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Emma Krumm

Professor Kate Kimball

ENC 2135

14 November 2021

Body Dysmorphia and Cosmetic Procedures

In an age where Kardashian is king and cosmetic procedures are the new normal, it is

easy for people to feel that their appearance is lackluster and to go under the knife. Body

dysmorphic disorder (BDD) is a disorder in which those affected have an obsessive fixation on a

perceived physical flaw in their appearance (Sweis et al. 950). People who have BDD are often

unhappy with their surgical results and have worsened body dysmorphia symptoms after

cosmetic procedures. Plastic surgeons are not required to screen their patients for any mental

disorders, even though this puts both the surgeon and their patient at risk. While some argue that

it would reduce the volume of patients from plastic surgeons, mental health screenings should be

required for plastic surgery patients before they undergo surgery. I will evaluate “A Review of

Body Dysmorphic Disorder in Aesthetic Surgery Patients and the Legal Implications” and a

commercial for CoolSculpting, which relate to cosmetic procedures and their relation to body

dysmorphic disorder. By analyzing the two artifacts, it will show how the cosmetic procedure

industry targets people with body image issues and why this is harmful for the surgeon and their

client.

The first artifact, “A Review of Body Dysmorphic Disorder in Aesthetic Surgery Patients

and the Legal Implications” by Iliana E. Sweis, Jamie Spitz, David R. Barry Jr., and Mimis

Cohen, is an academic article from the International Society of Plastic Surgery. It analyzes the

issues caused by plastic surgeons’ lack of guidance on patients with body dysmorphic disorder

and suggests solutions for this issue. As a journal article for medical professionals, the piece
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utilizes elevated tone and terminology through medical and psychological definitions. It also

contains an abstract at the beginning which summarizes the main points of the article. An

important trait of the journal genre is the use of references and charts—Sweis utilizes plenty of

each. The article’s target audience is plastic surgeons and other professionals who perform

cosmetic procedures because it appears in a plastic surgery publication and uses medical

terminology. The article focuses on logos, first giving the definition for body dysmorphic

disorder from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

so that everyone understands the issue. The authors continue by describing ways that plastic

surgeons can identify BDD in their patients. They also suggest that surgeons provide a pre-

procedure checklist, which would require a patient to initial several statements, such as “I have

never been diagnosed or treated for BDD” (951). The article’s straightforward and fact-based

approach of presenting the problem and a simple solution is a good way to get plastic surgeons to

favorably consider its ideas.

Another example of logos is when the journal article cites specific percentages from

surveys: “Sarwer conducted a survey of plastic surgeons which found that 84% admitted to

performing surgery on a patient with BDD without recognizing the diagnosis until post-

operatively” (952). The audience of medical professionals is likely to be persuaded by the

statistical analysis, and ethos is gained through citing the credible survey. The artifact next

recalls the case of Lynn G v. Hugo and describes how a patient who had BDD tried to sue the

surgeon who operated on her (952). Logos is displayed through the details of the court case and a

definition of informed consent, which was a large part of this case. While the surgeon ended up

winning this case, the journal notes that a case like this would not have been dismissed if the

patient had been diagnosed with BDD by a mental health professional prior to their plastic

surgery. This emphasizes the need for background screening of patients for cosmetic procedures,
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not only for the good of the patients, but also for the safety of the doctors. Thus, the audience can

see the personal benefit to conducting the screenings. We as readers can see the amount of

research that went into the journal article through the use of surveys and court cases, so it feels

more credible.

“CoolSculpting Commercial (60 sec),” posted by La Jolla Plastic Surgery & Dermatology

to YouTube, is a commercial for CoolSculpting, a cosmetic procedure for slimming down fat. As

an advertisement, the commercial is trying to sell us something—in this case, it is a cosmetic

procedure, CoolSculpting. It fits in with the advertisement genre by using attractive people and

convincing the audience that their life will change for the better if they get CoolSculpting

procedures. It also fits in with the genre by using a bright, clean, white background for most

scenes. In the commercial, patients who have undergone CoolSculpting procedures give

testimonials as their before and after pictures are shown, which establishes both ethos and

pathos. The audience for this commercial is people who want to appear slimmer, so it builds

ethos to have people who have had these procedures done describe their experiences. In the

video, there is imagery shown of people looking in the mirror, squeezing at their fat, and looking

dissatisfied. Following this, a solution is presented: CoolSculpting. The commercial presents a

relatable situation for many people (especially for those with BDD or eating disorders) and

immediately begins to convince their audience that they need to get CoolSculpting done.

While presenting CoolSculpting as a solution, the commercial uses logos. It describes the

process of CoolSculpting and how it works: “Patented cooling technology targets and kills fat

cells with no surgery or downtime” (00:00:26 – 00:00:32). While this information is presented, a

scientific graphic is shown of a figure with fat cells shrinking and disappearing. Viewers of the

commercial need to know how the procedure works and how much time it takes to heal in order

to choose if they should get the procedure done or not. In another testimonial, a woman named
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Anne describes how the procedure eliminated some of her insecurities: “I don’t have to think

about what I wear anymore and how it’s going to make me feel… And that’s a new feeling!”

(00:00:40 – 00:00:48). Pathos is used to play off the viewer’s potential unhappiness with their

body. The commercial tries to convince the audience that their lives will also improve if they

receive CoolSculpting procedures, just like Anne. We can, too, wear whatever we want to wear

and feel good about our bodies.

