Is beauty a right, which, like education or health care, should be realized with the help of public institutions and expertise? I have written about plastic surgery many times before, believing it is worth discussing. Especially when so many people like myself exercise or color their hair to look younger, fitter and “better.” My desire to have a six-pack is strictly vanity. If we want to look closer to our ideal of perfection, how can we be critical of others who resort to surgery?

So here is a very thoughtful article by Alexander Edmonds about the people of Brazil, where even those on the lowest end of the economic ladder feel that they want plastic surgery and even that they are entitled to it in a democracy, regardless of whether or not they can afford it.

(Over 10 years ago, I went to Argentina on a hunting trip with two friends who were plastic surgeons. All the locals described an obsession there with body enhancements, and there was much guessing about what was real or fake in the photographs in fashion and women’s magazines.)

This latest essay discusses one doctor’s vision of plastic surgery’s additional healing potential: to increase self-esteem…It also outlines a radical therapeutic justification for cosmetic surgery. He argues that the real object of healing is not the body, but the mind. A plastic surgeon is a “psychologist with a scalpel in his hand.”

…What is the difference between a plastic surgeon and a psychoanalyst? The psychoanalyst knows everything but changes nothing. The plastic surgeon knows nothing but changes everything.”

…Brazil’s pop music and TV shows are filled with talk of a new kind of celebrity: the siliconada. These actresses and models pose in medical magazines, the mainstream women’s press, and Brazilian versions of Playboy, which are read (or viewed) by female consumers. Patients are on average younger than they were 20 years ago. They often request minor changes to become, as one surgeon said, “more perfect.”

Dr. Ivo Pitanguy’s philosophy is disturbing for many reasons, yet it suggests a point about the significance of attractiveness often overlooked in philosophical or academic discussion. Pierre Bourdieu argued that nearly all aspects of taste reflect social class. He extends his argument to the body itself: posture, gesture, even habits of chewing food. Curiously, and almost in passing, he makes an exception for physical attractiveness. Bodies “should,” he writes, “be perceived as strictly corresponding to their “owners’” position in the social hierarchy.” And yet they don’t. “The high and mighty,” he argued, “are often denied the “bodily attributes of their position, such as height or beauty.” In other words, attractiveness is a quality that is at least partially independent of other social hierarchies. For example, the rich and well-born are not always good looking.

Beauty is unfair: the attractive enjoy privileges and powers gained without merit. As such it can offend egalitarian values. Yet while attractiveness is a quality “awarded” to those who don’t morally deserve it, it can also grant power to those excluded from other systems of privilege. It is a kind of “double negative”: a form of power that is unfairly distributed but which can disturb other unfair hierarchies. For this reason it may have democratic appeal. In poor urban areas beauty often has a similar importance for girls as soccer (or basketball) does for boys: it promises an almost magical attainment of recognition, wealth or power.