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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 15; 335(7619): 541.
PMCID: PMC1976481
Medicine and the Media

Cosmetic surgery gets under Dutch skin

Tony Sheldon, freelance journalist, Utrecht, Netherlands

A documentary has seen thousands rally against cosmetic surgery for young people

Television programmes in the United States and Italy have been criticised in the past for trivialising cosmetic surgery and misrepresenting the realities of taking such a step (BMJ 2003;327:295 doi: 10.1136/bmj.327.7409.295 and BMJ 2004;328:520 doi: 10.1136/bmj.328.7438.520)

Now a frank Dutch documentary, in which the film-maker is shown consulting a surgeon on whether to have vaginal surgery, has ignited a campaign in the Netherlands to ban non-essential cosmetic surgery for under-18s.

In Beperkt Houdbaar (Over the Hill), broadcast in the Netherlands this month for a second time, we see Dutch film maker Sunny Bergman visiting a Los Angeles cosmetic surgeon. “You could really, really stand for a laser reduction labioplasty,” the surgeon enthusiastically declares, eventually concluding his critique of Ms Bergman's vagina with: “You need the full works, my dear.”

The price starts with “laser vaginal rejuvenation for enhancement of sexual gratification, that's $8000.” The surgeon concludes, “With that you will have that Playboy look. I guarantee it.”

Bergman asks: “But do you think I am beautiful as I am?” The surgeon replies: “It's whatever you feel. It's not for others to judge.”

Why women feel a need to change their bodies to feel good is tackled head on in Bergman's provocative documentary. It has sparked a fierce debate on the negative influence of the media and cosmetics industry on women's self image.

It stresses the huge impact of an idealised cultural norm of youth and beauty served up by television, magazines and the internet, such that by the time every girl reaches 17 she is likely to have seen an estimated 250 000 beauty related images.

Every year in the Netherlands 1 000 young women seek cosmetic vaginal surgery—but why?

One factor blamed is today's manipulation, or photo shopping, of images, almost universal in Dutch glossy and youth magazines. To illustrate this Bergman has her image manipulated with Photoshop. You watch as her image is manipulated, a line brushed out, the upper lips balanced and eyebrows straightened. You see now the “sexy and glamorous” Photoshop image next to the “ugly sister” of reality.

Since Beperkt Houdbaar was first broadcast in March more than 7000 people, including many Dutch MPs, have signed a manifesto against “the sexualisation of society” where feminine images are defined exclusively by unrealistic ideals of beauty.

The Society of Sexuology, comprising professionals working in health and education, has backed the manifesto, in particular its proposal to ban non-essential cosmetic surgery for under-18s. Its deputy chairman, Peter Leusink, says that the society is confronted with, “the consequences of an idealised feminine image.” Legal challenges are also being considered against the cosmetics industry and, this month, several magazines are to state if they use manipulated photos or whether they are “Photoshop free.”

Articles from The BMJ are provided here courtesy of BMJ Publishing Group