Medicine and modern technologies provide plenty of ways to create and keep a person’s beauty. Nowadays, plastic surgery is not only a profitable industry but also a great moral issue. As it came out of celebrity prioritized zone, its social and psychological effects increasingly gain more recognition. On the one hand, surgeons cannot go beyond the client’s wish. On the other hand, the very existence of the opportunity to change one’s appearance for better becomes a continuous temptation that sometimes grows into a kind of obsession. The only aspect that is often left unrealized by the clients of plastic surgeons is that the gain of external attractiveness will not change the inner state of the person. They are convinced that they promote beauty, but the true fact is that they promote and feed their own vanity.
As research shows, many experts treat “plastic surgery” and “cosmetic surgery” as interchangeable notions. NSW Committee of Inquiry into Cosmetic Surgery delimits the domain of the latter by “reshaping or adorning normal structures of the body or its parts being initiated by the customer and not medical needs and excluding reconstructive surgery” (Ring 598). Such a definition is clear enough for distinguishing plastic surgery from the other kinds. Meredith Rachael Jones conducted a comprehensive research trying to find the differences between various types of surgery. She maintains that “plastic surgery” is the most generic term. “Reconstructive surgery” is the one dealing with eliminating the effects of diseases or injuries, thus being more medically motivated. “Cosmetic surgery” (also called “aesthetic”), according to her, presents a domain referring to elective and anti-aging procedures (Jones 3). The author claims that the difference between “plastic” and “cosmetic” surgery is rather adjacent to the sphere of moral attitude to the procedures. She also points out that, due to the fact of dealing with beauty considerations, solely cosmetic surgeons do not enjoy much respect from their colleagues who face “real problems”. The book by Jones presents special interest as it investigates the types of elective anti-aging procedures at length.
Many researchers who deal with this problem claim that the face of the plastic surgery has changed through the decades of its existence. If earlier it was a kind of a secretive deal unthinkable to boast about, nobody is ashamed to admit he or she was a subject of plastic surgery. Meredith Rachael Jones and Cressida J. Hayes joined their efforts in trying to exhibit the problem from a feministic point of view; however, generally, they state that “plastic surgery occurs at and highlights the intersection of tremendously complex and significant social trends concerning the body, gender, psyche, medical practice and ethics, globalization, aesthetic ideologies, and both communication and medical technologies”. Nowadays, plastic surgeons go so far as to coining new terms defining different kinds of imperfections that can attract the clients and make them use their services. Joan Ann George proves this statement in her dissertation referring to Ellis and Tillmann-Healy who use the term “minor bodily stigma”, which has been in use since 90’s and stresses the state when this defect does not influence the quality of life physically, but can be easily fixable with the help of plastic surgery. Hayes and Jones also manage to define the most peculiar feature of plastic surgery distinguishing it from the other kinds of major intrusions: there cannot be justification found for the operation in the physical medical area, in such a way it involves solely the patient’s own desires, which tightly connects the whole issue with psychological considerations.
‘Does Cosmetic Surgery Improve Psychosocial Wellbeing’
Castle, Honigman and Phillips devote their article “Does Cosmetic Surgery Improve Psychosocial Wellbeing?” to investigation of the problem of psychological effects of plastic surgery. Australian scholars report that while there exists statistical evidence revealing that most of plastic surgeons’ patients are satisfied with the physical results, less scientific attention has been paid to psychological outcomes of cosmetic intervention. Hayes and Jones support this idea maintaining that a large share of plastic surgery clients feel great disappointment after the procedure and “feel more damage by surgery than by their initial dissatisfaction”. Moreover, they point out the fact that defects can not only be corrected but also created by “the economical and technological engine that carries us along, generating even more impossible images”. Castle, Honigman and Phillips refer to the phenomenon of the constant dissatisfaction with one’s own body as to “body dismorphic disorder” (BDD). According to Melissa Dittermann, it is a psychiatric disorder mentioned for the first time in Diagnostic and Statistical Manual of Mental Disorders in 1987. It emerges when, firstly, people have overrated expectations prior to the operation and, secondly, when the procedure never leaves them satisfied in spite of the obviously positive outcomes. People with BDD are extremely concerned about the way they look like, they tend to exaggerate the existing defects, find all the possible ways of external reassurance, and when it is absent, they turn to plastic surgeons. Ironically, studies show that cosmetic surgery rarely turns out to be beneficial for such patients. Moreover, people with BDD often request for multiple procedures trying to improve the same body features. In such case, surgery plays the role of the drug only temporarily stupefying the development of serious psychological issues. Several studies show that from 7 to 12 percent of plastic surgery patients are reported to have some form of BDD (Dittermann). The scholars, however, stress that this syndrome is treatable with the resorting to usage of “serotonin-reuptake inhibitors and cognitive behavior therapy” (Castle, Honigman, and Phillips 603). The important aspect of the article by the Australian psychologists is the presence of recommendations for cosmetic specialists regarding ways to distinguish patients with BDD. They stress that a surgeon must be very attentive and emphatic, and try both not to seem as if he or she underestimates the problem confided by the client and not to encourage the desire to change something. In other words, objectivity is a priority in plastic surgery. Moreover, the expert should not conceal any outcomes of the surgery. It is especially important for BDD patients as finding out the truth about the difficulties of rehabilitation period may decrease their psychotic zeal. These findings prove how much responsibility is relied on plastic surgeons. They should realize that the economic factor should not be prevailing in dealing with the patient for, after all, plastic surgeons are physicians who are to heal, not to harm.
