Amid tense peace negotiations, violence remains a fact of life. This hasn’t stopped people from seeking out beauty.

Few people wanted new noses when Dr. Zalmai Khan Ahmadzai set up shop in 2006. Cosmetic surgery was still foreign to Afghanistan, and most who knew about it couldn’t afford it. Ahmadzai began appearing on TV to dispel rumors about plastic surgery and to advertise his work. Fifteen years later, business is booming. At $450, he can perform nose jobs at a fraction of the cost of doctors in wealthier nations. He performs about 50 of them a month. 

With prices so cheap, Ahmadzai’s schedule is tightly booked. He charges $300 for Botox injections, $1,000 for breast implants and $3,000 for liposuction. These prices exclude the vast majority of Afghans, but they attract the war-torn country’s nascent middle class. More people than ever have disposable income to spend on bodily enhancement. Their newly sculpted noses and lean figures prove that war doesn’t stop people from thinking about beauty. 

Social media explains why so many people are seeking cosmetic surgery. A growing number of Afghans, especially the young, have access to the internet, and social media offers a view into the broader world. Clients walk into clinics with pictures of their favorite Bollywood stars or Turkish telenovela actors. It also provides a space to share the results of plastic surgeries and to gain likes and compliments from friends.

Ahmadzai’s “Skin Beauty Specialized Hospital” is one of 10 clinics in Kabul that offer cosmetic surgery. From the outside, it looks like a mere pharmacy, an intentional design. Doctors occupy a dangerous position in Afghanistan. Thought to be rich, the Taliban frequently targets them for kidnapping and charges an exorbitant ransom. Plastic surgeons in particular bear societywide scrutiny. Cosmetic work carries a widely held stigma in Afghanistan. Many believe that a woman who focuses on her beauty to such an extent is immodest. Religious extremists threaten violence in the comment section of Ahmadzai’s Facebook page. They accuse him of tampering with God’s creation.

If the Taliban claims that Ahmadzai tampers with God’s creation, the group must concede that war does too. Ahmadzai splits his time between Kabul and Jalalabad, a city in the country’s east. There, he treats patients free of charge and mends injuries caused by violent conflict. People travel miles from the countryside to seek out his services. Years of war between the government and the Taliban have left countless people with disfiguring injuries. Others suffer violence in a more personal context.

One patient was married to an abusive husband who violently assaulted her on multiple occasions. After one argument, he pinned her to the ground and cut off her nose. After the police arrested her attacker, she shared her story on social media, where Ahmadzai first saw her wound. He took on the case and began a series of reconstructive surgeries, also free of charge. 

There is a dark side to this budding industry, however. A look inside Ahmadzai’s waiting room reveals Afghanistan’s unequal beauty standards. The overwhelming majority of clients seeking cosmetic surgery are women; they constitute 75% of Ahmadzai’s patients. Many parents seek the help of a plastic surgeon to beautify their daughter so that they can marry her off more easily. 

Exclusionary beauty standards risk being perpetuated also. Ethnic Hazaras account for 9% of all Afghans, the rest being mainly Pashtun and Tajik. They are vilified and persecuted by the Taliban and the Islamic State group as apostates. Visually, Hazaras can be identified by their smaller noses and eyes. Ahmadzai sees 20 to 30 Hazara clients a month, and almost all seek to modify their distinguishing features to resemble Afghans of different ethnic groups. 

If nothing else, the burgeoning cosmetic surgery industry signals at least one positive development: a growing middle class in Afghanistan. More women than ever have the disposable income to splurge on a nose job or liposuction. The increasing availability of medical resources is also heartening. The Afghan government reserves only 4% of its budget to the health sector, amounting to a measly $6.50 per citizen. Ahmadzai can expect just as many patients in the future, if not more. A question surfaces, however, as more and more women try to become prettier through surgery: why must a woman undergo a costly surgery just to feel beautiful?

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Michael is an undergraduate student at Haverford College, dodging the pandemic by taking a gap year. He writes in a variety of genres, and his time in high school debate renders political writing an inevitable fascination. Writing at Catalyst and the Bi-Co News, a student-run newspaper, provides an outlet for this passion. In the future, he intends to keep writing in mediums both informative and creative.