“Everybody did it, but no one talked about it”: The disputed cosmetic work of the plastic surgeons

Abstract

In this article, based on 80 interviews, together with observations and archives, we analyse the development of conflicts of legitimacy relating to plastic surgeons. We focus particularly on cosmetic medicine and cosmetic surgery, and the disrepute into which these two activities have fallen, particularly the latter, with respect to the surgeon's ethos. The aim is to understand these dynamics of finger-pointing and the conditions of rehabilitation in the light of inter- and intra-professional conflicts, but also in the light of individual and professional competition. First, we describe how cosmetic surgery has been rehabilitated in terms both of collective factors (the integration of new surgeons into the labour market) and of individual careers. The surgeons most resistant to cosmetic surgery often work in departments where this practice is quite restricted or even banned, though it would be an oversimplification to argue that there is a strict link here between the moral and social division of labour. We then look at the widespread disdain in which the practice of cosmetic surgery is held, and its apparent contradiction with the surgical ethos. Having identified what it is that discredits these practices, we resituate cosmetic medicine and its development in their historical context. Finally, we analyse how the disdain is negotiated within the framework of the changes taking place in the world of plastic surgery, changes that are increasing the space for cosmetic medicine.