The physical examination in cosmetic surgery: communication strategies to promote the desirability of surgery.

Cosmetic surgery is a controversial medical practice that is rapidly expanding in the United States. In 2004 alone, 9.2 million procedures were performed. From breast augmentation to tummy tuck, Americans are taking surgical/medical/health risks to alter their bodily appearance. Although many scholars have criticized the practice, few have looked closely at how plastic surgeons interact with prospective surgical candidates. This essay explores videotaped data of naturally occurring interactions between plastic surgeons and patients seeking to transform their physical appearance. Drawing on action-implicative discourse analysis (Tracy, 2005), the article describes plastic surgeons' embodied and discursive activities during a typical physical examination. The core analysis shows how the patient's body and its aesthetic features can be used by plastic surgeons as interpretive resources to promote the desirability of surgery. By touching excess tissue, pinching it, moving it, or applying tools and artifacts (e.g., tape measurer) on and around the body, plastic surgeons literally bring to life patients' bodily "flaws." Through their multimodal performance, I argue, plastic surgeons mark the desirability of surgical transformation. As medicine meets consumerism, medical activities turn persuasive, incrementally constructing the patient's body as a territory of surgical need.