Sociology Mind
2012. Vol.2, No.1, 109-115
Published Online January 2012 in SciRes (http://www.SciRP.org/journal/sm) http://dx.doi.org/10.4236/sm.2012.21014
109
Breast Implants for Graduation: A Sociological Examination of
Daughter and Mother Narratives
Lori Ann Fowler1, Ami R. Moore2
1NE Campus, Tarrant County College, Hurst, USA
2Department of Sociology, University of North Texas, Denton, USA
Received October 5th, 2011 ; revised November 6th, 2011; accepted December 6th, 2011
The purpose of this research is to examine through sociological theories how young women and their
parents make sense of the desire, attainment, and gifting of breast implants for graduation. A qualitative
study of 10 high school graduates and their mothers was conducted in the state of Texas, USA, in order to
understand why the daughters asked for implants as a graduation gift and why their parents, especially,
mothers paid for them. Four theoretical paradigms provided a better understanding of the gifting and re-
ceiving of breast implants for graduation: symbolic interaction theory, the social construction of reality,
reference group theory, and conspicuous consumption. This study shows that gifting and receiving im-
plants for graduation is primarily motivated by both personal feelings of physical inadequacy and so-
ciocultural representation of beauty.
Keywords: Breast Implants; Graduation; Adolescents; Sociological Theories; Texas
Introduction
Research has shown that of all age groups, teenagers are the
most likely to be dissatisfied with their appearance. In a longi-
tudinal study of girls and boys ages 11, 13, 15 and 18, Rauste-
von Wright (1989) found that satisfaction with one’s body was
reported highest at age 18, with males more satisfied than fe-
males at all age levels. However, those who developed secon-
dary sex characteristics after their peers were more satisfied
with their bodies than early maturers who developed secondary
sex characteristics before their peers.
Under pressure to look good and gain admiration from peers,
teens are now seeking breast enlargements at unprecedented
levels. Popular, well-endowed teen idols like Britney Spears
and Lindsay Lohan have made some girls dislike their own
bodies (More Girls Getting Implants, 2004: p. 5). Thus, young
women are seeking breast augmentation at younger ages (AS-
APS, 2004). Also, since the costs of getting plastic surgery
have gone down and technology is speeding up, these proce-
dures have become more viable to teens (Austin, 2000). The
message is that kids can, with enough money, change their
bodies for the better.
The numbers of teens that seek cosmetic surgeries nearly
doubled in just a few years. In fact, between 1996 and 1998,
teen cosmetic surgery rose from 13,699 to 24,623 (Austin,
2000). However, in 2003, almost 331,886 teens 18 or younger
had some kind of cosmetic surgery procedure, a 48% increase
over 2002 (Kelley, 2003). Breast augmentation and liposuction
are some of the areas where demand has been on the rise. The
number of teenage breast implants and liposuctions rose by
562% between 1994 and 2001 (Beyond Botox, p. 61).
Several reasons have been offered as to the unprecedented
growth in teen cosmetic surgery. Some believe that teens view
augmentation surgery as a quick fix. For some girls, augmenta-
tion may be considered a rite of passage or a link to a new iden-
tity. The young girls receiving the implants for graduation
claim they ask for them because they are about to embark on a
lifestyle change—leaving high-school and entering the college
atmosphere (More Girls Getting Implants, p. 4). As a report by
ABC News anchor John Stossel reveals (2005), the implants
allow some to feel more confident, more adult, and happy.
While some parents believe that helping daughters get breast
augmentation improves the psychological well-being of the
girls, mothers, especially report that they pay for breast im-
plants in order to boost their daughter’s self-esteem and make
them happy (McKenzie, 2006). In some instances, parents who
have the money to afford the implants cannot bear for their
children to be unhappy (ABC News, 2005). Furthermore,
mothers who have had breast surgery themselves seem more
likely to allow their daughters to undergo such procedures. The
reported boost to their own self-esteem becomes a gift they can
then pass on to their next of kin. There are cases where mothers
and daughters have the procedure done together. Indeed, it has
been found that in 25% of cases, mothers and daughters un-
dergo surgery at the same time (DeNoon, 2003).
The phenomenon of giving implants for graduation is taking
off across the country, but doctors say it is especially popular in
Texas and California (More Girls Getting Implants, 2004: p. 5).
Some parents believe that “it’s cheaper than a car and better
than a fountain pen” (Farrell, 2004: p. 2).
This study, like most body image research, focuses on
women alone for several reasons. There is general agreement
that the pressure to appear attractive is more pronounced for
women than for men (La Voie, 2000; Bulik & Kendler, 2000;
Holzgang, 2000). In addition, their self-concepts are highly
affected by television and print media (Rabak-Wegener, Eick-
hoff, & Vance, 1998). Research shows that women are less
satisfied with their bodies than men (Harrison, 2003). Addi-
tionally, women encounter more prejudice when they are con-
sidered overweight, they are more likely to diet, have plastic

L. A. FOWLER ET AL.
surgery, and have problematic relationships with food (Orbach,
1993). Thus, this research uses a narrative approach to investi-
gate reasons why some young women ask for breast implants
for graduation, and why parent(s) pay for such procedures.
