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“PLASTIC MAKES PERFECT”: MY BEAUTIFUL MOMMY , COSMETIC SURGERY, AND THE MEDICALIZATION

OF MOTHERHOOD

MICHELLE ANN ABATE

Hollins University, Roanoke

Perhaps more than any other genre of children’s literature, pic- ture books have been in the spotlight of late. Intended for the youngest and thus seemingly most innocent of child readers, they have also historically been associated with the most innocent of subject matters. In stark contrast to narratives for young adults that have become famous for their engagement with mature issues like drugs, divorce, and sexuality; picture books have commonly been connected with more lighthearted subject matter. In classic titles like The Tale of Peter Rabbit (1902), Goodnight Moon (1947), and The Very Hungry Caterpillar (1969), the gravest adventures involve mischievously nibbling on some carrots in a forbidden garden, not wanting to go to bed, and being preoccupied by an array of different delicious foods.

During the final few decades of the twentieth century, the traditionally innocuous subject matter of picture books begun to change. In the wake of growing societal beliefs that adults ought to be more honest and open with children, new narra- tives appeared that discussed topics which had previously been overlooked, ignored, or even forbidden. From the serious sub- ject of same-sex parenting in Heather Has Two Mommies (1989) and Daddy’s Roommate (1991) to the humorous issue of bodily func- tions in Everyone Poops (1993, English language version) and Walter, the Farting Dog (2001), these books pushed the boundaries of the genre in new and even daring directions.

In the years since, the range and variety of picture books meant to address formerly off-limits subject matter has only increased. In 2005, for example, Anne-Marie Gillet and Isabelle

Address correspondence to Michelle Ann Abate, 2127 Westover Ave SW, Roanoke, VA 24015. E-mail: [email protected]

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Gilboux released Standing Up, which details the struggles of a male protagonist as he learns how to urinate from a different physi- cal position. The following year, Ricardo Cortes’s It’s Just a Plant arrived on book store shelves; the picture book discusses the sub- ject of marijuana. Finally, the year 2008 witnessed the debut of Thierry Lenain’s Little Zizi, about a young boy who gets ridiculed by his classmates because of his small penis (or “zizi”) after they see him changing in gym class. The website for the national book- store chain Barnes & Noble identifies the story’s central theme: “Is it true that in the littlest of packages come the greatest gifts?” (“Synopsis”).

In spring 2008, the possible subject matter for picture books expanded into a new realm with the publication of My Beautiful Mommy. Written by Michael Salzhauer and illustrated by Victor Guiza, the narrative is billed as the first picture book to address the subject of cosmetic surgery. Told from a first-person perspective, My Beautiful Mommy relays the experiences of a young girl whose mother is about to undergo multiple elective aesthetic procedures. Although the story is fictional, it takes an informational rather than imaginative approach: the narrative provides young readers with a type of “guided tour” or instructive overview of the process. My Beautiful Mommy begins with the mother’s initial consultation at the doctor’s office, progresses to the day of her surgery, discusses the period of her recuperation, and ends with the removal of her bandages and the unveiling of her new, cosmetically altered self. To help explain the entire cosmetic surgery experience to child readers, the book appropri- ates a common metaphor from nature: it compares the mother’s transformation to that of a caterpillar into a butterfly, complete with even likening her bandages to a cocoon.

The mother in My Beautiful Mommy is undergoing not simply a random cluster of cosmetic surgery procedures, but a spe- cific grouping known as the “mommy makeover.” Comprised of a tummy tuck, liposuction, and a breast lift (with or without implants), it is a designed to help mothers regain their pre- pregnancy form. The procedure, which first received this name in the new millennium, has been increasing in popularity over the past five years. As an article in Newsweek explained:

No one specifically tracks the number of tummy-tuck-and-breast-implant combos (or ‘mommy makeovers,’ as they’re called), but according to the

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latest numbers from the American Society of Plastic Surgeons, breast aug- mentation was the most popular cosmetic surgery procedure last year, with 348,000 performed (up 6 percent over 2006). Of those, about one-third were for women over 40 who often opt for implants to restore lost volume in their breasts due to aging or pregnancy weight gain. There were 148,000 tummy tucks—up 1 percent from the previous year. (Springen, par 5)

These statistics exist against the backdrop of a general increase in all types of plastic surgery. As Victoria Pitts-Taylor has written, “Cosmetic modifications of the body have expanded dramatically in number, type, and scope. For instance, in the United States in 2005, there were nearly two million aesthetic operations—more than quadruple the number in 1984—along with over eight mil- lion nonsurgical procedures like Botox and skin resurfacing” (3). In addition, echoing the multi-procedural nature of the mommy makeover, “patients getting cosmetic surgery increasingly have multiple procedures during the same operation—in 2004, for example, one-third of cosmetic surgeries involved multiple pro- cedures. It is now ordinary for a cosmetic surgeon to package procedures, like a chin implant to go with rhinoplasty, or a breast lift to go with a tummy tuck” (Pitts-Taylor 3).

Given the growing number of women undergoing cosmetic surgery, coupled with the growing societal belief that parents ought to be more honest and open with their children, there was a growing need to have such procedures explained in a manner that young people could understand. As Abigail Jones aptly observed, while much attention has been paid to “the emotional effects plas- tic surgery can have on patients,” few have addressed the question “how does a mother’s plastic surgery affect her kids?” (par 6).

My Beautiful Mommy seeks to do just that. Released on the symbolic date of Mother’s Day in 2008, the picture book is aimed at children ages four through seven, and it is intended to ease the fear and anxiety that children experience when a parent undergoes cosmetic surgery. The jacket flap to the pic- ture book cites the following eye-opening statistic: “In 2007 more than 400,000 women with young children underwent cosmetic surgery in the U.S. alone.” Commenting on this phenomenon, author Michael Salzhauer has remarked: “‘Parents [facing elec- tive cosmetic surgery] generally tend to go into this denial thing. They just try to ignore the kids’ questions completely’” (qtd in Springen, par 6). In the face of this lack of information, he goes on to add, children “‘fill in the blanks in their imagination’ and

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then feel worse when they see ‘mommy with bandages’” (qtd in Springen, par 6). In this way, My Beautiful Mommy was framed— by its author, publisher, and accompanying press materials—as filling a need not yet met by extant books for young readers. Indeed, the About the Author section on the website for Barnes and Noble asserted, “As a father of four young children—and an avid bed-time storyteller—he recognizes the importance and value of using quality informational books to communicate effectively with children” (“About”). My Beautiful Mommy serves this function about the subject of cosmetic surgery. The jacket flap promises parents that by reading the narrative with their children and talk- ing about the issues addressed in it, “you will be able to calm your children’s fears, address their concerns, and help your family sail easily through the plastic surgery experience.” For these reasons, the blurb on the back cover asserts, “If you are a mother with young children and thinking about having plastic surgery—this book is a must-have” (emphasis in original).

These altruistic comments notwithstanding, Michael Salzhauer, the author of My Beautiful Mommy, is not a child psychologist, expert in early childhood education, or even pro- fessional writer. On the contrary, he is a board-certified cosmetic surgeon with a successful practice in Bal Harbour, Florida. Indeed, the About the Author section at the back of the picture book touts, Salzhauer “has performed hundreds of beautiful mommy makeovers during his career.” In addition, he “hosts a Sunday morning radio call-in show called ‘Nip Talk Radio’” (Boodman HE05).

