JAHR  Vol. 3  No.

5  2012

UDK 617-089:646.7:612.884:316
Short Communications

George Alexias*, Georgia Dilaki*, Charalambos Tsekeris**

The "Beautiful" pain: cosmetic surgery

and the embodiment of pain

Abstract

This article focuses on women undergoing plastic surgery operations, highlighting their par-
ticular attitude toward pain, which is caused by the desperate pursuit of beauty. Extracting
data from semi-structured interviews, it is shown how pain is defied, eliminated or even
denied by individuals undergoing cosmetic surgery. Since cosmetic procedures are carried out
for aesthetic reasons, people disconnect this process from any negative emotion and ignore
pain and trauma yielded from surgical operation. Hence, a special kind of pain embodiment
is reflexively emerged. Pain is not a one-dimensional biological stimulus; it is rather associated
with how each social group perceives, interprets and reacts to the biological stimulus, produc-
ing a particular mode of embodiment.

Key words: cosmetic surgery, embodiment, pain, sociology of the body, qualitative method-
ology

Introduction
Besides being a natural or biological phenomenon, pain has also a strong social and
cultural basis: "As well as being a medicalized phenomenon, pain is, of course, an
everyday experience linking the subjective sense of self to the perceived 'objective'
reality of the world and other people" (Bendelow and Williams, 1995: 162). Al-
though its "given" biological dimension triggers a form of physical or physiological
reaction, we do not react to the same stimulus in the same way: "Pain is never the
sole creation of our anatomy and physiology. It emerges only at the intersection of

* Panteion University of Social and Political Sciences, Department of Psychology, Greece.

** Correspondence address: Charalambos Tsekeris, PhD, Panteion University of Social and Political Sciences,
Department of Psychology, Syngrou Ave. 136, Athens 17671, Greece, e-mail: [email protected].

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bodies, minds and cultures" (Morris, 1991: 1). Various social sub-groups develop
different strengths and resistance against the same pain stimulus (Zola, 1966). The
analytical challenge here is to understand the reasons and ways in which different
stances against pain are developed (Frank, 2001; Smith, 2008).1
In recent decades, we experience a culture of commodification and commercialization
of the body, with increasing emphasis on the external appearance and the public display
of the self. The body is increasingly identified with the self so that the management of
public appearance becomes more and more important. In this cultural context, the
various body modification practices, which are purposefully performed to improve ex-
ternal appearance, such as the aesthetic plastic surgery, are of particular importance.
The aesthetic or cosmetic surgery enhances body parts, based on aesthetic criteria,
and often constitutes a psychological response to modes of frustration one might
feel in front of one's body image. But since aesthetic surgery is primarily a surgical
operation, it is inevitably linked with intense postoperative pain. The point here is
that this pain, as a result of people's attempt to improve their external appearance, is
deliberate. In other words, people deliberately undergo these operations and subse-
quently experience pain. This choice is voluntary because the surgery is not aimed
to cure a health problem or to offer a better quality of life.2 That is, the experienced
pain is not "therapeutic" and does not result from the attempt to restore or to main-
tain health; instead, it emerges as an inevitable "evil" in the attempt to form our
body according to accepted standards of beauty.
Therefore, it is expedient to better understand how people who undergo these surgi-
cal cosmetic procedures actually experience pain. However, as Bendelow and Wil-
liams (1995: 147) rightly point out, for a sociological analysis of pain, we should
necessarily begin from the sociology of the body. Within this analytical framework,
we use the embodiment approach aiming to understand the exact reasons and ways
through which people undergoing plastic surgery operations give meaning to and
accept pain.

The embodiment
The phenomenology of the human body systematically attempts to highlight its em-
pirical or experiential dimension as an active element in the formation of social rela-
tionships. Merleau-Ponty's (1962, 1968) main contribution to phenomenology in-

1 
Many useful anthropological insights and perspectives on pain can also be discerned in Good et al., 1992;
Brihaye et al., 1987.
2  Of course, this does not necessarily imply that the aesthetic surgery also leads to "better quality of life".

