Intentional permanent or semipermanent modifications of the living human body for religious, aesthetic, or social reasons. The methods of modification and mutilation used are incision, perforation, complete or partial removal, cautery, abrasion, adhesion, insertion of foreign bodies or materials, compression, distention, diversion, enlargement, and staining. Body modifications are frequently performed for magical and medical purposes, but cosmetic (aesthetic) motives are perhaps equally common.

The variability of the results in different cultures is an excellent indication of the relativity of ideals of beauty. Ritualistic motives for modification are concerned with religion (sacrifice, ascetic mortification), magical protection, mourning, the indication of status or rank or group membership, bravado, and punishment.

The practice of ritual mutilation is generally used to modify the social position of an individual in a manner visible to and recognized by other members of the society. Mutilation may be performed as a part of initiation, marriage, or mourning rites, or it may be inflicted as a means of punishment, either for serious crimes or for social transgressions.

The head Mutilation and modification of the head includes alterations of the skull, lips, teeth, tongue, nose, eyes, or ears. Cephalic deformation is the best-documented form, largely because archaeological skeletal remains clearly show its presence. Tabular deformations are produced by constant pressure of small boards or other flattened surfaces against the infant's head (see head flattening).

Annular deformations are produced by a constricting band; each kind is subdivided according to the resulting head shape, which is often strikingly different from the normal. Cranial deformation is known from all continents except Australia and from Oceania. It is rather rare in Africa south of the Sahara and apparently absent from south India.

Perforation of the lower lip (or less often the upper) for insertion of a decorative plug or other ornament is widespread in Africa and among lowland South American Indians and was formerly common among Indians of the northwest North American coast and the Eskimo. The most striking instance is that of the women of the Sara tribe of central Africa (commonly known as Ubangi after the name erroneously applied in P.T. Barnum's publicity), whose lips are slit and then stretched by saucer-shaped plugs.

Dental mutilations take the form of removal, usually of one or more incisors (ancient Peru, most Australian Aborigines, some groups in Africa, Melanesia, and elsewhere); pointing in various patterns by chipping (Africa) or filing (ancient Mexico and Central America); filing of the surface, sometimes into relief designs (Indonesia); incrustation with precious stones or metal (SE Asia, India, ancient Mexico, and Ecuador); insertion of a peg between the teeth (India); and blackening (south India, hill peoples in Myanmar [Burma], some Malaysian groups.) Ancient Aztec and Maya Indians drew a cord of thorns through the tongue as a form of sacrifice; some Australian tribes draw blood from gashes under the tongue at initiation rites.

For the insertion of decorative objects through the nose, perforation of the septum, or one or each of the wings, or alae (or both procedures combined), is widespread among South American Indians, Melanesians, and inhabitants of India and Africa; it is sporadic elsewhere (e.g., Polynesians, North American Indians). 

The ancient Maya Indians considered crosseyes beautiful and induced the condition by hanging an object between a baby's eyes. Perforation of the earlobe for insertion of an ornament is widespread. Sometimes the hole is gradually stretched to carry a larger ornament or to yield a greater distended pendant margin. More rarely, ornaments are inserted in holes along the auricular margin (eastern North American Indians and some African and tropical South American groups). The genitalia The best-known and most widespread genital modification is circumcision.

Subincision (opening the urethra along the inferior surface of the penis for a varying distance between the urinary meatus and the scrotum) is a common practice at puberty initiations among Australian Aborigines and is recorded as a therapeutic measure among Fijians, Tongans, and Amazonian Indians. Customary unilateral castration (monorchy) is known in central Algeria, among the Beja (Egypt), Sidamo (Ethiopia), San and Khoikhoi (southern Africa), and some Australian Aborigines, and on Ponape Island (Micronesia). 

Bilateral castration was common to produce eunuchs for Muslim harem attendants and for several centuries (until prohibited by Pope Leo XIII in the late 19th century) to produce male sopranos or contraltos called castrati (see castrato) for ecclesiastical chants in the Roman Catholic church. Bilateral castration is a mutilation mentioned as punishment for adultery among the Azande (central Africa), Babylonians, ancient Egyptians, ancient Chinese, and elsewhere. Among the Toradja and Sadang (Celebes) and some Dayak groups (Borneo), many adult men wore a penis pin, knobbed on each end and averaging about 1.5 inches (4 cm) long, in a permanent perforation through the glans, to increase pleasure in their sexual partners. 

The Alfur (Celebes) inserted pebbles under the skin of the glans for the same purpose. Female modifications include excision (of part or all of the clitoris--clitoridectomy, female circumcision--and sometimes also of the labia, mons, or both), in much of Africa, ancient Egypt, India, Malaysia, and Australia, and among the Skoptsy (a Russian Christian sect); incision (of the external genitalia, without removal of any part) among the Totonac (Mexico) and tropical South American Indians; infibulation (induced adhesion of the labia minora, leaving only a small orifice, to prevent sexual intercourse until the orifice is reopened by incision) in the Horn of Africa and among some Arabs; dilatation (of the vaginal orifice, often with incision) among some Australian Aborigines; elongation of the labia (tablier), recorded for southern Africa and the Caroline Islands; and artificial defloration (among Australian Aborigines and elsewhere). 

The limbs Constriction of the arms or legs by tight bands may cause permanent enlargement of the unconstricted area. The custom occurs among several East African and tropical South American peoples and also sporadically in Nigeria, Southeast Asia, and Melanesia. From the T'ang dynasty (AD 618-907) until the 20th century, many Chinese women had their feet tightly bound in early childhood, forming the famous "golden lily" feet, much reduced in size and deformed to match the aesthetic ideal.

Amputation of a phalanx or whole finger, usually as a form of sacrifice or in demonstration of mourning, was common among North American Indians, Australian Aborigines, San and Khoikhoin, Nicobarese, Tongans, Fijians, and some groups in New Guinea, South America, and elsewhere. Amputation of the toes is less common but occurred in Fijian mourning. 

The skin Mutilation and modification of the skin are accomplished primarily by tattooing and cicatrization, or scarification (see tattoo). In the former, colour is introduced under the skin; in the latter, raised scars (keloids) are produced by incision or burning, usually in decorative patterns. 

Scarification occurs primarily among darker-skinned peoples in much of Africa, among Australian and Tasmanian aborigines, and in many Melanesian and New Guinean groups; it is practiced both for aesthetic effect and to indicate status or lineage. Another form of skin modification is the introduction of objects under the skin: e.g., magical protective amulets inserted under the skin by some Myanmar (Burmese). 

The torso Mutilation and modification of the torso focus on the neck, trunk, and breasts. The Padaung women of Myanmar are famous for necks stretched by a coiled brass neck ring to a length of about 15 inches (38 cm), with about four thoracic vertebrae pulled up into the neck. The shape of the breasts has sometimes been customarily altered for aesthetic reasons by compression (e.g., in the Caucasus, in 16th-17th century Spain) or distention (e.g., among the Payagu of Paraguay).

Silicone gel implants to enlarge the breasts came into use in the United States and other modern societies in the second half of the 20th century. Mutilations are also known: removal of the right breast by the Amazons of classical legend; removal of both nipples of both breasts for religious reasons by the Skoptsy; amputation of the breasts as punishment under Hammurabi's Code.

Among several African peoples (Efik, Ganda, Nyoro, and others), girls were secluded at puberty for several months and fattened with special diets. Women in Middle Eastern harems were also artificially fattened for aesthetic reasons. The reverse effect was achieved in Europe by means of tight-fitting corsets that caused permanent and often deleterious deformations of the rib cage and internal organs.