IN THE HISTORY OF Western dress, fashion has long been the predominant tool for creating ‘ideal’ bodily shapes by covering up, transcending and reshaping our ‘actual’ bodies.¹ In 2015, this practice is still very much alive – just think of the use of shapewear and push-up bras. Over the last century however, shape-shifting has moved from the cloth that covers the flesh to the flesh itself; we live in a ‘makeover culture’ where cosmetic surgery has become commonplace.²

Like fashion, the cosmetic surgery industry is fuelled by continuous change. What started out as mostly scalpel surgery has transformed into a wider practice that also includes the use of fillers to make more temporary adjustments to lips, cheeks, hips and bottoms. As cultural studies scholar Meredith Jones puts it, ‘It is the new affordable and impermanent nature of much contemporary cosmetic surgery that brings it into alignment, symbolically and practically, with fashion.’³

While this might be considered a technological success, discourses of cosmetic surgery are also tightly interwoven with ideas of failure. Both those who justify and those who critique the practice describe it in terms of failure, though their interpretations are poles apart. What sort of failure does cosmetic surgery instantiate? Who fails, and who or what fails them?

Cosmetic surgery is founded on the twin supposition that bodies, especially female bodies, must be beautiful, and that they regularly fail to be so. The medicalised beauty industry represents the female body as both falling short and deteriorating. Although in its ageist logic, every body will fail eventually, the first cosmetic surgeons focused on the exceptionally failed body. To justify their interventions, they relied heavily on categories of disease and deformity. To have drooping eyelids, uneven breasts or a receding chin was, in other words, deemed literally pathological. Such pathologies, surgeons argued, had deep psychological effects that could be ameliorated with physical repair.

But deformed, diseased bodies are by definition exceptional bodies, and a body no longer needs to be exceptional to demand intervention. The reigning idea now is that all bodies can – and perhaps even should – be enhanced. Only a few decades ago, cosmetic surgery was a rare and exclusive practice; it is now widespread. In the U.S. alone, there were fifteen million procedures in 2014 (roughly double from 2007), if one includes non-surgical practices such as laser peels and injections.

In a recent cover story for Time magazine, medical journalist Joel Stein argues that cosmetic procedures will soon become both ubiquitous and obligatory.⁴ He describes South Korea as heavily populated with surgically modified citizens, and sees Western countries following suit. Medical cosmetic technologies, he argues, will become merely another activity of maintenance, upkeep and self-responsibility within the competitive markets of labour, consumption and lifestyle. Cosmetic surgery will not only be a mode of fashioning a normatively ideal body, but also a performance of neoliberal citizenship.

Undergoing a cosmetic procedure may, however, involve capitulation. Writing in the second person (and constructing his reader as middle-class, Western and female), Stein argues that ‘you’ will give in eventually: ‘You’re going to have to do it. And not all that long from now. Not because you hate yourself, fear aging or are vain. You’re going to get a cosmetic procedure for the same reason you wear makeup: because every other woman is.’⁵

Stein invokes a decades-long debate in feminism. While some feminists have argued that cosmetic surgery is a more or less pragmatic negotiation of gender norms, others insist that the ‘need’ for cosmetic surgery represents psychic failures. In this view, cosmetic surgery patients hate their bodies, or experience a form of ‘false consciousness.’

The stereotype of the self-loathing cosmetic surgery patient can also be found in the annals of psychiatry. Lacking much in the way of critique of gender norms, the mid-twentieth century psychiatric discourse addressed women who underwent cosmetic surgery as neurotics, disordered personalities or otherwise pathological subjects. Contemporary discussions of Body Dysmorphic Disorder similarly scrutinise the female psyche as vulnerable to self-hatred and, in addition, claim that they are susceptible to addiction. Such discussions feed into the belief that women – vulnerable, self-loathing and easily addicted – are responsible for the recent upsurge of cosmetic surgeries, instead of the other way around. There are good reasons to be wary of identifying the ‘surgery junkie’ as a culprit of the cosmetic surgery boom. After all, this logic lays the burden of cosmetic surgery’s problems on the shoulders of individual, mostly female patients, and ignores the institutional forces that account for its vast expansion.⁶

Whether cosmetic surgery corrects a failed body or suggests a failed psyche is an irrelevant question; in my view, these assumptions are both flawed. Instead, the explosion of cosmetic surgery is a symptom of catastrophic structural failures. In the U.S. and globally, its mass expansion is part of a broader turn toward enhancement medicine, where the ‘maximisation of lifestyle, potential, health, and quality of life has become almost obligatory,’ as sociologist Nick Rose puts it.⁷

This maximisation, however, takes place in a context of deepening social and economic inequality, one in which there is unequal access to health care, medical technologies and life-saving drugs, as well as food and environmental security. On a global scale, these disparities are extreme, but even within the U.S. context, according to the United States Centers for Disease Control and Prevention, life expectancy and other measures of health vary greatly by socioeconomic status, race and geographic location.⁸

Whether ‘you’ get cosmetic surgery in the future is not necessarily a measure of whether and how your body or psyche have failed you. It may depend more on your status in neoliberal capitalism. Cosmetic surgery and other forms of elective medicine are fostered by the profit-driven stratification of medicine. This system confers biomedical citizenship on those who can oblige demands for self-care, wellness and enhancement, while denying it to those who cannot. You are not failing, but our systems may be failing you.

