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Ideals of Beauty and Body Modification Martin T Donohoe , MD, FACP. Historical Ideals of Beauty. Ancient Greeks valued symmetry Contemporary definitions similar:

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Ideals of Beauty

and Body Modification

Martin T Donohoe, MD, FACP

historical ideals of beauty
Historical Ideals of Beauty
  • Ancient Greeks valued symmetry
  • Contemporary definitions similar:
    • “Ideal woman”: small chin, delicate jaws, full lips, small nose, high cheek bones, large and widely spaced eyes, and waist:hip ratio of 0.7
    • “Ideal man”: taller, waist:hip ratio of 0.9, dominant/rectangular face/chin, deep-set eyes, heavy brow
      • Suggests strong supply of testosterone
  • Common first name in Ancient Greece, parts of sub-Saharan Africa
  • Idea: give children bad names so demons won’t find them
  • Other favorites: “Disagreeable,” “Crippled”
historical ideals of beauty4
Historical Ideals of Beauty
  • Chinese foot binding
    • pain, osteoporosis, falls/imbalance
    • Surgery to reshape women’s feet for stiletto heels increasingly popular
  • Ancient Greek newborn female baby wrapping
historical ideals of beauty5
Historical Ideals of Beauty
  • Ancient Roman women colored their lips with red cinnabar stone, a type of mercury ore, lined their faces with white lead, and rouged their cheeks with red lead
  • Ancient Egyptians/Roman/Persians: antimony for conjunctival sparkle
  • Rome to medieval Europe: paleness preferred
historical ideals of beauty6
Historical Ideals of Beauty
  • Elizabethan hair plucking, ceruse makeup
  • Court of Louis XVI: blue veins drawn on neck and shoulders to emphasize noble blood
  • 16th & 17th century: belladona eye drops
historical ideals of beauty7
Historical Ideals of Beauty
  • 18th Century: vermillion makeup (sulfur and mercury)
  • 14th - 19th century: corsetting (whalebone and steel) – precursor to the girdle
    • Making a comeback at both high- and low-end retailers (takes up to 30 minutes to lace up; requires an extra set of hands)
historical ideals of beauty8
Historical Ideals of Beauty
  • Unibrow:
    • Sign of criminal tendencies in Victorian England
    • Mark of beauty in contemporary Iran
  • Breast implants (since 1903 - Charles Miller, MD)
    • First silicone breast enlargement 1962
contemporary ideals of beauty
Contemporary Ideals of Beauty
  • “Better Baby Contests” – Eugenic Movement / Social Darwinism
  • Tapeworms (Maria Callas)
  • Rib removal (Cher?)
contemporary ideals of beauty10
Contemporary Ideals of Beauty
  • Botox injections
  • Plastic surgery
  • Abusive subjugation of women through body modification – female genital mutilation
    • Cultural components
ideals of beauty
Ideals of Beauty
  • Brass neck rings (Paduang people of Burma)
  • Lip and earlobe expanders (certain African tribes)
  • Tattoos, body piercings, wings
ideals of beauty12
Ideals ofBeauty
  • Wonderbra, Brava Bra ($2500, suction device worn overnight for 10 weeks, promises 1 cup increase (actual increase ½ cup size), can cause broken blood vessels, skin rash, discomfort)
  • Wonderbum pantyhose (DuPont Lycra) – promises a “perfectly peachy, pert bottom”
  • Music industry depictions of beauty
ideals of beauty13
Ideals of Beauty
  • Ancient Greeks – symmetry
    • Remains true
    • Familiarity, personality traits also important
  • Evolutionary adaptation for survival of human species
    • Size, muscle power, pathogen-free status, fertility
the perks of beauty
The Perks of Beauty
  • The good-looking are more likely to get married, be hired, get paid more, and be promoted sooner
  • Height is associated with income and leadership positions
  • Strangers are more likely to assist good-looking people in distress
the perks of beauty15
The Perks of Beauty
  • The pretty/handsome are less likely to be reported, caught, accused, or punished for a minor or major crime
  • Role of ageism (more important for women)
  • The responsibility:
    • Attractiveness is recognized as a special gift, and its misuse is not tolerated
  • Concocted at home prior to 20th Century
  • Industry spawned by:
    • “Allure” of prostitutes/sexuality
    • Mass popularity of anti-aging products in 1920s
    • Women entering workforce
    • Migrations to cities
  • Food, Drug and Cosmetic Act (1938)
  • 2004 spending = $12 billion
    • 33% more than the amount needed each year (in addition to current expenditures) to provide water and sanitation for all people in developing nations
    • Slightly more than the amount needed each year (in addition to current expenditures) to provide reporductive healthcare for all women in developing countries
  • Average American adult uses 9 personal care products/day (with 126 unique chemical ingredients)
    • 89% of the over 10,500 ingredients used in personal care products never tested for toxicity
    • Little FDA oversight
  • Unusual ingredients include:
    • Cow colostrum
    • Gold
    • Foreskin
    • Placenta
    • Fetal cells
cosmetics and hair coloring
Cosmetics and Hair Coloring
  • Women devote average of 19 minutes per day to treating and altering their faces
  • 55% of American women between 13 and 70 color their hair
    • 1/8 American men between 16 and 60
  • The skin’s response to ultraviolet light injury
  • No such thing as a “safe tan”
  • 95% of Americans understand that sunburns are dangerous, but 81% still think they look better with a tan.
artificial tanning
Artificial Tanning
  • 47% of college students use a tanning lamp each year (females more than males)
  • 39% have never used a tanning lamp