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volves the emphasis given by perception on the role of the "living body", through
which we experience and perceive the world. Body has both an object's aspect and a
subject's one that sees, listens, touches and experiences the world with its physical
presence (Crossley, 1995: 43-63). It is not only a biological objective item, but also
a living subjective reality.
According to Merleau-Ponty (1962, 1968), the conscience of the world is actively
mediated by the body; we do not passively represent the world, but we demiurgical-
ly experience it through our bodies. Consequently, phenomenology features the
body as an active and dynamic element in shaping the social behavior and not as a
static and unchanging biological entity.
Hence, the phenomenological approach imaginatively highlights the concept of em-
bodiment as a central analytical category for the sociological analysis of modern so-
cieties. The rapid development of medical knowledge and technology, in combina-
tion with the emergence of a new perception upon which the body is identified
with the self and acquires an important role into the formation of each individual,
gave a unique impulse to the development of the Sociology of the Body (Feather-
stone and Turner, 1995; Shilling, 2005a, 2005b; Turner 1997a, 1997b). In this re-
gard, people do not merely have bodies, but they are bodies themselves, since they
are dynamically and actively involved in the development and shaping of their bod-
ies into time and space.
Within this sociological context, body is anticipated as an object, "as a project plan
to be implemented" by each individual subject (Shilling, 1993). In modern Western
societies, body is radically transformed into raw material, which we consider that we
can shape over, in order to get closer to the ideal figure that we have formed in our
mind (Featherstone, 2010). The identification of the self with the body and its si-
multaneous commercialization and objectification in the Western societies, illus-
trates the embodiment of people who undergo aesthetic procedures as an extremely
interesting object of study (Balsamo, 1997; Davis, 1995; Gimlin, 2006, 2007;
Covino, 2001).

The pain
Traditionally, pain was considered as a purely biological phenomenon in medicine,
linked with the reaction mechanisms of the body and independent of any cultural
influence or dimension. The experience (aesthesis) of pain was totally ignored by
scientific medicine as a kind of subjectivism that complicates rather than facilitates
the diagnosis and the management of health problems:

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In summary, the elevation of sensation over emotion in traditional medical and psycho-
logical approaches results in the lack of attention to subjectivity, which in turn leads to
a limited approach towards sufferers and a neglect of broader cultural and sociological
components of pain. In other words, a far more sophisticated model of pain is needed;
one which locates individuals within their social and cultural contexts and which allows
for the inclusion of feelings and emotions. (Bendelow and Williams, 1995: 146)
Thus, pain has two dimensions: it is both a natural and a social phenomenon. The
crucial thing here is that culture actively mediates between the physical stimulus of
pain and its manifestation with the particular historical figure it takes. The embodi-
ment of pain is what ultimately substantiates the (final) form of the manifestation of
the pain stimulus. However, this form significantly varies according to the subject.
That is, there are important qualitative differences observed in women, who are
considered more durable (Bendelow, 1993), in boxers (Wacquant, 1995) or football
players (Roderick, 2006), in patients with chronic diseases (Baszanger, 1992; Bury,
1991), in dancers (Turner and Wainwright, 2003; Wainwright et. al., 2005) or oth-
er groups, such as professional athletes and laborers who have learned from an early
age to accept pain stoically as a part of their daily lives (Kotarba, 1983).
Therefore, understanding pain requires a systematic study on how a group of people
experiences it, or on the way in which it is embodied by each group, as well as on
the messages a group carries; messages that construct a particular attitude towards
body and pain: "…People in pain … need the legitimacy of their pain and suffering
accepted by others, both medically and socially. This search for legitimation is …
involving a process of narrative reconstruction in the face of the biographically dis-
ruptive nature of pain and suffering" (Bendelow and Williams, 1995: 162). The
point here is that this attribution of meaning to pain, as well as its legitimization
and justification escapes from the analysis offered by scientific medicine.

The "Beautiful" Pain

The pain under consideration in this article is the one induced not for medical rea-
sons but for aesthetic ones, by individuals' choice. In particular, we will deal with
the embodiment of pain in women (Johansson, et. al., 1999; Bendelow, 1993) who
undergo aesthetic procedures. Women of course constitute the vast majority of
those who undergo such operations, although in recent years, men undergo similar
procedures as well (see Atkinson, 2008).
Holliday and Taylor (2006: 185-189) argue that, although feminists elaborating on
cosmetic surgery have reported a variety of incentives for women who have under-

