Beauty and the Nose

In sharing ‘news from home’, Leslie, a young Peruvian woman in my Italian language class, recently reported that her sister was recovering from nose surgery. The operation corrected disfiguration sustained in a car accident several years ago, but Leslie went on to say that nose jobs in South America were very, very common.

That was news to me. Are nose jobs really more common in South America than in other parts of the world, and if so, is there a reason, cultural or other, to explain this?

A quick internet search revealed numerous advertisements and forums promoting cheap, quality nose jobs. Former patients, mostly from North America, praised the medical standards of the South American surgeries. But as Leslie implied, there is far more to the South American nose job than medical tourism.

According to a 2010 article by the BBC, ‘Cheap nose jobs are changing the face of Bolivia’, and indigenous people, in particular, are the target of plastic surgery campaigns. The subject raises the standard issues concerning cultural assimilation: dominant culture ideals of beauty, cultural discrimination based upon these ideals, the threat to non-dominant cultural identity, the ‘solution’ of assimilation, and, of course, economics.

In Bolivia, one of the most impoverished countries in South America, nose jobs are about a fifth of the cost of other countries, and for some low-income patients, surgery is available at a reduced cost – or even free. While the nose jobs – which for Bolivia’s Aymara or Quechua ethnic groups usually mean nose reductions – significantly increase self-esteem for some, for others the ‘democratization’ of plastic surgery comes at a cultural cost. ‘I think cosmetic surgery is an effect of the global and Western idea of beauty that is now ruling the world’, says Pablo Groux, Bolivia’s former minister of culture and an expert on issues of indigenous identity.

According to Richard Herrera, who runs a plastic surgery in Bolivia’s capital of La Paz, the campaigns were started ‘with the aim of reaching out to impoverished people, to help the people with no access to surgeries. So we developed a low-cost surgical package, we have special prices; special discounts to poor people and in every campaign we even operate on some patients for free. People that never thought about surgery, not even having access to a specialist, now they do and they feel they need that change of image’.

Whether these medical campaigns are providing positive solutions to pre-existing ‘problems’ or, instead, are exploiting Bolivia’s ethnic poor may depend upon one’s perspective (see, however, the critique below). In any case, by offering Bolivia’s indigenous ethnic groups affordable nose jobs, personal self-esteem and cultural identity remain at the mercy of the medical market place.


But the current news of the noses actually takes us to Afghanistan, where bigger is more beautiful. In the last year, a number of news stories have covered the emerging cosmetic surgery industry in Afghanistan, now rich in surgeons with years of experience working with the war wounded. New personal and economic freedoms are offering opportunities to change one’s looks. Yet, like Bolivia, there is a distinct ethnic dimension to the practice.

The New York Posts summary of an article published by The Sunday Times (Oct 7, 2012) cuts to the chase, if rather crudely:

‘Bigger is better — especially in Afghanistan. Westerners may go under the knife to reduce their noses to button-shaped perfection, but a growing number of Afghans are clamoring for bigger schnozzes to conform to the Pashtun ideal of beauty. . . . Nose enlargement is the most popular procedure at the Hamkar hospital in western Kabul, where Dr. Daud Nazari can barely keep up with demand. Many of Nazari’s patients belong to the Hazara minority, who feel out of place in Afghan society with their eastern features and flatter noses. Others simply want to refine their looks to bag a good husband. . . . A nose job in Kabul costs about $300, meaning that even for some Afghans on lower incomes, beautification is within reach’.

And earlier this month, Noorjahan Akbar posted a blog on UN Dispatch (November 13, 2012) critiquing the UK’s Channel Four recent documentary, Nip, Tuck Kabul (September 29, 2012) on the grounds that it perpetuates racist standards of beauty.  Her comments are worth citing at length:

‘The story of a young woman, Shaheda, who has saved several months’ salary to get her nose enlarged, is highlighted in the story. Shaheda is glorified as her decision to change her ‘flat nose’ is portrayed as an example of personal freedom. The case of Mrs. Zalmay who is being pressured by her husband to get a nose job is another narrative brought to light. . . .

