Ad Feminem

Who's Touching Your Kids?

"I can't see any reason why a child … would need to expose their intimate body parts to strange adults for the sake of fashion or a trend," said New South Wales Minister for Community Services, Kevin Greene, following that Australian state’s recent ban on the piercing of children’s nipples and genitals.
His view seems fair enough, yet is one will all too little resonance among US states. Take Iowa, for example, where two attempts at similar regulation failed. Republicans there balked at the idea of raising license fees for body-piercing establishments, needed to ensure there was financing for enforcement.
Reports from Philadelphia, meanwhile, show that girls as young as eight are having bikini waxes for non-existent public hair in the back rooms of state-licensed salons. What training and guidance does the State Cosmetology Board provide there, on the subject of children? None. Ad Feminem did the research. The Governor’s office is unconcerned. Neither is the Department of Public Welfare, charged with implementing Pennsylvania’s Child Protective Services law.
The same story is told by the FDA, which has technically banned the marketing of breast implants to teens, yet sits idly by as thousands more girls each year go under the knife for bigger breasts.
Is it really too much to ask that eight year olds not be subjected to bikini waxes? The simple shock jock response is of course to evoke the exercising of parental responsibility. But such a response is merely emblematic of a superficial approach to society consistent with making appearance matter too much in the first place. In fulfilling its role as the arbiter of a fair society has a responsibility to protect those who cannot protect themselves.
The campaign being fought against self confidence by the beauty industry and its collaborators is so ferocious that merely attaining the age of 18 provides little defense. But it’s a line we’d like to see drawn all the same.

Nevada to Nix Botox Cowboys?

Add Nevada to the list of states currently considering regulations for plastic surgery. A new legislative health subcommittee is looking into just who does what (against reports of cosmetic surgery spa receptionists wielding the ubiquitous hypodermics of poison and filler).

Physicians, Fix Your Ads

"Is your younger teenage daughter struggling with low self-esteem because her breasts aren’t developing fast enough?", asks Mountain View's Dr. Rosenberg in a self-penned advertorial pushing breast augmentations for girls He gives advice, much of it self-serving naturally, like the importance of a plastic surgeon being board certified. But beyond simply promoting the idea of breast augs for girls, he does fail to mention one thing. The FDA does not indicate the use of implants for kids, unless to correct congenital defects.

Cosmetic surgery practices regularly go "off-label" when it comes to FDA indications. Botox is regularly used beyond the "frown area" it is indicated for. Cocktails of drugs are injected in unapproved ways for fat loss "mesotherapy" or its tradenamed derivative LipoDissolve. Few practitioners publicize this. None mention it in their print advertising. And cosmetic surgery propaganda is clearly just that. Take this clinic's reassurance regarding the mesotherapy cocktail:

While all cocktail ingredients are individually FDA approved, the use of a combination of them is a so-called "off-label" procedure. Each practitioner is using slightly different mixtures. Our solution medications are purchased from highly reputable pharmacies. Off-label use of medication is common.

Would you have guessed from this information that mesotherapy has already been banned and Kansas, is likely to be banned in Nebraska and has already been regulated in Brasil?

 

If print advertising for pharmaceutical products must include all information we've become used to on indicated use and side effects, shouldn't regulations also apply to print advertising for procedures relying on Botox, Restylane and breast implants?

Dr. Laura Gets Smacked Around

“When you talk about mothers and swinging them against walls,” said the agitated, gold-bedecked woman at the microphone, “how productive is that?”  Her question for Dr. Laura Schlessinger, ""radio's number one relationship and family values talk show host," came at the end of Saturday’s crowded panel session at the LA Times Festival of Books.  She’d interrupted advice columnist and panel host Amy Alkon’s closing remarks to ask it. “And speaking of plastic surgery,” the woman wanted to know, hadn’t Dr. Laura had any herself?  “Some Americans,” responded Alkon, “have no sense of humor.” 

How had Schlessinger incited this woman’s ire?  By responding to my request for a comment on the growing popularity of cosmetic surgery for teenagers.  “I’d like to take their mothers by the ankles and smack them against the wall,” she’d said. Recently, various news outlets have reported on the trend of sweet 16 surgeries and graduation breast gifts, a bit of information which was met by a resounding gasp from the mostly-female crowd in UCLA’s Ackerman Ballroom. Apparently, this particular crowd had missed the reports.  Schlessinger had gone on to answer my question by asserting that these mothers (who allowed the cosmetic surgery for teens) were promoting a “Stepford mentality.”  The message they sent their daughters, she’d said, was “that ‘synthetic you’ is better.”

She may have been right about the message, but Schlessinger’s focus on mothers was reductive and curiously disingenuous, given her seat here in the epicenter of image manufacture.  Then again, the protesting woman’s response to Schlessinger was reactionary and ad hominem.   Somewhere in the middle, though, lies an approach which girls sorely need us to take.