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gone aesthetic procedures, there is a general agreement on some key issues. That is,
the fact that the misogynistic culture produces aesthetic surgery as an issue that con-
cerns women (since the whole construction of being a patient or a surgeon is gen-
dered), as well as the fact that aesthetic surgery produces normalized bodies and is a
normalizing technology.
A third key element in the feminist literature on aesthetic surgery is the issue of
pain, both physical and psychological. Holliday and Taylor (2006) refer to Morgan,
according to whom we need a feminist analysis to understand why women choose
to participate in the "fetishistic" approach of their bodies, as if they purchase a "re-
stored youth" and "permanent beauty", despite the considerable risk of postopera-
tive complications and the discomfort entailed by the whole process of the aesthetic
surgery (Morgan, 1991: 26).3
Naomi Wolf referred extensively to the concept of surgical pain, toward which it is
required from women to be stoic (Wolf, 1990: 254-257). For Wolf (1990), pain
constitutes a "reality" when there are other people around to believe the sufferer.
When there is no one to believe the woman except herself, her pain is characterized
as madness, hysteria, or her own feminine failure. Women have learnt to be submit-
ted to pain, listening to institutional forms – doctors, priests, psychiatrists – who
reassure them that what they feel is not pain. Indeed, Wolf reports some cases of
women who could say that their pain was not real.
According to her argument, women's pain is contradicted through its trivialization.
The trivialization and the childish approach of pain eventually flood the language of
plastic surgeons when they talk to women. That is, the pain caused in the pursuit of
beauty is considered minimal, since it is supposed that women choose it freely (Wolf,
1990: 257-260). Nevertheless, Wolf believes that women's choices in the Era of Sur-
geries are not free and, therefore, we have no excuse to refuse to see their pain as real.
Sheila Jeffreys (2005) sees all body modification practices as "culturally harmful"
and dangerous for the physical and mental health of women. Furthermore, she ar-
gues that, depending on the degree of severity, they ought to be subjected either to
penalization or rebuke. Particularly, Jeffreys characterizes aesthetic surgery as the
most known form of severe self-mutilation with one's own concurrence being more
and more brutal (Jeffreys, 2005: 154).
According to Jeffreys, the message boards and forum discussions, which the indus-
tries of aesthetic surgery have established in recent years, vividly show how women's

3 See also Gagné and McGaughey (2002) for a clear and succinct overview of the various feminist perspectives
on agency, culture, and cosmetic surgery.

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forms of interaction that were developed to deal with oppression – that is, the dis-
cussion of common experiences, encouragement and support – have become an ob-
ject of exploitation in order to increase the profits of the industries. Women discuss
their pain and despair but, instead of criticizing the procedure in which they are in-
volved, they support each other in undergoing aesthetic plastic procedures (Jeffreys,
2005: 156).
For Ann Cahill (2003), when the woman chooses to use her beauty or to rely on it
in order to boost her self-esteem, she significantly risks downgrading herself to
nothing more than an object of a man's desire, thus eliminating the possibility of
her own free will. The positive dimension of female beauty requires a frank and
critical belief that someone gets involved in this procedure for one's own purposes
and not only to meet social (and predominantly male) expectations (Cahill, 2003:
59). The process of beautification should be understood and experienced as if it ex-
ists for the beautified woman's pleasure and satisfaction.
Only when beautification confronts this situation, it can avoid the "cloak" of social
coercion. A good test for determining whether the process of beautification exists to
satisfy the woman herself is, according to Cahill (2003), the tolerance to pain, anxi-
ety and discomfort. If there is no limit to those (a woman stands the whole painful
recovery required after many aesthetic surgery procedures), we should then be suspi-
cious whether she does it exclusively by her own free will.
The literature on the surgical transformation of the female body grows so rapidly as
the surgical operations themselves. One of the main criticisms of the aesthetic sur-
gery points to the multiple dangers linked to surgical operations. Even the anesthe-
sia may pose significant risks to the health of an individual. Aesthetic surgery is un-
deniably painful and dangerous, and every operation poses its own potential
complications (Gimlin, 2000: 79-80). For example, pain, anesthesia, bruising and
discolorations, often following a liposuction, usually last up to 6 months after sur-
gery. Similarly, facelifts can cause damage to the nerves, leaving the person's face
permanently numb.
More serious complications include infections, dehydration, fat embolisms, blood
clots and in some cases death. The most common side effects in breast augmenta-
tion include reduced sensitivity of the nipples, swelling, congestion or sclerosis of
the breasts that poses difficulty in raising the arms easily without moving the im-
plants. Even more serious is the problem of encapsulation, where the body reacts to
foreign materials forming a capsule of fibrous tissue around the implants, which
sometimes forces the plastic surgeon to cut off the sclerotic material from the chest
wall.