Theoretical Background
Symbolic Interaction and Cosmetic Surgery
The symbolic interaction perspective is a valuable tool in
analyzing human behavior at the microlevel (Blumer, 1969).
Symbolic interaction theorists purport that behavior originates
within the constructs of the mind. The world humans inhabit is
seen as a social construction, a product of our ability to think
and express our thoughts symbolically. Things we recognize as
being part of our society may simply be products of our own
mind. Society is therefore an elaborate fiction we create in or-
der to help make sense of our relationships and the world
around us.
Symbolic interaction theory may serve as a basis for under-
standing how women interpret their own beauty and respond to
the environments in which they live. The internalization of
media images and a woman’s perception of her own beauty
may influence whether she chooses or refuses cosmetic surgery.
Internalization is a process through which people come to
identify parts of the culture as themselves, especially in relation
to norms that guide decisions about appearances and behavior.
Internalization is a crucial element that may lead some people
to regulate their own appearance in accordance with accepted
forms, i.e., those displayed in the media.
Further, symbolic interactionists such as Charles Horton
Cooley (1964), George Herbert Mead (1934), W. I. Thomas
(1923), and Erving Goffman (1959) all described thought proc-
esses that might motivate women to create good impressions, to
put on good performances, and to reflect upon their own body
image. Cooley described the self-concept as an entity formed
through social interaction. His concept of the looking-glass self
is one derived from the outside world. According to Cooley,
one’s body image reflection may involve three principal ele-
ments: the imagination of our appearance to the other person;
the imagination of his or her judgment of that appearance; and
some sort of self-feeling, such as pride or mortification in re-
turn. The imagined judgment is quite essential. The thing that
moves us to pride or shame is not the mere mechanical reflec-
tion of ourselves, but an imputed sentiment, the imagined effect
of this reflection upon another’s mind. We often imagine, and
in imagining, share the judgments of the other mind (Cooley,
1902).
Cooley stated that the social self is simply an idea drawn
from society. The person looks to others for a sense of how he
or she is perceived and comes to judge the self according ly. The
self-concept, once formed, explains motivations for behavior.
Also, Cooley believed that internal thinking involves imaginary
conversation carried on silently within one’s mind. The as-
sumption may then be made that one’s own level of attractive-
ness is based on the interpretation of other’s perceptions. Con-
sequently, one who feels unattractive to others or to oneself and
has the financial means to change her appearance may have
private mental conversations leading to cosmetic surgery (Didie
& Sarwer, 2003).
Expanding on Cooley’s notion of the “looking-glass self”,
Mead examined the parts of oneself that emerge in different
social situations. According to Mead, after one has interacted
with other people over time, a “me” emerges. This “me” is how
a person would imagine and describe her own behavior if she
were to role-play in various situations (Mead, 1934). Mead
believed that our concept of “self” is derived from social ex-
perience. The “me” or self-image, emerges after interaction
with others. The “me” can become the imaginary person that
we act out in various social settings in our minds to role-play,
and to try out certain things before we actually do them in real
life. In a way, this “me” might represent the voice that talks to
women in the mirror, “If I only had breasts that were up here,
then I’d be happy”, or “If my thighs were only this thin, then I
would be…” Before a woman undergoes such surgery, she is
likely to play out in her mind what her life will be like when
she gains the “perfect body part” that she believes she is cur-
rently lacking (Sarwer, Magee, & Clark, 2004). Indeed, while
Cooley’s looking glass allows for a woman to think about cos-
metic surgery; Mead’s role-playing practices explain how she
pretends in her new body.
Other theorists that give insights as t o why some women get
plastic surgery are W. I. Thomas (1923) and Erving Goffman
(1959). Thomas believed that within everyday life, the way one
defines a situation will not only influence the present, but the
entire personality of the individual. If, for instance, a certain
behavior becomes defined as prestigious, and is internalized,
then this behavior may be what people desire. While Goffman
stated that humans go through life as though they were per-
forming on stage. On the backstage, our true self emerges but
on the front stage, we try to manage the impression we want
people to have of us. Consequently, behaviors that become
identified as prestigious are used as tools, in the front stage
especially, to gain status and create specific impressions in the
minds of others (Goffman, 1959). In today’s society, the beau-
tiful woman and her behavior have become a prestigious status
symbol (Synnott, 1989).
Further, advertising and media icons strive to pressure con-
sumers, especially women, to reconsider their appearances. As
stated by Kilbourne (1994), if a “look” is portrayed as the ideal
in society, women often choose that prestigious, beautiful im-
age even when it comes at a costly price. Women who internal-
ize media images as real may be more likely to choose cosmetic
surgery in order to attain prestige, whereas women who view
media icons as unattainable, false representations may be less
likely to undergo elective procedures (Harrison, 2003).
It is important to note that the American socialization process
is influenced by the media, thus our meanings and interpreta-
tions of beauty are influenced as well (Harrison, 2003). We
have been socialized to know what is considered “beautiful” or
“ideal” (Kilbourne, 1994). When we cross paths with either the
beautiful or the unattractive, interpretations of physical symbols
may drive the way in which we view the people we see, and
ourselves. As reported by Didie and Sarwer (2003), Western
culture, media influence, and symbolic interaction may result in
body dissatisfaction, thus motivating some women to undergo
cosmetic surgery procedures.
