As an intellectual, Gilman has impressive credentials. He is a professor at the University of Chicago, a major center for the study of sociocultural aspects of medicine. There, he holds appointments in the departments of Germanic studies, comparative literature, psychiatry, and human biology.
Gilman's book displays his academic virtuosity. Ostensibly a cultural history of aesthetic surgery, it is in fact an intensely personal interpretation of events by a learned and opinionated man. The unifying argument is that people have always sought cosmetic surgery to mitigate physical features that label them as members of an unfavored minority group. In particular, Gilman is obsessed with noses. Jewish and Irish patients might want less ethnic noses, black patients may demand a nose that is "less negroid," and even syphilitic patients of centuries ago are said to have wanted surgery not so much to look beautiful, but rather to avoid the stigma of low social status and illness. Other body parts are, in Gilman's view, targeted for the same reasons. Large breasts may be undesirable among the Brazilian aristocracy because of their associations with the "too black" underclasses, and operations to undo circumcision may alleviate locker room embarrassment in anti-Jewish societies. People, apparently, want desperately to be inconspicuous.