This article examines My Beautiful Mommy as at least as much of an advertisement campaign intended to promote and justify a specific medical industry as a children’s book designed to edu- cate and enlighten, perhaps more so. During this process, I locate the book within the growing cultural interest in and even obses- sion with cosmetic surgery and techno-constructions of the body. I examine the way in which the book is both a product of and catalyst for the Western beauty industry and patriarchal attitudes about female appearance. I also explore the messages that My Beautiful Mommy sends about the commercialization of modern medicine, the cultural reproduction of femininity, and postmod- ern views of identity as malleable. While Salzhauer’s picture book can be read via the lens of feminist ethics and the question of

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female agency with regard to elective cosmetic surgery, its more dominant and disturbing message concerns the medicalization of the female reproductive body. Throughout My Beautiful Mommy, women’s post-pregnancy physique is cast as a problem that medi- cal science in general and a male plastic surgeon in particular can solve.

On the Cutting Edge of Motherhood

In the same way that picture books have been the subject of increased media attention as well as public notoriety, so has cos- metic surgery. As Victoria Pitts-Taylor has written, whereas tummy tucks, breast augmentations, and nose jobs were formerly cloaked in secrecy—performed behind closed doors and not publicly dis- closed let alone casually discussed—“cosmetic surgery is now cul- turally ubiquitous. On television, in magazines, and on the Web, there are endless discussions of cosmetic surgery, from makeover shows where participants get multiple surgeries to documentaries and celebrity gossip” (4). Fueled in part by the American interest in self-improvement and in part by our confessional tell-all cul- ture, cosmetic surgery has moved out of the shadows and into the spotlight. Whereas celebrities used to conceal their cosmetic procedures, figures like Cher, Kathy Griffin, and Joan Rivers have openly discussed the numerous nips, tucks, lifts, and injections they have had done on their bodies.

Nor is cosmetic surgery merely the realm of the rich and famous. With the advances in medical technology making proce- dures more affordable, and the ascendency of postwar American capitalism giving many individuals increased disposable income, cosmetic surgery has been democratized, reaching into the mid- dle class. “Dr. Alan Matarasso, a plastic surgeon in New York City and a spokesman for the American Society for Aesthetic Plastic Surgery, told The Economist in 2003, ‘Ten years ago, you could reconstruct a woman’s breast for $12,000. Now it can be done for $600’” (Kuczynski 16). With untold thousands more individuals now potential patients, advertisements about procedures—ranging from Botox and liposuction to facelifts and hair transplants—can be found almost everywhere. “Beauty and health magazines, local television news programs, and the

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Internet are replete with consumer information about cosmetic surgery—how to shop for a surgeon, what procedures are better than others, what the latest technology can accomplish” (Pitts- Taylor 4). For those who cannot afford cosmetic surgery but want to live vicariously, or for those who would like more information about the experience before deciding whether to go under the knife themselves, television programs like ABC’s Extreme Makeover (2002–2005), Fox’s The Swan (2004–2005), MTV’s I Want a Famous Face (2004), and the Discovery Channel’s Plastic Surgery: Before and After (2002–2005) document an individual’s transformation— to strong audience ratings. During its second season, “Extreme Makeover produced ABC’s highest Adult 18–49 rating (3.2/8) in the hour in more than 7 months” (Rogers, par 2). By early October, the program’s audience size had spiked even more, “up over the prior week by 1.4 million viewers (8.4 million vs. 7.0 million) and by 19% among Adults 18–49” (Rogers, par 2).

When viewed collectively, the proliferation of cosmetic surgery in American popular, print and material culture “point toward its normalization” (Pitts-Taylor 4). As Elizabeth Haiken has aptly observed, “Today the stigma of narcissism that once attached to cosmetic surgery has largely vanished, leaving in its place the comfortable aura of American pragmatism, with a whiff of optimistic commitment to self-improvement thrown-in” (7).

As cosmetic surgery has become a more common phe- nomenon in the United States, so too has it become a more gendered one. Kathy Davis has written that “where previous patients were men disabled by war and in industrial accidents, now the recipients are overwhelmingly women who are dissatis- fied with the way their bodies look” (16). She goes on to provide some illuminating statistics: “Nearly ninety percent of the opera- tions are performed on women: all breast corrections, ninety-one percent of face lifts, eight-six percent of eyelid reconstructions, and sixty-one percent of all nose surgery” (Davis 21). In this way, cosmetic surgery has emerged as one of the largest and most lucrative branches of the Western beauty industry. Anthony Elliott has noted, “In the United States alone, it is estimated that cos- metic surgery is an industry generating $15 to $20 billion a year” (21). Market research and public polls indicate are that the attrac- tion and appeal of cosmetic surgery is likely to expand further. Deborah Sullivan revealed that according to a survey of women

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conducted on the eve of the millennium, “More than one-third would like to alter their thighs. One-fourth would like to change their buttocks, and about the same proportion would like to erase their facial wrinkles. Nearly one in five want different breasts and one in seven want different noses” (ix). Existing on the nexus of consumer culture and medical technology, cosmetic surgery has become the emblem of the nation’s postmodern makeover culture and its attendant belief in the malleability of the self.

My Beautiful Mommy is both a product of this climate and a cat- alyst for it. The book portrays the attraction, appeal and benefits of cosmetic surgery, but it also perpetuates its many ethical problems, psychological dilemmas, and epistemological flaws. Salzhauer’s narrative fails to explore serious questions about women’s choice and agency in the face of the cultural reproduction of feminin- ity and patriarchal views about female appearance. In addition, it greatly minimizes or even ignores the numerous potential risks, problems, and complications associated with cosmetic surgery. Finally, and perhaps most disconcertingly, My Beautiful Mommy offers a problematic message to young people in general and— given its possession of a young female narrator—elementary-aged girls in particular about self-image, body type, and self-esteem.

∗ ∗ ∗ The troubling information about personal appearance and

female beauty in My Beautiful Mommy begins even before readers open the picture book and examine its first page. The cover image to the narrative presents a full-length portrait of a young, slender woman—the mommy of the title. Echoing longstanding associa- tions of cosmetic surgery with narcissistic vanity, her proportions are not simply perfect, but almost Barbie doll-like in nature: she has a full bosom, a slim waist, and pleasingly curvy hips. Her legs are long and lean, with a slender knee, and modest definition around the calf. Her long auburn hair, dainty feet and equally perfect creamy white skin—which is without a blemish, freckle or even hint of body hair—complete the picture.

The clothing that the mother is wearing calls further atten- tion to her body: she is depicted in hip-hugging, form-fitting dark pink pants and a light pink half-shirt, her belly button exposed. Throughout the book, in fact, the mother will retain this attire, wearing snug pants and shirts that expose her midriff.

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Accentuating both the feminization and the fairy-tale nature of this image, the mother is surrounded by whimsical ribbons of sparkly dust. Bright stars or twinkling bits of diamond glimmer in the spotlight. The entire cover of the book is fuchsia-colored. This bright color palate combined with the exaggerated eyes and heavy black border outlining her figure gives the illustrations a cartoonish-like appearance in general and makes her resem- ble one of the princess characters from Walt Disney’s popular animated movies in particular. Author Michael Salzhauer has him- self acknowledged the similarities. During an appearance on the Today show to promote My Beautiful Mommy in April 2008, he dis- cussed how illustrator Victor Guiza “Disney-fied” the illustrations (“Mommy’s Makeover”). Although this decision likely arose from a desire to give the book a “familiar” look, it bundles together the many—and often problematic—messages about women’s gen- der roles, the female body and compulsory heterosexuality that permeate Disney films and have been discussed by critics.