Social Constr ucti o n of Reality Theor y and Cosmetic
Surgery
The social construction of reality represents the social proc-
esses by which humans collectively construct, interpret and
assign meaning to their actions, institutions, roles, and events
110

L. A. FOWLER ET AL.
(Berger & Luckmann, 1966). The human body itself may be
seen as a social construct, a means of social expression or per-
formance by which our identity and value is created, tested, and
validated (Sile, 1981). For instance, Simone de Beauvoir
clearly expressed this idea when she stated: “One is not born,
but rather becomes, a woman…; it is civilization as a whole
that produces this creature which is described as feminine”
(1952: p. 267). In fact, in social interaction throughout life,
humans learn others’ expectations and act and react in accor-
dance, maintaining the gender order (Lorber, 1994). Gender is
constantly created and re-created out of human interaction and
depends on everyone constantly “doing gender”.
As a process, gender construction creates the social differ-
ences that define a “woman” and “man”. In daily encounters,
humans produce gender, behaving in ways they learned were
appropriate. In The Politics of Women’s Bodies: Sexuality, Ap-
pearance, and Behavior, Rose Weitz demonstrates how societal
standards of beauty affect women’s lives (1999). Weitz states
that once ideas about ideal body types become accepted and
generated by the media, they can serve as powerful—and po-
litical—tools for controlling women’s appearance, sexuality,
and behavior. Media depictions of ideal body types reflect and
reinforce the powerlessness that many women have over their
own bodies. Social constructions often are powerful enough
that women augment their breast size with silicone and recon-
struct their faces with cosmetic surgery to conform to cultural
ideals of feminine beauty. As stated by West & Zimmerman
(1987), when women change their own body structures consis-
tently, the se gender constructs are rendered legitima te.
Reference Group Theory and Cosmetic Surgery
The basic premise of reference group theory is that much of
human behavior is driven by reference groups, or those groups
that influence the attitudes and behavior of individuals (Dawson
& Chatman, 2001). People often take the standards of signifi-
cant others as a basis for making self-appraisals and compari-
sons (Hyman & Singer, 1968). Reference groups give individu-
als a basis for comparing themselves to others and are often
used as a sort of yardstick allowing one to measure how they
“stack up” relevant to some standard.
According to research, how people stack up against the group
with which they most often compare themselves has an enor-
mous impact on their behavior. Schor (1998) analyzed con-
sumerism and television, and found that the more TV a person
watches, the more he or she spends. Shrum, Burroughs, and
Rindfleisch (2005) found that the more people watch dramatic
TV shows, the more they think American households have
tennis courts, private planes, convertibles, cell phones, maids,
and swimming pools. These same viewers overestimate the
proportion of the population who are millionaires, have had
cosmetic surgery, and belong to private gyms. Thus, it is safe to
conclude that media, especially TV has significant impacts on
its viewers who not only tend to compare themselves to the
stars and icons that are portrayed in the different shows but also
think everyone else looks just like the stars and icons excepts
themselves.
In general, individuals seek membership into certain groups
because of the groups’ perceived status and the benefits gained
from belonging to such groups (Dawson & Chatman, 2001).
Reference groups possess power through their ability to influ-
ence individuals who desire to become members. A woman’s
perception of her own appearance may be driven by compari-
sons with women in the media, or women others view as
“beautiful”. Women may seek affiliation with women viewed
as beautiful because they are depicted as having desirable social
status. Some women may choose beautiful women as a refer-
ence group and ultimately undergo surgery in an effort to feel
part of a more favored group.
Conspicuous Consumption Theor y and Cosmetic
Surgery
In Veblen’s classic work, The Theory of the Leisure Class,
he states that status is determined by displaying wealth through
acts of conspicuous consumption (1899). Conspicuous con-
sumption involves the acquisition and display of items that
attract attention to one’s wealth or suggest that one is wealthy.
It is an economic, cultural, and social process that reflects the
opportunities and constraint s within a society (Zukin & Maguire,
2004). Consumer goods are often used by socio-economic
classes to differentiate their status from others. These goods
serve as symbolic cues that signal levels of prestige.
The Veblen thesis proposes that the rich set standards that the
rest follow. For example, the middle class may emulate the
upper class by purchasing fine articles of clothing, and the
lower class may emulate the middle class by driving a fine
automobile in an effort to elevate perceived status. Americans
are engaged in an intensifying “national shopping spree” rooted
in competitive emulation—keeping up with the Joneses on a
manic scale (Schor, 1998). The wealthy have set spending pre-
cedents for everyone else.
The eccentricities of the rich have a purpose, to reaffirm their
status as members of the leisure class and to display power
(Veblen, 1899). According to Veblen, the display of power was
external in pre-industrial society. It was easy to “see” who the
powerful were in feudal society because they commanded large
armies and ruled over segments of society while living in cas-
tles (Carolan, 2005). There was no need to speak of conspicu-
ous consumption because all consumption was a display of
power. Individuals today, however, no longer rule over peasant
classes. Consumption is now something done by all. As such,
status is displayed in other ways. We are no longer content with
merely surrounding ourselves with “nice things”. But instead,
as reported by Carolan (2005), we now strive to become the
“nice thing” itself—to literally embody conspicuous consump-
tion.