  • More than 90% of users are aware that premature aging and skin cancer are possible complications of tanning lamp use
  • WHO: tanning beds cause cancer
  • Tanning as a substance abuse-like disorder
  • Tanning produces endorphins
  • Most countries do not limit access of youths to tanning parlors
  • SPF of at least 15 should be worn when outdoors (and re-applied frequently)
artificial tanning24
Artificial Tanning
  • Many lotions and creams available
  • Burgeoning industry
  • “Natural” does not necessarily mean safe
  • Tattoo from Tahitian word “tatau” (“to mark”)
  • Reached apogee among Maori
  • Popularized in West by sailors returning from Polynesia
  • Aesthetic choice
  • Initiation rite
  • Time-saving way for disabled to overcome difficulties of applying makeup
  • Adjuvant to reconstructive surgery (particularly face and breast, to simulate natural pigmentation)
  • 30 million Americans have tattoos
  • Ancient practice: Maori tribesmen, Thracian women of 5th Century Greece
  • Tattooing still illegal in South Carolina and Oklahoma
  • More than 50 different pigments and shades employed
    • None approved for skin injection
    • Some industrial grade printer’s ink or automobile paint
the fringes
The Fringes
  • Anal bleaching
    • Initially porn stars and sex workers
    • Now available to general public for $75/treatment
    • Can cause eczema
  • Money: Jim Nelson auctioned off his head on eBay for a corporate logo tattoo in 2003
risks of tattooing
Risks of Tattooing
  • Tattooing associated with risky behaviors in adolescents
  • Infection
    • e.g., hepatitis B, C, and HIV
    • Am Assn Blood Banks requires one-year wait between getting tattoo and donating blood
  • Removal problems
  • Allergic reactions
risks of tattooing31
Risks of Tattooing
  • Granulomas
  • Keloid formation
  • MRI complications
  • Swellings/burns
  • Image quality suffers (particularly with permanent mascara)
the most common problem dissatisfaction
The Most Common Problem:Dissatisfaction
  • 17% of those tattooed later regret it
    • Chief reason = the person’s name in the tattoo
  • Practitioners’ skill levels vary widely
  • Fading with time
  • Blurring when injections too deep
the most common problem dissatisfaction33
The Most Common Problem:Dissatisfaction
  • Human body changes with time
  • Styles come and go
  • With facial cosmetic surgery, appearance of tattoos and permanent makeup may become distorted
tattoo removal techniques
Tattoo Removal Techniques
  • Laser treatments
  • Dermabrasion
  • Salabrasion
  • Scarification
  • Surgical Removal
  • Camouflaging
temporary tattoos
Temporary Tattoos
  • Fade after several days
  • Allergic reactions
  • FDA alert re risks with foreign-made products
  • Freedom-2 Ink: Biodegradable dye capsules – when zapped by laser, dyes absorbed by body and tattoo disappears
risks of henna tattoos
Risks of Henna Tattoos
  • Henna products risky
    • Henna approved for use as a hair dye, not for injection into the skin
    • Produces a reddish-brown tint, raising questions about what ingredients are added to produce the varieties of colors labeled as henna (e.g., “black henna,” “blue henna”
  • Botulinum toxin:
    • Cause of botulism
    • potential biowarfare/bioterror agent
  • Medical Uses: blepharospasm, spasmodic torticollis, migraines, back spasms, chronic pain, axillary hyperhidrosis, wrinkles due to normal aging
  • Unlikely to work on sun- or smoking-induced wrinkles
  • Manufacturer = Allergan
    • Allergan also markets Latisse (bimatoprost, the same ingredient in the glaucoma treatment Lumigan) for topical “treatment” of “hypertrichosis of the eyelashes”
    • Myobloc (Solstice Neurosciences – not yet FDA-approved)
  • 2.5 million procedures in 2008 (costing $1.1 billion)
  • Large direct-to-consumer ad campaign
    • Olympians Mark Spitz, Nadia Comanici involved
  • $80/dose + physician’s fee ($443 avg.)
  • Most users white, age 35-50
  • 12% are men
  • In-home Botox parties; Botox scams
  • Hollywood actors
  • Retreatments required q 3-4 months
  • Side effects: muscle weakness, masklike facies, drooling, slurred speech, aspiration, dysphagia, dysnpnea, rare allergic reactions; may spread via neurons back to spinal cord or even CNS
    • 87 hospitalizations, 16 deaths reported 1997-2006
    • FDA boxed warning 2009
rivals to botox
Rivals to Botox
  • Collagen injections (from cows, possible allergic responses)
  • Perlane (“natural” collagen alternative from human tissue)
  • Fat injections
  • Face lift/eyelid surgery
dermal fillers
Dermal Fillers
  • Alternative to botox
  • Cow collagen, liquid silicone, plastic microbeads, synthetic bone and ground-up human cadaver skin (association with for-profit tissue banks)
dermal fillers44
Dermal Fillers
  • $700-$900 per treatment (lasts a few months)
    • Compare with $4000-$6000 for a facelift, which lasts 10-15 yrs before requiring touch-ups
  • Side effects
    • Include renal failure
  • Ideals of beauty: some relatively constant, others change
  • Multiple methods of body modification: some dangerous, even abusive
covered in other slide shows
Covered in Other Slide Shows
  • Cosmetic surgery
  • Female genital cutting
  • Body weight and the obesity epidemic
  • Ethical and policy issues
  • Donohoe MT. Beauty and body modification. Medscape Ob/Gyn and Women’s Health 2006;11(1): posted 4/19/06. Available at
  • Donohoe MT. Cosmetic surgery past, present, and future: scope, ethics and policy. Medscape Ob/Gyn and Women’s Health 2006;11(2): posted 8/28/06. Available at
re tanning
Re Tanning
  • See slide show by Anuru and Salmon on risks and regulations related to indoor tanning at
contact information
Contact Information

Public Health and Social Justice Website