This article was first published in Vestoj On Failure.

Victoria Pitts-Taylor is a professor of Feminist, Gender and Sexuality Studies at Wesleyan University.

Cara Phillips is a Brooklyn-based photographer, curator, writer and lecturer.

1. A Hollander, Seeing through Clothes, University of California Press, Berkeley and Los Angeles, 1993 [orig. 1975] ↩

2. M Jones, ‘New Clothes, New Faces, New Bodies: Cosmetic Surgery and Fashion,’ in S Bruzzi and P Church Gibson (eds), Fashion Cultures Revisited: Theories, Explorations and Analysis, Routledge, New York, 2013, p.294 ↩

3. Ibid., p.289 ↩

4. J Stein, ‘Nip. Tuck. Or Else,’ Time, June 18 2015 ↩

5. Ibid. ↩

6. D Sullivan, Cosmetic Surgery: The Cutting Edge of Commercial Medicine, Rutgers Univerity Press, New Brunswick, NJ, 2001 ↩

7. N Rose, The Politics of Life Itself, Princeton University Press, Princeton, NJ, 2006, p.25 ↩

8. Centers for Disease Control and Prevention (CDC), ‘CDC Health Disparities and Inequalities Report – United States, 2013,’ Morbidity and Mortality Weekly Report, Vol. 62, No. 3, 2013, pp.1-187 ↩

Not only do the shoes appeal to height-challenged customers (including celebrities), but also attract men working in security and law enforcement, highlighting a link not only between height and confidence, but also with power. Even so, the website still has to reassure their customer with ‘discreet packaging’, orders arrive anonymous and free from Taller branding. Body enhancement products, though readily accepted by parallel female markets, are reluctant to take off for men. Jennen hopes elevated shoes will simply become the new normal, a boost of confidence without the social stigma. Speaking with Vestoj, the designer and entrepreneur explains how the shoes work, what made him start his own company and what it takes to feel comfortable within your own centimetres.

***

I remember looking up celebrity heights online and there was an American advertisement that kept coming up claiming that Tom Cruise or Mark Wahlberg wore elevated shoes, so I decided to buy a pair from the States to try. I’m five foot seven inches and my partner at the time was taller than me when wearing heels, particularly when we used to perform on stage together. I realised that a lot of men faced the same issue with partners in heels and I saw a market to bring them to Australia, but to incorporate better quality and design.

When I began Taller Shoes I designed eight styles and began with an order of six hundred pairs. The shoes themselves are an adaptation of a normal shoe – a sneaker, for example, which fits a thin insole. Taller Shoes have a much thicker, elevated insole that goes into the shoe in the same way, but if you were to put a thick insole into a normal shoe you can’t fit your foot inside and it slips out. So our shoes are designed to be higher at the heel of the shoe creating space to accommodate the raised insole. In designing the shoes we look at what’s on trend but we’re also mindful of what styles suit the structure of the elevated insole. There are a lot of styles that wouldn’t work: for example, more streamlined, narrow shapes don’t work. The shoes are made in our factory in China: for each shoe there are about twelve different people involved the making process. Then we try them on and see how they look, there’s a lot of back and forth with the factory in tweaking the samples.

We’ve built on the original styles seasonally but also through feedback from customers – hearing what they like has been hugely important to the growth of Taller. In order to keep the business sustainable we have to cater to a wide audience, so we have a broad range of designs. I’m quite out there with my taste in fashion – I like to look a bit different – but I find I have to be more restrained when I design for Taller to cater to a more conservative man. I have a few more adventurous styles but they are slower moving in the range; the majority of customers are more subdued in their taste.

In the beginning you learn about the business and what’s important to your customers. I had a few people email me complaining that they had the shoes delivered to their work, because they didn’t want people to know they were wearing these types of shoes. It can be difficult to market ourselves when our customers want their purchase to be discreet, but I guess men just don’t want others to know they’re wearing elevated shoes. We have a lot of shy customers that prefer to buy online rather than come into our stores, but we send all our packages discreetly to satisfy this.

A lot of the customers are women who come in with their male partners, particularly for special occasions like weddings, and our best sellers are black formal shoes. Word of mouth is also very important for our business, especially where men don’t openly want to talk about wearing the product. Before we were doing a lot of advertising in Men’s magazines like GQ, Men’s Health and fitness periodicals, but in fact we did much better when we advertised in women’s magazines.

I also realised there was a big market in the security industry, for police officers and bouncers for example. Customers that might already be tall, but want that extra height to give them a sense of power, and as a result we’ve increased our sizes to go up to size twelve. The reason for buying our shoes might be the height of your partner, or your job, but what’s most important is that we give our customers a sense of confidence. It’s amazing, I’ve had smaller guys come in and you see the change in them; they leave and they’re happy and smiling. I think a powerful person is someone who has a strong presence. In the end this is all in the mind and how you feel about yourself carries through to how you present yourself. To me, a powerful person is someone with a lot of self-confidence, someone who is self assured and without hang-ups. This is an alpha person: confident in the way they walk and move. Ultimately, it doesn’t depend on how tall you are at all. The extra few centimetres is more about a psychological difference. I used to be more self-conscious and thought I needed to be taller, but as I’ve become more confident in myself, height doesn’t make a difference anymore, and that’s a nice realisation.

Laura Gardner is Vestoj’s former Online Editor and a writer in Melbourne.