The increasing incorporation into cosmetic medical practices of “complementary services” such as skin-care advice, massage therapy, and nutrition and weight loss counseling, to mention only a few, and the proffering of medical services and products by nonmedical businesses like spas have made it nearly impossible to distinguish between the retail beauty industry and cosmetic medicine. Some writers have referred to this as the “medicalization of beauty.” I would argue that what is happening is the reverse: the demedicalization of health care proffered in the service of beauty and other vanity concerns.
The cosmetic medical message is often less about medicine and more about product, and products and services are sold by the same psychological methods developed one hundred years ago. “Cure your inferiority complex” has become “improve your selfesteem.”
Cosmetic medical marketing predictably aims to cultivate a fantasy that begs to be fulfilled or to create a sense of anxiety that demands relief, and often does so by presenting images of “patients” who are evidently enthralled and satisfied with their results and their new lives. You do not have to be harboring a long- held secret wish to undergo a cosmetic intervention; you just need to be receptive to the suggestion that changing a feature or features might improve your life. Marketers know the perfect pitch: “Our product can earn you the recognition that you deserve, which makes it well worth the price.”
No matter where one stands on the endless debate as to whether fashion is the result of consumers influencing industry or of industry manipulating consumers, one thing is certain: Industry leaves no avenue unexplored in the search for ways to sell products. Every form of media is used to sell beauty and cosmetic medical care, and visual media magazines, television, the Internet reign supreme. The Internet is an especially potent hybrid of static and dynamic imagery plus virtually limitless interactive capabilities and will undoubtedly revolutionize marketing in the future.
The marketing approach to cosmetic medical care refl ects our primary cultural drive to want more and better and is not unique to this segment of medicine. Numerous observers have bemoaned the allegedly industry-driven “sickening” of Americans with widespread diagnoses of often asymptomatic conditions; they cite high cholesterol, low thyroid hormone levels, osteoporosis, erectile dysfunction, high blood pressure, executive dysfunction, sleep disorders, mitral valve prolapse, gastroesophageal reflux, arthritis, irritable bowel syndrome, anxiety, depression, chronic fatigue syndrome, and a variety of other states, for many of which drugs are recommended for treatment.
The inevitable effect of mass diagnoses of these at times variably or poorly defined conditions is, of course, big profits for pharmaceutical companies, which are mostly responsible for the spread of the messages and sometimes even manage to redefine the test criteria by which the diagnoses are made. Cosmetic medicine is sold in much the same way: Normal body conditions are redefined as deformities that should not be tolerated, especially because products and procedures to correct them are available.
As with any newly launched treatment for an incurable problem, certain cosmetic procedures and products receive tremendous press coverage of early claims far in excess of what is warranted by the scientific evidence. Just as the diet drug combination fen-phen was at first widely praised by the media, diet doctors, and Wall Street, yet in time proved to be potentially lethal, so are unproven cosmetic therapies, such as mesotherapy for cellulite, machines for nonsurgical facelifts, and hormone treatments for various signs of aging, regularly and prematurely lauded in the press.
Fortunately, many cosmetic therapies turn out to be more useless than harmful, yet most of the public interest and demand for them is generated through marketing soon after release, well before most potential complications or long-term effects are known. The basic approach by manufacturers and, unfortunately, too many providers to marketing new drugs and technologies is simple: Exaggerate the benefits, underplay the risks, and convince customers of a need they didn’t know they had.
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