Sure, some mothers – like the ones described in Carrie Denny's recent Philadelphia Magazine article as insisting on bikini waxes for their pre-pubescent girls – do deserve Dr. Laura’s lashing.  But they’re the minority.  From Bratz dolls to tabloids to Extreme Makeover to Maxim to Tom Leykis, girls are deluged with that Stepford mentality.  Mothers attempting to counter those ideas must do so in the face of a daily storm of synthetic messages pelting their daughters like hail. 

Despite FDA guidelines against the procedure for girls under the age of 18, plastic surgeons performed 8,000 breast augmentations on underage girls in 2007.  This is a 400% increase from the number of cases performed in 2001, when the FDA published its guidelines. Clearly, doctors and patients alike are taking advantage of the regulatory loophole approving the procedure for reconstruction and congenital defects, including asymmetry.

Almost all women have some degree of asymmetry in their breasts.  How much asymmetry qualifies a pair of teen breasts as congenitally defective?  The FDA provides no specific criteria, which means the flaw is in the eye of the beholder.  It’s no stretch to see how easily normal asymmetry can get reclassified as defective.

Every day our culture sends the message to teens that they’re not good enough.  Not only do we present them with an unattainable ideal, we promote the reclassification of normal idiosyncrasies as defects. While it’s not surprising that Dr. Laura didn’t offer a more measured response, it’s no more productive to point fingers at her for her own decisions regarding cosmetic procedures than it is for her to lay blame solely on mothers for their daughters’ requests, especially when those requests are made in the context of Los Angeles.  Rather than simply condemning mothers, Schlessinger could have called for an examination of the messages with which their daughters are inundated every day.  With cosmetic surgery now routinely advertised on the radio - as if buying 36-inch breasts requires no more thought than buying 20-inch rims - these messages come through the media machine into which Schlessinger has inserted herself as a profitable cog.

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That Bathing Suit We Shouldn't Have to Die to Buy

In light of all the recent stories of women like Stephanie Kuleba, Donda West and Olivia Goldsmith losing their lives during or as the result of cosmetic procedures, I thought I'd post the following.  It's since been removed from the website, but was originally posted on the website for the Genetic Institute for Anti-Aging (an "aesthetic medicine" and cosmetic surgery clinic) when their URL was still just www.stopmyaging.com.  The GIAA no longer uses that address other than to redirect to their new URL www.getyournewlook.com, which is appropriate, if you think about the fact that in the most morbid of ways, death on the operating table is one sure way to stop aging. 

Q: Dr. Jazayeri, If I am overweight, how can I improve my figure?
A: The great news is that a great figure is very attainable with plastic surgery. We have all tried to exercise, go on never ending diets and we still can't get into that bathing suit that we are dying to buy. Procedures such as liposuction, tummy tuck, breast augmentation and breast reduction can all help you to attain that great figure. (Emphasis mine.)

Despite Jazayeri's flippant figure of speech, women truly are dying to fit into the right bathing suit.  Perhaps they're pushed along by comments like the kind made by "renowned plastic surgeon to the stars" Dr. Robert Rey while hawking his Shapewear line as an "Affordable, Painless Alternative to Plastic Surgery" on HSN.  Rey, whose obvious pride in his wife's 90-lb physique is tempered by his claim that even she looks better wearing one of his waist-cinching products, claims that every woman has an unattractive "poof" around the middle - even the 6'-tall, 120 lb supermodels he knows. 

That's right.  According to Dr. Rey, there's not a single woman alive who naturally has the "right" figure.  Not even supermodels and 90-lb anorexics are thin enough. Or shapely enough.  It's a losing battle, ladies - unless of course, you buy some Shapewear, or you lie down on the operating table.  And if you never get off that table again, or you starve yourself to death in the process - hey, look on the bright side - at least you won't be fat anymore. 

How many women have to die before we stop privileging an unnatural physique?

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Singapore Slings New Lipo Regulations

Earlier today, Singapore announced a long-awaited tightening of regulations on liposuction: according to draft regulations, patients will have to sit out an 15 day cooling-off period before the procedure can be carried out, and doctors will be required to meet minimum standards for specific training.

Regarding the 15 days, Health Minister Khaw Boon Wan said: "We think this period is useful, otherwise, some operators might hard sell and force the customer to go and lie down and do it immediately.”

In order to be certified to carry out the procedure, doctors would be required to undergo at least a year of general surgical training and also receive specific instruction on liposuction. While this falls well short of the board-certification requirements for plastic surgeons, it would at least improve the training levels of general practitioners posing as cosmetic surgeons.

The draft regulations have met with much debate. A notable voice in favor has proven to be that of liposuction's inventor, Professor Yves Illouz, who points out that allowing untrained doctors to carry out the procedure was a "disaster" in his native France, resulting in 65 deaths.

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How Old is Beautiful?

Academy Award winner Juliette Binoche has slammed the Hollywood-driven definition of beauty, deriding it as being a simple combination of "youth and big breasts. "In France," continues the Binoche, 44, "beauty is much more subtle - and there is a greater acceptance of age." She also criticizes the growth of cosmetic surgery (ab)use among American actresses of uncertain age: "Botox makes people look older. You look at women who have had it, you see the fear of ageing on their face."