The mother is not the only figure on the cover of Salzhauer’s picture book. Her daughter—who serves as the narrator of the story—is standing to her right. In a gesture that simultaneously infantilizes the young girl while it traffics in the historical associa- tion of children with cuteness, she is holding a plump teddy bear. Moreover, as she gazes at her new, surgically altered mommy, the youngster has a look of wonder, joy, and even amazement on her face. This image of a young girl worshipping the image of white, Western feminine beauty and the proportionally perfect—because it has been cosmetically altered—female body foreshadows the message or, at least, sets the tone that will permeate My Beautiful Mommy.

In keeping with Salzhauer’s goal of easing kids’ fears when a parent undergoes cosmetic surgery, the narrative of My Beautiful Mommy begins at the beginning: with the visit to the doctor’s office. The opening page reads, “Mommy picked me up early from school today. She said we were going to the doctor . . . but it wasn’t my doctor, Dr. Jill. . . . Today we went to a new doctor for Mommy: Dr. Michael.” Several pages into the story, we learn that the young narrator has a sibling, a brother named Billy. Although he is older, it is only by a few years. Judging by the illustrations, Billy is still in elementary school. Although the mother’s cosmetic surgery will undoubtedly affect her son as much as her daughter,

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Salzhauer’s book is focused on the young girl. In fact, through- out the twenty-two pages that comprise My Beautiful Mommy, Billy is only mentioned four times, and it is only briefly and usually as part of the background.1

While Salzhauer’s decision to focus his book on the daughter may have arisen because she is younger and thus presumably more frightened by the procedure as well as less able to understand what is happening, another and more culturally constructed rea- son is also possible. By telling the story from the daughter’s point of view and almost omitting the perspective of brother, the book highlights the highly gendered nature of beauty and the added pressures that women face about their appearance. Indeed, far from simply tacitly acknowledging this fact via the choice of narra- tor, My Beautiful Mommy almost seems to indoctrinate the daughter to this reality. The picture book’s initial sentence “Mommy picked me up early from school today” is significant, for it indicates the mother’s deliberate decision to include not simply her child but her female child in the process. After all, she picks up her daugh- ter early from school in order to bring her to the consultation with the cosmetic surgeon, but not her son.

That the mother chooses to expose either child to this process is also troubling. While many reviewers have lauded Salzhauer’s desire for more openness and honesty with children, they have nonetheless wondered whether, when it comes to the subject of cosmetic surgery, doing so is too much information too soon. Reconstructive surgeon Dr. Pete Costantino thinks so, remarking,

1The first instance occurs when the mother explains to her daughter that she is going to have an operation; the young girl asks if it will be anything like her brother’s game called Operation. Later, when the mother discusses her the period of recovery from her procedure, her daughter asks: “Are you going to have a cast like when Billy broke his arm playing baseball?” A thought bubble above her head shows the young boy in his baseball uniform with his arm in a sling. It is only after the mother has returned home from the hospital that Billy returns. The caption reads “Daddy told Billy and me that we had to play quietly downstairs while Mommy was resting.” In the illustration that accompanies this text, Billy’s back faces the reader. Finally, near the end of the book, the young man gets one page to himself. While the mother is recuperating, the narrator notes: “Billy even picked up his clothes and put them in the hamper without being told. Mommy was so proud.” The page shows Billy in his bedroom loading his laundry into the hamper. Appropriately boyish toys and decorations surround him: a fire truck, baseball, and fielder’s mitt are scattered on the floor. Meanwhile, the walls are adorned with posters of professional athletes and sports stadiums.

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“Children are still in the process of developing concepts of self- image and beauty and ugliness and so forth. . . . They’re in a formative phase, and I don’t think it’s valuable to children to push aesthetic surgery in their face” (qtd in Friedman, par 21). Debbie Then, a child psychologist, agrees, commenting that this phenomenon can be especially damaging for young girls given the added pressures that they experience about appearance: “There is a concern that if we focus the attention of young children on this topic, we will encourage very young girls to start obsessing about their looks at an even earlier age than they already do” (Friedman, par 24).

The illustration that accompanies the opening remark in My Beautiful Mommy is equally problematic, for it reinforces long- held stereotypes of cosmetic surgery as the realm of the white and wealthy: the image shows the young Caucasian girl walking hand-in-hand with her equally fair-skinned mother on a palm tree–lined street with perfectly manicured landscaping. In the background is a seemingly new, pristine, and gleaming white high- rise building, presumably the locale of Dr. Michael’s office. Images of upper-middle-class wealth and privilege form the backdrop for this passage. On the page where the mother and daughter return home from the consultation, a large, silver SUV is parked in the driveway and a spacious, modern suburban home—designed in the style that is sometimes pejoratively called a “McMansion” or a “Garage Mahal”—can be seen across the street.

The second page of My Beautiful Mommy depicts the mother sitting across from the cosmetic surgeon’s desk; her daughter stands beside her, leaning on the chair. In an image that conveys the prowess of scientific knowledge and the power conferred on male medical authority, no fewer than eight diplomas tile the wall behind the plastic surgeon. Meanwhile, his certificate from the American Board of Plastic Surgery is prominently displayed on an ornate wood easel atop his desk.

The visual representation of Dr. Michael furthers the asso- ciation of cosmetic surgery not with the correction of physical problems but with the creation of perfect bodies: with his small head, almost comically broad chest and huge pectoral muscles, Dr. Michael looks like a superhero. Adding to this vision of vanity, not one but two portraits of a young girl winning a beauty pageant appear in frames on the wall directly above the mother’s head.

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Finally, the conversation that Dr. Michael has with the mother forms a final element of unease. The speech bubble above the plastic surgeon’s head offers the following cartoonish render- ing of this serious conversation: “Blah, Blah, Blah, Tummy, Blah, Blah, Blah, Nose.” While this dialogue is perhaps meant to reflect a child’s experience of a grown-up conversation—glossing over words that she does not understand and perking up at terms that she recognizes—its vacuous content and flippant tone minimizes the seriousness of cosmetic surgery.

On the opposing page, the surgeon’s assistant takes the “before” photos of the mother in what the child narrator describes as “a funny gown.” Seeing the mother standing before a full- length mirror—with her slim waist, long legs and proportional bosom—one wonders what surgical procedures are needed. As Kathy Davis has noted about one of the diagnostic peculiarity of plastic surgery, “In most medical specialties, patients don’t know what their problem is, and leave it to the specialist to figure out. Not so with cosmetic surgery. Here, it is the patient who knows what’s wrong and the surgeon who often has a hard time seeing it” (2). Indeed, throughout her experience interviewing cosmetic surgery candidates in The Netherlands, Davis found: “Not only did I rarely see what the applicants were coming in to have done, but once I knew what the problem was, I found myself feeling astounded that anyone could be willing to undergo such drastic measures for what seemed to me such a minor imperfection” (72).

For some men and women, this personal discomfort becomes a type of pathological fixation, a condition known as Body Dysmorphic Disorder (BDD). As Victoria Pitts-Taylor has written, BDD is defined as “a mental disorder characterized by a per- son’s obsession about a slight or imagined flaw in his or her appearance to the point of clinically significant distress or dys- function” (2). Individuals who are diagnosed with BDD are not candidates for cosmetic surgery and, in an effort to help sur- geons identify those who suffer from it, the American Society for Aesthetic Plastic Surgery developed guidelines during the 1990s for how much cosmetic surgery is too much for an individual. Not surprisingly, the list of acceptable procedures is rather lengthy, “establishing a regimen over one’s adult lifetime that, if one took the advice to its maximum, would amount to approximately fif- teen surgical procedures, along with numerous laser treatments

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and dozens of injections, sustained over a span of forty to fifty years” (Pitts-Taylor 29). In the words of Pitts-Taylor once again, “Generally, they see women who get cosmetic surgeries, even most that get multiple procedures, as people who understand the social pressures surrounding youth and beauty and who want to improve or maintain their good looks and their self-esteem” (116).

