Abstract
In Botox Nation: Changing the Face of America, Dana Berkowitz examines the history of Botox, how Botox has been marketed to potential consumers, and the growing consumption of Botox. In addition, she studies the “turf war” within the medical community directly related to Botox, how individuals become Botox users, what it means to have undergone Botox procedures, and finally, the agency behind Botox bodies. Berkowitz explicitly notes that the goal of her book is to “interrogate how Botox makes visible the ways that cultural norms and social inequalities are mapped onto bodies, how gender is significant in the production of bodies, and how bodies become the object and subject of consumption” (p. 7). She effectively addresses these goals and answers her research questions. Berkowitz utilizes qualitative methodology including semistructured interviews of both practitioners and patients, document analysis, and historical framing to examine her research questions. Overall, this examination is clearly organized and is well-written.
Berkowitz acknowledges that the main consumers of Botox are white women and thus she focuses primarily on the experiences of white women of various social classes, though men and a few people of color are represented and discussed in this study. In addition, she underwent Botox herself as a part of her study though this does not appear to be something she had originally set out to do as a part of the research process.
Berkowitz’s discussion of the growing “turf war” within the medical community and the history of Botox was fascinating. She examines how this toxin was developed and the perspectives of those who perform these procedures. For example, several participants explained how this toxin must be used carefully and should not be used by just anyone. Berkowitz notes that there were various arguments made by the medical community when discussing who were appropriate medical staff (yes, some individuals do not have to be doctors to use it) to administer the drug or to perform the procedure. Some individuals discussed how someone who had been trained (even if only in brief trainings) and had a keen eye could be perfectly capable of performing the procedure while plastic surgeons and even dentists argued that those who perform this procedure needed more training.
As a sociologist who specializes in inequality, I found her discussion of social class a bit lacking. I wanted to know more about the women of all classes who undergo Botox—and not just the few she mentioned about waiting for their tax returns to get Botox. She noted that Botox costs about $300 (which is not covered by insurance) per treatment and this would need to be performed again within four to six months (p. 102). On this note, her discussion of Botox and the positive effect this had on careers as well as how individuals were perceived by others (ranging from bosses, coworkers, to students). She also discusses how many women in her study use Botox as a preventative measure (the youngest participant in her study was 19—though not the average participant or user). In addition, she thoroughly discusses how first-time Botox users would often get into it because of a good deal they encountered. She also discussed how some even got it free (much like how drug dealers may give someone a trial) assuming that the person will love the experience and then return for more.
Although Berkowitz examines a very interesting phenomenon, I am left wondering how expansive or generalizable her research is. Her focus on white women, the majority of whom are middle to upper class, and individuals who live in major metropolitan areas (such as Miami and New York), makes me wonder if this is a nationwide phenomenon. A stronger discussion of the importance of place is warranted though she does discuss the significance of these specific locations, but generalizing to the entire nation seems a bit presumptuous. With this in mind, she addresses stigma related to having Botox and how conspicuous consumption plays an important role in her participants’ lives. For example, participants discussed the fine line between looking younger and looking “Botoxed.” She also explains that individuals who have had Botox may not disclose this information to others for fear of judgment and backlash.
Berkowitz’s research may be useful for scholars to use in upper-level undergraduate sociology or women’s studies courses that are focused on gender and the body since this book discusses experiences that are not openly discussed and directly related to gender norms. This research may be an uncomfortable read for feminists who see the growing objectification of women’s and men’s bodies as problematic, especially as it relates to neoliberalism.