What do Michael Jackson, the Kardashians, and Cristiano Ronaldo have in common?
Plastic surgery.
In his 1988 autobiography Moonwalk, the King of Pop writes that he has undergone several rhinoplasties, let aside the forehead lifts, chin surgeries, and skin repair that have drastically changed his face. According to local magazines, the Kardashians “have changed the face of plastic surgery”; and the Portuguese football star has spent “several thousand euros in cosmetic surgery over the years.” Nonetheless, the list of icons and big television figures with periodic visits to plastic surgeons programmed in their schedules is far from finished. These celebrities constitute as little as 1 in a millionth of people across the globe that get plastic surgeries every year. Per the 2020 statistics report issued by the American Society of Plastic Surgeons, $16.7 billion was spent on cosmetic procedures in the U.S. during 2020 alone.
Originating from the Greek word “plastikos”, meaning to mold and shape, the field of plastic surgery can be divided into two main subtypes: cosmetic plastic surgery and reconstructive surgery. As a start, it is worth drawing a fine line between the two as the terminology is very often mixed among both categories. While the former is medically necessary to restore the normal functioning and appearance of deformities, trauma, medical accidents, and cancer, the latter is not. Some of the most famous examples of reconstructive operations include cleft repair, breast reconstruction after cancerous growth, and treatment of burn injuries. In contrast, cosmetic procedures are simply performed to “enhance overall cosmetic appearance by reshaping and adjusting normal anatomy to make it visually more appealing.” Under this sub-specialty of plastic surgery fall the procedures which are very often easily noticed and cannot be ignored, such as breast augmentation, lip filling, tummy tucks, facelifts, and liposuction. In reality, however, this fine line between plastic and reconstructive procedures is very often blurred because the final product of both procedure types always funnels down to attaining the maximum cosmetic appearance possible. For instance, rhinoplasty or nose surgery is one of those procedures which can be deemed both “reconstructive” and “cosmetic”. After a nasal fracture, surgery to restore normal breathing is not purely therapeutic per se, but also walks in parallel alongside the aesthetic improvement of nose structure. Ironically, the icon Michael Jackson knew this very well. “I’ve had no plastic surgery on my face. Just for my nose; it helped me breathe better so I can hit higher notes,” says the King of Pop when questioned about his face transformation. Yet, in spite of Jackson’s nose injury while performing on stage, rhinoplasty surgeon Dr. Pamela Lipkin tells ABC News that it is unlikely that better singing was the sole purpose behind Michael’s nose reshaping.
Regardless, patients seeking for any plastic surgery operation should do their homework thoroughly, and make sure their surgeon is board-certified (one of the many yardsticks in determining a surgeon’s qualifications). Studying the credentials of the doctor permits the patient to rest assured that the physician has completed the essential training, and possesses the expertise to deliver a service of utmost quality. Alas, gaining patients’ confidence is easier said than done, not to mention the difficulty of becoming a plastic surgeon in the first place. Statistics say the overall competitiveness of plastic surgery residency post-medical school is “extremely high”, not to mention its longer training period compared to other specialties. According to the NCBI, plastic surgery (PS) residency is considered one of the most competitive; and so are controversies around it.
Yes, PS is controversial as much as it is competitive. Despite the evident boom in plastic surgery, many experts and scientists around the world are not very happy about it. So, where does the so-called “always do what is best for the patient, and the patient comes first” fall short? And what’s all the fuss about?
Overall, there are more questions around the “good or bad” nature of plastic surgery than there are answers. Hence, it is only by weighing the pros and cons of such procedures, that a fair verdict can be made in this regard. With the present culture becoming increasingly concerned with image and appearance, it is by no surprise that advocates of plastic surgery consider themselves agents of wellbeing. In a recent study by the University of Pennsylvania School of Medicine, 87% of patients reported “satisfaction following their surgery, including improvements in their overall body image and less negative body image emotions in social situations.” If you could get “quality-of-life” boosts from plastic surgery, why do oppositions stand firm? The response is that expectations are not always met. Unfortunately, plastic surgery has been linked to poor post-surgical outcomes in many instances, the repercussions of which have transcended depression and other psychological disorders, going as far as suicide. One study by the National Cancer in 2001 concluded that patients with breast implants were 4 times more likely to commit suicide. Nonetheless, correlation does not simply mean causation; these accusations remain mere speculations in light of the underlying personality characteristics predisposing these surgery recipients to suicide and what they carry with unrealistic expectations of aesthetic outcomes. In a nutshell then, the majority of plastic surgeries lead to better self-esteem and confidence.