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Abigail Brooks (2004) also analyzes descriptions of the print media about the body
that undergoes aesthetic surgical operations, focusing on the ways in which they
promote normalizing perceptions on aesthetic surgery. These descriptions of the
body, along with descriptions of the results of aesthetic surgery, foster new bodily
perceptions which are friendly towards aesthetic surgery. Thus, they are able to en-
courage readers and viewers not to pay attention to the physical pain, the swelling,
the bruising and the bleeding, as well as not to realize them as potential warning
signs or indications of concern (Brooks, 2004: 225).
In this way, aesthetic surgery causes a growing distrust against physical signs. The
pain, blood, bruising, swelling and infections are ignored, even though they cause
feelings of anger and rebuttal from clients of the cosmetic procedures (Brooks,
2004: 230). Brooks (2004) also refers to the fact that the normalization of aesthetic
surgery has, as a result, the promotion of the "frozen", motionless body. The aes-
thetically modified bodies may fail to regulate the environmental temperature varia-
tions, as in the case of breast augmentation, where the silicone implants often cause
numbness or reduced pleasure.
Moreover, some aesthetic procedures, such as botox, often limit the natural mobility
of the muscles. To this reduced expressive capability is significantly added up the
elimination of the physical proof of the past self-expression activity. The aesthetical-
ly modified face and body contain no trace of the uniquely lived history and the
complexity of subjective experience, in comparison to an unmodified one (Brooks,
2004: 228-229).
This condition is also theorized by Mike Featherstone, who perceptively notes that
the new ideal of the "unmarked" face, with the use of botox injections, has resulted
in faces without memory traces of the lived experiences, promoting a "game of
masks", where the "mask of aging" is simply replaced by a new one (Featherstone,
2010: 204). In addition, Grayson Cooke emphatically stresses the high risk of "mus-
cle recruitment", namely the emergence of new, secondary lines and wrinkles in the
most unexpected areas of the face, while the face tries to "compensate" for the inertia
of the paralyzed muscles, recreating the effect of frowning (Cooke, 2008: 33-34).
Sonnie Berry (2007) has also mentioned that there is still the risk that the result
does not meet the expectations of the person who underwent the aesthetic surgery.
The dissatisfied are willing to undergo repeated plastic operations, to "start from
scratch". The repetitive reparative operations – or "remodeling" – are often per-
formed due to a previous failed surgery, which resulted in non-fixed or worse char-
acteristics, or even unforeseen medical complications.

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Hence, the individuals may be submitted to multiple repetitive procedures, trying

to correct the same part of their body. Things become incomprehensible when an
individual submitted to a cosmetic procedure has a problem with its repetition, but
still redoes the repetitive procedure, a process resulting into an increase of medical
dangers and a reduction of the probabilities of a satisfactory aesthetic result – main-
ly due to the accumulation of damaged tissues and the loss of cartilage.
Finally, Meredith Jones (2008) refers to the anaesthesia during surgical modifica-
tions of the female body, which she parallels with the story of some fairytales, like
those of "Sleeping Beauty" and "Snow White and the Seven Dwarfs". The promise
of transformation during sleep, according to Jones, has its roots in myth. The anaes-
thetic is the poisonous instrument that helps women "die" and wake up trans-
formed in a magical way, having "escaped" from their problems (as in fairy tales).
According to Jones (2008), the surgically modified female body experiences a "fake
funeral". While aesthetic surgery is presented as a reaction to the fear of aging and
mortality, it is exactly the opposite. It involves the killing of a living human body
part (skin, muscle, etc) and its replacement with a lifeless part (e.g. implant). Simi-
larities also exist between the processes of preparing the body for embalming and for
an aesthetic procedure. Both processes damage the skin of the body to maintain its
outer surface (Jones, 2008: 93-96, 99-100).
The main conclusion of the analysis is that, in the context of aesthetic surgery, it has
produced a medical discourse that energetically encourages women to ignore or to
minimize the pain in a stoic apotheosis of appearance. The prior socialization of
women, within the patriarchal society, produces the docile, normalized and sexually
attractive body, as well as the necessary form of embodiment. The woman gets iden-
tified with the body as a sexual object and thus pain is just an inevitable "evil",
which she "should" simply tolerate. The analytical challenge here is to methodologi-
cally elaborate on the form this embodiment of pain takes.

Research
The research was conducted between March and December of 2008, in the region
of Athens, Greece. The basic method used for doing this research was the qualitative
in-depth interview. The semi-structured interviews were administered to 18 women
who had undergone the aesthetic interventions, and they were conducted in various
places, face-to-face, with the use of a voice recorder. They had the form of an open
discussion, with questions modified or reformulated, even with new ones added
during the interviews.

