Book Review by Joselyn Quiroz PhD Candidate, Department of Sociology University of California – Los Angeles In Alka Menon’s new book, Refashioning Race: How Global Cosmetic Surgery Crafts New Beauty Standards, she identifies the ways in which cosmetic surgeons generate and apply knowledge, theory, and technique using racial categories, thereby reshaping and refashioning racial categories on an individual, interactional, and broader cultural scale. Menon examines the case of cosmetic surgery as a racial project, both in national and transnational contexts, arguing that “beauty is a key site where race is made material and embodied” (5). The book works to delineate popular discourses in global cosmetic surgery, using the U.S. and Malaysia as field sites, given that they both have racially diverse populations, a robust middle class, and stated commitments to multiculturalism. Menon identifies themes in global expert discourse among cosmetic surgeons, including standardization of techniques, crafting a “natural look”, and racialized customization. At its core, Refashioning Race creatively draws attention to the ways in which cultural meaning is fashioned and refashioned within biomedicine and popular culture by cosmetic surgeons, illuminating the discipline on how these professionals participate in race-making and reshaping through their work. Using interviews, content analysis, and participant observational data, Menon examines how cosmetic surgeons generate and apply knowledge based on racial categories, arguing that the clinical knowledge and tools used in cosmetic surgery produce “conventionally beautiful, racially legible bodies” (8). She identifies cosmetic surgeons’ use and development of racial types, which span across global expert discourses. Menon notes these racial types—race-specific standards for cosmetic surgical procedures—are a form of what Steven Epstein calls “niche standardization” (see Epstein’s 2007 Inclusion: The Politics of Difference in Medical Research for more), or knowledge generated for intermediate sized groups, like race, as opposed to knowledge applied universally for all humans or individuals. Menon finds that racial types serve as guidelines for surgeons to ensure the “ethnic preservation” of their patient’s physical appearance and not standardize or whiten their features. Menon illustrates how beauty fits in the architecture of racial meaning and inequality by using beauty culture as a site for understanding the semiotics of race. In doing so, she builds on extant research on racial disparities in health, crime, housing, the law, and other social domains. According to Menon, cosmetic surgery is, in fact, a racial project that makes racial identities “material, identifiable, and coherent” (4). Given the intertwined nature of race and beauty, Menon notes that cosmetic surgeons recognize the role race plays in human aesthetics and seek to ensure surgical interventions are natural and appropriately contextualized to racialized bodies. In her chapter on race and customization in the cosmetic surgery market, Menon uses the case of buttock augmentation procedures to illustrate the ways in which surgical alternatives to white ideals, like the Brazilian butt lift, can be celebrations of Black beauty. However, while the procedure challenged white and thin norms of beauty, it did not dissolve hierarchies of beauty, race, and class within niche specializations like Black patients. As medical practitioners with an aesthetic orientation, cosmetic surgeons hold responsibilities to their patients beyond a medical context, given their role in shaping, challenging, and rewriting narratives of racial meaning. First, they must ensure they “do no harm,” adhering to the Hippocratic oath and adequately weighing potential risks of bodily and psychological harm against patient requests for surgical intervention. Then, they generate a race-specific approach to create the patient’s desired changes and establish standards of what is appropriate cosmetic surgical intervention for a given racial category, shifting from a once “one-size-fits-all” approach toward more racial-specific standards of beauty. Finally, the surgeon must wrangle with the tension between science and art that permeates throughout their work, with their completed procedure being a negotiated outcome of such tension. Upon completing the procedure, producing the desired appearance sought out by their patient, and ensuring physical ethnic preservation, the cosmetic surgeon reshapes and refashions race on the micro level of the patient and on the macro level of the culture. While comparing U.S. and Malaysian surgeons’ scales of racial meaning and the boundaries that define them, Menon argues that cosmetic surgeons serve as cultural intermediaries—sitting at the intersection of beauty and medical industries at both a national and global scale and are tasked with mediating and maintaining relations between them. As cultural intermediaries, cosmetic surgeons “take narratives of racial meaning and elevate or reject them” (128), holding the power to both manifest and reinforce structural racism in cosmetic surgery, as well as broaden or reconfigure notions of racial pride for either surgeon or patient. How do cosmetic surgeons map physical features onto social identities, like race, and what consequences do they bring for those identities? Menon elegantly unravels this empirical puzzle by delineating the ways in which surgeons’ professional judgments about race link symbolic racial and cultural meanings into context-dependent beauty ideals at the micro, meso, and macro levels.

Beauty, like race, class, and gender, can affect life course outcomes—career aspirations may be affected by a person’s particular look, or body capital, thereby reinforcing racialized hierarchies of beauty. While racial anthropology and skull measuring have been discredited for centuries, historical legacies of such schools of thought linger in racial categorization schemes. Menon’s inquiry into aesthetic racial categorization, race-specific surgical pedagogy, and global expert knowledge exchange enhances our understanding of racial projects that transcend international borders and look beyond sociological levels of analysis. Sociologists of all specialties would benefit from engaging with a book like Refashioning Race, as it encourages us to revisit the case of beauty as a racial project and recognize that outdated racial typologies have staying power in biomedicine, popular culture, and beyond.