Chapter 1. Introduction. on trauma, in which the Egyptians in 3000 BC were known to have their facial

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1 Chapter 1 Introduction Rationale and Significance of the Problem People have desired to modify their bodies since ancient times as seen in the Edwin Smith Papyrus, an ancient Egyptian medical text and the oldest surgical study on trauma, in which the Egyptians in 3000 BC were known to have their facial fractures fixed, particularly, their nasal fractures. Other historical evidence of human body modification was found in Sanskrit texts in which Samhita, the father of Indian medicine, developed techniques for nose reconstruction (Guyuron et al. 3). Surgical modification, when done for the purpose of repairing an injury, is referred to as Reconstructive Surgery. As advancements in technology have continued to improve, people have striven to perfect their physical appearance by a surgical process called Aesthetic Surgery (or Cosmetic Surgery) (3). Cosmetic surgery today can be classified into two different procedures: (i) surgical; and (ii) nonsurgical. It is generally perceived that nonsurgical procedures, such as Botox, laser hair-removal, hyaluronic acid injection, and laser skin resurfacing have seen an increase in popularity as they are not as invasive as surgical procedures. According to a 2008 study by the American Society for Aesthetic Plastic Surgery (ASAPS), cosmetic surgery has seen a surge in popularity. The study found that, as of 1997, both surgical and nonsurgical cosmetic procedures have seen an

2 2 increase of over 162%. In 2005 alone, the British Association of Aesthetic Plastic Surgeons reported 22,041 cosmetic procedures performed by its members (Over 22,000 surgical procedures in the UK in 2005). In Thailand, in 2004, the SuanDusit Poll, conducted by Suan Dusit Rajabhat University, revealed that 34.56% of a 1,125 sample population found the idea of cosmetic surgery a reasonable option for those desiring to improve their appearance and increased self-confidence only 23.64% of the sample population thought the idea extravagant and unnecessary [ส ข ม เฉลยทร พย 1 (Sukhum Chaleoysap 1)]. A 2009 online survey, the Dek Dee Poll, found that 57.77% of 5,074 interviewees, aged between ten and twenty-five, were in fact interested in receiving cosmetic surgery. As many as 346 of the 5,074 individuals interviewed had already received some form of cosmetic surgery of these, 81.82% stated their reason for undergoing the procedure as a desire to look good. Dr. Krichart Pornsinsiriluck, Director of Plastic Surgery at Yanhee Hospital, states in the online Dek Dee Poll that children as young as thirteen have felt pressure from their mothers to undergo cosmetic surgery, that they might find a greater chance of getting a job in the entertainment field (Wai Run Kap Kha Ni Yom). Cosmetic surgery, however, is not considered a conclusive means of attaining physical beauty, nor does it guarantee the acquisition of a well-paid job. It is viewed as a double-edged sword for some. Nigel Mercer, a consultant plastic surgeon to the President of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), warns that all cosmetic surgeries are medical procedures and that there is an inevitable rate of failure (Mercer ). Among those who undergo cosmetic surgery, regardless of how perfectly a wound is stitched, 4% will have a bad scar

3 3 that will take at least four months to fade. Moreover, minor corrections are often required when the doctor or patient finds something unsatisfactory. These procedures have remained exceedingly costly, according to Mercer, despite the increase in demand over the last twenty years and unfortunately cosmetic surgery has not yet been included in any healthcare or insurance system in any country. One unfavorable issue concerning cosmetic procedures includes the possibility of psychological after-effects. Bradbury, a consultant psychologist and honorary senior clinical lecturer at the University of London School of Medicine and Dentistry (227-31), finds that patients, no matter how satisfactory a surgery result is, face psychological risks. He cites seven epidemiologic studies which have identified a relationship between cosmetic breast augmentation and suicide. Breast augmentation patients are two to three times more likely to commit suicide than patients undergoing other cosmetic surgery procedures. In identifying the reasons for this increase in suicide potential, there are many factors to consider. Following breast augmentation, in Characteristics of Women With and Without Breast Augmentation (Cook, LS et al. as cited in Bradbury 228), after interviewing and studying the demographic profile of women who had received augmentation, the researchers used the prevalence odds ratio (POR) to measure the association. They found that women who received breast augmentation experienced a greater likelihood of using tobacco and alcohol, had a greater number of more sexual partners, became pregnant earlier than others of a similar age, and were more likely to get divorced. These problems could eventually lead to psychological issues, to the point that life seems unbearable and suicide a reasonable option.