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The age of the individuals who were submitted to aesthetic interventions varies be-
tween 25 to 65 years. They were submitted into various types of aesthetic interven-
tions, either surgical or non-surgical. The majority of the surgical procedures were
liposuctions (7) on various parts of body (legs, arms, abdomen) and breast interven-
tions (6) (breast augmentation, breast reduction and restoring - mastopexy). In ad-
dition, there were rhinoplasties (3), otoplasties (3), facelifts (3), blepharoplasties (2),
abdominoplasties (2) and one liposculpture, after a loss of massive bodily weight.
The majority of the non-surgical interventions concerned various injectable materi-
als, such as botox, hyaluronic acid, mesotherapy, as well as dermabrasion, peeling
and laser hair removal.
The women who participated in the interviews had not been submitted exclusively
to a single intervention, but in some cases, to more than one intervention. From the
18 women involved in the research, 11 had undergone a mixture of procedures, ei-
ther combining these procedures under the same sedation or undergoing them at
separate times. Six of them had combined surgical procedures with non-surgical in-
terventions. From the 18 women of the research, 8 had needed correctional inter-
ventions, due to either unsatisfactory results or ex-post complications.
The questionnaire consists of 70 questions. Each interview lasted on average from 1
hour to 2 hours. During the interviews, participants were encouraged to freely ex-
press their thoughts about the questions asked. The participants were registered un-
der a pseudonym in the form of name initials. Participants were informed that the
conversations would be recorded for research purposes only, and signed a consent
form declaring their agreement. After the conduct of the interviews and the whole
process of transferring the recorded material into a written form, it followed a quali-
tative analysis of their contents consisting into an overt content and a latent content –
that is, the deeper meanings emerged from the answers given.
Content Analysis was used to analyse the qualitative data of the interviews. This
study followed the standards for the conduct of good qualitative research as de-
scribed by Elliot et al. (1999). Triangulation, as an attempt to increase the reliability
and validity of qualitative results, was attempted by using the three researchers in-
volved in this study to analyse the data separately, with the aim to ensure that the
identified themes were in accordance with the interview material. In order to fur-
ther enhance the credibility of the data, the text was read multiple times and criti-
cally discussed by the three researchers.
In addition, participant theme validation was pursued as participants were offered
transcripts and drafts of the thematic analysis throughout the preparation of the re-
port. It is important that qualitative researchers should be self-critically aware of

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their own involvement in the analytical processes, constructing contexts for their
analysis based on previous literature or existing knowledge, in the pursuit of their
own research questions (Krippendorff, 2004).
The researchers/authors of the present article have much experience in critically in-
vestigating issues of embodiment, within the theoretical framework of the sociology
of the body, and are reflexively aware of their own position in the research process.

The embodiment of pain

During the interviews, we asked those submitted in aesthetic procedures to describe
how they experienced pain. Their responses were categorized according to the re-
ported intensity of pain they felt. The main categories in which we were eventually
led by the analysis of their answers were three: some women (7) ignore pain, while
for most of them (9) pain is minimal to nonexistent, since they "freely" chose to
undergo aesthetic surgery. Finally, for a few women only (2), pain is a reality.

Defying pain
Women who defied pain acknowledged its (objective) existence, but they did not
give importance to it in order to achieve the desired body image. The 63 years old
K., a retired midwife, exemplifies a person who defied pain to undergo the blepha-
roplasty she desired:

Now, I am a bit tough with pain… I was always tough with myself… my
character is a bit tough… and I give no importance to such things. A little
pain… minor things, I didn't pay attention to them… that is, they were
unnoticeable, yes, little things…

The 36 years old private sector employee N. also mentioned that she is tough with
herself:

It wasn't very intense. It had to do with how much pain you can bear. That is,
I can bear pain. For me, what I felt was moderate and predictable. No, no,
no. Others can't bear this pain. Others might say "I am in terrible pain" for
what I call just an annoyance. It has to do with the strengths of each organism.

It is characteristic that pain was defied not only by women whose postoperative
course was smooth, but also by many women who had complications or needed re-

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constructive surgery after the completion of their aesthetic surgery. The 59 years old
salon owner C., who risked losing her life during her abdominoplasty and needed
blood transfusion, while she had also been receiving cortisone injections in the ab-
domen for two years before the reconstructive abdominoplasty, underwent an oto-
plasty and a mini lifting six years later; not only did she degrade pain and suffering,
but also dropped some hints for women who reported pain:

I thought… many people die during surgical operations! I could have died,
too. With all that bleeding…it's still a surgery […] Physically, the pain wasn't
so intense […] My ears had been aching slightly for some hours… Yes, it is
hard in this part, when it takes place. I believe that women saying they are in
pain are exaggerating.

The same attitude against pain has the 38 years old employee in Greek Public Ser-
vices, F. who also underwent an abdominoplasty and a reconstructive abdomino-
plasty one and a half year later:

I can't say that pain was…extreme… There was pain…but it was bearable…
I felt as much pain as a surgery induces…

The 34 years old gymnast E. not only exemplifies the defiance of pain, but also feels
responsible for her plastic surgeon's discomfort due to the complications and bleed-
ing she had during her breast augmentation and liposuction on her legs (in the
course of the same anesthetic period, followed by a reconstructive liposuction three
months later). Her words:

[…] Once waking up after everything had gone well, I don't mind the pain
or anything else… I put on a corset and that was an unpleasant experience for
me, since I am generally claustrophobic and I don't want anything to press
me… that was a discomfort, because I was constantly feeling something
squeezing me and I didn't like it… I felt really oppressed. I can handle with
pain, I have no such problems […] I was bleeding because I used to work out
and my muscles… anyway, my doctor said that I lost too much blood and I
was bleeding from my thighs … afterwards, the only thing you can feel in
pain is the legs, the liposuction, because you don't feel it on the breast. At
least, I didn't feel the pain at all…