While it is unclear whether the mother in My Beautiful Mommy suffers from Body Dysmorphic Disorder—as readers do not know if she has had cosmetic surgery before and are also unaware how much she fixates on her body image—many will likely agree that her perceived flaws are just that: merely perceived.

The mother’s justification for wanting the mommy makeover only enhances this view. As Anthony Elliott, Sander Gilman, and Elizabeth Haiken have all written, plastic surgery has historically been viewed in a negative light. Women who have had face lifts, tummy tucks, and breast augmentations are commonly seen as victims of a patriarchal Western beauty system that imposes strict, limited, and even oppressive standards about how the female body should look. Deborah Sullivan aptly summarizes this perspective in a comment from a recent book: “cosmetic surgery inscribes our gendered beliefs about appearance, physical fitness, and age in our flesh. It personifies the social, psychological, and economic value we place on an attractive appearance, regardless of gender. . . . It incarnates the image-obsessed consumerism and compet- itive free-market economy of the late twentieth century” (x). Women who succumb to societal pressures about their appearance by going under the knife are seen as suffering everything from narcissistic vanity and patriarchal brainwashing to pathological ill- ness and even a masochistic longing for self-mutilation. Indeed, women’s desire for cosmetic surgery is often viewed, especially by feminist critics, as little more than an outward manifestation of “internalized oppression” (Pitts-Taylor 9).

The popularization of cosmetic surgery during the past few decades—combined with postmodern views about the malleability of the body and personal identity—has challenged this viewpoint. Rather than viewing women as “brain-washed victims of media hype” or “cultural dupes” of the patriarchal beauty culture, psy- chologists, sociologists, and even feminists have sought to “explore how women actually experience and negotiate their bodies in the context of many promises and few options” (Davis 49). This

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approach resists discounting or discrediting women’s desire to have cosmetic surgery and instead strives to listen to their ratio- nale, acknowledge their reasons and respect their choices. Kathy Davis has documented how, for many women who have elective cosmetic procedures, the desire to have a tummy tuck, breast lift, or liposuction does not arise from a longing to have the perfect body and be model “beautiful,” but rather to correct a long-disliked personal trait and become everyday “ordinary” (12). After conducting interviews with dozens of women who were candidates for cosmetic procedures, she discovered the extreme amount of psychological suffering that they had experienced: self-consciousness over small breasts, embarrassment because of a crooked nose, and even self-loathing as a result of protruding ears. In an acute reversal of the language of victimization, after decades of having their self-image hampered by a certain disliked physical feature, they decided to be a victim no more. Ironically, many of these women drew on the language of feminist empowerment to describe this decision, describing their cosmetic surgery as an act that finally allowed them to “take control” of their body and “take charge” of their life. In this way, as Davis notes, cosmetic surgery is reframed and reconfigured not as a symptom of pathology or the product of patriarchal victimization, but “as a strategy for inter- rupting the downward spiral of suffering which can accompany a woman’s problematic relationship to her body” (12).

This alternative way of viewing cosmetic surgery, however, is neither this simple, nor one-sided. Even if we see tummy tucks and breast augmentations as a form of empowerment, this rationale does not eradicate the problems associated with our contempo- rary beauty culture. After all, a woman’s new, surgically modified body may liberate her from feelings of inadequacy, but it creates a standard by which other women are judged. As a result, as Davis notes, cosmetic surgery participates in the oppression of women while it paradoxically helps them to escape it. For this reason, cos- metic surgery remains a site of profound cultural debate. Deborah A. Sullivan encapsulates this dilemma, writing: “Respect for the right of competent adults to make decisions about their own bod- ies should not blind us to the larger cultural and social context in which personal choices occur” (5).

My Beautiful Mommy participates in the debates surrounding cosmetic surgery while illuminating its many paradoxes, problems,

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and contradictions. On the whole, the book presents the mother’s decision to have a mommy makeover as the result of personal suffering and the decision to “take control” of her body. When the young narrator asks her mother why she is having an opera- tion to make “her tummy smaller,” she gives the following reply: “You see, as I got older, my body stretched and I couldn’t fit into my clothes anymore.” As the mother kneels down while explaining this rationale to her daughter, a thought bubble beside her shows her struggling to button her jeans. In an effort to convey both the physical frustration and psychological discomfort associated with this situation, her cheeks are puffed out, her eyes are crossed, and her knees are knocked. In language that echoes the sentiments of many women about cosmetic surgery, the mother matter-of-factly informs her daughter: “Dr. Michael is going to help fix that and make me feel better ” (emphasis added).

In these and other passages, My Beautiful Mommy partici- pates in the growing societal distinction of health versus wellness. Victoria Pitts-Taylor delineates the important semantic difference between these seemingly synonymous terms: “Whereas the sick body was once the primary territory of medicine, appearance and beauty are now increasingly seen as occasions for medical con- sumerism, and healthy bodies are regularly tuned up both inside and out” (28). While health has traditionally been defined as the absence of disease or sickness, wellness refers to a state of satisfac- tion, contentment, and happiness (both physical and psychologi- cal) with a body that is more than simply free from pathogens. “In all, the trend toward lifestyle medicine has ‘massively expanded’ the subjects of health care from sick bodies to the whole popula- tion” (Pitts-Taylor 28). Under the auspices of “wellness,” women as well as men “take more elective medicines, from those to improve our sex lives to those that limit menstruation, or help us sleep, con- centrate, relax, perform athletically, or look better” (Pitts-Taylor 28). In addition, they diet, exercise, and even see psychotherapists. As a result of the ascendency of a wellness approach to living, “The body is no longer simply a dysfunctional object requiring medical intervention, but a commodity—not unlike ‘a car, a refrigerator, a house—which can be continuously upgraded and modified in accordance with new interests and greater resources.’ It can be endlessly manipulated—reshaped, restyled, and reconstructed to meet prevailing fashions and cultural values” (Davis 17).

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The mother’s desire for cosmetic surgery in My Beautiful Mommy can be located within discourses of wellness and not simply health. After all, her pre-surgical body is a medically healthy one, but one in which she does not experience personal, physical, and psychological wellness.

Akin to the ethically complex and morally complicated arguments surrounding cosmetic surgery, its depiction in My Beautiful Mommy is equally fraught. Although the mother does ultimately frame her desire for a tummy tuck, liposuction, and breast lift as a method to alleviate suffering and “take control” of an unruly body, her initial explanation is far less noble. “Why are you going to look different?” the daughter innocently asks about the aftermath of the cosmetic procedure. In what forms the most oft-discussed and vehemently criticized passage in the book, the mother gives the following response: “Not just different my dear—prettier!” Even more problematically, a thought bubble above the mother’s head shows her wearing an evening gown and the burly Dr. Michael placing a crown on her head. A sash draped across her body reads, “The Prettiest Mom.” This detail alters the overall message in My Beautiful Mommy about elective aesthetic procedures. As Linda Lowen laments, “instead of looking at plastic surgery as part of the spectrum of self-improvement inside and out, it offers the ‘mommy wants to be prettier’ cliché” (par 7). Julie Deardoff concurs, commenting on the implications of this message to young readers:

Although many parents strive to teach their children that beauty begins from within, many do not and the book reflects that. Parents who choose plastic surgery for non-medical reasons are going to emphasize the impor- tance of physical appearance whether they have a book to read to their children or not. Kids ape everything we say and do; if you’re unhappy with how you look, chances are your kid will be questioning her own appearance too. (par 7)

Of course, societal pressures about beauty and looks are highly gendered. Child psychiatrist Elizabeth Bergen, author of Raising Kids with Character , “worries that kids will think their own body parts must need ‘fixing’ too. The surgery on a nose, for exam- ple, may ‘convey to the child that the child’s nose, which always seemed OK, might be perceived by Mommy or somebody as unacceptable’” (qtd in Springen, par 14).