Binoche's view is one that resonates not just with Europeans, but also with those taking a deeper look at the impact of Hollywood's beauty culture and its offshoots, those unreal Orange County-centric reality shows.

Maggie Little, a bioethicist at Georgetown University sums up the prevalent US definition of beauty well: “The notion of what we’re supposed to look like comes from celebrities and it’s really distorted,” she says. “As a culture, we’ve developed this very narrowed view of beauty — only one decade, the 20s.”

FHM Magazine published its list of the world's 100 sexiest women today. The average age of the top ten choices, all Hollywood actresses (could there possibly be a sexier profession?), is  26.

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Germany to Ban Teen Cosmetic Surgery

Deputies from Germany's dominant Social Democratic Party (SDP) laid the groundwork for a legislative ban on cosmetic surgery for teens, Wednesday. Rising numbers of medically unnecessary procedures for minors is cited as the reason to introduce the new law.

"I believe that the beauty ideal, mostly for teenagers but also for children, has gone astray," said SDP health expert Karl Lauterbach according to an AFP report. The German Federation of Paediatricians supports the ban, while unsurprisingly, the German Society for Cosmetic and Plastic Surgery is rather less enthusiastic.

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U.S. Plastic Surgery Groups Fail Minors

Following up on yesterday's story about Australian bans on plastic surgery for minors, it is fast becoming clear that surgeons' groups here in the USA have no plans to follow suit. Or to even consider the matter.

The American Medical Association, which has no policy positions on under 18s according to a spokeswoman, and does not plan to even consider the pros and cons of a ban, despite the skyrocketing numbers for cosmetic procedures ranging from breast augmentations to botox.

The American Society for Plastic Surgeons has no formal position on surgery for minors, and neither does the American Society for Aesthetic Plastic Surgery. The latter states: "Most experts agree that for appropriately selected teenage patients, cosmetic plastic surgery can have a positive impact on physical and emotional development." But a spokeswoman declined to cite references for those experts.

Watch this space as we look further into training and guidance provided to accredited plastic surgeons with regard to minors (or the lack thereof) . Oh and remember, a doctor doesn't have to have any special training or be board certified in order to call him or herself a plastic surgeon.

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Australian Bans on Teen Procedures

The Australian state of Queensland has banned cosmetic surgery procedures for under 18s, a move lauded by the doctors of the Australian Medical Assocation. New South Wales had already planned to implement a three month “cooling off” period on decisions by teens to undergo cosmetic surgery starting July 1 and may now go further.

Australian Medical Association (AMA) NSW branch president Dr Andrew Keegan said a cooling-off period was "heading in the right direction", but a total ban was preferable when it came to teenagers.

"We'd have them leaning toward making it even tougher for young people to get surgery," Dr Keegan said.

"I think the possibilities of a ban need to be considered."

Dr Keegan said he worried teenagers were seeking physical solutions to what may be psychological problems.

"There is a psychological dimension involving body image in the impulse to seek cosmetic surgery," he said.

"If you've got low self esteem, then you have to have your self esteem improved - you don't need some kind of reconfiguring."

New South Wales already has already banned breast augmentations and rhinoplasties on minors from its public hospitals. Most significant, in a country known for its beach culture and embrace of active lifestyles, is the recognition of the need to protect the immature against a culture of profiteering by surgeons pushing cosmetic procedures as a psychological shortcut amid a culture of unrealistic physical perfection. Further recognizing the unique nature of cosmetic surgeons as aggressively seeking to sell procedures to the imperfect, NSW is also calling for advertising to include information regarding the reality of  those ubiquitous before and after pictures.

In the USA meanwhile, 2007 provided a bumper crop of breast augmentations for the under-18 set, with cosmetic surgeons reaping over $40 million, a 260% increase on 2006’s total. In the US, there is a ban on augmentations From KMBC's reporting on a teen who died as a result of the surgery:

The Food and Drug Administration doesn't approve breast augmentation for patients under 18. However... there are plastic surgeons who ignore the 18-and-under warning.

Indeed, the FDA does not approve of breast augmentation for under 18s. But this FDA disapproval also comes with loopholes big enough to render it meaningless.

"As in most cases, the devil will be in the details," said Dr. Thomas J. Gampper, vice chair of plastic surgery at the University of Virginia in Charlottesville. "The law allows procedures to correct deformities would be allowed [sic], along with undefined procedures to help a teenager's medical, psychological or social well-being. Those three exceptions are the reasons for the vast majority of all our adult cosmetic procedures, so theoretically, it may not ban any procedures on teens."

The FDA's regulations have been in place since 2000. The loopholes allow for saline implants to be inserted into the breasts of minors for reconstruction and to correct asymmetry.  And the regulations were put in place, there has been a four-fold  increase in the number of breast augmentations for minors. The figures for breast reductions, also genuinely used to to correct asymmetry, have remained constant.

While bigger breasts for teenagers have become big business, the numbers for otoplasty (ear surgery) and rhinoplasty (nose surgery) have declined.

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