There have been many feminist critiques of cosmetic surgery practices in recent times, however, with the notable exception of Jane Megan Northrop’s recent study Reflecting on Cosmetic Surgery: Body Image, Shame and Narcissism, there has been little explicit analysis of cosmetic surgery with respect to the experience of body shame. Despite remaining largely unarticulated by both patients and doctors, Northrop argues that shame about the body is the structure driving not only women’s decisions about surgery, but also the entire “transformative arc in which cosmetic surgery is located” (Northrop, 2012: 173). Attempting to transform body shame into pride is, in fact, central to the drama of cosmetic surgery: shame drives women to seek out surgeons; surgeons cultivate it in order to acquire and maintain their clients; and, ultimately, surgeries are performed in order to alleviate it. As such, this paper will explore the dynamics and politics of body shame in the clinical encounter, with a particular focus on the practice of cosmetic surgery. Looking at the highly gendered relations between surgeons and patients which underpin the majority of cosmetic surgery practices, I will argue that the ‘psychological cure’, often cited as a justification for the medical need for cosmetic surgery, must be critically examined with respect to the intersubjective and political dimensions of shame about the body.