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Far from mere speculation, the number of young people having cosmetic surgery is on the rise. According to Diana Zuckerman, “In 2003, more than 223,000 cosmetic procedures were performed on patients 18 years of age or younger, and almost 39,000 were surgical procedures such as nose reshaping, breast lifts, breast augmentation, liposuction, and tummy tucks” (par 1). Especially among the upper- and upper-middle classes, it is now not uncommon for parents to give their daughter a breast augmentation, some liposuction, or an ear pinning as a sixteenth birthday present. In Flesh Wounds, for example, Virginia Blum recalls being taken for a nose job when she was a teenager: “my mother considered it parentally irresponsible not to do what she could to make me more ‘marketable’” (9). The number of young people having elective aesthetic procedures has increased so much in recent years that a small but growing sub-genre of nonfiction books has appeared to discuss the subject. Texts such as Cosmetic Surgery for Teens: Choices and Consequences (2003), Can I Change the Way I Look?: A Teen’s Guide to the Health Implications of Cosmetic Surgery and Beyond (2005), and Magdalena Alagna’s Everything You Need to Know about the Dangers of Cosmetic Surgery (2002) weigh the pros and cons involved in getting cosmetic surgery as well as the various procedures that are available, how much they cost, and the medical risks associated with them.2

2To a lesser extent, cosmetic surgery has also been discussed in works of fiction. Laura and Tom McNeal’s novel Crooked (1999), for example, explores the life of teenager Clara Wilson. Coupled with troubles with friends, homework, and her parent’s recent separation, the young girl struggles with an additional hardship: as the title of the young adult (YA) novel implies, she has a crooked nose. The opening paragraph of the novel demonstrates the extent to which the self-conscious young girl fixates on this trait. The language recalls the discourse of suffering that Kathy Davis discusses in Reshaping the Female Body:

Before everything stopped being normal, the thing that Clara Wilson worried most about was her nose. It wasn’t straight. The bridge began in a good downwardly ver- tical line, and the it just swooped off to the left. It was crooked even in her baby pictures. It look as if someone—a doctor? A nurse? God in a mean mood?—had laid a finger at the side of her nose and pushed the straightness out of it. The problem was, a crooked nose could make a whole face look crooked. Even when she was in a good mood and smiling, some little part of Clara was observing herself. She smiled a crooked smile. She grinned a crooked grin. She walked a crooked mile.

Her best friend, Gerri, whose nose was perfect, said Clara’s nose wasn’t that bad, but if it bothered her that much, why didn’t she just get a nose job and forget about it? (McNeal and McNeal 1; italics in original)

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If readers feel unease with the mother’s reason for visiting a cosmetic surgeon, then they are likely to experience even more discomfort with how the book helps the young girl cope with the procedures and their disruption to her family life. As the narra- tor leaves Dr. Michael’s office with her mother, she notes, “A nice lady in the office gave me two lollipops and a cookie.” The use of not simply food but sugary sweets to console the child continues throughout the remainder of the story. On the day of her mother’s surgery, the youngster’s grandmother takes her—and her alone, her brother is not present—for a double-scoop ice cream cone. Finally, on the closing page, after the mother’s bandages have been removed, she is rewarded with candy once again: “Mommy took out two big lollipops shaped like butterflies. Mommy gave me the pink one, which is my favorite color.”

The “mommy makeover” is not the only type of cosmetic surgery that the mother in Salzhauer’s book receives; she also has rhinoplasty, or a nose job. As Elizabeth Haiken, Virginia Blum, and Sander Gilman have all written, this procedure is one of the his- torically oldest but also most culturally fraught. In Making the Body Beautiful: A Cultural History of Aesthetic Surgery, Sander Gilman dis- cusses the longstanding practice of cosmetic surgery being used to alter the appearance of members of racial and ethnic minor- ity groups and allow them to “pass” into white American culture. In the words of Haiken, “Race- and ethnicity-based surgery has always focused on the most identifiable, and most caricatured fea- tures: for Jews, noses; for Asians, eyes; for African Americans, noses and lips” (176). In the 1920s, for instance, Fanny Brice became famous for having a nose job to alter her “Jewish” appearance (Haiken 1–2).

Such practices continue to this day. Kathy Davis recounts attending a conference in the early 1990s where a cosmetic sur- geon gave a lecture about successful techniques for making the eyes of Asian women appear Western (2). Finally, many sociol- ogists, psychologists, and cultural commentators have discussed entertainer Michael Jackson as “only one among hundreds of thousands of Americans who have attempted, through plastic

Clara ultimately decides not to get a nose job, realizing that in light of life’s myriad other difficulties her crooked nose is not really a problem. Crooked was the recipient of the California Book Award in Juvenile Literature.

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surgery, to minimize or eradicate physical signs of race or ethnic- ity that they believe mark them as ‘other’ (which in this context has always meant ‘other’ than white)” (Haiken 175–176). The use of cosmetic surgery to eliminate physical markers of ethnicity has become so pervasive that Gilman devotes an entire chapter to just what he calls “the racial nose.”

The mother in My Beautiful Mommy is presented with a vis- age that could be placed in dialogue with this phenomenon. In the illustrations by Guiza, she possesses a noticeable bump and downward-sloping hook to her nose, traits that Gilman, Blum, and Haiken have all written are historically coded as markers for Jewishness. Even if the mother in My Beautiful Mommy is not trying to eradicate a real or imagined sign of ethnicity through rhinoplasty, she is nonetheless perpetuating homogenized notions of what it means to be attractive. In the words of Haiken, “by recognizing ‘ugliness,’ diagnosing inferiority complexes, and pre- scribing surgery, plastic surgeons reproduced and replicated a definition of beauty that clearly derived from and relied on Caucasian, even Anglo-Saxon, traditions and standards” (10).

The conclusion to My Beautiful Mommy amplifies this theme. “One afternoon, Mommy came home from her appointment with Dr. Michael—and all of her bandages were off. She was smiling. She looked different. ‘Your cocoon fell off,’ I said. ‘Yes, I feel much better,’ Mommy answered.” The illustration that accompa- nies these remarks nearly replicates the one that appears on the book’s cover. The mother is shown in a full-length pose against a fuchsia background. She is smiling and her arms are open and extended up in a “Ta-dah!” type gesture. As on the cover, the mother is wearing a light pink half-shirt and darker pink form- fitting and hip-hugging pants. Indeed, as Catherine Price has written, although slim and shapely before, she now possesses “the sort of waist-to-hip ratio that’s the stuff of Barbie’s dreams” (par 1). Finally, in a detail that presents surgical makeovers as not simply a medical marvel but something nothing less than magical, streams of sparkly fairy dust, bright laser beams, cartoon stars, and rays of sunlight emanate from her body.

The following page shifts the perspective of the reader’s gaze to show the daughter’s reaction. Amazed and astounded, the youth asserts: “Mommy, your eyes are sparkling like diamonds. You’re the most beautiful butterfly in the whole world.” A huge

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smile adorns the daughter’s face, her eyes are open wide in amaze- ment, and her hands are clasped in adoration. A thought bubble beside the young girl’s head depicts the mother as a beautiful, col- orful butterfly. On the closing page, the pair is cuddled on the couch, the girl’s head lying on her mother’s lap. Brightly colored butterflies dot the page and the caption reads: “We snuggled on the sofa and Mommy hugged me tight. I fell asleep dreaming of butterflies.”

