More Than Skin Deep: Exploring the Real Reasons Why Women Go Under the Knife

San Francisco plastic surgeon Eskenazi denies that most of her female patients who undergo breast enlargements, face-lifts, liposuction and other cosmetic operations are insecure dupes of an ageist, "female-hating culture." Rather, cosmetic surgery is but a modern version of an ancient rite of passage that celebrates life stages by marking the flesh, thereby filling "the hole left in the fabric of our communal life by the loss of ritual." Like the ancient initiate, the modern patient leaves her identity behind as she strips off her street clothes, is purified by antibacterial scrubs, prostrates herself on the altar of the operating table, undergoes a death/rebirth sequence of anesthesia and wakes up to a body that is marked and transformed. To this end, Eskenazi's patients work with ritualists and psychotherapists, keep dream journals, build altars, practice meditation and create prayers to accompany surgery. Aided by Streep (Necessary Journeys ), Eskenazi posits an interesting myth-infused approach that will be embraced by like-minded readers. Others will see this as preposterous New Age babble served up by a rationalizing doctor who wants to see herself as a shaman and her patients' desire for bigger breasts as a spiritual, high-minded quest. (Feb. 6)