Under the Knife

Cosmetic Surgery, Boundary Work, and the Pursuit of the Natural Fake

Samantha Kwan and Jennifer Graves
Book Cover

PB: $27.95
EAN: 978-1-4399-1933-0
Publication: Jul 20

HC: $92.50
EAN: 978-1-4399-1932-3
Publication: Jul 20

Ebook: $27.95
EAN: 978-1-4399-1934-7
Publication: Jul 20

212 pages
5.5 x 8.25
4 tables

How the pursuit of a “naturally” beautiful body plays out in cosmetic surgery

Read Chapter 1 (.pdf)


Most women who elect to have cosmetic surgery want a “natural” outcome—a discrete alteration of the body that appears unaltered. Under the Knife examines this theme in light of a cultural paradox. Whereas women are encouraged to improve their appearance, there is also a stigma associated with those who do so via surgery.

Samantha Kwan and Jennifer Graves reveal how women negotiate their “unnatural”—but hopefully (in their view) natural-looking—surgically-altered bodies. Based on in-depth interviews with forty-six women who underwent cosmetic surgery to enhance their appearance, the authors investigate motivations for surgery as well as women’s thoughts about looking natural after the procedures. Under the Knife dissects the psychological and physical strategies these women use to manage the expectations, challenges, and disappointments of cosmetic surgery while also addressing issues of agency and empowerment. It shows how different cultural intersections can produce varied goals and values around body improvement.

Under the Knife highlights the role of deep-seated yet contradictory gendered meanings about women’s bodies, passing, and boundary work. The authors also consider traditional notions of femininity and normalcy that trouble women’s struggle to preserve an authentic moral self.


“This 2020 book on cosmetic surgery…. (includes) discussions of boundary work and...provides an excellent discussion of this topic and extends the earlier sociological writings…. Overall, this book is a good addition to the literature...well written, easily followed, and a good example of research on these types of topics.”
Gender and Society

“Under the Knife is a timely, accessible, and unique intersectional analysis of cosmetic surgeries. Kwan and Graves unravel the paradox that surrounds people’s desire to undergo cosmetic surgery in a society that overwhelmingly continues to stigmatize the practice. Kwan and Graves’ theorization of the ‘natural fake’ will become a key concept that sociocultural scholars who study bodies and embodiment will draw on for years to come. Under the Knife is a very strong and impressive book.”—Georgiann Davis, Associate Professor of Sociology, University of Nevada, Las Vegas, and author of Contesting Intersex: The Dubious Diagnosis

“Under the Knife draws on a rich set of interviews to shed new light on the expectations for femininity that place women in a double bind between trying to enhance their appearance by having cosmetic surgery and facing the stigmatization of doing so. Kwan and Graves present a clear, interesting, and novel argument regarding consumers’ claims that their surgeries were not life changing; these women asserted that they have maintained ‘an authentic self.’ This book contributes to the study of boundary work and the sociology of culture and will resonate with a broad readership.”—Maxine Leeds Craig, Professor of Sociology, University of California, Davis, and author of Sorry I Don't Dance: Why Men Refuse to Move

Table of Contents


1. The Cosmetic Surgery Paradox
2. Motivations and Concerns
3. Pursuing the Natural Fake
4. Setting Boundaries
5. Negotiating “Unnatural” Results
6. Resolving Paradoxes

Appendix: Participants’ Pseudonyms, Demographics, and Surgeries

About the Author(s)

Samantha Kwan is an Associate Professor of Sociology at the University of Houston. Her research focuses on how people embody, resist, and negotiate body norms and scripts. She is coauthor of Framing Fat: Competing Constructions in Contemporary Culture and coeditor of Embodied Resistance: Challenging the Norms, Breaking the Rules; The Politics of Women’s Bodies: Sexuality, Appearance, and Behavior; and Body Battlegrounds: Transgressions, Tensions, and Transformations.

Jennifer Graves is a Lecturer of Sociology at the University of Houston. Her research focuses on the sociology of the body and embodiment with a particular interest in fat studies. She is coauthor of Framing Fat: Competing Constructions in Contemporary Culture.