4 4 Aside from the undesirable physical and psychological effects following surgery, misleading advertising boasting miraculous results, with little or no mention of the possible risks, can cause further post-operative complications, such as wound infection and post-operative fever. According to Nahai, a board certified plastic surgeon and President of the International Society of Aesthetic Plastic Surgery (232-36), because the practice of cosmetic surgery has remained largely unregulated, many countries face problems concerning the qualifications of practicing physicians, the eligibility of individuals performing such surgeries, and locations sufficiently appropriate where in which to operate. Nahai further notes that in many countries, the United Kingdom and the United States of America in particular, any licensed physician, regardless of surgical background, including physicians who have observed such cosmetic operations but have had no hands-on experience, can legally perform cosmetic surgery. In Thailand, a number of unqualified physicians have run cosmetic surgery clinics without proper certification, luring clients desiring affordable cosmetic surgery. In 2006, there were 436 court cases regarding cosmetic surgeries (จ บตาภ ย ศ ลยกรรมพลาสต ก 1) (Chap Ta Phai San La YaKam Plastic). Evidence illustrating the risks of receiving cosmetic surgery abounds in Thailand. In 2004, the owner of a cosmetic surgery clinic in Chiang Mai was sentenced to four years and three months imprisonment for recklessly using expired drugs in performing a liposuction operation which directly led to the death of a seventeen year-old girl; she died on the operating table (ย นค กส ป หมอชาล ด ดไขม น1) (Yuen Khook Si Pi Mor Charlie Dud Khai Man). In 2007, criminal proceedings were brought against a surgeon who tried to have his

5 5 patient killed after she revealed a botched cosmetic procedure (ย อนรอย...ฆาตกรรม ต อเน องเหย อไบโอคล น ก! จ ดจบจ บ หมอไพศาล1) (Yon Roi Khadtakam TonuangYuea Bioclinic! Chutchop Maw Paisan). Most botched cosmetic surgeries result from unqualified physicians who market themselves as legitimate surgeons who have little regard for medical standards and use various forms of advertising to deceive and lure potential patients while striving more toward profits as opposed to a patient s well-being. There are also a number of complicated cases stemming from patients health conditions, as well as patients contributory negligence in following post-surgical advice. Regardless of the potentially undesirable results and less than positive effects of cosmetic surgery cited above, cosmetic surgery remains phenomenally popular in Thailand. The reasons for the increasing popularity of cosmetic surgery are difficult to pinpoint. The study Looking Good: Factors Affecting the Likelihood of Having Cosmetic Surgery, conducted by Swami, an academic researcher in psychology at the University of Westminster in London, and his team suggests that the possible reasons for the increasing demand include: higher disposable incomes; advances in cosmetic surgery; loss of stigma and the influences of both media and entertainment (211, ). A study performed by Solvi (674) reports similar findings and suggests that the media plays an important role in the decision-making process of undergoing cosmetic surgery that is, when viewers are exposed to the advantages and disadvantages of cosmetic surgery, a better informed decision becomes more likely. In most advertisements for beauty-related procedures, cosmetic surgery, in particular, the headlines and sub-headlines are most important in drawing the reader s