What concerns the underlying premises of the disorder, the urge to constantly change something in one’s own appearance may be the result of the inferiority complex, the researchers claim (Hayes and Jones 5). This idea is also supported by the investigation results of Hussain, Schofield and Loxton: “poor body image and low self-esteem” are considered to be the major factors leading women to plastic surgery clinics. Researching the measure of psychological influence of the conducted surgery on the general well-being of the person, Castle, Honigman and Phillips pay attention to another important aspect – citing other authors. They suggest that for operations involving more serious intrusions (so called “type change”), for instance, rhinoplasty or increase of the breasts, there exists enhanced likeliness of a deep body-image disturbance, while “restorative” procedures like face-lift are not distinguished by such an effect. Scientists claim that physical adjustment to any plastic surgery procedure is inevitably connected with the psychological one, and this sensory disturbance only aggravates the difficult period. Regarding the issue of overrated expectations, the researchers suggest that for those plastic surgery patients who hope that the operation will eliminate all the problems in life, the outcomes are most likely to be devastating. The existence of positive associations between undergoing a cosmetic surgery in the past and the current use of medication prescribed against anxieties and sleep disorders, as it was shown by a research carried out in Australia, may be an indicator of a psychological distress (Hussain, Schofield, and Loxton).
This idea is supported by Melissa Dittmann, a journalist of APA Online Monitor on Psychology. She quotes the results of the research carried out by Castle, Honigman and Phillips in 2004: findings show that patients who are not satisfied with the results of the operation may either try to change it and undergo a repetition of the procedure or stifle their dissatisfaction and put up with it, which will later lead to depression and problems of adjustment. Negative consequences of a plastic surgery may also include such serious problems as “social isolation, family problems and self-destructive behaviors” (Dittmann). It triggers the feeling of anger towards surgeons and their assistants who operated these people. Some of the investigations on the matter cited by the author reveal connection between dissatisfaction after the surgical procedure with suicidal inclinations: their results manifest that for women who have breast implants, the likeliness of committing suicide is four times higher than for other patients of plastic surgeons of the same age. As for the other three studies on the topic that were used in the article, they reveal that the rate of suicide for plastic surgery patients is even two to three times greater. Melissa Dittmann states, however, that in such cases, the operation itself is not a sufficient factor for triggering self-murder moods, explaining that the psychological state of the patients prior to the procedure plays the central role in the possible tragic outcome. The research by the Monitor staff journalist is valuable due to the presence of remarks on the psychological status of people who undergo plastic or cosmetic surgery. Dittmann points out that their mental images are subjects of considerable alternations: if only 30 years ago a lot of mental health experts treated such patients as the ones experiencing certain psychiatric issues, many studies conducted since then maintain that “those who seek cosmetic surgery have few differences pathologically with those who don’t have surgery”. These facts allow the journalist to draw a conclusion that the prevalence of plastic surgery is likely to present a lot of psychologists with a new stratum of clients – those who contemplate a radical change of their appearance have already resorted to it. Thus, the findings of many experts serve as evidence to tight connections existing between the state of the person prior to surgical invasion and after it, and the general tendency indicating that the mental condition of the person is unlikely to improve.