Within American consumer society, the youthful and attrac-
tive body has become a status cue. Beauty has come to repre-
sent the good life—viewed as a display of high social status and
prestige (Sile, 1981). A fit, firm, exercised, and well-regulated
body has come to symbolize personal triumph over impulse. A
body in control over itself has come to represent a body in con-
trol of the world around it (Carolan, 2005). The opportunity for
one to control the world around them is marketed heavily in the
West (Davis, 2003). Cosmetic surgery is a form of consumption,
and a very conspicuous one at that (Carolan, 2005). What could
be more conspicuous than something which alters your body,
the very thing you take with y ou everywhere?
This study uses narratives to sociologically examine the rea-
sons that motivate on one hand daughters to ask for breast
augmentation for graduation and on the other hand parents to
pay for such procedure.

L. A. FOWLER ET AL.
Methods
The study used a qualitative design in order to capture the
experiences and decision making processes of those giving and
receiving breast implants for graduation. A narrative approach
is used because narratives are discourse with clear sequential
order that connect events in a meaningful way (Hinchman &
Hinchman, 1997). The chronology of events distinguishes it
from mere description by linking a prior choice or event to a
subsequent one. Also, narratives empower research participants
and allow them to determine the most important themes in an
area of research. The telling of a personal narrative aids in the
development of one’s sense of self (Mishler, 1995).
Further, as stated by Ferber (2000), narratives do not merely
reflect experience, they give meaning to it. In the re-telling of a
life experie nce in t h e form of a narrative, an individual is forced
to reflect on those experiences most readily remembered. It is
this process of making sense out of experience that makes nar-
ratives different from and better than structured interviews.
Thus to gain a better understanding of the world of women
(daughters and mothers) who underwent or paid for breast
augmentation surgery, using narrative will shift responsibility
to the subjects (Chase, 1995).
Recruitment Procedure and Data Collection
Participants were selected by means of purposive sampling.
Daughters who have received breast implants for graduation
and their mothers were asked to participate in the study. Only
mothers were asked to participate because they too may have
undergone breast augmentation. For mothers who had not un-
dergone breast augmentation surgery themselves, perhaps the
gift was motivated by their own unmet desires.
A total of twenty interviews were conducted and digitally
recorded by the first author from June to September 2008. The
daughters and mothers were all Texas residents. Eight daugh-
ters had received breast implants as a graduation gift from their
parent(s) and two from their grandmother(s). The participants
lived in nine cities in North Central Texas. Several of the
daughters were living away on college campuses and were
interviewed while home visiting family members. All inter-
views were conducted in accordance with the University of
North Texas Institutional Review Board (IRB) policies.
Data Analysis
The interviews were transcribed verbatim. Both authors in-
dependently read the transcripts several times in order to be
‘immersed’ in the text. Each author separately analyzed the data.
Recurrent themes, phrases, and explanations were classified
and inductively analyzed. Some patterns emerged from the data
independently of predetermined analytical approaches (Patton,
1990). The authors then examined the relationships between
categories. They had frequent meetings whereby categories
were operationalized and consensus was reached.
Sample
Participants ranged in age from 19 to 61, with a mean age of
50 for the mothers and 21 for the daughters. Five mothers had
undergone breast augmentation themselves. Of the ten mothers,
six were married and four were divorced. Of the ten daughters,
only one was married, all others were single. Only one of the
daughters had children, but all others planned to in the future.
Sixteen of the participants self-identified as Caucasian, and four
as Hispanic. Both mothers and daughters were at least high
school graduates. Also, two of the daughters did not hold a paid
job while the rest were employed with incomes ranging from
$100 to $3600 per month. Two of the daughters reported being
upper-class, three being upper-middle, and five being middle
class. However, one mother classified herself as upper-class,
five as upper-middle, and four as middle-class. Using the tax
appraisal database, primary residence property values ranged
from $91,900 to $235,400.
Findings
Several behaviors and practices of both daughters and moth-
ers can be explained by symbolic interaction perspective. Most
of the daughters in the narratives told stories of “faking” the
appearance of large breasts prior to implant surgery. To achieve
the desired look, they used heavy cotton padding, water bras, or
multiple bras. Some sewed shoulder pads into their bra cups;
others sewed darts into their shirts. These secret efforts to
manage impressions were hidden in some cases from friends
and boyfriends.
Evidence of a metaphorical backstage to front stage transi-
tion was exemplified in Annie1’s description of her costume
change:
I mean people would see me, and they would think I had
boobs just cuz of the bra; but, I really didn’t.
In accordance with Goffman’s theory, Sheryl’s efforts made
backstage allowed her to believe she was perceived as well-
endowed:
All through high-school I wore padded bras, and I made it
look realistic, and then they’re like, “Oh, I didn’t even know
you needed surgery”.