‘The filmmakers are quick to call these cosmetic surgeries ‘freedom of choice’. Phrases like ‘promise of emancipation’, ‘new-found freedom’ and ‘symbol of free choice’ are used liberally to describe the operations. The women and men undergoing cosmetic surgery are commended for defying rules about how they must look, which the narrator argues have been created by religious leaders. The film ends with the thought that women like Shabnam and Shaheda represent the ‘new Afghanistan’, if there is such a thing.

‘Medical ethics and standards of beauty are tied with cosmetic surgery everywhere in the world. Afghanistan is no exception. Cosmetic surgery in Afghanistan is tied to bigger questions of racial, ethnic and gender hierarchy and standards of beauty. Shaheda and Shabnam are both women from the Hazara ethnicity in Afghanistan. These two women receive facial surgery to ‘fix’ her ‘flat’ nose and lift her ‘baggy’ eyes respectively. Both facial features are more common, though not exclusive, to Hazara people in Afghanistan. These women, in other words, are at the  cosmetic surgery clinic to erase from their face, literally, their ethnic identity.

‘According to Nip, Tuck Kabul, men and women make the choice to disguise their ethnicity, and this should be celebrated as an act of personal freedom and rebellion because for too long religious leaders have determined how people should look. The underlying hypocrisy in the film is that it ignores that women and men are changing their faces because of other rules that exist in the society about their facial features, rules that are racially-based. It is not freedom of choice for racial minorities to change their looks to conform to the majorities’ standards of beauty. If it is wrong for religious leaders to make rules about appearance, it should be equally unacceptable for racial hierarchies to set standards of beauty.

‘The documentary, though it mentions that many are undergoing surgery to conceal their ethnicity, ignores the racial, ethnic and gender hierarchies of the business and continues to call these modifications ‘acts of freedom’. It overlooks that many of the customers are Hazara women who change their looks because of the inferiority assigned to their physical features by a culture that views big eyes and tall noses as superior and values women based only on their appearance.

‘By not questioning the motive of these surgeries, the documentary, like those receiving surgeries, assumes that in fact big noses are ‘better’, or ‘in-fashion’, as the anchor phrases it, and that ‘Hazara’s flat noses’ must be ‘fixed’ and ‘concealed’ for being somehow ‘inferior or ugly’. Nip, Tuck Kabul perpetuates the racist standards of beauty that exist in the Afghan culture by calling these surgeries liberation and freedom of choice’.


From Khaled Hosseini, The Kite Runner:

‘They called him ‘flat-nosed’  because of Ali and Hassan’s characteristic Hazara Mongoloid features. For years, that was all I knew about the Hazaras, that they were Mogul descendants, and that they looked a little like Chinese people. School text books barely mentioned them and referred to their ancestry only in passing. Then one day, I was in Baba’s study, looking through his stuff, when I found one of my mother’s old history books. It was written by an Iranian named Khorami. I blew the dust off it, sneaked it into bed with me that night, and was stunned to find an entire chapter on Hazara history. An entire chapter dedicated to Hassan’s people! In it, I read that my people, the Pashtuns, had persecuted and oppressed the Hazaras. It said the Hazaras had tried to rise against the Pashtuns in the nineteenth century, but the Pashtuns had ‘quelled them with unspeakable violence’. The book said that my people had killed the Hazaras, driven them from their lands, burned their homes, and sold their women. The book said part of the reason Pashtuns had oppressed the Hazaras was that Pashtuns were Sunni Muslims, while Hazaras were Shi’a. The book said a lot of things I didn’t know, things my teachers hadn’t mentioned. Things Baba hadn’t mentioned either. It also said some things I did know, like that people called Hazaras mice-eating, flat-nosed, load-carrying donkeys. I had heard some of the kids in the neighborhood yell those names to Hassan’.


Also see Born Pakistani, He Died a Hazara in The International News (May 31, 2012).

About Rodney Aist

Rodney Aist, Ph.D. is the course director at St George's College, Jerusalem. Visit him at
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