What Stories About Botched Plastic Surgery Miss

The problem with fixating on botched-plastic-surgery stories

In the music video for "Rumors," released last month, two of music's most controversial figures cast themselves as goddesses but speak candidly about the joys and challenges of being Black women in unruly bodies here on Earth. Decked in gold all the way to her press-on nails, the singer Lizzo addresses the people who have taken umbrage at her confidence as a fat Black woman. Cardi B, then visibly pregnant with her second child, perches atop a throne, her torso uncovered but for a custom-made gold breastplate. "All the rumors are true, yeah / Fake ass, fake boobs, yeah / Made a million at Sue's, yeah," she raps, a reference to the now-defunct strip club where she danced before finding fame as a reality-TV personality and later as a rapper.

On its face, "Rumors" is a catchy and self-deprecating callout of haters. But the song is also about the impossibility of navigating the music industry—and the world—as Black women who are either too fat or too pregnant or too fake to be valued. Both women face constant commentary on their bodies and what they choose to do with them: To hear their critics tell it, Lizzo promotes obesity by simply existing in public; Cardi is a bad mother because she bares her surgically enhanced breasts, even while pregnant.

After the "Rumors" video premiered, Lizzo broke down about all the body-shaming she received in response. Cardi, meanwhile, has spoken candidly about her experiences with cosmetic surgeries in the past, including the ones that helped her make that million at Sue's. In a 2018 GQ profile, she recounted the experience of getting illegal butt injections in a Queens basement while working as a stripper, the job that enabled her to get back on her feet after an abusive relationship: "They don't numb your ass with anything," she told the magazine of the $800 injections, which leaked for days afterward. "It was the craziest pain ever."

That might sound like an astonishing physical toll for an idealized body, but Cardi's story—and Lizzo's, and so many others’—illustrates the immense pressure that Black women face to conform to a specific beauty standard. "There's a little bit of an assumption, or a preconceived notion, that all Black women should at least have shapely buttocks or hips," Aisha Baron, a plastic surgeon based in the Atlanta area, told me. "I see patients come in a lot of times and they’re like, ‘Oh my gosh, I’m the only one in my family that doesn't have a butt or doesn't have any shape.’"

This is a pressure that asks Black women to have a perfect body and to have gotten it the right way. It's a pressure that is inescapable, especially now that social-media algorithms encourage young people, particularly girls and women, to compare themselves with celebrities, models, and influencers whose looks seem more attainable despite being no less altered. And it's driven some women to spend their money and risk their lives in pursuit of acquiring value—interpersonal, economic—in a society that has always held up white women as the physical and moral ideal.

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Though white women remain the demographic most likely to seek cosmetic procedures, the surgery that's been omnipresent online for the past several years is one more often associated with Black women. Gluteal-fat grafting, typically referred to as the "Brazilian butt lift" or just BBL, is a complex procedure in which fat is suctioned from certain parts of the body (usually the midsection, back, and thighs), then purified and injected into the hips and buttocks to create or enhance an hourglass figure. The procedure is far more popular now than it's ever been, thanks to the recent relative democratization of cosmetic surgery; according to a survey from the International Society of Aesthetic Plastic Surgery, the number of BBLs performed globally increased 77.6 percent from 2015 to 2019. Some 40,320 gluteal-fat grafts and implants were performed domestically last year.

The surgery's popularity has spawned memes, such as one featuring the "Miss BBL" character played by the TikToker Antoni Bumba, who makes a melodramatic spectacle of doing everyday tasks like eating Chinese food or getting out of a car, because that's what surgically enhanced bad bitches do. That parody is all in good fun, but other corners of the internet are far more vitriolic; elsewhere, the BBL has provoked widespread condemnation and mockery of the women who undergo the procedure. Some people have even gone so far as to proclaim that they feel no sympathy for anyone who dies following complications from it—and many women have. The BBL is among the most dangerous cosmetic surgeries; some surgeons have called for a ban on the procedure, citing figures such as those in an urgent 2018 notice from the American Society of Plastic Surgeons that noted a mortality rate as high as one out of every 3,000 BBLs performed.

More recent data have put the mortality rate at about one in 15,000 to 20,000, but lower-cost surgery clinics, some run by doctors who are neither board-certified nor sufficiently trained in plastic surgery, are performing high numbers of surgeries in unsafe, cost-saving conditions. These clinics are also most likely to target Black and Latina women with intense marketing campaigns and misleading information. Cardi's surgery was not a BBL, but it's not hard to draw a line from that Queens basement to what is happening now in cities such as Miami and Guadalajara. "There's this pervasive body dissatisfaction that plagues Black women," says Rachel Goode, an assistant professor at the University of North Carolina at Chapel Hill's School of Social Work, who notes that people—even in her field—often fail to recognize the ways that body dysmorphia can present among Black women, and the role that racialized trauma can play in exacerbating it.

And yet one recent viral tweet calls dying from a BBL "hilarious," because "you could’ve been alive wit no butt but look at you." The open hostility toward women seeking out dramatic body modifications underscores an old truth. Like the virulent fatphobia and transmisogyny directed at those who do not fit into an idealized archetype of a Black woman's body—"a cartoonish version of a fertile woman, a cross between the Venus of Willendorf and Jessica Rabbit," as the writer Rebecca Jennings put it—the hyperfixation on surgery stories serves as an uncomfortable reminder that there's still no right way to have a body if you’re a Black woman.