From removable external padding to surgical internal pad-
ding, the transition was undetectable according to some women.
One of the participant’s mother stated:
Traci covered her issue that she did not have babushkas
(breasts) well. She dressed, she fixed, you would never know.
Further evidence of fa king out the audience is seen in Sandy’s
statement regarding her daughter, Jane:
You know I think a lot of people don’t know, just because
we did it in between high-school and college. So unless you
knew her when you went to high-school, there’s really not a
change.
Additional support for Goffman’s claim that one wishes to
convince their audience that they are valuable to society, i.e.,
well-endowed, is found in Sheila’s description of how Stepha-
nie has convinced her audience that she has always been well-
endowed:
…The people she is dealing with now, unless she came right
out and told them, they have no clue she had her boobs
enlarged.
All of these women made efforts to conceal their true ap-
pearance in the backstage to manage how they appeared on the
front stage and to create the desired impression. With the
growing availability of breast augmentation surgery, more and
more women now have the option to permanently alter their
breast sizes to change the body they display to audience mem-
bers.
Another symbolic interactionist theory, Cooley’s looking-
1Names are pseudonyms.
112

L. A. FOWLER ET AL.
glass self, can also explain some of the behaviors found in this
study. According to Cooley, one’s body image reflection may
involve three principal elements: the imagination of one’s ap-
pearance to the other person; the imagination of his or her
judgment of that appearance; and some sort of self-feeling, such
as pride or mortification in return. The imagined judgment is
quite essential. We often imagine, and in imagining, share the
judgments of the other mind (Cooley, 1902).
These practices were reported by most of the participants.
Amber, for instance, stated the following when asked how she
thought people saw her prior to her implants:
I know that I’m better than the average person you see shop-
ping at Wal-Mart, but not as good as the girl shopping at Aber-
crombie. You know, it’s all relative. I think I’m really cute for a
mom, but if I had to go on a date or something, I’d be really
worried.
Carol explains what she thinks others think of her appear-
ance:
I’m thinking they are probably thinking I still have a really
flat chest…
Kim’s imagination comes to life in the following excerpt:
I would just think, oh gosh, next to somebody else I would
say, “Wow—it’d be nice to have my body look like that in a
bathing suit”. Just like, “That sucks! That’s not fair! I got the
short end of the stick genetically!” You think people don’t like
the way you look or they look at you and say stuff about you…
As a result of these imaginary judgments, according to Coo-
ley, in the end one experiences some sort of self-feeling, such
as pride or mortification.
Jennifer feels proud now that she has had augmentation sur-
gery:
I’m confident in what I wear. I don’t lack confidence because
of my chest anymore. I don’t let my lack of confidence hold me
back anymore.
George Herbert Mead’s imaginative role-play helps us un-
derstand how the daughters “me” emerged and then engaged in
role-play practices prior to implants. They went through a re-
hearsal process with an imaginary self that created having the
perfect breasts. For instance, Annie’s behavior reflects Mead’s
theory of identifying her “me” through social interaction:
I guess seeing pictures of other girls who have boobs in
magazines, I just wanted them. The way they look right here
(she touches her breast bone), cleavage, I like that.
Annie, after she had interacted with people over time (pic-
tures of other girls in magazines) saw herself as less than those
women depicted.
In another case, as shown in the comment below, Jane, talk-
ing about her surgery went through a role-playing process.
I went in and showed them pictures of what I wanted, what I
didn’t want, you know. I did not want to be too big, that was
my biggest thing. I wanted to look natural. And so I took pic-
tures in and he (the surgeon) gave me some implants to wear
underneath my shirt to see how I liked the size. He gave me a
375 cc, which is like 375 tablespoons and that, was pretty much
the equivalent to a full C cup. And I liked that one, I thought it
was great, so we were gonna go with that.
The women altered their real self that they learned not to like
through social interaction, and through role-play they imagined
having larger breasts in various situations and ultimately liked
that better. In some cases, their role-playing techniques allowed
them to transition smoothly from practicing with breasts to
actually having them.
Another trend inductively discovered in the data was how the
participants of the study use implant to construct gender. The
following section focuses on the social construction of reality
paradigm to examine the efforts made by both mothers and
daughters prior to surgery in order to construct gender. The
mothers often referred to their daughters in a pre-surgery state
as though they had something physically wrong with them.
They were not whole, missing something, immature, not femi-
nine, and they looked like “boys”. Sammie explained why she
thought her daughter’s flat breasts kept her from dating:
Susan wasn’t dating; the guys were all her friends, just her
friends. So at some point you have to wonder if they just stay
friends all the time because she was flat chested like one of
them. At what point does she get to become a young lady?
Which is sad to say but it’s almost like if she doesn’t have
boobs then the guys would never see her as more than just a
buddy which is what she was.
Not only were the mothers influenced by the social construc-
tion of gender, but the daughters as well. The daughters will-
ingly underwent elective surgery in order to obtain larger
breasts, those that would be clearly identified as womanly,
separate and distinct from manly. Through the portrayal of the
daughter’s surgical narratives, one can see how the young
women actively took part in “doing gender”. As illustrated in
the following comments, many of the subjects talked about
altering their boyish image, becoming more beautiful and femi-
nine.
