When a recent NY Times article by Mark Oppenheimer, "'Catholics, Plastic Surgery, and the Truth of the Feminine Self'" cites a source that compares plastic surgery to a "burqa made of flesh", critiquing surgery for creating "unrealistic beauty standards", I have to loudly and clearly defend my noble specialty on behalf of the millions of people plastic surgeons have helped.
The article by Oppenheimer focuses on different religious groups' views on plastic surgery. This topic is interesting to me as someone with a background in both medicine and anthropology. How different cultures deal with body image, appearance, and modifying the body form was the subject of my college honors thesis back in 1991. People have been decorating or changing their bodies from the beginning or recorded history, in cultures all the world over. How this history of adorning the body fits into modern cosmetic surgery has been a research interest of mine.
This article, like many media stories covering my profession does, wrongly I believe, focus on plastic surgery as simply for beauty or vanity. The reality is far more complex (like most controversial topics). These cases of chasing a society's ideal of beauty by changing an essentially normal and healthy body to become a different person altogether are actually rare. Most of my patients’ requests lie somewhere in between the extremes of life threatening deformity and pure vanity. They simply have physical features bothersome enough that it impacts their everyday life or their overall health.
Since the American Society of Plastic Surgeons was founded in 1931, its members have pioneered amazing innovations which have created the fields of burn surgery, trauma reconstruction, transplantation, nerve repair, hand surgery, facial birth defect repair, skin and breast cancer reconstruction. These very same reconstructive techniques can be employed for "cosmetic" reasons as well, but on close study, it’s often difficult to tell when "reconstructive" surgery ends and "cosmetic" surgery begins.
Very few would argue against the correction of cleft lip and palates in children. Thanks to Dr. Ralph Millard and other plastic surgery innovators, this relatively common and severe deformity can be safely corrected, even in developing countries with limited infrastructure. Only the most rigid religious thinkers would withhold available medical care and declare it “God's will” that these children endure humiliation, malnutrition and a life of suffering, abuse or even death.
Right up until the 1980's, many cancer surgeons did not offer plastic surgical reconstruction to women undergoing mastectomy surgery for breast cancer. Most believed that the cancer removal should be enough of a benefit and plastic surgery to rebuild a normal breast was frivolous. We now know how emotionally and psychologically beneficial it is for most women to have breast reconstructive surgery and restore a semblance of normal body form.
What of the common case of a woman with breasts so large that they limit her ability to exercise, wear clothing normally, or socialize normally without her deformity impacting how she is perceived? Or the man with eyelids that droop to the point that even reading driving at the end of the day are impacted. He always appears tired and lacking energy to his co-workers and family. There are countless other examples, including deformities after weight loss, pregnancy, skin cancer treatment, or other past surgical disfigurements. Whether we like it or not, it is very human to judge those who are "outsiders" based on appearance. Bringing those outside the norm back in to the norm has been shown, time and time again, to provide extraordinary benefits to people, impacting their lives in countless positive ways, in both beauty and function.
Indeed, there are those who seek cosmetic surgery for the wrong reasons-- to repair fractured relationships, correct failures at work, or repair a long-held negative self-image. And we, as ethical surgeons know that we cannot help them with body changes alone. Our specialty has studied body dysmorphic disorder patients so we can try to recognize those with significant body image issues prior to treatment with surgery. But it is not the specialty of plastic surgery or our patients at fault. An ongoing public dialogue of realistic expectations of health, beauty, aging, disease and deformity is a good start for finding the healthy balance between beauty and body modification.
Dr. Michael S. Suzman is a Plastic Surgeon with WESTMED Medical Group in Westchester County NY, and a Clinical Instructor in Surgery at Weill Medical College of Cornell University in Manhattan, NYC. He is on staff at Greenwich Hospital in Fairfield County CT, White Plains Hospital and Rye Ambulatory Surgery Center.