In the United States plastic surgeons can be the heroes of a TV show (think ‘Nip/Tuck’) but in Brazil they can become heroes of an entire nation. Arguably, there’s no plastic surgeon in the world who has achieved as much fame as Rio de Janiero’s Dr. Ivo Pitanguy. In 1999, a Carnival parade in Rio was staged in homage to him. The doctor took the lead trailed by skimpily dressed samba dancers. A singer praised him for “awakening the self-esteem in each ego” with a “scalpel guided by heaven.” It’s hard to imagine a more spectacular promotional campaign for a surgeon’s services. For Pitanguy plastic surgery is an equal opportunity for rejuvenation and transformation. In his view plastic surgery is for everybody. “The poor have the right to be beautiful, too,” he has said. For a people as obsessed with cosmetic enhancement as Brazilians this sentiment is widely shared. For many people, though, plastic surgery remains a schizy enterprise. On the one hand, it is therapeutic, focused on repairing disfigurement and deformities due to severe burns, injuries or congenital defects. On the other, it is a way of combating the encroachment of age (at least temporarily) or of improving the assets you were born with. Pitanguy sees it as a means of boosting self-esteem, making the mirror more of a friend. Pitanguy likes to cite such intellectual heavyweights as Michel Foucault and Claude Lévi-Strauss in books otherwise devoted to medical techniques, bolstering his reputation as the “philosopher of plastic.” In his magnum opus, Pitanguy puts forward what Alexander Edmonds, an anthropologist and author, refers to as a “radical therapeutic justification for cosmetic surgery.” A plastic surgeon is a “psychologist with a scalpel in his hand,” uniting with his handiwork both the cosmetic and reconstructive aspects of his trade. “In both types of surgery,” Edmonds wrote in a 2011 essay for The New York Times Magazine, Pitanguy claims that “beauty and mental healing subtly mingle… and both benefit health.” Because of its capacity to improve mental health, at least in Pitanguy’s formulation, plastic surgery can be considered “psychoanalysis in reverse” – a short cut (forgive the pun) to attaining mental health, a project that might otherwise take a good deal of money and several years on the couch. That might be another reason why one of Pitanguy’s admirers observed, “The poor prefer surgery.”
Pitanguy began his training as a surgeon in the 1940s and has gone on to train over 500 surgeons, teaching them not only his surgical techniques but inculcating them in his philosophy as well. Now Pitanguy is not a model for any character in The Donors but he nonetheless served as an inspiration both in terms of his practice and his philosophy. The characters in the novel are desperate to escape their circumstances and slough off their identities, usually because they face extinction if they don’t. At the same time the chance at a new life in a new skin with a new face exerts an eerie appeal all of its own. You don’t have to die to be resurrected; you can do it in this lifetime and shed all the sins and regrets accumulated by your old, worn-out, washed-up self. And then there’s another chance at the genetic lottery that you might not have won at birth. The veneration of beauty and celebrity has raised the stakes; it isn’t enough to look merely ‘normal,’ and indeed, studies have shown that those of either sex who are better looking receive better grades in school and obtain jobs easier and for higher pay. Talent and hard work are all well and good but if you can turn heads people might tend to impute both qualities to you without your necessarily having to do much if anything to prove you have either.
“Beauty is unfair,” Edmonds writes, “the attractive enjoy privileges and powers gained without merit. As such it can offend egalitarian values. Yet while attractiveness is a quality ‘awarded’ to those who don’t morally deserve it, it can also grant power to those excluded from other systems of privilege. It is a kind of ‘double negative’: a form of power that is unfairly distributed but which can disturb other unfair hierarchies.”
But beauty isn’t entirely an advantage as evidenced a recent ruling by the Iowa Supreme Court. The case involved a suit by a woman who’d accused her former employer, a dentist, of firing her because of her looks – more specifically because he found her beautiful and had become sexually attracted to her. He claimed that he and his wife had agreed that if they were going to save their marriage he had no choice but to get rid of her. (The save me from myself defense.) Although her lawyer argued that being a source of temptation was hardly reason for sacking someone, the all-male judges on the court ruled against her, asserting that beauty – and the distraction and aggravation it could provoke -- was reasonable grounds to let her go. Beauty may be in the eyes of the beholder but it can also, it seems, put you in the unemployment line.