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>> 1 Introduction It’s like if you’re not pretty, you’re not even a human. —14-year-old girl in a personal conversation, 2007 In the summer of 1990, my tween friends and I invented a game. The rules were simply this: One girl posed a question, and everyone in the room had to answer . . . honestly. Our game worked differently from Truth or Dare, the ubiquitous slumber party game in which adolescents, most often girls, ask each other revealing personal questions or challenge fellow players to embarrassing tasks. In our version, players were faced with telling the “real truth” about another player. These questions had tricky answers. The game, tinged with all kinds of girlhood sadism, always ended with someone in tears. Most often that someone was me. Some questions were fairly benign, such as “Who is the most fun to spend the night with?” There were moderately hurtful questions, like “If you had to choose one best friend in the room who would it be?” Of course, you hoped you were the one, but not every girl could be every other girl’s best friend. So there was a sheepish camaraderie that arose amongst those of us not picked. But there were also questions that resulted in the articulation of a clearly delineated hierarchy. Sometimes, one girl would ask each girl to rank everyone in the room from smartest to stupidest. I was rarely the smartest, but I was never the stupidest, 2 > 3 picture tainted with my face, but it seemed cruel that I had to take the picture at all. I imagined that our neighbors upon receiving our Christmas card remarked, “They’re really a beautiful family. It’s such a shame about Heather.” When I look at childhood photographs, what I see is shaped by a vantage point that my ten-year-old self could never have imagined. I left Louisiana. I pierced my nose. I dyed my dishwater hair chestnut brown. And I am struck by how not ugly I was. I was not a beautiful child, but I was not especially unsightly either. The truth is that this is where most of us live: in the space between what is perceived to be attractive and what is designated as ugly. Regardless of where we find ourselves on the appearance spectrum, aesthetic intervention contours all of our lives. Beauty culture—the shared set of language, meanings, norms, and practices focused on the cultivation of attractiveness—has received inordinate amounts of scholarly attention in the last thirty years, and for good reason.1 In anthropologist Michael Taussig’s recent examination of body beautification, he asks: “Have we not become blind to the force of the aesthetic, of beauty, if you will, coursing through everyday life? Surely beauty is as much infrastructure as are highways and bridges, storytelling and the Internet, rainfall and global warming.”2 Not only have rates of cosmetic surgery exploded, but other methods for optimizing appearance have proliferated, too. Skin whitening, cosmetic dentistry, Botox injections alongside other facial fillers, and laser skin resurfacing are on the rise, rapidly shifting our bodily (and cultural ) infrastructure. Correspondingly, the desire to be intervened upon has solidified as a widely shared cultural longing, contingent on social class and access to resources. Research indicates that most of us would pursue cosmetic surgery if we were not financially constrained.3 Cultural critics have crafted nuanced accounts describing the ways gender norms, makeover culture, heightened consumerism, credit availability, and global travel coalesce to make the production of beautiful bodies not only more accessible, but also more desirable. The irony, of course, is that cosmetic intervention is characterized as “elective” surgery. Studies of beauty culture seem to suggest the contrary—beauty feels essential or requisite in this day and age. Yet attractiveness is not the only longing that results in aesthetic intervention, and cosmetic surgery is only one method of managing bodily appearance. 4 > 5 persists into adulthood and becomes a motivating impetus to monitor and alter one’s appearance throughout life. Bodily features outside the norm from birthmarks to acne to scars are routinely medically treated, pharmaceutically medicated, or surgically fixed. So much seems to depend on appearing normal. Reconstructive surgeries often facilitate vital physiological processes such as eating, and in this way, the practice is unlike cosmetic intervention . Yet the most commonly cited difference between the specialties is that cosmetic surgery is elective while reconstructive surgery is needed. The cases described throughout this book—the surgeries featured on...

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