Cosmetic Surgery

Cosmetic surgery, also called plastic surgery or aesthetic surgery, refers to surgical operations changing, transforming, reconstructing, and shaping the physical human body, and adding or removing body parts for aesthetic purposes. Cosmetic surgery includes operations on the face (such as face-lift and rhinoplasty) and operations on other parts of the body (such as breast augmentation or reduction, liposuction, and abdominoplasty), all conducted under anesthesia. The most common procedures include rhinoplasty, which is usually known as a nose job, as well as breast augmentation or reduction. A subgroup of aesthetic medical procedures, called minimally invasive procedures (such as injection of botulinum toxin or injecting filler materials around lips), are also widely employed.

From a medical perspective, what we know today as cosmetic surgery dates to antiquity. The Sushruta Samhita, written approximately 600 BCE, has the oldest known account of nose reconstruction performed in India and Egypt. Procedures have been improved by the introduction of anesthesia and antiseptic techniques in the latter part of the nineteenth century. After World War II, the branch of aesthetic and reconstructive surgery has begun to specialize and organize. At the same time, public demand has increased as surgical techniques became more refined and advanced. Today, technology for cosmetic surgery is highly sophisticated. Along with the expertise of the surgeon, critical points for consideration with regard to cosmetic surgery include the professional liability of the doctor, appropriate “patient selection” criteria, and informed consent of patients.

Patient selection becomes especially important as patients might be overly concerned with “magical” results of the surgery and expect that the surgery itself will change the problems in their lives, such as a marriage problem or problems at work. Also, some patients are obsessive about how they look, called body dysmorphic disorder, which affects the way they perceive their bodies and surgical results. Some patients are never satisfied, because they always perceive some flaws on their bodies.

Looking at cosmetic surgery as a method of making physical appearance more attractive makes it a method of beautification, which itself is a very old concept. History is full of stories and examples of ancient people who were highly interested in beauty and changed their physical appearances in different ways. Some examples include molding of skulls among Mayan society, making girls' and women's feet very small through painful processes in China, or wearing rings on the neck to make it look longer in Thailand. More decorative and less demanding tools include makeup, hair styling, as well as dieting and exercising, but they are considered less significant since permanent decorative forms are associated with more enduring constructs, such as gender, group affiliations, and cultural norms. Cosmetic surgery, in its current form, is a concept applicable to modern societies.

When cosmetic surgery is considered as a method of beautification, the distinction between reconstructive and aesthetic surgery becomes more problematic. Reconstructive surgery can be used following traumas, injuries, infections, tumors, birth defects, or developmental problems. Aesthetic surgery, on the other hand, can be perceived as elective; and aesthetic surgery patients can be perceived as not really sick. Accordingly, one of the labels for cosmetic surgery in modern societies is that it is unnecessary, nonmedical, and that it is a sign of vanity. The goal in cosmetic surgery is mostly perceived as making the patient's appearance closer to the current ideal.

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