Accounting for Cosmetic Surgery in the USA and Great Britain: A Cross-cultural Analysis of Women's Narratives

The concept of ‘accounts’ (Scott and Lyman, 1968) – or linguistic strategies for neutralizing the negative social meanings of norm violation – has a long history in sociology. This work examines British and American women's accounts of cosmetic surgery. In the medical literature, feminist writings and the popular press, aesthetic plastic surgery has been associated with narcissism, psychological instability and self-hatred. Given these negative connotations, cosmetic surgery remains a practice requiring justification even as its popularity increases. Drawing on interview data, I argue that respondents' efforts to account for cosmetic surgery vary according to the ‘repertoires of evaluation’ (Lamont and Thévenot, 2000) made available by their own nation and, particularly, by its healthcare culture. In the market-based US healthcare system, women justify cosmetic surgery by referring to their personal and financial ‘investments’ in physical attractiveness and well-being. Such explanations are less legitimate in Britain, where healthcare is considered a social right rather than a consumer good. In the latter context, women employ narratives that medicalize the pre-surgical body by stressing the physical pain and emotional distress that it caused.