Nip/Tuck Truth

In spite of the Salzhauer’s oft-stated commitment to “quality informational books to communicate effectively with children” (“About”), My Beautiful Mommy does not present an entirely accu- rate, honest, or even realistic portrait of cosmetic surgery. His narrative ignores important aspects of abdominoplasty, liposuc- tion, breast augmentation, and rhinoplasty while it minimizes or glosses over others. The most significant and perhaps most notice- able omission is the level of pain and discomfort that patients experience. Near the middle of Salzhauer’s picture book, the young girl asks her mother about her rhinoplasty, “Mommy is it going to hurt?” to which she gives the following decorous reply: “Maybe a little . . . but only for a few days.” The truth is that nose jobs are tremendously painful, as surgeons often need to break the nasal bone and/or chisel it down. In addition, many rhinoplas- ties necessitate having skin grafted, removed, or reconstructed. Several patients quoted on an informational message board for those contemplating rhinoplasty likened their nose job to being punched in the face (“Making” par 5). They describe the tremen- dous pain that they experienced whenever they moved their face and which left them nearly unable to lie down, chew, and, at times, even talk. In addition, nose jobs involve extensive facial bruising and swelling, often with double black eyes and blood oozing from the nasal cavity—symptoms which can persist for several weeks or even a month (“Making,” par 5).

Abdominoplasty and liposuction are even more debilitating. In spite of its playful name, a tummy tuck is major abdominal surgery. First, two large incisions are made in the skin, from hip bone to hip bone, one above the belly-button and one

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below it. Then, the large crescent-shaped piece of flesh that is located between the two cuts is removed. Afterward, the muscles are realigned and the belly button—which has been surgically isolated—is reattached and repositioned. The wound is then sutured closed. Recovery time is lengthy: the procedure requires at least an overnight stay at the hospital, one week with surgical drains in the wound, around two weeks before the stitches can be removed, and roughly six weeks until the patient is able to get around without assistance or significant discomfort (“Tummy Tuck Recovery,” par 6).

The healing period for liposuction varies, depending on the size of the area targeted. However, as Dr. Jim Greene noted on an open-access informational website, some medical benchmarks exist: “For the first 3 to 14 days following the liposuction surgery you can expect some pain. This pain can range from mild all the way up to severe depending on the technique that was used during the procedure as well as the type of liposuction proce- dure that was performed” (Greene, par 2). He continues: “For the first 2 weeks all the way to more than 2 months you can expect swelling associated with your liposuction procedure. . . . Furthermore along with this swelling you will also need to expect some bruising for at least the first 2 weeks” (Greene, par 3). Loss of sensation and drainage of fluid from the incision are also common side effects. “Numbness in the treatment area will be limited to the actual skin and can last several weeks after hav- ing undergone the liposuction procedure” (Greene, par 4). To help combat all of these symptoms—pain, swelling, numbness, and fluid—liposuction patients don a compression garment. The item is worn for at least the first few weeks after surgery and, in the days following the procedure, it must be changed almost daily (Greene, par 5).

The presentation of the mother’s post-surgery appearance, her experience with pain, and the time needed for recovery in My Beautiful Mommy is markedly different. When the mother comes home from the hospital, she is shown with a thin bandage across the bridge of her nose. In reality, most individuals receiving rhino- plasty have several bandages: one across the bridge of the nose, one running down the length of it, and one extending beneath the nostrils. For at least the first few days, these items are often bloodied. Not so with Salzhauer’s mommy. Not only does her

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face show no sign of bruising, blood, or swelling, but her solitary bandage is pristinely white.

Salzhauer’s presentation of the mother’s liposuction and tummy tuck is even more unrealistic, and misleading. As Karen Springen notes, the mother has only a “demure” dressing around her waist, not the compression garment that, because of oozing fluid, needs to be changed every few days (par 7). In addition, as Sandra G. Boodman humorously observes, “she’s up and around a few days after her tummy tuck, not lying in bed in a haze of pain waiting for her next Percocet” (HE 05). Indeed, on her first day home from the hospital, the girl narrator says of her mother: “She was sitting up in bed and eating chicken soup.” Her most serious symptom is that “She looked sleepy.” The next day, the mother is out of bed. The young girl comes home to find her mom dressed and downstairs “sitting in her chair watching television.” On the following morning—which, in the timeline created by the book, is only four days after the surgery—she has returned to almost her normal routine. “The next day, Mommy was up in the kitchen helping Daddy make breakfast. I ran over and gave Mommy the biggest hug in the world. I passed her the milk because Daddy told me she couldn’t lift heavy things.”

Together with not accurately presenting surgical recovery, My Beautiful Mommy also does not truthfully present the many risks, dangers, and side effects inherent with cosmetic procedures. The book ends with the mother’s cosmetic procedures a seeming suc- cess. The young narrator happily reports, “Each day over the next week I could see that Mommy was feeling better and bet- ter.” However, for some cosmetic surgery patients, this is not the case, as they experience an array of complications. “Following a liposuction, the skin can develop a corrugated, uneven texture or dents so that the recipient looks worse than she did before the surgery” (Davis 28). Breast augmentations carry perhaps the most numerous as well as serious side-effects. In the words of Davis:

Health experts estimate that the chance of side effects is between thirty and fifty percent, some of which are very serious. The least dramatic and most common side effects include decreased sensitivity of the nipples, painful swelling or congestion of the breasts, hardening of the breasts which makes it difficult to lie down comfortably or to raise the arms without the implants shifting position, or asymmetrical breasts. (Davis 27–28)

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There are more dire problems, however. Among the most debili- tating is what is known as “encapsulation, whereby the body reacts to the presence of foreign matter by developing an enclosing cap- sule of fibrous tissue around the implant. This happens in nearly thirty-five percent of the cases. The implant becomes door-knob shaped, rock hard, and painful” (Davis 28). As Davis goes on to note, in certain cases, encapsulation can be corrected via a non-invasive procedure: “a firm massage on the part of the sur- geon (euphemistically called ‘fluffing them up’) will break up the tissue—at great pain to the patient” (28). If this tactic fails, however, “the implants have to be removed—a formidable proce- dure sometimes requiring that the hardened implants be literally chiseled from the patient’s chest wall” (Davis 28).

Another common risk with breast implants, of course, is leak- age and ruptures. Typically called a “gel bleed” by surgeons, the presence of silicone in the human body “can impair a woman’s immune system permanently, leading to arthritis, lupus, con- nective tissue disease, respiratory problems, or brain damage” (Davis 28). Patients who experience no medical side effects may still experience aesthetic ones. Breast augmentations by a surgeon who is unskilled or simply inexperienced “are disfiguring. They leave the recipient with unsightly scars instead of a bigger chest size” (Davis 28). Finally, even successful cosmetic surgical proce- dures are not permanent solutions. “Cosmetic operations often have to be redone. While facelifts fall and have to be repeated every five years, silicone breast implants need to be replaced after fifteen years. Fat which has been removed from the thighs or buttocks may return, requiring another liposuction, or the skin may bag and have to be cut and redraped” (Davis 28). Along with omitting many of the many possible complications associ- ated with cosmetic procedures in My Beautiful Mommy, Salzhauer does not even hint that she will need to undergo surgery again in the future, likely sometime when the young narrator is in high school. In this way, the “mommy makeover” may help the narrator’s mother “feel better,” but this fix is only temporary.

