Rear view: the big business of bottoms
The
press briefing for October’s Clinical Cosmetic Reconstructive Expo in
London was delayed – there had been another death. A cluster of
journalists gathered on the mezzanine while below them visitors filtered
past signs for She Lase and Zero Gravity Skin and a stand for a company
called Eurosilicone that claims to have been “Empowering women for over
30 years”. At the far end of the conference hall, a woman was having
her jawline enhanced with fillers in front of a rapt crowd; the Safety
in Beauty stand was empty.
Back on the mezzanine, there was a rustle of suits as the
British Association of Aesthetic Plastic Surgeons (BAAPS) entered the
room. Apologies for the delay, one said solemnly, there has been another
death. A second British woman has died this year after a Brazilian Butt
Lift (BBL). Which made their announcement that they were henceforth
warning surgeons not to perform the procedure particularly urgent. The
brief was called “The Bottom Line”.
Bottoms are big business in 2018. For a generation whose mothers
spent mornings trying to shrink their thighs in front of Jane Fonda
videos, today there is no such thing as a bum that’s too big. The
perfect body has changed every decade over the past century, stretching
and curving over time like a time-lapse sand dune.
Body parts have come in and out of fashion depending on the
mainstream obsessions of the moment, from the lean boyish chests of
flappers in the 1920s, signifying liberation from corsetry, through 30s
bosoms and 40s legs, to the sexualised femininity of Marilyn Monroe’s
hourglass figure, and on eventually to 80s muscles (Power! Strength!),
and 90s, well, bones. Extreme slenderness was maintained beyond the
millennium, but with added breasts, a modified Monroe, minus the tummy.
“Big bums are now associated with women with attitude and a sway who are non-white, which is desired,” says Susie Orbach, the psychotherapist who has been analysing women’s relationships to their bodies for more than 40 years.
In 2012, I spoke to a group of 20-year-olds about the media pressure
to change their bodies. Rather than extreme thinness, they said the
pressure was to look sexy. “Everyone wants to look like Kim Kardashian,
not Kate Moss. Curves, not bones.” Which sounded like a positive
development, a move away from disordered eating and dangerous attempts
at control, until they pointed out that it also requires a tiny waist.
You can starve yourself bony, but “the sexy body is much more
unattainable”.
In 2014, the focus turned to the bottom. Butt lift injections and
buttock implants were the fastest-growing plastic surgery in the US, up
58% from 2012. The French sociologist Jean-Claude Kaufmann cited
economic reasons. “In uncertain times, people look for security,” he
said. “Men are attracted to women’s hips and the buttocks for security
and reassurance. Women
respond to this. It’s deeply psychological.” Or, from Jennifer Lopez:
“The bigger your butt is the more attention you get.” In 2015, the
American Society of Plastic Surgery dubbed 2015 another “year of the
rear”.
And then came the deaths, 33 of them in the US following complications from BBLs in the last five years.
Today, the aesthetic ideals of pornography have seeped into the
mainstream. If a woman isn’t built with a big bum, exercise might
reshape it, but there’s no diet that can create it, hence the booming
business in surgery and cosmetic procedures, as well as entry-level
purchases, such as firming creams and “butt lift” leggings. At an
average cost of £3,000 abroad and £8,000 in the UK, the BBL uses
liposuction to extract fat from a patient’s thighs to then inject it
into their buttocks, but less invasive treatments proliferate. Nearly
320,000 buttock augmentation or buttock lift procedures were performed
globally in 2015, according to the International Society of Aesthetic
and Cosmetic Surgery, a 30% increase in the number of procedures since
2014.
“My generation are 100% more interested in the shape of our bottoms,
rather than our boobs,” 24-year-old Beth Cobb told a newspaper,
explaining her investment in weekly bum-lift procedures using a roller
that emits microcurrents of electricity. “It’s probably because we see a
lot more celebs showing them off on Instagram. Now we have the
technology, we can make our bodies change to fit the trends, not just
change what we wear.”
Instagram, that seductive hellmouth where women
holiday in their lunchbreaks, contributes to the growth of bums in a
number of ways. There are the celebrities, yes, sharing their “belfies”.
There is the fetishisation of the bodies of black and Latina women. Kim Kardashian’s 2014 naked shoot by Jean-Paul Goude for Paper
magazine, arguably the launchpad for the body trend that is today
called “thicc”, was inspired by Goude’s (who is white) 1976 portrait of
Carolina Beaumont, who is black; the portrait was published in his book Jungle Fever.
In 2014, American Vogue declared the big bum on trend... for
white women: as soon as a trend goes mainstream, women of colour are
eliminated from the story. “So common is the process, it has its own
Twitter hashtag,” wrote Yomi Adegoke.