Plastic surgery and the age of the patients
Melissa Dittmann presents statistics for the US in 2004 revealing that the most popular procedures included “nose reshaping, breast lifts, breast augmentation, liposuction and tummy tucks”. Overall, in that year, nearly 240,682 minors used the services of cosmetic surgeons. The journalist points out that psychological follow-up of this statistics leaves much to be desired, for the research on the topic is rather insufficient when taking into account the seriousness of the problem. Generally, the experts agree that the safety and possible long-term risks of these procedures on adolescents still constitute crucial points to be examined. They stress that adolescence is the period when a person continues to develop both mentally and physically. The desire to conduct a radical change of appearance may be dictated by the unstable self-image so typical to teenagers. Mass media with the exaggerated beauty canons it instills contributes to this uncertainty. A distorted perception of bodily beauty by no means facilitates a normal and adequate self-concept. However, it should be kept in mind that the adults with their already formed personalities are affected with these marketing-planned advertising messages streaming from fashion magazines and TV screens in the same way. The combination of teenage plastic surgery with the anti-aging one constitutes another stratum of this complicated phenomenon. At the same time, it manifests the general prevalence of resorting to the services of plastic surgeons trying to keep up with the artificial standards of physical attractiveness.
Another important factor which distinguishes plastic surgery from other kinds of medical intrusion is its private character. Surgery of this kind is not financed by the state. That is why the proposal of the Senate is to introduce a 5% tax for elective cosmetic surgery procedures expressed in 2009 (which acquired a jocular name “Botax”) that caused such a commotion in the rows of American plastic surgeons. This situation at least allowed to find out that the industry of cosmetic surgery is mostly supported by people whose incomes are not very high (Beam 1). Being a full-fledged industry, plastic surgery resorts to strategies and uses the levers inherent to any business. The side effect of this business is the deliberate implanting of certain values that generally fall under the category of prejudices. In other words, plastic surgeons are the most active propagandists of lookism. Ann Ring claims that there exists sufficient evidence that the tactics of turning aging into a negative quality is actively abused by medical practitioners, resulting in great profits for them and the distortion of the image of this natural bodily process for their patients. It is executed through a range of media and various advertising technologies. The negative social and ethical effect of it, apart from morality considerations, is displayed by “undermining public confidence in the medical profession” (Ring 599). Patients tend to trust the experts working in the medical sphere, no matter what domain they represent. The traditional confidential doctor-patient relationships are also subjects to certain changes triggered by lower prestige of this surgical branch. Jayne O’Donnell gives a physician’s insight to it claiming that the old relations between doctors and patients are simply violated: “People want it cheaper, faster and don’t ask enough questions”. Thus, people must be very cautious in order not to fall victims of a consistent marketing trick by trying to improve their lives.
Dangers for health
Apart from quite understandable physical discomfort connected with the long and painful healing period, plastic surgery conceals rather definite dangers for health when various complications are concerned and even for life when the operation is conducted by an underqualified person. Jayne O’Donnell in her article calls plastic surgery “a booming business” and tries to explain the nature of this boom. She warns the readers that in this aspect, quantity is not supported by quality: sales pressure on plastic surgery clinics of a new kind forces the hiring of barely adequate medical personnel – surgeons who are “either board-certified or up for certification”. Such doctors do not pay enough attention to the medical history of the patients, do not screen their state after the procedure and, due to profit-gaining considerations, they often persuade people to undergo certain operations without any evident necessity. The results of such an approach can easily be predicted. The facts of “incompetence, negligence or malpractice” gain public attention very fast. Tragic story of an Argentinean model Solange Magnano, who died after the unsuccessful gluteoplasty when the liquid injected into her buttocks aimed to make them firmer caused “a pulmonary embolism and blocked a lung artery”, is not the only one (Worden). It can be called a classical case when the life of the natural beauty finished in a mindless pursuit for an unreachable ideal. The story of this model received such resonance because of her celebrity status. The real amount of victims of the plastic surgery must be frightening. Even Food and Drug Administration is concerned with the use of silicone gel breast implants motivating it by the absence of long-term research which could prove their safety (Dittmann). Before venturing for a plastic surgery, such a risk factor as overdose of pain medication (referred to in the study of O’Donnell), which is not directly connected with plastic surgery operation, also must be taken into account. Of course, the surgeons themselves will keep stressing the safety of procedures of the kind, “with very low rates of complications” (Gonzalez 425), but as well as in any surgery, there always exist certain risks. Probably, when a doctor himself claims that, for instance, embolism is an “unavoidable complication of liposuction” (O’Donnell), even if it is plain self-defense in the court, people should finally pay attention to such statements. It leads to drawing a conclusion that a person waging for this radical intrusion into the body must think twice whether the inner beauty is worth taking this risk.
