The rise of the cosmetic nation: plastic governmentality and hybrid medical practices in Brazil.

In this article, I trace the historical and sociopolitical construction of plastic surgery as a basic health need in Brazil. I argue that plastic surgeons deploy "plastic governmentality" in order to portray their work in public settings as humanitarian in nature, while simultaneously using poor patients as experimental subjects to train new surgeons and develop new techniques. This seemingly contradictory positioning is only possible because aesthetic surgeries are relabeled as reconstructive surgeries, producing a pliable form of statecraft that uses statistics and medical discourse to reinforce the support of the state and civil society for the practice. The form of governance I describe elucidates how the state can become instrumentalized in the benefit of private interests under neoliberalism, and how unprofitable public health needs are rendered invisible by the very biopolitical forms of governance that claim to address those needs.