This chapter presents our theoretical approach to cosmetic surgery and its discourses. We argue that cosmetic surgery tourists are seeking value, and that for many of those we spoke with, their bodies were the only asset it was possible for them to invest in. We argue that existing feminist theories of cosmetic surgery fail to account for material, fleshy bodies that change over time. Whilst most cosmetic surgery theories point to an external (‘perfect’) body of popular culture to which the cultural dopes of cosmetic surgery are subject, we point instead to instances of melancholy for a lost body, when comparisons are more often with one’s own body as it used to be than with ‘image culture’. Images do however provide guides and possible styles: when one wants to change one’s body, one has to illustrate how. So, while we do not see cosmetic surgery as totally outside any regime of images, we argue that images have a more complex and nuanced role than cosmetic surgery discourse allows. The chapter includes a discussion of the PIP scandal as a way to interrogate the workings of this discourse.

in Beautyscapes

This chapter challenges some of the dominant framings of international medical travel through a discussion of the shifting geographies that have reshaped patient flows, redefined centres of excellence and expertise, and redrawn the world map of medical tourism. We show how cosmetic surgery tourism has ‘decentred’ previous models of medical travel, drawing on previous discussions of South–South, cross-border and regional patient movements. We explore how our empirical work and its theorising helps us in decolonising and disorienting understandings of how cosmetic surgery tourism is assembled geographically – where geography is as much imagined as it is a material reality. Using insights from fieldwork in South Korea, Thailand and Tunisia, we counter the dominant view of footloose global elites gliding seamlessly around the world in search of transformation. Our patient journeys were very different, often leading to disorientation.

in Beautyscapes

This chapter outlines the theoretical framing of medical tourism that we deploy in the analysis presented in Beautyscapes. It draws on Appadurai’s notion of disjunctive global flows and ‘scapes’, combining this with insights from work on networks and from assemblage thinking, in order to theorise how cosmetic surgery tourism is assembled by heterogeneous actors, and to show how this coming together is contingent and emergent. Global flows come together in particular places at particular times, and this notion helps us understand the comings-together that characterise cosmetic surgery tourism. Empirical detail drawn from our fieldwork enables us to develop a nuanced analysis of how networks are assembled and how cosmetic surgery tourism takes place and makes place. Our analysis is guided by a further conceptual framing that we also introduce in this chapter: Mol’s discussion of the logic of care and the logic of choice. Rather than simply counterposing these two logics, we see them as intricately entangled in the ways in which cosmetic surgery tourism is understood by the many actors with a stake in it.

in Beautyscapes
Abstract only

This chapter consists of a plate section of forty-three colour images.

in Beautyscapes
Caregiving companions and medical travel facilitators

This chapter begins an exploration of the forms of work or labour that are brought together to make cosmetic surgery tourism happen. The analysis is framed by discussions in the sociology of work about care work, body work, emotional labour and aesthetic labour. The chapter opens with an overview of the cosmetic surgery tourism industry to provide context for the analysis of forms of work. The remainder of the chapter focuses on forms of work undertaken by those who travel with cosmetic surgery tourists and the various intermediaries who work to facilitate surgical journeys. In the former category we show how informal caregivers who travel with patients perform a vital function in enabling and supporting those travelling for surgery. In the case of intermediaries, facilitators and coordinators, we explore how this novel set of roles has emerged as a new business sector with increasing heterogeneity and complexity. We provide a typology of medical travel facilitators (MTFs), drawing on our ethnographic material to show who these workers are and the forms of work they perform. We show that MTFs occupy a central but contested position in the cosmetic surgery tourism assemblage.

in Beautyscapes
Health workers and patients

This chapter discusses the work of nursing staff and surgeons in cosmetic surgery tourism. For surgeons, our research uncovered ambiguities surrounding professional standing and identity, and we explore how surgeons narrate their career trajectories and the pride they have for their work, as well as how they attempt to head off criticisms of their specialism. The discussion draws on sociological research on care work, body work, emotional labour and aesthetic labour. We discuss how surgeons negotiate an increasingly entrepreneurial role, showing how tensions emerge in their interactions with medical travel facilitators. We show how key moments such as the clinical consultation frame both doctors’ and patients’ understandings of surgery. The consultation is not simply about surgeons asserting their professional authority over ‘duped’ patients; instead, it is a negotiation towards a desired outcome for both parties. This leads us into a discussion of the forms of work that patients themselves undertake in cosmetic surgery tourism. Rather than passive recipients of others’ labours, patient-travellers work hard to accomplish their surgical journeys – and some later capitalise on this work by themselves becoming medical travel facilitators and guiding others through the same journeys.

in Beautyscapes
Open Access (free)
Race, class and school choice

All in the mix: class, race and school choice considers how parents choose secondary schools for their children and makes an important intervention into debates on school choice and education. The book examines how parents talk about race, religion and class – in the process of choosing. It also explores how parents’ own racialised and classed positions, as well as their experience of education, can shape the way they approach choosing schools. Based on in-depth interviews with parents from different classed and racialised backgrounds in three areas in and around Manchester, the book shows how discussions about school choice are shaped by the places in which the choices are made. It argues that careful consideration of choosing schools opens up a moment to explore the ways in which people imagine themselves, their children and others in social, relational space.

Open Access (free)

This chapter turns directly to the question of school choice – to examine how parents experienced the injunction to choose. It finds that, for many, the feeling that they had ‘no choice’ increased stress and anxiety around schooling. Nonetheless, the feeling of having ‘no choice’ often included a prior disregarding of some schools that their children could reasonably be expected to gain admission to. The chapter also explores what parents said about both private provision (including private Islamic schools) and state selective schools in the form of grammar schools. Approaches to school choice, including to private and selective education, also varied by area. The chapter considers the ways in which parents talked about processes of choice and focuses on one particular account of a mother living in Cheadle Hulme which shows the anxiety that trying to get the best outcome for your child sometimes produced. It shows that previous work on school choice, which tends to focus on the concerns of the professional (white) middle classes, may risk underestimating the ways in which worrying about schools and education is shared across class and ethnic differences.

in All in the mix
Open Access (free)
in All in the mix
Open Access (free)
Negotiating with multiculture

This chapter focuses explicitly on parents’ discussions of ethnic diversity. These are put in the context of policies around multiculturalism and integration in which schools have been a key policy site. Parents were more likely to consider diversity as something related to race or ethnicity rather than class. The chapter contends that we lack a differentiated vocabulary for discussing diversity and ‘mix’. Furthermore, there are distinct discourses around ethnic diversity circulating in the different areas, with parents in the area with the least ethnic diversity, in particular, expressing reservations and fears about increasing diversity. Parents of BME children have a particular stake in seeking out schools with an ethnic mix as they see those schools as potentially offering their children security against the racism and racialised othering which they might face in more white schools (and which the parents themselves may have experienced in their own schooling in Britain). Thus the book argues that it is critical that we consider questions of both class and race when understanding parents’ views about school choice, but that we should also be attentive to ways in which ideas and imaginations of place frame parents approaches to schooling and education.

in All in the mix