The artifacts differ from each other in many ways, from target audience to rhetorical

appeals. While they both relate to plastic surgery, only the first artifact directly covers body

dysmorphia and cosmetic surgery in an analytic way. It aims to convince plastic surgeons to

screen their patients for body dysmorphic disorder using mainly logos with definitions, surveys,

and court cases from the past. The academic journal article is straightforward with its points and

lays out the problems with failing to screen plastic surgery patients and how to solve these

problems in a simple way. In the commercial artifact, a cosmetic procedure called CoolSculpting

is advertised to people who are unhappy with their bodies using ethos, with past patients

expressing their satisfaction with their results and showing their before and after pictures. It also

uses pathos by having a past client describe the ways her life has improved for the better after

having CoolSculpting procedures done, making people who are unhappy with their bodies—and

possibly suffering from BDD—want to get CoolSculpting. As a commercial, it is visually

stimulating and shows before and after pictures, a diagram of fat cells shrinking, and imagery of

people looking in the mirror and grabbing at their fat. Both of these artifacts present sides of the

argument for body dysmorphia and cosmetic procedures, although they are different sides of this

argument. While the advertisement indicates that CoolSculpting will make everyone happier, the

journal acknowledges that some people will be harmed by cosmetic procedures. The pieces argue

against each other; the CoolSculpting commercial shows how people with body dysmorphic
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disorder are persuaded to get cosmetic procedures by showing imagery that they can relate to,

while the journal shows how harmful this really is for surgeons and their clients.

In the past, plastic surgeons have not done background screenings for mental illnesses,

which is detrimental to patients who have body dysmorphic disorder. Plastic surgeons should

make sure their patients do not have BDD before operating on them in order to protect

themselves and their patients’ mental health. These artifacts show how people with BDD may be

easily convinced to get cosmetic procedures. The first artifact shows the problems that arise

because of this, such as lawsuits and worsening issues in clients with BDD, while the second

artifact shows how the cosmetic industry can be alluring to patients with BDD, convincing the

audience that that their lives will improve if they get CoolSculpting procedures done. The plastic

surgery board should provide guidance on how to handle patients that surgeons suspect of having

BDD and should require mental health screenings on patients. It helps the patients, because

people with BDD get worse symptoms post-surgery and these patients can receive help with their

mental health after being diagnosed. Screenings would also protect the surgeons from danger

through lawsuits. Providing guidance on the topic would make many cosmetic surgeons

reconsider their current practices. In our current society where plastic surgery is constantly

promoted as a solution for insecurities, plastic surgeons should make sure that they are not

operating on someone whose mental health would be further damaged by a procedure.

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Works Cited

La Jolla Plastic Surgery & Dermatology. “CoolSculpting Commercial (60 sec).” YouTube, La

Jolla Plastic Surgery & Dermatology, 24 Apr. 2015, youtu.be/Dk-H3l5ihUg.

Sweis, Iliana E., et al. “A Review of Body Dysmorphic Disorder in Aesthetic Surgery Patients

and the Legal Implications.” Aesthetic Plastic Surgery, vol. 41, no. 4, 2017, pp. 949–954.

Reflection on Essay #2 Revision

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I chose to revise Essay #2 because I got a lower grade on it than Essay #1 and there

appeared to be more comments about changes I could make to improve it. I started my revision

process with rereading the essay and the constructive comments, and reviewing both of the

artifacts again. I noticed a couple of things that needed editing, but what jumped out at me first

was the thesis statement. As the comments indicated, it was quite wordy and complicated for

readers to understand, so I simplified it to state the basics of how the two artifacts communicate

with one another. “By analyzing the two artifacts, it will show how the cosmetic procedure

industry targets people with body image issues and why this is harmful for the surgeon and their

client.” I noticed that with the changes, I was repeating some of the points that I had already

made in the introduction paragraph, so I also took those sentences out.

I also noticed that, as the comments indicated, the body paragraphs in my essay were

much too long and needed to be split into different sections. I went through and tested different

places that I could split the paragraphs up before I settled on splitting them roughly in half by

separating them when I move on from discussing the first rhetorical component to the second

rhetorical component. This makes it less daunting to read through the paper, because there are no

longer any paragraphs that take up a whole page.

Reading through, I realized that I described many more rhetorical components than I did

genre traits. I decided to add a few more sentences describing genre traits for each artifact. For

my first artifact, I added a sentence about how journals use lots of references and charts. I also

added a sentence describing more clearly how some of the genre traits affect the audience it

intends to reach. For the second one, I added a sentence about the way it uses bright colors and a

clean, white background to get the viewer’s attention.

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I noticed that my comparison paragraph seemed a little lackluster, compared to my other

paragraphs. Previous to the revision, I had basically just restated what I had already noted in the

other body paragraphs. I wanted to talk more about how the articles fit together in the

conversation and compare them more, because I had previously mainly contrasted them. I added

a sentence to clarify the two different sides of the argument presented by the two artifacts, and

another to show how the commercial can be directly harmful to people with body dysmorphia.

I tried to incorporate all of the suggestions that were made, as well as strengthening areas

of the essay that I noticed were weaker, like the thesis sentence and the comparison paragraph.

Reading through, my essay is much clearer and better conveys my idea that patients should be

screened for body image disorders before undergoing cosmetic procedures.