Jennifer, describing how she asked her parents for augmenta-
tion for graduation, stated:
It came down like I told him (her father). I was flat like an 8
year old boy. And it’s not something that bothered him, it both-
ered me. To the point that I was wearing two padded bras when
I was in middle school.
Although another respondent, Jane, didn’t specifically say
she looked like a boy, the social construction of what a woman
should look like taught her she was deficient:
I was not happy with how I looked. I wasn’t comfortable. I
didn’t feel like a woman. I felt like a thirteen year old girl and
they (breasts) weren’t gonna get any bigger. And I was not
comfortable, I was not comfortable at all. I dunno, I just wasn’t
comfortable. When you are so small, it doesn’t make you feel
like a woman.
Sheryl described how she didn’t feel beautiful prior to sur-
gery, but talking about her post-surgery image stated:
I am able now to look in the mirror and say you know, I am a
pretty girl! I am a beautiful girl. I can say that. I used to not be
able to say that.
Social construction of reality theory clearly weaves through
the comments above. The women underwent augmentation
surgery to appear as feminine, grown women. The daughters,
maintaining the gender order, became society’s constructed
definition of “woman” after surgery.
Reference group theory explains how the women in this
study use others as yardsticks to evaluate their own beauty. In
each of the narratives, the women made realistic comparisons
using relatives or friends and idealistic comparisons using me-
dia icons. Each of the daughters described the reference groups
that played a role in their decision to undergo breast augmenta-
tion. These reference groups included coworkers, close friends,
and fellow sorority sisters. Sheryl used her coworkers as a
“yard-stick”, comparing her breasts to those of the women she
worked with:

L. A. FOWLER ET AL.
A couple of girls I’ve worked with, actually there were 2
girls there that had boob jobs. And then my boss did. They
talked about how I would like it (breast augmentation) and I
would be happy. They gave me advice.
Also, some participants created a mental image of what their
friends look like physically and compared themselves to these
friends. For instance, Annie describing her experiences with her
peers since junior high commented:
Uh, well it’s been going on like, since I was in junior-high.
When am I gonna get boobs? …Oh, like, how the girls have
been developing and I haven’t. Like when you wear a sports bra
and go and change, I didn’t have anything.
In other cases, the respondents described their sorority sisters
and how breast augmentation was popular within the sorority
house. The respondents recognized that breast augmentation
was common within this reference group, something one has
done if “needed”. Jane described how augmentation seemed
common among all the girls she was around:
All the people that I was around, I felt like it (breast aug-
mentation) was socially acceptable. It wasn’t really like, “Oh
my God—you’re gonna get that done?” I think everybody who
had to get it done would have done it.
Reference group theory allows for an understanding of how
the women in this study took note of their close friend’s body
structure, weight, and breast size. Using friends as a tool for
comparing how they themselves ranked, many girls acknowl-
edged that their bodies were not as attractive as their friend’s.
Those in the study who belonged to sororities came to view
breast augmen tation as common, regular, and “no b i g deal ” .
Veblen’s conspicuous consumption theory (1899) can ex-
plain the behaviors and practices of the participants. As Veblen
described in his theory, rich people who display their wealth
often receive acknowledgement. When something is valued,
those who can afford it often purchase it. All of the women in
this study belonged to what may be defined as a “modern day
wanna be leisure class”. The average value of their homes was
$159,321. Some drove luxury vehicles such as Lexus, BMW,
and Mercedes; others drove SUVs and Sedans. The parents paid
an average of $1,441.00 per month towards the daughters living
expenses. This leisure status afforded the parents to pay for not
only their daughters’ living expenses, but their breast augmen-
tation surgery as well.
Kim describes why women feel large breasts give them de-
sired status:
…I would think the media, I mean it’s just so, so like stereo-
typical of what a perfect woman is. You know, big boobs,
really skinny, looks like specific celebrities, models and every-
thing. It’s about diets, no carbs, no this and that. You know,
everything in a magazine, everything on TV, you know every-
one is beautiful. I mean if everybody was fat and had no boobs
then I probably wouldn’t have wanted them, but if that’s the
way we grew up, the society you grow up in, you want to look
a specific way. Like you would like to have a small waist with a
bigger chest. I mean I’m sure that’s our American culture in
general.
Amber’s description of Angelina Jolie brings to focus a de-
scription of this American standard of beauty:
I like Angelina because I think she is the most beautiful
woman. She’s Amazon tall, gorgeous hair, and big lips. Looks
like she just crawled out of bed and had every hair fall perfectly
into this mess of dreaminess. And she has kids hanging all over
her. She lets the rest of us know how bad we suck.
Further, those women who augment their breasts may “fla sh”
them to others as the ultimate display of conspicuous consump-
tion.
Linda describes how the attainment of larger breasts has
brought her daughter, Kim, esteem and admiration by men
especially:
She has on occasion gone places with me, with like the little
spaghetti strap top that she really shouldn’t have been wearing.