6 6 attention (Kleppner 318). Research has found that headlines are read three to five times more frequently than the body content of advertisements (Bovee and Arens 294). According to a research by ร ชน ไกรค ม (Ratchanee Kraikum), การศ กษาคา วล ประโยคภาษาอ งกฤษและว จนกรรมเพ อเร าความสนใจท ปรากฏในพาดห วหล กของเอกสารโฆษณา เคร องด มสม นไพรในอ นเตอร เน ต (A Study of English Words, Phrases, Sentences and Attracting Speech Acts Appearing in the Headlines of the Herbal Beverage Advertising Home Pages on the Internet), headline-writing is a key feature that impresses the readers, guiding them into an article, and ultimately persuading them to buy the product (1-3). Headlines from foreign home pages were chosen for her research, as they created first impressions on readers who viewed a lot of advertisements a day. She has found four characteristics of headlines: (1) giving the truth; (2) using precise words; (3) being straightforward; and (4) rounding up all details. In advertisements, not only do the eye-catching headlines draw reader s attention on the Internet, but language used in printed media also plays a vital role as a persuasive tool. Panpothong in her study, BeingUnattractive is Like Having a Disease: On the Advertising Discourse of Cosmetic Surgery in Thai, states that cosmetic surgery advertising, both verbally and non-verbally one, persuades consumers, especially women, to redefine cosmetic surgery as a necessary cure (23). She examines the linguistic ideologies of cosmetic surgery advertisements based on Critical Discourse Analysis (CDA). The data were collected from four women s magazines and from brochures of cosmetic surgery clinics in the Thai language. It was found that six linguistic devices: presupposition, lexical selection, metaphor,

7 7 manipulation, quoted utterances, and the technique of claiming common, were employed in advertisement presentations. These devices functioned in convincing readers to consider the Asian look and the signs of aging as unattractive and serious problems that need modifying and fixing. The advertisements induced readers to see cosmetic surgery as a necessity as a means to solving a problem. Many studies on advertisements from different forms of media have been conducted. However, research that has focused on the headings (titles, headlines and blurbs) of articles concerning cosmetic surgery has not been extensively carried out. Thus, this research is an attempt to use the magazine Cosmetic Beauty & Anti Aging for the study, as it focuses on cosmetic surgery. This magazine, first published on November 1, 2008 by Portal Media Co., Ltd., is a monthly magazine founded and circulated in Thailand. It is also the only magazine in the country which features cosmetic surgery. The magazine presents a list of surgeons experienced in performing cosmetic surgery, the updated news in the entertainment industry, a variety of advertisements of cosmetic surgery clinics and hospitals, and the articles about health, beauty, and the types and processes of cosmetic surgery. Interestingly, almost 50% of its content consists of advertisements and articles regarding surgical and nonsurgical cosmetic procedures. A significant feature of this magazine is that each article consists of headlines, subheads, and body. The headline and subhead in each advertisement are designed to attract the reader s attention, provide a summary or gist of the body content presenting a method or form of surgery, or emphasizing its potential benefits. The body content illustrates how to enhance or fix an unsatisfactory part of the human body using cosmetic surgery. Provided at the end of

8 8 each article is a box of cautions from specialists warning readers about the potential side effects of cosmetic surgery. The body contents range in length from a half page to two pages. As all headings summarized the main ideas and are presented as starting point, which are meant to lead readers to read more into the articles, it is crucial to analyze the headings of the articles, in particular. The researcher is also confident that the data selected from the magazine, Cosmetic Beauty & Anti Aging, will be sufficient for analysis. This study aims to analyze the language used in headings of articles concerning cosmetic surgery in the magazine Cosmetic Beauty & Anti Aging in order to identify the verbal strategies presented in the persuasive language. The analysis will be based on both the discourse and the persuasive strategies used by the magazine. Purpose of the study To examine the persuasive strategies and linguistic devices in the heading samples (headlines, titles, and blurbs) found in cosmetic surgery discourse in the Thai magazine Cosmetic Beauty & Anti Aging. Application and educational advantages 1. To further the understanding of how verbal language is used to convince readers of the benefits of cosmetic surgery. 2. To further broaden public awareness, as to the persuasive schemes employed by the magazine designed to promote cosmetic surgery, and to allow for a better informed public with a greater decision-making capability in choosing whether to undergo cosmetic surgery.