The 37 years old private sector employee O., who underwent a liposuction on the
legs and the abdomen, as well as a reconstructive liposuction 3 months later, exem-

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plifies a person who defied pain because she had to hide it; and this is because she
was in the same hospital room with a young person who suffered from cancer, wak-
ing up to her feelings of shame and guilt for this pain:

In the same room there was a young woman, one year older than me, who
had cancer in the pancreas. And… you know… this comparison… that is…
I was there happy in a manner of speaking, I was swaddled, but I would be
discharged from the hospital and I would be a new person, that is,
psychologically better… and she was in this situation! And I thought "look at
this now"… I felt it was a bit unfair… in the sense that God gives you health
and, instead of being happy with this, you enter into a process of operations
etc… I was in pain then… And I say how awkward this is. … I couldn't get
up… I said "ouch", she said "ouch"... and after that, I was ashamed to say
"ouch" again. Fortunately… they didn't ask me what my problem was…
but… I was too ashamed to say… what could I say? That I undergone a
liposuction, while the other girl…was dying? I was ashamed to say that,
indeed. Confronting the problem this other girl had, she could say… "You
asked for it, you got it"… […] I was in pain and couldn't turn over and… I
thought I can't say "ouch" now.

In the same way, the 34 years old shop owner A. described the liposuction on her
legs and waist, and argued that she defied pain, although it was obvious for her that
"objectively" there was pain:

All the pain and suffering lasted… 5 days. Afterwards, there was nothing else.
Of course, the difference was huge from one day to another… On the first
day, I couldn't even stand up; I needed help to pull myself up. Well, it took
me fifteen minutes to leave the hospital and get in the car. […] On the fifth
day, I returned to work…

Elimination of Pain
There are participants in our study who eliminated pain completely. For instance,
the 42 years old public sector employee R. who underwent liposculpture and be-
lieves that, if she had undergone that surgery for health reasons, she would have felt
more pain:

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That was insignificant. Namely, I got over it too fast, because I expected to see
the results… In my opinion, if I had to enter such a process for another
reason, with so many stitches and such a narcosis and this whole package, I
believe that I would have been in greater discomfort… if I had to do it
exclusively for health reasons and if the recovery took more time, wouldn't I?
Yes, I got over it more easily, because it was my decision; that was what I
wanted to do.

The 45 years old gymnast P., who has undergone breast augmentation and non-sur-
gical aesthetic procedures (botox and mesotherapy) on a regular basis, said:

Very little … Barely … There is no… there is no pain, nothing. First of all,
there are some creams, anesthetic, you can place them on your face half an
hour earlier, I don't know if you are aware of them, and… you feel no pain…

The 25 years old beauty salon owner S., who underwent liposuction, breast aug-
mentation and had to undergo a reconstructive procedure on her right breast twice,
due to complications and the formation of a capsule, attributes the reduced pain she
felt to her toughness:

No… nothing special… Ok, some insignificant pain, due to the stitches
etc… yes, but in general, no genuine pain […] The liposuction wasn't
painful. The only problem I had was that I had to wear a corset for one
month. That was the only annoying thing. No pain or anything else. Well…
ok, I am very resistant to pain.

The 38 years old hairdresser H., who underwent rhinoplasty and reconstructive rhi-
noplasty one year later, experienced pain as a discomfort, reducing its intensity:

Discomfort yes, pain no. No pain in its real sense … Swelling yes, but no pain
in the sense of suffering. No! This had more to do with my nerves, you know…

Denial of Pain
Besides these subjects, there were women who totally denied pain. One of them is
the 65 years old T., a businesswoman and former dancer, who underwent a total
facelift when she was 42, that is, 23 years ago (when the methods and techniques of
aesthetic surgery were of course not as developed as nowadays). And not only did
she denied the pain, but she also presented herself as a hero, dropping hints for

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women who reported that they felt pain; she was even introduced by doctors of all
medical specialties as an example in the hospital she was admitted:

There was no pain! That wasn't a negative experience… I didn't feel bad… I
went there and I just did it; I did it at an age when others don't do it. […] I
was so happy, I was jumping from joy… it was a phenomenon, let's say, that I
hadn't complained about anything, I didn't even tell them this bothers me or
that hurts… I met surgeons, general physicians, psychiatrists, celebrities, all of
them, and they said "look at this girl, she did all these and at this age and she
is so funny". […] That is, when a woman decides to do something like that
she should be determined… I didn't feel any discomfort at all…

Similar was the answer of the 28 year old private sector employee L., who under-
went liposuction on her abdomen and legs and attributed the absence of pain to her
determination and to the fact that it was her choice, also dropping hints to women
who report the existence of pain:

I will do that… and I don't care if it's painful, I just don't care… it's not my
concern. It wouldn't concern me normally. […] Pain…nothing… For me, it
was painless […] No, everything was just like…I thought it would be. And I
can say that it was even better, because I didn't feel pain… I didn't… that
is… when they say that it hurts, I just wonder. Maybe I was really determined.
I was so determined … I said … I don't care, no matter what… […] Maybe it
was something… something that didn't induce pain and I was forced… it was
something… I chose to get through this procedure. There was nothing that
made me feel discomfort or pain, as they call it, no… everything was fine.

