing” (whether bone or cartilage or soft flesh)—physicians and patients have collaborated in an endlessly inventive, and sometimes even dangerous, process of experimentation. PREMODERN MIRACLE: PARAFFIN Not until the late 1930s did plastic surgery become a recognized medical specialty, with its own organizations, publications, and standards of education, training, and certification. Until then, plastic surgery was an 172 ELIZABETH HAIKEN [34.236.152.203] Project MUSE (2024-03-19 09:20 GMT) amalgam of dentistry, oral surgery, otolaryngology, and general surgery , as well as what was then called “beauty culture,” though plastic surgeons are still loathe to admit this. Would-be plastic surgeons resembled , more than anything, pioneer scientists alone in their basement laboratories (think, for example, of Warner Brothers’ Young Tom Edison), brewing and sculpting solutions to the perceived problem...