This blog post was written following the second Beauty Demands workshop. The third workshop will take place 14-15 October in Birmingham and will focus on the globalisation of beauty. The deadline for abstracts is 16 July at 4pm. This is the first of two blog posts.

Earlier in June, the Nuffield Council hosted a workshop on ‘Professionals, practitioners and beauty norms’, bringing together academic experts on body image and fashion, psychologists, philosophers, lawyers, surgeons and GPs to debate the role of professionals in responding to the changing requirements of 'beauty'.

Bunch of barbies_web

This was the second of four such workshops to be held as part of the year-long multi-disciplinary AHRC-funded BeautyDemands project looking at changing attitudes to body image, and the consequent changing uses of procedures that have traditionally been regarded as 'medical' in order to attempt to achieve beauty norms.

Speaker after speaker presented evidence as to the ever stronger emphasis and value placed on women’s (but also increasingly men’s) looks, and how the fashion ideal of looking 'very young, very thin, very white' (plus big breasts) is translating into demand for invasive surgery. In the UK, the operation most in demand is breast augmentation surgery, followed by eyelid surgery and facelifts, while we were told that in China leg-lengthening is de rigueur, and in South East Asia eye-widening to achieve a more 'western' look is popular.

A recent growth area of demand in the UK, one for which there are only isolated case reports from the 1970s, is that of 'corrective labiaplasty' for women (and girls) troubled by the size of their labia. A recent survey of the top ten websites promoting 'designer vaginas' found an extraordinary total of 72 procedures offered to assuage these newly emerging needs.

And alongside this apparently insatiable demand for procedures (assuming it's true that the apparent downturn in 2014 was due not to changing trends but the pressures of the recession) there is plenty of evidence as to high levels of body dissatisfaction and the distress it causes. One Bristol based study, for example, produced the shocking statistic that 18% of teenagers surveyed felt they had no good features at all. Negative consequences of 'appearance dissatisfaction' include lowered self-esteem and anxiety, teasing and bullying, poor academic and occupational performance, and physical ill-health, for example as a result of poor diet and smoking.

So, if the many and varied medicalised procedures on offer can help alleviate such distress, presumably they are a good thing? Well, no – or at least not necessarily, and certainly not always. Quite apart from any qualms we might have about the actual nature of contemporary 'young, thin and white' ideals (of which, more below), there is good evidence to show that the beauty myths used universally to sell beauty products and services – that they will make you happier and more successful – are precisely that: myths. Beauty procedures will not 'solve' all the difficulties associated with low self-esteem and distress about body image.

Thought-provoking research with teenagers with and without cleft lip and palate, for example, has shown that those who have had to come to terms with disfigurement actually have greater confidence in their own appearance than teenagers without any such disfigurement. While initially counter-intuitive, this finding correlates well with psychological research showing that in fact happiness with the way we look is multi-factorial, and includes factors such as resilience, acceptance of self, and the value placed on aspects other than appearance.

Nevertheless, if it were as simple as that, clinics offering cosmetic procedures would long since have gone out of business. Of course there are many people who do not suffer from low self-esteem or anxiety disorders or anything else – they just don't like some feature of their face and body. And if someone simply wants bigger or smaller breasts, a different shaped nose or fewer wrinkles, what business is it of anyone else’s to question their motivation or interfere in their choices?

And this question leads into a whole host of contradictions. From a feminist perspective, is the choice to undergo cosmetic procedures an example of empowerment, whereby women take control of their own bodies and determine for themselves what is beautiful or normal? Or is it collusion with oppression – a submissive response to those who actively create a sense of bodily 'shortcomings' to feed our sense of personal inadequacy and thereby sell a medically unnecessary service?

Is beauty understood as an ideal, as an exception to the normal or mundane (see the stunning Defining Beauty: the body in ancient Greek art exhibition at the British Museum) – and hence attempts to attain it inevitably doomed to failure and distress? Or is beauty something that everyone can achieve – the democratising effect of beauty products and procedures releasing us from limitations imposed by nature? And if so, does this mean that cosmetic ‘work’ is so normal as to be expected or even required?

And pervading all talk of choice and empowerment is this question of how free those choices are and who, in fact, is making them. A fantastic film by Dove captures, from a child-eye view, the deluge of images with which we are constantly being inundated; Ken and Barbie have significantly changed shape in recent decades (and I don’t recall Barbie exactly reflecting the average British woman in my own childhood either); air-brushing is the norm; and any sign of normal ageing seen as failure. While male ideals of beauty (see Ken’s highly toned torso) at least have some overlaps with bodily fitness and strength, for women these ideals have particularly dangerous synergies with disordered eating, infantilisation (returning the body to its pre-pubescent state) and mental ill health.

If we simply accept these ‘ideals’ and seek to conform to them, what are the implications for ageism and racism? How about people with disabilities? (see the inspiring Pro Infirmis film "Because who is perfect?"). And what about if cosmetic procedures go badly – or even are just too obvious? The gloating in certain sections of the press over celebrities perceived to have made poor choices with respect to cosmetic procedures bear unpleasant similarities to the freak shows of the nineteenth century.

So, where does this leave us? The responsibilities of professionals who develop, provide and promote these procedures is clearly an important issue. One which we discussed in depth at the workshop (more on that in my next blog - From botox to face lifts – should professionals say yes?), and will also be the focus of the Council’s own work on cosmetic procedures.

To finish on a positive note, I'd like to report on the final tip from one of our speakers: next time you see yourself in a mirror: smile. And remember that, while in a first encounter others may focus on our appearance for the first ten seconds, thereafter it’s what we say and do that really steers what they think of us.

As James Partridge of Changing Faces reminded us: "How I looked wasn't nearly as important as how I behaved."

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