Like many young women, Renee Donaldson, a London-based influencer who goes by Miss RFabulous, got a BBL to address the discomfort she felt after constantly comparing herself with women she’d seen on social-media platforms such as Instagram, Snapchat, and TikTok—the same apps where users openly mock women who have had obvious surgery done. She told me about spending hours scrolling, watching perfect shape after perfect shape glide past her. "Sometimes you just lay there and think to yourself, I’m not happy with my body." After hearing about another woman's positive experience with a clinic in Turkey, where many women from the United Kingdom and other parts of Europe travel to for less expensive surgeries, Donaldson decided to go for it. When the practitioners found out about her large YouTube following, they offered to perform her surgery for free in exchange for promotion, which she did not disclose to her followers at the time. It seemed like a pretty sweet, if also dubiously ethical, deal.

But last summer, Donaldson warned her followers about the dangers of the BBL after having had complications with her surgery. She says the surgeon injected fat into her thigh, which she never asked for, and she's been in pain since having the procedure. When she reached out to the clinic to rectify the mistake, it insisted that she not tell anyone on social media—the clinic had already had new clients come in because of her. It's been an ordeal Donaldson deeply regrets, not just because of the effects on her own body but also because young followers of hers have had complications too. She recalls getting DMs from a young woman who told her that the clinic wasn't providing her with basic care after her surgery, and says she's shepherded several others through postoperative pain and anxiety. "I know how it can have a massive impact on your mental health, because it's something that you have to live with," she said. "You consistently remind yourself, Oh my God, there's some part of my body that's not okay because I changed something."

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For most of the country's history, Black women have been necessarily excluded from the dominant narrative about beauty—that is to say, beauty as an instrument of social and economic power. And for all the understandable concern about botched surgeries and predatory clinicians, there's been precious little acknowledgment of how unrelenting the social pressures facing Black women can be, and how few avenues exist for advancement and personal fulfillment in such a hostile climate.

"When we are in a world that does not even value body diversity, it means that there's one or two body types that you must ascribe to, that you must work for, that you must toil for, in order to be worthy," Donna Oriowo, a Washington, D.C.–based therapist who focuses on Black women's sexual and mental health, told me. It's not enough to have the perfect, almost anatomically impossible Coke-bottle body of a video vixen; you also have to prove that you got it the right way, because to have gotten it through surgery is to be vain, or lazy, or stupid. "The sacrifice of your mental health, the sacrifice of good food, the sacrifice of pleasure, the sacrifice of you to get to where they said you should be means that now you’re an even more worthy individual to be with."

In The Body Is Not an Apology, the author and activist Sonya Renee Taylor writes that "relationships with our bodies are social, political, and economic inheritances." To the extent that Black women's physical bodies have inherited any legacy in this country, it's been one of external control—whether through legislation, labor, violence, or sex. There is no neutral way to occupy a body as a Black woman; you are lazy or masculine or dangerous or hypersexual or desexed or invisible altogether. Women—such as Cardi and Lizzo, for example—have the kinds of unruly bodies that are often pitted against one another in conversations about artifice, vanity, and beauty standards. "There's a message that is being given that you’re not okay the way you are," Carolyn Coker Ross, a physician who focuses on eating disorders and integrative medicine, told me. "Your Black features are not okay; your size is not okay."

That's not to say Black women haven't resisted such demands and pathologies since they began to emerge. Taylor's book, and work like it, directly challenges readers to help create a world in which all bodies can be unburdened from tyranny. But, especially among girls and young women, a persistent pressure remains to have the right kind of body, the kind of body that makes a Black woman valuable, the kind of body that makes a Black woman real.

Black women have been wrestling with unrealistic body expectations since before the radical contours of the BBL body became so pervasive that they "broke the internet." Entire industries benefit from selling solutions to the problems women are supposed to have with their body. Look no further than Oprah Winfrey, who purchased stock in Weight Watchers back in 2015 after decades of publicly struggling with her body image. (Who can forget the time she dragged a little red wagon filled with 67 pounds of animal fat onto the stage of her show to celebrate how much weight she’d lost?)

Weight Watchers rebranded as simply "WW" in 2018, responding to a cultural shift away from the vulgarity of talking openly about dieting and toward the more polite but no less demanding pursuit of "wellness." Today, Oprah is joined in promoting WW's programs by celebrities including the singer Ciara and the actor Kym Whitley, who smile in Instagram posts and tell their followers about counting "points." It may be less dangerous than going under the knife, but the messaging—from these trusted sources, no less—remains that women should discipline their body into submission.

For every rogue surgeon or unlicensed practitioner wielding fatal syringes in a motel room, countless more individuals and businesses profit less directly from the rigid beauty standards placed upon Black girls and women: shapewear companies, "detox tea" purveyors, waist-trainer brands, athleisure lines. A New Jersey marketing agency advises plastic surgeons on how to reach users on TikTok and other social-media platforms now that the "#plasticsurgery hashtag on TikTok has over 2.7 billion views" and "some of the most successful plastic surgeons have become influencers." (That hashtag-view number has since gone up to roughly 10 billion.) What remains rare, though, is any encouragement to consider Black women's bodies on their own terms, without factoring in what they can do for someone else. As Oriowo put it, "If you feel like shit, someone's making a dollar."

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