“#Columbising – when, like Christopher Columbus, white people think
they have discovered something that was already in existence.” There is
that. There is also the rise of “body positivity”, of women sharing
pictures of curves they’d been taught were shameful. And there is
Instagram as a platform for cosmetic surgeons to advertise directly at
women who, tipsy on the combination of insecurity and images of arses as
empowerment, will click through to adjust their own.
The latest post from Elite Aftercare, a clinic in Turkey (home of
medical tourism) is a headless portrait of a happy customer,
photographed from the front and from behind and tagged #BBL, #choices
and #mybody. Scroll through to September, and there’s an update about a
post-mortem on another of its patients, Leah Cambridge. She was a mother of three from Leeds, who, following this procedure, died on the operating table in August.
At the Expo’s press briefing, the BAAPS doctors discussed a study
analysing one London hospital where, since 2013, they’d seen a six-fold
rise in cases needing urgent follow-up care from procedures done abroad.
Complications from BBLs ranged from severe bacterial infections to
tissue dying, scarring, wound ruptures and abscesses. One patient had a
“flesh-eating” infection. BBLs have the highest death rate
(conservatively, 1 in 3,000 operations) of all cosmetic surgery
procedures, due to the risk of injecting fat into large veins that can
travel to the heart or brain. In August, a celebrity Brazilian cosmetic
surgeon, Instagram name Dr Bumbum, was charged with murdering one of his
patients. Dr Denis Furtado had performed an operation on Lilian Calixto to enlarge her buttocks in his own flat. He had nearly 650,000 followers.
“A vulnerable group of patients are openly being targeted through
social media,” said outgoing BAAPS president Simon Withey, “to travel
abroad for cheaper cosmetic surgery – and this trend is likely to rise.”
On Instagram, foreign clinics offer British customers “mummy
makeovers”, and deals where the flight is free if you buy multiple
operations – everywhere they promise that clients will feel “empowered”.
Their glamorous imagery is in stark contrast to the photos
accompanying an NHS report on the wall at the Expo, about the
complications of cosmetic surgery abroad, one of which shows a buttock
abscess being drained. “Hot!” choked a security guard, walking by.
It’s not just cosmetic surgeons who claim they can empower women. For
those who felt their bodies had been dismissed and sneered at for
decades, but now find their arses the height of fashion, the big butt
trend has been sold by the body positive movement as a step towards a
more diverse body acceptance. But… can body trends ever be a good thing?
“The move towards bigger bums isn’t a good thing,” says Orbach, “It’s a
thing. What may at first seem to mirror some women’s previously
excluded experience simultaneously excludes other women, which would be
OK if commerce weren’t riding on it and suggesting that big bums are the
solution.”
While fatalities are the most headline-grabbing result of Britain’s
new pursuit of the bigger bottom, the implications of a changing
obsession are less shocking, and more depressing. A realisation. Women
will never be comfortable in their bodies, because the goal posts of
what is acceptable keep shifting. We are encouraged to remain constantly
at war with ourselves, shrinking, growing and utilising all the
evolving technology that claims to alleviate the same anxiety that,
simply by existing, it continues to feed us. And, to do so – to try and
create your own Kardashian butt – is a rational reaction in 2018. The
alternative is to be irrelevant, unbeautiful, and therefore, unseen.
“Bodies and the surface are not our only calling card,” Orbach adds.
“We are not brands, but people who can contribute and challenge and dare
to live from our unique bodies, not facsimile ones.”
Whew. All this from a bum. How did we get here? How did we get here
from something that seemed so simple, so positive, so cheeky? A
punchline, an inherently funny aspect of being human? An arse, we’re
learning, is never just an arse. This is a trend we may need to sit on
for a while.
The bottom line
The costs, risks and significant rise of the Brazilian Butt Lift
• A Brazilian Butt Lift, or BBL, is the
colloquial term for buttock fat grafting, an elective cosmetic procedure
which can cost up to £8,000 (in the UK) and involves removing fat from
one part of the body via liposuction and transplanting it via injection
into the buttocks, for a fuller effect.
• The British Association of Aesthetic
Plastic Surgeons (BAAPS) said it was the most dangerous cosmetic
procedure to undergo. Gerard Lambe, consultant plastic surgeon,
explains: ‘It has the highest death rate of all procedures due to the
risk of injecting fat into large veins in the buttocks, that can then
travel to the heart or brain.’
• In the past five years, plastic surgeons have seen a 150% increase in the BBL business in the UK.
• In the US, the American Society for
Aesthetic Plastic Surgery has tracked a 26% jump from 2016 to 2017,
making BBLs the surgical procedure that has seen the second most
significant increase in that period – 33 people in the US have died
after the surgery in the past 5 years.
• About one in every 3,000 BBL patients
worldwide has died of a pulmonary fat embolism. Twice as many developed
chronic or serious complications.
• Nearly 320,000 BBL procedures were
performed globally in 2015, according to the International Society of
Aesthetic and Cosmetic Surgery, a 30% increase since 2014.
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Rear view: the big business of bottoms
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