Cosmetic surgery, body image and sexuality.

COSMETIC surgery is not a new phenomenon. Facelifts, nose jobs, breast reduction and breast implants have been common among women for decades, and the profession and practice of cosmetic surgery is well established in many countries, including many developing countries. However, in the past 10–15 years, there has been a seismic shift in what is considered possible and desirable to change as regards the bodies we are born with. What has been labelled a “body-changing culture” is being popularised and becoming pervasive in many societies, and now includes changes to almost all parts of the body, especially the most intimate ones, through a growing list of surgical procedures. Author Naomi Wolf argues in The Beauty Myth that the most frequent cosmetic procedures are currently being performed on the areas of women's bodies most associated with “femaleness”: thighs, stomach, buttocks, and breasts. But this has gone further to include vulvas and vaginas, and for men, penises. Very few people I have spoken to in the sexual and reproductive health and rights field, especially those older than 35, were aware of this “culture”, let alone the extent of it, whether in their own countries or elsewhere. I decided to take it up in the journal because it seems to be having an important influence and it is highly relevant to our work. Why surgery? Human beings have always tried to make themselves look attractive and beautiful, with clothes, jewellery and other adornments, hair styles and colouring, and beauty products, but apparently these aren’t enough anymore. Surgery – for the most part emanating from the private, profit-making health care