We were in a restaurant once and men just kept ogling her. We
were in the grocery store once and the same thing. There were
these firefighters that were trying to see over the aisle and look
at her…
It is important to note here that Kim isn’t wearing the spa-
ghetti strap innocently, she wants to make sure her breasts are
visible, admired, and can enhance her status. The flashing of
breasts demonstrates that their chests are augmented and they
can afford to buy them.
Discussion
This research sociologically explored the lives of twenty
women who either gifted or received breast implants for
graduation. First, symbolic interacti on illuminated why most of
the daughters in the narratives “faked” the appearance of large
breasts prior to implant surgery through the use of heavy cotton
padding, water bras, or multiple bras. All of these women made
extreme efforts in the backstage to conceal what they really
were and manage how they appeared in the front stage, in order
to create the feminine impression desired. The daughter’s nar-
ratives supported both Cooley’s practice of reflective judgment
and Mead’s role-playing techniques. All of the daughters in this
study practiced having larger breasts before undergoing surgery,
and considered the procedure a success when audience mem-
bers couldn’t tell they had surgery.
The social construction of reality paradigm offered a means
to analyze the efforts taken to construct gender by examining
how both mothers and daughters actively engaged in the per-
petuation of the construction of gender. The mothers often re-
ferred to their flat-chested daughters in a pre-surgery state as
though they were physically marred. They were not whole,
missing something, immature, not feminine, and they looked
like “boys”. The daughters also wanted to undergo breast aug-
mentation surgery in order to obtain larger breasts, those that
would be clearly identified as womanly, separate and distinct
from manly.
Reference group theory provided a means to explain ways in
which women compared themselves to friends and often to
those they consider more beautiful than themselves. The per-
ception of the actual self in relation to the ideal one resulted in
a sense of failure. Therefore, the daughters proceeded with
implants in order to look like their reference group members.
As conspicuous consumption theory explained, when the
level of consumption necessary to be conspicuous becomes
more readily available, people want to demonstrate that they
have a high quality of life. All of the women in this study be-
longed to the middle class or what may be defined as a modern
day leisure cla ss. This lei sure status afforded them the ability to
pay for not only their daughter’s living expenses, but their
breast augmentation as well.
It is important to report that most of the daughters and moth-
ers were very clear that the decision to undergo breast implant
surgery occurred at a young age. Critical events leading to sur-
114

L. A. FOWLER ET AL.
gery included encounters with ill-fitting clothing and the wish
to be supplied with a generous gift for graduating from high-
school. The gifting of breast implants for high-school gradua-
tion often took place because the daughter finally reached age
18, the age at which most surgeons first allow the surgery.
This study shows that gifting and receiving implants for
graduation is primarily motivated by both personal feelings of
physical inadequacy and sociocultural representation of beauty.
In fact, the majority of respondents expressed complete comfort
with their gifting and receiving of breast implants for gradua-
tion, claiming it was a great decision. Most said they ha d never
experienced such comfort in clothing, self-confidence, and that
they would do it again if necessary. Additionally, most of the
mothers agreed surgery was worth any risk to increase their
daughter’s confidence.
REFERENCES
American Society for Aesthetic Plastic Surgery Inc. (2004). Top 5
female cosmetic procedures. URL (last checked 30 March 2008)
http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/com
monspot/security/getfile.cfm&PageID=16734
Austin, A. (2000). More teens opt for plastic surgery. Christian Science
Monitor, 92, 14.
Berger, P., & Luckmann, T. (1966). The social construction of reality:
A treatise in the sociology of knowledge. New York: Doubleday Dell.
Beyond, B. (2003). Beyond botox. Economist, 369, 61-62.
Blumer, H. (1969). Symbolic interactionism: Perspective and methods.
Englewood Cliffs, NJ: Prentice Hall.
Bulik, C., & Kendler, K. (2000). I am what I (don’t) eat: Establishing
an identity independent of an eating disorder. American Journal of
Psychiatry, 157, 1755-1760. doi:10.1176/appi.ajp.157.11.1755
Carolan, M. (2005). The conspicuous body: Capitalism, consumerism,
class and consumption. Worldviews, 9, 82-111.
doi:10.1163/1568535053628436
Chase, S. (1995). Ambiguous empowerment: The work of narratives of
women school superintendents. Amherst: University of Massachu-
setts Press.
Cooley, C. H. (1964). Human nature and the social order. New York:
Charles Scribner’s Sons.
Davis, K. (2003). Dubious equalities and embodies differences: Cul-
tural studies on cosmetic surgery. Lanham, MD: Rowman and Little-
field.
Dawson, E., & Chatman, E. (2001). Reference group theory with im-
plications for information studies: A theoretical essay. Information
Research, 6, 1-26.
DeNoon, D. (2003). Latest plastic surgery trends and stats: His/hers,
mom/daughter surgery new trend. Web MDHealth Medical News.
URL (last checked 17 January 2007).
http://www.webmd.com/skin-problems-and-treatments/news/200306
05/latest-plasticsurgery-trends-stats
Didie, E., & Sarwer, D. (2003). Factors that influence the decision to
undergo cosmetic breast augmentation surgery. Journal of Women’s
Health, 12, 241-254. doi:10.1089/154099903321667582
Farrell, J. (2004). More teens see implants as a right. Miami Herald.