Marie Claire shares some statistics concerning plastic surgery in America dating back to 2010. It is once more emphasized that the industry is no longer concentrated on well-to-do people, which finds its reflection in the number of operations performed nationwide – “3 million cosmetic surgical and nonsurgical procedures”. This number constitutes a 155-percent increase compared to 1997 when the statistic on the issue was gathered for the first time. The glossy magazine also specifies the most widespread procedures which include “breast augmentation, liposuction, eyelid surgery, abdominoplasty, and breast reduction”. The fact of presence of two opposite operations on breasts may be a brilliant example of the relevant value of plastic surgery. The underlying premises of such an industry boost may be explained by a simple psychological fact that many Americans are not satisfied with the way they look, as studies show (Hussain, Schofield, and Loxton). Such nationwide statistics proves that moral and psychological aspect of plastic surgery comes to the foreground in America.
With the whole scope of negative effects produced by resorting to plastic surgery, positive outcomes of it reflected at the psychological level must also be taken into consideration. Venturing a fundamental cosmetic intrusion, people feel that the aftermath of the operation will generate enhanced “self-esteem, mood and social confidence” (Castle, Honigman, and Phillips 601). Studies maintain that the majority of the patients turn out to be pleased with the results of plastic surgery and generally begin to feel better about themselves. Surprisingly enough, a large share of this group consists of women who underwent breast reduction operation. This fact alone manifests how relative and unclear the beauty canons are: while most of the women feel depressed having too small sizes, some of them feel a tremendous relief finally acquiring these small sizes. The authors themselves, however, stress on the disadvantages of the given research pointing out such defects as “small sample sizes and potentially biased ascertainment”. Another important argument for plastic surgery is the economic one. It is explained at length in the article by Christopher Beam, who suggests that applying to the services of the plastic surgeon can generate incentives for changing life for better. The journalist cites doctors who claim that their operations contribute to making people feel as “more productive and valuable employees”. It is supported by the widespread idea that physically attractive executives of many industries tend to be more successful than their colleagues with an average appearance. Evidence shows that “professional, managerial, administrative and sales occupations” are at the top of the rating concerning the number of women proceeding with careers in these spheres who used the services of plastic surgeons (Hussain, Schofield, and Loxton). Such international data allows establishing connections between plastic surgery and success at work. Beam cites Daniel Hamermesh who conducted a comprehensive research proving that good looks increase wages. More crucial is, however, the remark of this professor of economics that reveals that trying to look better, be it realized by wardrobe alterations or surgical intervention, leads to the same results, but people are still able to distinguish natural beauty from that acquired by scalpel and syringe.
Plastic surgery is a great manifestation of the technical progress of mankind in medicine. History proves, however, that lately rare scientific achievements truly make our lives better in terms of moral approach. From the expensive and exclusive phenomenon in ancient times, due to medical progress, plastic surgery managed to turn into a great temptation. The complexity of this phenomenon can be proved by the presence of medical, legal, economical and psychological aspect in it, each with its own negative features. But those who venture cosmetic surgery often do not realize that it is not a matter of necessity, and instead of slicing their bodies, they could deal with their emotional and psychological problems first. Body dysmorphic disorder is an illustration of how far a person can go from finding defects where they are absent to destroying the beauty that was given by nature because of these false convictions. Both minors and middle-aged people constitute a focus group for the industry of plastic surgery. Such an urge to become better looking is encouraged by the prevalence of plastic surgeons providing low-quality operations presenting risks for the health of their patients. Numerous complications and even lethal incidents are factors that can make people think whether the result is worth it. Probably, before lying under the scalpel, potential plastic surgery patients should learn to love their bodies the way they were created. There are arguments supporting the idea that new appearance may lead to improvements in self-esteem, personal life and career. Nevertheless, people should not perceive plastic surgery as the universal solution to all of their problems.