Next, the 59 years old theatre technician B., who also underwent a facelift, showing
us her face, she said:

Look, there are no scars, are there? There is no pain… I didn't feel pain at
all… I didn't take aspirins… I did nothing… at all. It doesn't hurt at all…
[…] No. Only a discomfort…so… for those 10 days that you are swollen. I
went shopping on the third day after the operation. I didn't care, you know.
They thought that I might had a toothache or… well, I was in bandages; I
was saying "I had a lifting".

Extremely negative about the existence of pain were two other women, the 33 years
old private sector employee M., who underwent rhinoplasty and the 45 years old

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nurse D. who underwent blepharoplasty and liposuction on her legs; their answers
were: "No pain at all" and "no, no, there wasn't (pain)" respectively.

Acknowledgment of pain
Women who admit the existence of pain were very few. The 28 years old police-
woman Z., who underwent otoplasty and reconstructive otoplasty one and a half
years later, is one of these persons:

[…] Once the anesthesia leaves the body, there is pain. And there is
discomfort as well; because… you can't sleep. You can't rest your head on any
side of the pillow… You are in bandages and… in pain. You can't sleep with
your head upright. This resulted in insomnia for at least one week. I was in
pain… I was in pain for a long period of time, approximately for two months.
[…] And the second time, for one month. Yes, for one month I was in pain
again… I was in discomfort, with bruises…

The 34 years old dietician Th. also acknowledged the suffering and pain, as well as the
difficulty to engage in her daily activities, being a mother of two under-aged children:

There was pain about 5 days later… it was intense. […] It was harder for me
because of the kids… well, it was a bit difficult.

The aesthetic surgery as a deliberate trauma

In connection to the question about the lived experience of pain, we asked the women
who participated in the survey if there were moments they felt that they deliberately
injured themselves in order to achieve beauty. Some women reported that, after hav-
ing the cosmetic procedures, they felt that they indeed injured themselves. The case of
X. is demonstrative; she characterized ex post facto her act as superficiality:

Yes. Not without reason. I injured myself. […] I was fine. Just, ok… let's
say… I got carried away. I thought if there is a way to improve the thing that
bothered me so much, then why not? Well, something like that. I was fine.
Maybe it was superficiality. […] It would have been better if I hadn't done it,
of course.

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A. felt that she injured herself as soon as she came out of the operating room, des-
perately begging to return to the previous condition:

When I came out I was…terrified. Ah…because I was swollen… and I said…

"Oh my God, help me go back to what I was before and … never mind".
[…] That is, I got disappointed. I told you, I was saying "Oh my God, help
me go back to what I was before and … never mind" […] Eh… I got
disappointed at some point, "what did you do" I told myself.

O. told us in many parts of the interview that she has felt she injured herself with-
out any reason, after her liposuction of the legs and abdomen:

I had no problem, that is, a health problem. In fact, I got involved… without
reason; only for aesthetic reasons. […] Well, they say that fat is good; in
general, it protects the bones from osteoporosis. So, listening to all these, I
thought "did I do a stupid thing? … Why didn't I leave it as it was?" You
know…some uncertainties of this kind.

Furthermore, she mentioned that she still suffers from abdominal pains in the area
the plastic surgeon applied the liposuction:

Let me tell you… Yes, I felt that I injured myself. Especially in some
abdominal areas, here, because even now I go through some pain, some
disturbances, and I think about it sometimes. I say… "What have I done"…
On the other hand, I don't know… It's like a stitch, you know. […] Well,
even now, I feel it from time to time… I don't know how I got these surgical
incisions, where the stitches were sewed, where the tubes were inserted and
everything else… But even after the operation, I remember that I was in
severe pain, here, on the side of the body… I can remember the pain… I
couldn't turn to the right or to the left.