InfoTrac Newspapers database. URL (last checked 10 July 200 5 ).
Ferber, A. (2000). A comment on Aguirre: Taking narrative seriously.
Sociological Perspec t i v e s , 43, 341-349.
Goffman, E. (1959). The presentation of self in everyday life. New
York: Doubleday.
Harrison, K. (2003). Television viewers’ ideal body proportions: The
case of the curvaceousl y thin woman. Sex Roles, 48, 255-265.
doi:10.1023/A:1022825421647
Hinchman, L., & Hinchman, S. (1997). Introduction. In L. P. Hinchman,
& S. K. Hinchman (Eds.), Memory, identity, community: The idea of
narrative in the human sciences (pp. 13-30). New York: State Uni-
versity of New York Press.
Holzgang, J. (2000). Body image project: Facts on body and image.
URL (last checked 6 November 2006)
http://www.justthink.org/bipfact.html
Hyman, H., & Singer, E. (1968). Readings in reference group theory
and research. New York: Macmillan.
Kelley, R. (2003). Giving the gift of rhinoplasty. Newsweek, 142, 76.
Kilbourne, J. (1994). Still killing us softly: Advertising and the obses-
sion with thinness. New York: Guilford Press.
LaVoie, A. (2000). Media influences on teens: Facts compiled by Alli-
son LaVoie. URL (last checked 13 April 20 00).
http://kidsnrg.simplenet.com/grit.dev/london/g2_jan12/green_ladies/
media/
Lorber, J. (1994). Paradoxes of gender. New Haven, CT: Yale Univer-
sity Press.
McKenzie, J. (2006). New grad gift: Breast implants. Mind & Body, 5,
15-18.
Mead, G. (1934). Mind, self, and society. Chicago: University of Chi-
cago Press.
Mishler, E. (1995). A matter of time: When, since, after Labov and
Waletzky. Journal of Narrative and Life History, 7 , 69-73.
Moberg, M., Siskin, J., Stern, B., & Wu, R. (1999). Sara Lee: Wonder-
bra. URL (last checked 6 July 2005)
http://wwwpersonal.umich.edu/~afuah/cases/case15.html
More girls getting implants (2004). The New York Post (pp. 1-8). Re-
trieved July 19, 2006, from InfoTrac Newspapers database.
Orbach, S. (1993). Hunger strike: The anorectic’s struggle as a meta-
phor for our age. London: Penguin.
Patton, T. (2006). Hey girl, am I more than my hair?: African American
women and their struggles with beauty, body image, and hair. NWSA
Journal, 18, 24-51. doi:10.2979/NWS.2006.18.2.24
Rabak-Wagener, J., Eickhoff, S., & Vance, K. (1998). The effect of
media analysis on attitudes and behaviors regarding body image
among college students. Journal of American College Health, 47,
29-36. doi:10.1080/07448489809595616
Rauste-von Wright, M. (1989). Body image satisfaction in adolescent
girls and boys: A longitudinal study. Journal of Youth and Adoles-
cence, 18, 71-83. doi:10.1007/BF02139247
Sarwer, D., Magee, L., & Clark, V. (2004). Physical appearance and
cosmetic medical treatments: Physiological and socio-cultural influ-
ences. Journal of Cosmeti c D e rm a t ology, 2 , 29-39.
doi:10.1111/j.1473-2130.2003.00003.x
Schor, J. (1998). Keeping up with the Trumps: How the middle class
identifies with the rich—Excerpt from “the overspent American:
Upscaling, downshifting, and the new consumer”. URL (last checked
9 September 2005).
http://findarticles.com/p/articles/mi_m1316/is_n7-8_v30/ai_2098784
0
Shrum, L., Burroughs, J., & Rindfleisch, A. (2005). Television’s culti-
vation of material values. Journal of Consumer Research, 32,
473-479. doi:10.1086/497559
Sile, V. (1981). Body and social constructionism: Formation of indi-
viduality in the process of socialization. Unpublished Doctoral Dis-
sertation, Vilnius: Vilnius State University.
Synnott, A. (1989). Truth and goodness, mirrors and masks—Part I: A
sociology of beauty and the face. British Journal of Sociology, 40,
607-637. doi:10.2307/590891
Thomas, W. I. (1923). The unadjusted girl. Boston: Little Brown.
Veblen, T. (1899). The theory of the leisure class. London: Allen &
Unwin.
Weitz, R. (1999). The politics of women’s bodies: Sexuality, appear-
ance, and behavior. Teaching So cio logy, 27, 429-431.
doi:10.2307/1319054
West, C., & Zimmerman, D. (1987). Doing gender. Gender and Society,
1, 125-151. doi:10.1177/0891243287001002002
Why are parents buying their girls the gift of surgery? (2005). [News
broadcast transcript]. In 20/20 (Producer), ABC news. New York:
ABC. URL (last checked 27 December 2011).
http://abcnews.go.com/2020/story?id=875821
Zukin, S., & Maguire, J. (2004). Consumers and consumption. Annual
Review of Sociology, 30, 173-197.
doi:10.1146/annurev.soc.30.012703.110553