Owing to medicine, you can correct your “problems”, feel comfortable with yourself, and radiate positive emotions in everything you do, wherever you go. While this peace of mind that results from PS seems far more artsy than actual, psychology has entered the stage to show the public that these marvels are in fact true. “Studies have shown that physical attractiveness correlates with professional success, such as hiring decisions, promotions, and salary,” therefore awarding plastic surgery a seat in “the pillars of career prosperity”. For others, the perception people have of themselves isn’t even the prime factor behind resorting to plastic surgery. All that matters is that they, themselves, are bothered by these apparent slights and imperfections and thus have every reason to do whatever they please in order to feel better about their looks. Alas, life isn’t always black and white. Such a phenomenon also raises big questions on inequality. Equitable access to healthcare is regarded as a basic human right. However, resources are limited and it is not possible for any health service to provide aesthetic surgery for all those who would like it. This is especially true in the private sector where plastic surgery has become synonymous with those who can afford to pay. As a result, opponents of beautification movements argue how such procedures increase the gap between society’s different classes, aggravating the misfortune of the poor. Nevertheless, plastic surgeon Luis M. Rios Jr.—who served a residency at the University of California and became the Chief Resident of Surgery—totally disagrees. “Don’t assume that cosmetic surgery is something that’s […] limited to millionaires and the like. Many high-quality plastic surgery procedures are more affordable than ever before,” he claims. As he puts it, if you want to enhance your looks and maintain your budget at the same time, “plastic surgery can be your best friend.”
In the eyes of some, what preceded may be viewed as luxury, but plastic surgery is also a necessity in many circumstances…dictating the fate of our quality of life. These cases are mostly relevant to the reconstructive umbrella of the field, more commonly referred to by doctors as “medically practical” conditions. Atop such examples would be a patient whose eyesight is highly impaired by the hooded portion of the eyelid partially blocking the field of vision. Plastic surgery is a beam of hope at the end of this dark tunnel, and can effectively solve the issue by a simple eyelid lift. Furthermore, individuals with abnormally oversized breasts or 20 pounds of loose skin, could respectively undergo breast reduction and skin removal post-weight loss in order to alleviate daily pain and insecurity. In addition, disfigured patients and breast cancer survivors with single or double mastectomy could benefit from reconstructive medicine. The culmination of such processes is simple: an increase in physical activity/productivity and more importantly a chance at regaining a sense of equality. Referring to the aforementioned problem of inequality which anti-plastic surgery movements take pride of, the latter is a firm argument for equity rather than against it. According to the University of Utah Health, “plastic surgery, performed together with orthopedic and vascular surgery, can restore substantial function to severely injured limbs.” With that being said, naturally born amputees and victims of both traumatic and surgical amputation can get a good shot at normal functioning thanks to plastic surgery.
“Plastic surgery is the most dynamic specialty. One moment you’re repairing a cleft lip on a neonate, the next you’re […] working next to a neurosurgeon and reattaching a skull,” answers Dr. Tony Weaver—surgeon from Huntsville, Alabama, United States—when asked why he chose his career path. Ranging from minimally-invasive treatments like Botox injections and laser treatments, to surgical procedures, this branch of medicine is a museum of art worth discovering and admiring. With the Ancient Egyptians carrying out nose jobs long ago and the Indian physician Sushruta conducting plastic surgery in 6th Century BCE, plastic surgery is no recent domain. On the contrary, it is the product of centuries of technological advancements and medical discoveries which have made the field of surgery what it is today.
If you thought plastic surgery is synonymous with looks and appearances defining who you are, reconsider your beliefs. “When people make up stories that I don’t want to be who I am, it hurts me,” says Michael Jackson to ABC news. Jackson’s words are exactly those of every woman and man that view plastic surgery as their beacon of self-worth and inner ease. Dr. Steven Haughlin—Michael’s surgeon—believes he “fulfilled Jackson’s wishes[…]to make him, possibly, happy.” Now that is the take-home message every surgeon strives to deliver: if something makes you happy, pursue it. One thing is for sure: plastic surgery is not one of the many “double-edged swords”. Why? Simply because its benefits clearly outweigh the disadvantages.
Man’s pursuit for happiness and meaning is like a treasure, the realm of medicine…its key. With the key to the lock in clear eyesight, all we have to do is stand up and approach the treasure…which when opened, shines brighter than gold.
Edited by Mohamad Wehbe