Given the numerous and often serious side effects associ- ated with the procedures involved in a mommy makeover, figures like Natasha Singer have questioned the ethics of doctors “pack- aging multiple procedures under a cutesy nickname” (par 23). This tactic is an effective marketing strategy, but it undercuts the

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seriousness of cosmetic surgery, directs attention away from its many risks, and obfuscates the fact that it is an invasive medical procedure.

∗ ∗ ∗ My Beautiful Mommy may be the first picture book to discuss

cosmetic surgery, but it is not the only one to address body dif- ference. Several recent narratives for young readers explore the issues of appearance and even self-fashioned modification. Mommy Has a Tattoo (2006), written and illustrated by Phil Padwe, for example, examines these subjects in the context of permanent physical adornments. The narrative tells the story of boy named James who is afraid of a new neighbor because of his many, vis- ible tattoos. “He had big tattoos all over his arms . . . and even one on his neck!” James is so frightened by the tattooed new neighbor’s appearance that he avoids talking to, waving back at, or even being outside when he is around. This situation contin- ues until his older sister tells James that he need not be afraid, for their mother also has a tattoo. The young boy is shocked and initially refuses to believe her. Their bickering (“Yes, she does!,” “No, she doesn’t!”) eventually leads the duo outside to ask Mommy herself. When they find her, she is in the yard talk- ing to the new tattooed neighbor. James ducks into the bushes so that the scary man doesn’t see him, but the hiding place allows him to closely observe the man’s tattoos for the first time, and he is struck by how beautiful and colorful they are: “He saw clouds . . . and purple sky . . .” When James leans over to try to get a better look, he loses his balance and tumbles out of the bushes. The accident affords him the opportunity to be offi- cially introduced to the tattoo man. Of course, once James begins talking with him, he realizes that neither he nor his tattoos are frightening. This realization is further reinforced when the young boy’s mother shows him her own tattoo: a pink and lavender bluebird on the small of her back. James asks if he can touch it and when he does, his ticklish mother giggles, which causes James himself to laugh, and furthers demonstrates that tattoos are not fearful. The book ends with the tattooed neighbor—who is humorously named “Mr. Too”—giving James a variety of tempo- rary stick-on tattoos, which the young boy happily wears. In the About the Author section at the back of the book, Phil Padwe

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asserts that he wrote the book out a desire for “Teaching Tattoo Tolerance.”

Joe O’Connor’s Where Did Daddy’s Hair Go? (2004) can also be grouped in this category. While the picture book does not address the subject of a parent who has voluntarily modified their appearance—by having a cosmetic surgery or getting a tattoo—it does address the issue of physical appearance and, more importantly, bodily difference. The text tells the story of elementary-aged Jeremiah, whose life is changed when a man at a baseball game shouts at his Dad, “HEY BALDY—SIT DOWN!” The comment—which his father takes in stride, joking with the man “How did you know my name?”—causes the young boy to notice his father’s lack of hair for the first time. Soon, it is all he can think about. Jeremiah tries to picture himself without hair and is alarmed by the image. When the young boy overhears his father comment on the phone “Ever since I lost my hair . . .” a few days later, he is inspired to search for his father’s “lost” hair. His quest takes him on a scavenger hunt both inside and outside of the house; Jeremiah looks for his father’s missing locks in the closets, cupboards, garage, drawers, bathtub, yard, and even toilet bowl. At one point, the young boy tries to imagine what his father might look like if he finds his missing hair. Jeremiah pictures him with everything from long feathered locks to a bushy perm and won- ders, somewhat nervously, “Would Daddy be a different person?”

Jeremiah finally talks with his father about all of his questions concerning balding, asking him whether he was born without hair, whether it hurt when his hair fell out, if his scalp bled, and if he cried when he started losing his hair. The pictures, drawn by award-winning cartoonist Henry Payne, aptly illustrate a child’s fears: one shows his father holding his head in agony; another pictures him with “Ouch-Aids” crisscrossing his bald scalp; and a third presents him sitting in a chair sobbing uncontrollably and the room already filled up to his knees with the resultant water. Jeremiah’s dad answers each of queries calmly but honestly, assur- ing him that going bald didn’t hurt, it didn’t make his scalp bleed, and while it was unsettling, it wasn’t emotionally devastating: “I was a little upset, but I realized having hair doesn’t matter. It’s who you are on the inside that counts.”

This message is reinforced the following day when Jeremiah and his family take a trip to the beach and the young boy sees

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people with an array of body types. “Jeremiah looked around at the people. They were all different shapes and sizes and colors. Some were small, others tall, some skinny, some fat.” Jeremiah even notices the variation among bald heads: “Some looked like doughnuts, others like horseshoes. Some were completely bald like the man in the moon.” This experience leads Jeremiah to another realization, and one that forms the closing comment of the book. Looking at his father and seeing the sun glinting off his bald head, the young boy tells him: “I don’t need to look for your hair anymore. I think you are perfect just the way you are.”

The message in Where Did Daddy’s Hair Go? and Mommy Has a Tattoo is not that men and women should conform to some imag- ined, uniform or ideal body type, but rather that there is a wide range of unique, wonderful and equally beautiful physiques. Each book encourages children to recognize this diversity and not sim- ply come to accept it, but celebrate it. Indeed, Publisher ’s Weekly commends Daddy’s Hair for its “thoughtful and comical aspects, which emphasize Daddy’s self-acceptance and prompt Jeremiah’s awareness of the beauty of human diversity” (“Where” 65).

By contrast, My Beautiful Mommy possesses a largely opposite theme. Rather than encouraging child readers to accept them- selves and others for who they are, it educates them about the process by which they can “correct” or at least change their physi- cal appearance. Salzhauer’s picture book asserts that, rather than human bodies existing in many shapes and sizes, an ideal exists by which we are tacitly being measured and to which we should actively strive to conform. In this way, the book advocates a homog- enized view of human appearance that frames corporeal difference and physical diversity not as elements to be feted, but as medical problems to be scientifically diagnosed and surgically solved.

Diagnosis: A Severe Case of Motherhood

Of course, the problematic physical features being treated in My Beautiful Mommy do not appear on merely any bodily form, but a post-pregnancy one. The loose skin, extra fat and sagging breasts that the mother has the cosmetic surgeon alter are the direct result of pregnancy and childbirth. In so doing, Salzhauer’s picture book adds a new component to the longstanding medical- ization of motherhood in the West.

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Feminist critics have frequently discussed the way in which the largely male medical establishment—especially the specialties of obstetrics and gynecology—have cast women’s reproductive pro- cesses as medical “problems.” As Iris Marion Young has written, “Medicine’s self-identification as the curing profession encour- ages others as well as the woman to think of her pregnancy as a condition that deviates from normal health” (408). Instead of viewing pregnancy, childbirth, and even menstruation as part of women’s natural biological processes, they see them as debilitating “conditions” requiring the interventionist treatment of (mostly male) physicians. As Phyllis L. Brodsky, Amanda Carson Banks, and Charlotte G. Borst have all written, the professionalization of medicine during the nineteenth century—with the advent of com- pulsory attendance at medical training, the rise of allopathic as opposed to homeopathic approaches to health, and the formation of the American Medical Association—transformed the stages of reproduction from being handled by women in the home to being managed by male medical professionals often in a hospital setting. For generations, for example, women experiencing their periods have been encouraged by male doctors to refrain from strenuous activity and to douche thoroughly. Meanwhile, those who became pregnant were subjected to an array of medical tests, advice, and procedures, many of which encroached on their privacy, placed unnecessary restrictions on their movement, and reduced their body to a mere vessel. These phenomena only increased during childbirth. While delivering a baby, women have been subjected to everything from epidurals, enemas, and episiotomies to having to lie prostrate in stirrups, being subjected to vacuum extractions and the removal, through shaving, of their pubic hair.

