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Split tongues & nipple removal: the grey area of extreme body modifications


TextLaura Pitcher

Even with consent, there’s a grey area for specific procedures that ultimately do harm to the body – especially when mental health is taken into account

For Steve Haworth, body modification artist and the inventor of subdermal and transdermal implants, having access to body modification is as important to personal choice as having the freedom to style your own hair. Yet, modifications such as sensory magnet implants, ear pointing, shaped punches, and extreme plastic surgeries such as having ribs removed, all have varying degrees of mental and physical health risks that the patient is willingly undertaking.

Earlier this year, Brendan McCarthy, a tattooist known as Dr Evil, was sentenced to 40 months in jail for performing consensual body modifications, including ear removal, nipple removal, and the splitting of a tongue. Then there’s Robert Smith, a former surgeon who performed voluntary amputations on patients that were later found to be suffering from a body dysmorphic disorder (BDD), a mental illness involving an obsessive focus on a perceived flaw in appearance, known as apotemnophilia. 

With the legal punishment of surgeons and body modifiers performing consensual procedures, the question becomes who really can be held accountable for a person’s desire for modification, even at the risk of bodily harm? While many view body modification as a tool for self-expression, psychological disorders such as body dysmorphic disorder bring into question the issues with consent when coming from someone with a mental illness. 

While body modification artists such as Steve Haworth actively advocate for the right to self-expression through modification and perform ‘extreme’ procedures, the moral line for modifiers and surgeons varies from person to person. Dr Barry Eppley, a cosmetic and reconstructive surgeon in Indiana, told The Cut earlier this year that if his practice had a slogan, it would be “We don’t care why you want it.” Haworth, on the other hand, takes requests on a case-by-case basis and does deny asks through his professional ‘black line’.

This, he says, is usually when someone who has no visible tattoos or piercings and is asking for something like horn implants or when it’s a request to make the body appear more ‘normal’. “I have been asked to effectively perform nose jobs or tummy tucks, I have been asked to take a stretched lobe and close it back to normal. All of these things modify the person to what society considers normal,” he explains. “I will modify a stretched earlobe to a smaller size but I will not close it down completely. My art form is all about modifying the individual away from what society considers normal or pleasing. It always has been and it always will be.” 

Dr Ira D. Papel, a professor in the division of facial plastic and reconstructive surgery at Johns Hopkins University and the medical director at the Aesthetic Center at Woodholme, navigates whether or not to perform a surgery using the opposite mentality. “To make someone happy about a fad, which will come and go with a permanent procedure and which there really is no going back to ’normal’, that's not a good thing,” he says. “We should be advising patients not to do that kind of thing.”

Through first-hand experience of performing on patients that he was unaware were untreated for BDD and through his research into the connection between plastic surgery and BDD, Dr Papel says he is currently saying no to ‘extreme’ requests every week. “Increasingly, people come in with strange ideas, like wanting their eyebrows raised so high that they're in the middle of their forehead or a rhinoplasty done to make their nose so small that it would not only look funny but hard to breathe as well.” While he doesn’t think this should be imposed by national standards or regulations, he believes each surgeon should navigate every patient’s request with a variety of physical and psychiatric indicators in mind. 

“Are they asking for reasonable things? Occasionally, someone comes in and they want something way out of the normal, which it’s never going to serve them well in the long run and it’s our job to talk them out of it,” he says. “Then there is if you feel that there’s an underlying psychological pathology such as body dysmorphic disorder. You need to then get them help.” He’s aware this means that they may go on to another surgeon, but views the argument for freedom of complete self-expression as “kind of a cop-out” and instead makes his decisions using his own moral compass.

Amber Breeana Luke, a 24-year-old body modification enthusiast from Brisbane, Australia, appears far different than what surgeons such as Dr Papel would consider ‘normal’. Tattooing 90 per cent of her body, including her eyeballs, and having breast augmentation surgery, her tongue split twice, and ears pointed twice, she’s never been told ‘no’ by any body modification artist or doctor and sees it as something that is “ultimately your decision”. “I suffer from severe clinical depression and BPD with schizophrenic traits. I see tattoos like I see life, super painful sometimes, but if you stick through it you’re left with a beautiful reminder that you did it,” she says. ”It’s an outlet for me to release negative energy and emotions I’ve built up inside, it feels like that negative energy gets drained every time I get tattooed.”

For Grace Neutral, television presenter, model, and hand-poke tattoo artist, every modification she has had – including getting her eyeballs tattooed, scarification, tongue split, ears pointed, and belly button removed – has been an “integral part” of her personal growth. “It has helped me gain a deeper understanding of myself,” she explains. “The physical pain I went through helped me become mentally stronger and also understand my body, and it’s own personal limits and how far I needed to push them to gain a higher vibration.” 

“You should be able to do whatever you like to your own body. Risk is something you have to weigh up in your head whether the reward will be greater than the risk of going blind or getting blood poisoning” – Grace Neutral

Neutral believes that as long as someone is of “sound body and mind” and the procedure is not life-threatening, “you should be able to do whatever you like to your own body”. As for extreme procedures, she believes a large part is finding the right person to do it. “For me, personally, it took me a while to find someone who could understand my artistic vision and could carry out the procedure with the highest precision,” she says. “Risk is something you have to weigh up in your head whether the reward will be greater than the risk of going blind or getting blood poisoning.”

This year, the American Society of Plastic Surgeons (ASPS) released data that shows there was almost a quarter of a million more cosmetic procedures in 2018 than in 2017 in the US, with almost 18 million people undergoing cosmetic procedures last year. We’re also just beginning to see the beginning impact of social media filters on plastic surgery requests, dubbed as “Snapchat Dysmorphia” by a 2018 study.

As technology evolves, we’re also beginning to see a rise in the concept of ‘transhumanism’, meaning future surgical asks and body modifications are still yet to be determined. This too means that each individual line of the modifier is constantly in flux. However, with people suffering from disorders such as BDD needing medical screening and protection, body modifiers and plastic surgeons are accountable for accessing what state the person is in when making the request and if the procedure will be a tool for self-expression or self-destruction.

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