Increasingly, people are using medical techniques to alter their inherited ethnic features to fit in to a predominantly white society. What are the ethical issues of this emerging trend for deracialisation surgery - and what is the context in which it is taking place?
The controversy
So-called ‘Ethnic Plastic Surgery’ has come under controversial fire for promoting a more ‘Caucasian’ look. Smaller noses; removal of the East Asian epicanthic fold on the eye; breast reduction; and liposuction are all common plastic surgery procedures that are criticised for being ways of achieving a more European version of beauty.
Janie Ward, head of the Africana Studies Department at Simmons College in Boston says, ‘The beauty ideal has been white for a very long time. I think it's a little bit naive to say it [ethnic plastic surgery] is about personal aesthetics and choice. That negates 400 years of history.’
In the beauty industry there has been a call for greater ethnic representation and critics argue that too many models worldwide are European in appearance.‘African-American women in particular have a complicated relationship with their bodies and sense of beauty,’ she said. ‘A lot of it has to do with a culture that says your nose is too wide, your hips are too wide, your hair's not right. The image that's in women's heads when they walk into a surgeon's office, when they think of 'proportionate' — that's very much shaped by the images they've been consuming in the media.’But others disagree, saying that minorities seek cosmetic surgery for the same reason as those of European descent: in a world obsessed with appearance it's just one more way to look better. African American plastic surgeon Julius Few says, ‘More people who are performing these procedures actually come from those ethnic backgrounds, and we're sensitive to those perceptions.’
The American Society for Aesthetic Plastic Surgery (ASAPS) has said that concerns over loss of ethnic identity have, in the past, deterred some people from having procedures but that new awareness and techniques are available so that for instance, rhinoplasty needn’t obscure the ethnic heritage of the patient in question.
Dr. Julius Few says, ‘It is vital to preserve the ethnic heritage of the given patient and understand that ethnic rhinoplasty is more about balance of the face and not assuming the look of another racial or ethnic group - a fear that many African American patients still have.’
Michael Jackson’s physical transformation
Michael Jackson’s most notable transformation was the paling of his skin - visible by the early 1990’s. He was so criticised in the media for turning his back on his African ancestry that in 1993, he revealed that he had a skin disease that turned patches of his skin white. The following year his dermatologist Dr Arnold Klein testified that he had Vitiligo.
There are many theories about what exactly happened to Michael Jackson and it’s only possible to guess the likely steps he may have taken after being diagnosed with Vitiligo, a pigmentation disease that can leave sufferers patches of skin in the negative. If after some time the disease had left Michael’s skin with more white patches than his normal skin colour then the daily chore of hours of makeup would not only have been time-consuming but distressing.
It is quite feasible that he would have sought a permanent solution. One common option might have been depigmenting his skin to even out his skin tone. This procedure would have been carried out under the supervision of a dermatologist and although it might have evened his skin tone through permanent and irreversible loss of skin pigment, it is likely to have made him more prone to sun burn which might explain why he covered his face and body when he went outdoors.
His nose and face shape also changed dramatically and another theory is that he suffered from body dysmorphic disorder (BDD), a psychological disorder that causes extreme anxiety and pain resulting from self-hatred of one or more bodily features. BDD, exacerbated by his Vitiligo, may have driven him to undergo more and more transformative procedures, from plastic surgery to skin fillers, and implants in the hope that it would take the pain away.
Whatever the reason what seems likely is that were it not for his death earlier this year he may never have stopped.
Skin bleaching
There’s a long history of skin lightening in ancient and medieval societies and it can be traced back to the beginning of the cultural class structure many centuries ago.
For example, in ancient Asian cultures those who stayed inside, usually the wealthy and educated had, fair white skin. On the other hand, those that worked outside and were exposed to the effects of the sun had much darker skin and were considered part of the lower class.
As a result, those with darker skin tones tried to lighten their skin, using a variety of natural ingredients, so that they would not be immediately classified. Geisha achieved their whitened skin with make-up.
India’s caste system placed a positive value on paler skin and this was reinforced by colonial racism and colorism practised by the British Empire. In Britain at the time, darker skin was associated with those who worked for a living while pale skin was associated with the non-working upper classes.The process of skin lightening still continues today in affluent and non-affluent parts of the world, either to even skin tone or to change skin tone. It is a multi-million dollar business despite the fact that some of the chemical ingredients involved are so dangerous that they are banned across Europe, Pacific Asia and Africa.
The rise of ‘ethnic plastic surgery’
Plastic surgery was once the preserve of wealthy women of European ancestry but in recent years its popularity has been growing in other populations. In USA and Britain so-called ‘ethnic plastic surgery’ – plastic surgery practised on minority populations such as Asians, East Asians and African-Caribbeans – is on the up.
According to statistics released by ASAPS, ethnic cosmetic plastic surgery procedures are the fastest growing and increased 11 percent:
• Hispanic women represented the biggest increase, up 18 percent
• African Americans were up 10 percent
• Asian Americans were up 5 percent.
On the other hand, cosmetic surgery procedures for European Americans saw a decrease of 2 percent.
According to the plastic surgeons that work in the field there can’t be a one-technique-suits-all approach. There are different challenges depending on the population: differences in scarring patterns and cartilage thickness that must be taken into account.
• Very dark skin can be prone to hyper-pigmentation and raised scarring called keloid formation
• Thicker cartilage in those of African descent can have ramifications for rhinoplasty.
Common Procedures
Blepharoplasty
The No. 1 procedure in Asia is a form of blepharoplasty, in which a crease is created above the eye by scalpel or by needle and thread; in the U.S. blepharoplasty also ranks near the top, but involves removing bags and fat around the eyes.
Botox
Westerners use botox, or botulinum toxin, to diminish wrinkles—while in Korea, Japan and Taiwan, botox is injected into wide cheeks so the muscle will atrophy and the cheeks will shrink.
Calf-reduction
Liposuction is effective on the legs of people whose calves contain fat but some Koreans, unhappy with the naturally muscular shape of their calves are undergoing a more radical form of calf-reduction. Earlier attempts to carve the muscle were painful and made walking difficult. Today a nerve is severed behind the knee, which causes the muscle to atrophy, reducing its size up to 40%.
Rhinoplasty
Plastic surgery to change the shape of the nose is one of the more popular forms of ethnic plastic surgery. Asians seek changes to increase the projection of their nose while those of African origin may seek reduction in the width of the nose and an increase in projection.
Sex
In China, Korea and Indonesia, where virginity is highly prized, young women go in for hymen reconstruction in time for their wedding night. In Japan, Indonesia and Korea, men ask for penis-enlargement procedures, in part to avoid shame when bathing en masse.
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