The night before the operation, my craniofacial surgeon sat clicking his tongue in my AirBnb in Buenos Aires. He shifted his tanned, expansive body on the couch. Surgeons think they’re gods, and he had the presence of Hephaestus—a craftsman so confident in his work that he had no need to wear expensive clothes or Botox away every wrinkle like so many Fifth Avenue doctors straight out of Nip/Tuck. We were meeting to talk through the specifics of how, the next day, he was going to cut apart my jaw.
I had a request outside of the strict medical goings-on we discussed: Could I keep the excised bone that he was going to remove from me? He frowned and sighed. "No…no, I don't think so." He cited some policy about medical waste—hospital rules.
Trying to hide my disappointment, I nodded in the obsequious way expected by medical professionals. My pursuit of surgery to reduce my jawline and shorten my chin was, in part, motivated by a desire to feel ownership over my body. The refusal to allow me a piece of that body— my body—couldn’t help but undermine that feeling.
"Unless," he said, a thick eyebrow arching in thought, "Tomorrow is Monday, so not many people will be in the hospital. I'll see what I can do."
Twelve hours later, an anesthesiologist jabs at me. This is the worst part of surgery: a broad steel needle slips into my hand, searching for a vein to pump its pacifying venom into. It hurts, it hurts—but then I’m gone.
My surgeon makes an incision on the underside of my jaw, inserts a small saw, and begins slicing at the bone. He's cutting, cutting, sanding down. Hephaestus, attending to a block of stone to reveal the statue underneath.
When psychologists talk about body dysmorphia, a condition similar to obsessive-compulsive disorder in which patients become fixated on imagined or slight bodily imperfections, they describe how sufferers pore over mirrors or avoid them entirely, miss work and social engagements, and sometimes self-harm. That’s not the whole story. It doesn't get at the more profound experience of unrecognition—how, looking at my reflection, I think, That's not me. That can't be me. If that's really me, then I'll kill myself.
My brain is incapable of recognizing the reality of my image—or else it does, and something in me knows that that image only deserves desecration. I am told endlessly by strangers and friends alike that I am beautiful, yet I find ways to wriggle away.
Body dysmorphia is made more difficult by the fact that the cause is biopsychosocial, a complex cocktail of genetics, upbringing, and thought patterns. Body dysmorphia is difficult to treat, but the usual prescribed course is antidepressants and cognitive behavioral therapy, which is a practice based around changing destructive thought patterns. My therapist urges me not to say that my brain is broken, but my mother once told me that there’s something in our family’s minds that doesn’t connect right. Her side of the family is marked by melancholia, mood disorders, and depression. I wonder how we made it far enough to get to me.
Whether my mother is right and some circuit in my head is incomplete; whether some traumatic event in my childhood changed how I see myself; whether I’m swayed by the omnipresent imperatives of beauty propagated by all forms of media—who knows. I’ve done years of therapy, taken drugs, practiced mindfulness exercises. Nothing’s worked, not really.
Many psychologists say the worst thing people with body dysmorphia issues can do is get surgery—it won’t satisfy them, or else their fixation will shift to another part of the body. But my obsession with the shape of my jaw was so intense—I was so convinced that it threw my entire face out of proportion—that I did it anyway.
After my surgery, I wake inside the post-anesthetic haze where you don't know what time it is or where you are. The IV drip keeps me hydrated, but it doesn't fix the dryness in my mouth. My surgeon enters with a proud smirk. "I was able to get one piece—that's all," he says, placing a small plastic cup next to me on the hospital bed.
I can barely see the raw bone through the specimen cup, which is itself enclosed in a plastic bag. Just shapes, really; colors: a slash of off-white, streaked with red. It's too much for me to handle. I had asked for this half-jokingly. Looking at it from the bed, I feel like if I touch it, or even get a good look at it, some contact-reaction might reduce my body to a pile of thousands of those shards. I stuff the cup in my canvas bag, doing my best not to think about it while I sprawl across the AirBnB’s couch, trying to open my jaw wide enough to take tentative bites of an empanada.
Weeks later, after I arrived back at home in New York, I pulled the cup out of the bag, unscrewed the lid, and actually touched the bone. The closest experience I’d had was pulling a loose baby tooth, but this was something different. The piece of me that sat in my hand had been deliberately cut out, and though I thought of bones as bleached and clean, dried blood and tissue clung to mine, reminding me that it was previously classified as medical waste. This is what's sitting just under my skin. It didn't feel like me.
No matter how much I try to shake the foundational mind-body at the root of so much European philosophy, I see myself as exterior shell and soul. I wanted to keep this fragment of my jaw for a reason that went beyond simple fascination. I wanted to make a part of myself into something wonderful.
I became aware of the preservationist Christian Fox via Twitter after I put out a call for an artist who knew how to work with bone. Their career history includes work on Salt Lake City’s famed Mummies of the World exhibit, the study of myriad preservation techniques, and even giving their mother her preserved post-hysterectomy uterus as a Mother's Day gift. ("She said it was the most ‘me’ gift possible," they told me.)
I knew very little about Christian when I entrusted them with a piece of my body—when they processed and cleaned it, divided it into two pieces, and mounted those pieces on earring hooks. Even though Christian was a stranger, some part of me knew they were the right person for the job even before we’d had this conversation. That was reconfirmed when they recently told me, "My work helps me realize how much I've got in common with everything else breathing, and [how] to appreciate the body I'm not always comfortable in a little bit more."
"Fun fact," Christian tells me. "If you fill out a form and agree to allow a pathology holding before retrieval, you can keep more or less anything removed from your body." It's true—while there is a widespread perception that it's illegal for doctors to give patients any viscera expunged during medical procedures, there is in fact no such law, nor is there any law against owning your own body parts.
Why don't more doctors offer the option of keeping what’s removed from patients’ bodies? There seems to be a mutual assumption that patients don't want to be confronted with anything that comes out of them. For most of our collective existence, seeing our inside parts on the outside meant bad news. In a culture that repudiates death, seeing our inner workings in broad daylight is anathema.
My jaw is still healing. I avoid mirrors, use a compact to do my makeup so as not to have to take the whole thing in at once.
Here, I want to lie to you. I want to tell you that this is it—that I'm happy now, that I can finally see myself in my body. I can't. I want to say I won't ever get more surgery. I know that I will repeat this process, having my flesh and bone invaded and remodeled. That I’ll continue chasing something always just a little out of reach.
Every week, I take a picture of my progress. I compare my image to older ones, rifling through my photos to find a clean head-on shot unadulterated by makeup or filters. It’s slow, painful work. It makes me start to wonder whether psychiatrists have a point about surgery: whether I’m broken in a way that no amount of sculpting will fix.
When the earrings arrive in a plain white envelope, I take them out; feel them between my fingers; put them on. The unrecognition and queasiness I felt before is overwhelmed by awe. Christian has transformed something dejected—otherwise destined for the hospital incinerator—into something beautiful. At the very least, my bone is mine to do with as I wish.
I wear my earrings almost daily, periodically reaching up to stroke the smooth shards. My therapist tells me they're a wonderful way to honor my body as we work to process my utter disconnect with it. They're a reminder that this body is all I have—that it can be reshaped, cleaned up, cut, and sewn, but, one day, everything but bone will be gone. Eventually, even that will turn to dust. I might as well make the most of it while I can.
One truth I can tell you: Now, after my surgery, there is at least one part of my body that I admire. As I move through the world, I still evade and turn away from my reflection. But now I have a talisman—a piece of me that is perfect, lasting, and divine.