2nd Year Paper Facial Profiling: Race and Ethnicity in American Cosmetic Surgery.

Ethnic cosmetic surgery (ECS), an elective practice that changes a patient's appearance through modification of racial markers, can be understood as technological manipulation of one's physical appearance to conform to specific ethnic norms. Within the field of ECS as practiced in the U.S., there has been a growing trend toward preserving or enhancing certain ethnic markers, linked to a call for cultural competence in medicine. This study examines how surgeons and patients engage in a joint cultural production of the nose and more generally how ECS conceptualizes race and ethnicity at the phenotypic level in a genomic era. The conceptualization of race and ethnicity by physicians is examined through a content analysis of 80 procedural guides and standards for ethnic-specific facial surgeries for men and women from 1993 to 2012. I uncover three nested levels of symbolic boundaries that surgeons draw in the practice of ethnic cosmetic surgery: first a distinction between patients and consumers, next a boundary between white or "Caucasian" and "ethnic" or "non-Caucasian" and lastly boundaries between different ethnic groups. To examine patient voices, the study also analyzes an online discussion forum on ECS. Findings from this study indicate that standardization contributes to the construction and maintenance of boundaries, which are both symbolic and material. ECS represents a (re)investment in the physical materiality of race as a mode of asserting racial and/or ethnic authenticity. The practice of ECS paradoxically reveals that physical markers of ethnicity are mutable--literally, via the surgeon's scalpel--even as it simultaneously relies on and reinforces established notions of ethnic difference. In this sense the drive to implement cultural competence in cosmetic surgery may result in a biological re-inscription of ethnic and cultural stereotypes. [ABSTRACT FROM AUTHOR]