Turning Prisoners Into Model Citizens … With Plastic Surgery

Turning Prisoners Into Model Citizens … With Plastic Surgery

By Zara Stone


Because better-looking means better-behaved. Maybe.

By Zara Stone

In this original weeklong series, The Plastics: The Changing Face of Cosmetic Surgery, join OZY for a guided tour at the frontiers of enhancement, from aesthetics to pain relief to power performance.

Things were not looking great for the 23-year-old prisoner. Joe (not his real name) was serving time for breaking and entering, his third conviction in two years, and his sociologist described him as “extremely negative with an inferiority complex.” This may have been due, in part, to the fact that the same sociologist labeled him as short with a big hooked nose. But in the run-up to his release, his nose changed, becoming smaller and more refined, and his personality did a corresponding 360. When Joe got out, it was reported that he was now enthusiastic, positive and hardworking.

This was back in the 1950s, when a prison crisis was underway in Canada and America. People were constantly re-offending, and there seemed no way to curb it. But Dr. Edward Lewison, a prominent facial surgeon in Canada, believed he had the answer: free nose jobs and face-lifts for inmates.

“A criminal is an individual who is in some way handicapped,” he wrote in 1965, in a paper published in the Canadian Medical Association Journal. Lewison hypothesized that more attractive patients would behave better. He set out to prove this by performing more than 450 operations over a decade at the Oakalla Prison in British Columbia, where nose jobs made up the bulk of his work.

People feel they’re discriminated against based on how they look.

Kevin Thompson, professor of criminal justice

“Formerly hostile and incorrigible individuals became polite and gracious,” Lewison wrote. His data indicated that his scalpel worked wonders: The recidivism rate for prisoners who underwent surgery was 42 percent, far lower than the 75 percent for the non-altered inmates. The idea caught on, spreading to more prisons and eventually seeing thousands of inmates treated.

“They operated on inmates that felt they were being held back in the labor market,” says criminologist Kevin Thompson, currently a professor in the department of criminal justice and political science at North Dakota State University. Thompson’s interest in this subject was sparked in the early ’80s, when he lived in Texas. He had been researching strain theory, a branch of criminology that assesses how society’s pressures cause people to turn to crime — and was surprised to hear that many of the local prisons ran residency programs for plastic surgeons. But this wasn’t basic trauma reconstruction work; it was working on inmates’ love handles and eye bags — the assumption being that these “flaws” were part of the reason they offended. Inmates needed to be on their best behavior in order to receive this pro bono work. 


“Surgery is regarded as a privilege rather than a right,” Thompson wrote in a paper published in the Criminal Justice and Behavior journal in 1990. Back then, in Texas, surgeons would meet interested prisoners and categorize them by perceived level of need: minimal, moderate, marked or gross. The chosen few then went through psychological screening. Overall, nose jobs were the most popular operations, but prisoners also opted for face-lifts, chin implants and liposuction.

Thompson wasn’t surprised by the inmates’ desire for surgery. “People feel they’re discriminated against based on how they look,” he says. “This starts early on in school with the peer group and teachers.” It’s a well-documented fact that attractive people receive better attention and more opportunities, and that the reverse is true for those considered ugly. Could that be the real reason for criminal activity?

In the ’60s and ’70s, the premise of the “hots” versus the “nots” was oft-repeated, backed by a large number of papers that discussed the unusually high rate of disfigurement in prisons. In 1967, a study by cosmetic surgeons F.W. Masters and D.C. Greaves from the University of Kansas found that 44 percent of homicide prisoners and 62 percent of rapists had facial deformities.

The hope with all these programs was that a new face would lead to new behavior, and, to many, it seemed that this was achieved. Out of nine cosmetic surgery recidivism studies that Thompson evaluated, six showed surgery reduced recidivism by between 6 percent and 33 percent, two found no change and one found it actually increased it by 12 percent. When drug users were excluded from the study, the reduction improved significantly. 

By the mid-1990s, most of the programs had been dismantled, owing to a human rights backlash, Thompson says. Some finished earlier, as they were experimental programs used to assess prisoner behavior. Overall, it seemed that prisoners who had surgery and social help on release were less likely to re-offend. But critics point out that the studies lacked proper controls and follow-up. Overall, though, there seems to be some correlation between surgery and success. So should the government think about bringing these beautifying programs back?

Not according to Thompson. “The findings are too mixed — there’s other things going on in people’s lives, and they’re using the lack of attractiveness as a crutch to blame others for their problems,” he says. Instead of making criminals look better, he says, “we should focus more on skill building and character development.”