In addition, there was another moment that O. felt she injured herself without any
reason. It was after the lipo-dissolve injection in her legs:

To be honest … I don't really like injections. That is, I regretted even the one
they gave me in the summer. The lipo-dissolve one. Because… you know
what? I'm against injecting something in your body. Well, I believe that
removing some fat is less dangerous. Adding substances though is… bad. And
because…generally… you know, many athletes who were injected in the
past… not dopes and other such drugs, just to dissolve the fat locally to reveal

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the muscles and such… and afterwards they exhibited many problems; cancer
in the liver and many others … because these drugs are metabolized in the
liver. And in general… it all frightens me a bit. […] I was more frightened
and troubled. I was thinking "Did I make a mistake?"… Because that
substance entered my organism and I felt…

Also, after the mesotherapy O. felt that she caused a problem to her body: "I had
gone mad! I went there with a problem and I left with a bigger one". For Th. as
well, there were moments she felt that she had injured herself, especially during
those days she was in severe pain:

A couple of times in the first five days… when I was in severe pain… Eh, I
was constantly at home… lying down … I was taking painkillers and thinking
"oh my God, all these for bigger breasts?" … Well, during my recovery, it is
true that I thought "Did I do something wrong? What did I do?" seeing
myself swaddled like that.

Discussion – Conclusion
Most women defied, ignored or denied pain completely, in order to acquire the big
prize of beauty. Namely, since they underwent plastic surgery for aesthetic purposes,
they try to disconnect this process from any negative emotion, focusing only on the
positive side of their aesthetic surgical procedures, as well as on the benefits they will
probably gain.
There were certainly some people who mentioned that they felt they deliberately in-
jured their bodies, due to superficiality or vanity. However, most of those who un-
derwent cosmetic procedures ignored the discomfort. Even those who had compli-
cations and underwent reconstructive surgery, or lived the aesthetic surgery as a
totally negative experience, described their failure as a statistical exception to the
rule, relegating all the problems.
The survey recorded the way in which women experience the pain of cosmetic pro-
cedures. Pain is socially fashioned and significantly constrains the expression of bio-
logical stimuli (with only few exceptions). In most cases, ignoring pain is considered
almost imperative to the woman, who wants to transform herself into a "real" wom-
an, rendering her body as the ultimate standard of female beauty.
Explaining the defiance of pain helps us to understand better the special kind of em-
bodiment all these women actually experience. The effort to achieve the female beauty

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standards requires the experience of pain not as an unpleasant feeling but as a neces-
sary ritual process. We could assume that women discipline themselves: while they are
in severe pain, they succeed to downplay their feelings for the sake of achieving the
desired standard of beauty. In other words, they almost feel that it is a woman's duty
to undergo such procedures and thus become the "real" woman, formatting the body
in accordance to the accepted standards (the woman as a sexual object).
Those who undergo these procedures and do not express their true feelings of pain
are in their minds "real" women. Typical cases are C.: "I believe that women who
say that they are in pain are exaggerating", L.: "When they tell me they are in pain, I
wonder", T.: 'It was a rare phenomenon that I didn't complain about anything",
and P.: "I was a pioneer". The important thing here is that, in order to justify the
non-expression of pain, they compare cosmetic medicine with the surgeries done to
treat a disease. As explicitly stated by T.: "The one is for beauty, for happiness, and
the other for disease". In the same context, O. said: "Here you have to do with a
beautician… you don't have the stress of illness".
Because aesthetic surgery is a conscious choice, a reflexive way to implement your
will and become beautiful (not subjugated as in the case of an illness), women "he-
roically" bracket pain. As stated by L.: "Maybe I was very determined. It was some-
thing… I chose to get involved in this process". In the same spirit, S. stressed: "My
will' to do it was so strong, that I paid no attention to it". Finally, R.:

I got over it much easier having in mind doing what I wanted to do and that
it was my own decision… I believe I would have been in much more
discomfort if I had to do some kind of surgical operation for health reasons…

The very fact that women ambitiously and self-consciously chose to undergo these sur-
gical operations probably demands from them to deny pain, in an almost volunta-
ristic and heroic manner. After all, "Pain is beautiful".
English proofreading: Tina Bošković, prof.

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About the Authors

George Alexias is a medical sociologist. He is Assistant Professor at the Department
of Psychology, Panteion University of Social and Political Sciences, Athens, Greece.
His research interests include the sociology of the body, the sociology of genetics
and cyber-sociology.
Georgia Dilaki is a sociologist. Her PhD thesis was about cosmetic surgery and the
social construction of the body through medical discourse. Her research interests
involve the sociology of the body and the sociology of emotions.
Charalambos Tsekeris graduated with Distinction from Brunel University (West
London, UK) and earned his doctoral degree in Reflexivity from Athens
Panteion University. He is Member of the Hellenic Sociological Society and Sen-
ior Researcher at the Lab of Virtual Reality, Internet Research & E-Learning. He
has more than 50 publications in peer-reviewed journals and edited volumes.
His research interests involve psychosocial studies and sociological theory.

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