In this way, the male medical establishment largely cast women’s reproductive functions as health problems or at least “infirmities” rather than as natural bodily processes. In the words of Young once again, there is a “tendency within gynecological and obstetrical practice to approach menstruation, pregnancy, and menopause as ‘conditions’ with ‘symptoms’ that require ‘treatment’” (415). Moreover, some of the practices prescribed by medical professionals were not simply unhelpful but actu- ally harmful. Douching, for instance, which was once commonly recommended by physicians to ensure feminine health and hygiene after menstruation, is now discouraged for the way that it interferes

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with the body’s natural levels of bacteria and its attendant ability to clean and regulate itself (see Jones, “Douching,” par 3). Likewise, midline episiotomies, which had been routinely performed on women in labor, are now decreasing, given the way in which they can cause nerve damage and interfere with both sexual and excre- tive function. In a vivid demonstration of the gendered split between the realm of male doctors and the largely female realm of midwives and doulas, the latter have sometimes equated episiotomies with female circumcision (Cameron and Anderson 53). In a recent book, in fact, Caroline Sweetman groups episiotomies among various societal practices that constitute “violence against women.”

My Beautiful Mommy extends this medicalization of the female reproductive body. The narrative, written by a male surgeon, goes beyond simply casting menstruation, pregnancy, and childbirth as conditions requiring medical intervention, but casts motherhood itself. My Beautiful Mommy presents the mother’s post-pregnancy body as a medical problem or, at least, a condition that needs treat- ment. Instead of viewing her changed breasts and altered shape as the natural by-product of pregnancy, childbirth and breastfeed- ing, it views these elements as physical deformities that can be surgically corrected and scientifically cured by the male medical establishment. Far from being limited to the perspective of one fictional picture book, this viewpoint has been expressed by many factual physicians. Dr. David A. Stoker, a plastic surgeon in Marina Del Rey, California who specializes in mommy makeovers, has remarked: “‘The severe physical trauma of pregnancy, childbirth and breast-feeding can have profound negative effects that cause women to lose their hourglass figures,’ he said. His practice, Marina Plastic Surgery Associates, maintains a website, amommymakeover.com, which describes the surgeries required to overhaul a postpregnancy body” (qtd Singer, par 3; my emphasis).

Such attitudes exacerbate the pressures placed on wives and mothers by society’s already powerful beauty culture. “Many women struggle with the impact of aging and pregnancy on their bodies. But the marketing of the ‘mommy makeover’ seeks to pathologize the postpartum body, characterizing pregnancy and childbirth as maladies with disfiguring aftereffects that can be repaired with the help of scalpels and cannulae” (Singer, par 7). This attitude stands in sharp contrast to the way in which women’s post-childbirth bodies have historically been viewed. “In 1970,

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‘Our Bodies, Ourselves,’ the seminal guide to women’s health, described cosmetic changes that can happen during and after pregnancy simply as phenomena. But now narrowing beauty norms are recasting the transformations of motherhood as stigma” (Singer, par 5). Indeed, with the marketing materials for mommy makeovers detailing how pregnancy, childbirth, and breastfeeding “deforms” breasts and “disfigures” a woman’s stomach, they turn “the postpregnancy body ‘into a socially unacceptable thing’”— a condition to be diagnosed, treated, and cured (Singer, par 8). As Karen Murphy, a mother of four and author of the blog StrollerDerby aptly noted, “Those badges of motherhood have turned into badges of shame” (qtd in Singer, par 30).

∗ ∗ ∗ Even women in the United States who do not have chil-

dren have likely heard of the “Supermom.” A legendary, mythic, and even larger-than-life figure, Supermom is not simply a skilled wife, mother, and homemaker, but a perfect one. Her home is always clean, her husband is always chipper, and—perhaps most importantly—her children are always nutritiously well-fed, socially well-adjusted and publicly well-behaved. Shari Green provides a more detailed portrait of this powerful female persona:

Supermom is amazing. She’s always got her act together and is never fraz- zled and unorganized. She never goes out with her blouse mis-buttoned, and she certainly never smells like baby barf. There are no runs in her stockings. Her hair is shiny and soft, and her skin glows. There are no bags under her eyes.

Supermom’s home is tastefully decorated, spotlessly clean, and smells of freshly-baked bread (think Martha Stewart). She lovingly prepares tasty, well-balanced meals for her family. Her baby is always beautifully dressed and never screams in the supermarket. Supermom is always patient and gentle, and every night she sings her baby to sleep with the voice of an angel.

As Supermom’s baby grows up, Supermom efficiently and cheerfully juggles a successful career, volunteer work, carpooling, gym workouts, and domestic duties. She does it all, and she does it all well . (par 1–3)

As these comments indicate, akin to the comic book figures from which Supermom draws her name, there is no childrearing crisis that she can’t handle, no domestic challenge that she can’t overcome, and no parenting obstacle that she can’t leap in a

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proverbial single bound. As a consequence, in the words of Green once again, “Supermom is set up as the ideal after which mothers everywhere strive to model themselves” (par, 4).

My Beautiful Mommy adds another trait to the already daunt- ingly long—and, of course, impossibly unobtainable—standard of the Supermom. Now, in addition to having the perfect house, the perfect children and the perfect husband, women also need to have the perfect post-pregnancy body. Natasha Singer has observed, “There is more pressure on mothers today to look young and sexy than on previous generations” (par 20). For individu- als whose bodies do not naturally return to their pre-childbirth form, My Beautiful Mommy relays that they can—and possibly even should—obtain it via a surgical intervention. Viewed from this perspective, perhaps it is no longer surprising nor even vain or inappropriate that Michael Salzhauer presents his picture book persona with the physique of a comic book hero, for it seems fitting that only a “Supersurgeon” can create a “Supermom.”

Between the stresses of a successful career and the demands of home life, the pressures that twenty-first-century American society places on women in general and mothers in particular have perhaps never been greater. Salzhauer via his picture book raises these expectations even more. Although the surgeon-author claims to have penned the narrative to alleviate the fears that young children experience when a parent undergoes cosmetic surgery, his text tacitly addresses another, far different anxiety: the one experienced by many young mothers that they will not be seen as a “Supermom” who “has it all.” Ultimately, this mes- sage about possessing the perfect house, husband, children and even body is the one that My Beautiful Mommy conveys via its young female narrator to a presumably young female audience, a group who embodies—conveniently and not coincidentally—the nation’s next generation of wives and mothers.

Works Cited

“About the Author.” Page for My Beautiful Mommy. BarnesandNoble.com. <http:// search.barnesandnoble.com/My-Beautiful-Mommy/MichaelSalzhauer/e/97 81601310323/?itm=1> 21 July 2009.

Alagna, Magdalena. The Dangers of Cosmetic Surgery. New York: Rosen, 2002.

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Banks, Amanda Carson. Birth Chairs, Midwives, and Medicine. Jackson: University Press of Mississippi, 1999.

Boodman, Sandra G. “Taking a Kid’s-Eye View of Cosmetic Surgery.” The Washington Post. 22 April 2008: HE05.

Borst, Charlotte G. Catching Babies: The Professionalization of Childbirth, 1870–1920. Cambridge, MA: Harvard University Press, 1995.

Brodsky, Phyllis L. The Control of Childbirth: Women versus Medicine through the Ages. Jefferson, NC: McFarland, 2008.

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