Up@dawn 2.0

Tuesday, May 5, 2015

Ethics of the Cosmetic Industry: When Patients Make the Wrong Decision and the Practitioner Lets Them

III. Rehabilitation of Self Image- Solutions to Decisions Made in Vainity
 In the last installment,  we left off with Bruce Jenner's potential transgendered surgery as the defining statement to his long history of cosmetic modification. In our youth abs beauty fixated society,  how a person looks is everything these days.  Cases wherein cosmetic surgery is medically needed to improve an individual's quality of life,  such as with skin graphing burn victims or the American coalition to give free plastic surgery to victims of the bombings of Hiroshima and Nagasaki after World War II, famously known as the Hiroshima Maidens. This group of 25 school girls were horrifically disfigured from the atomic bombs,  and in 1955 their journey was televised. 

Cosmetic surgery is not under attack here. It is one of the most innovative medical procedures we have been able to master in the modern age.  But as we all know,  with great power comes great responsibility.  The responsibility does not rest on the shoulders of the patients,  but on the surgeons and medical consultants to not preassure patients who may be disposed to psychological disorders or body image issues.  Rather than treating patients as a means to make a sell by feeding them whatever manipulative jargon is going to result with patient's strong and sure affirmative,  they need to instead provide the proper advice and information to let the patient know that if this is a quick fix to a deeper psychological trauma they'd are other avenues to explore prior to going under the knife.  With cosmetic surgery becoming such an integral component of our society,  the procedure is treated as recreational, which objectifies the human form to be treated as a new accessory to be updated with the fashion of the season.  
Rather than representing itself for the prestigious medical advancement it is, cosmetic surgery instead advertises itself as a confidence booster. This is detrimental to the patient in two ways.  Firstly,  it is trying to sell a perception where there are no means by which a true guarantee can be given or physical acquisition can be gained from "confidence" as a product. Secondly, the tactic of selling confidence perpetuates the insecurities of our culture. The article "A New Face: What Are the Psychological Risks?" in the Huffington Post by physiologist and author Dr. Vivian Diller Ph.d. examines the escalaction of cosmetic sugery in our culture:
You see, there are two important but separate issues at hand: the immediate emotional concerns faced by patients opting to surgically alter their physical appearance, and the farther-ranging cultural one about what this trend means in terms of ourdefinition of beauty, its impact on our self-image and on our society at large.

Now that we possess the capacity to change  every aspect of our nature from our environment to our bodies, we ha e made self-improvement limitless and have transformed survival of the fittest to take on a complately new meaning as we have introduced a slew of newly sought-after traits to our proverbial pallet. Take the competitive nature of Hollywood culture where survival really does depend on your loss when trying to be successful in either the film or movie industries.  If this is your world,  one obsessed with power and image,  your family's pedigree of a long history of tall men with strong broad shoulders is more likely to be overlooked in favor of what new feature you've added to your face or who you went to to have those few extra inches shaved off your knees to give you your willowy figure.  Do not mistake this for cynicism.  I am using extreme examples and rougher descriptions in order for us to understand just how much damage our obsession with self-image had done to the natural order of things, and Hollywood does almost makes too perfect a setting to see just how much damage we have wrought. 


The Rise and Fall of the Unnaturally Enhanced

I. Morality Salience

Many of us may go throughout our lives without ever letting the inevitability of our own mortality bring us down.  Maybe some of us look forward to it as the great test of the soul, or maybe you see it as some great experience where you can learn and grow.  Maybe it doesn't effect you and you are unencumbered. Then again, the essence of mortality could bring about about existential crisis,  where you find yourself asking "WHO AM I!" in the biggest way. 
Morality salience is when the self-awareness of mortality results in an anxious melancholy that begins to effect our personal/world view and wreak havoc on self-esteem.  It would be easy to say this principle is the cause to every power hungry, blindlessly greedy, treacherous effect in human history,  and in some cases you wound be right, but in our age of biomedical enhancement the anxiety has shifted to a more personal veiw. In our era,  should Napoleon Bonaparte be born again,  he needn't attempt to try to conquer the world to prove himself a "big" man. He could just do what the guy in this video did and have his legs broken and have telescopic rods implanted into them so that he may grow about one millimeter a day. No thousands of casualties and woes of revolutionary war need apply. Our history books taught us trying to conquer the world is messy and hardwork, and now that it's mostly done for us anyway with globalization it is so much safer to consult a plastic surgeon to fix yourself. 
But where does self-improvement become detrimental,  and how does "changing the self" come to effect the inner self in the end?

Tune in next time for: Who Is This Monster in the Mirror, and What Have You Done With My New Lips?

Extraneous Metamorphism Does Little to Mend Internal Strife

II.  Who Is This Monster in the Mirror, and What Have You Done With My New Lips?

The prestige of cosmetic surgery began to rise during the late 1960s and early 1970s and medical advancement grew and the emergence of the "self-esteem" generation begins to take hold, of which there is a full emanation come the 1980s- or the era of "Me. From the first breast augmentation in 1895 to the first plastic surgery instruction by french surgeon Dr. Hippolyte Morestin during the first World War, the desire for humanity to physically alter their appearance is not as unique a trait of our post-modern, transgression generation as we would of thought. After Dr. Hippolyte Morestin's efforts, cosmetic surgery steadily grew until it became fully integrated into medical institutions by 1959, but it climbed to pragmatic heights after the invention of the Silicon breast implant in 1962. 
However,  what at first glance seems like a simple easy solution to self-improvement, a study done in 2009 yields evidence to support the claim by many that cosmetic surgery does little to fix the preexisting psychological conditions driving many individuals to go under the knife.  It goes without saying that a quick decision to change a reflection in a mirror is going to do little to the real problems that dwell just beneath the surface. Yes, there are many success stories of plastic surgery,  but it is when we let our patients make life-altering decisions with an unhealthy mind the ethical sanctity of the medical profession hangs in the balance.  

Early cosmetic surgery advertisement from 1890s

In the 2009 article "The Effects of Cosmetic Surgery on Body Image,  Self-Esteem, and Psychological Problems" published by T. von Soest, I.L. Kvalem, H.E. Roald, and K.C. Skolleborg, they conduct an experiment via a questionnaire from 155 female patients six months after their cosmetic sugery. Results yielded an improvement of body image but no change was apparent in relation to the psychological conditions the patients had preoperation. "Postoperative measures of appearance satisfaction, self-esteem, and psychological problems did not differ from values derived from the comparison sample," (von Soest etc al. 2009). Because the patients sought out cosmetic surgery in order to fix whatever it was about themselves they considered to be a problem, once they realize the problem is still there,  they aremore likelyto repeat process to search for a new solution. This is how cosmetic surgery addiction has found itself among a hord of new age self-inflections that really takes the "finding that next fix" component to an entirely different level. 

We find ourselves in a generation that can examine the long term results cosmetic surgery has on its patients, both the good and bad,  healthy and unhealthy alike. A recent example would be the extreme long-term physical (and hypothetically as a result from this-psychological) transformation of celebrity Bruce Jenner. 

After his face became a staple of the Wheaties box and he was thrown into the realm of reality television stardom from his marriage to Kris Kardashian,  Bruce Jenner has struggled to keep his body image culturally relevant for nearly the last two decades. There has been recent tabloid buzz of Jenner's long-term battle with depression and body image and how he has made the recent decision to undergo transgendered cosmetic surgery. In a recent article by false gender transformation activist and author Walt Heyer, he relates his own story to that of Jenner's by stating,  "Bruce’s desire to be a woman could be the result of the adult onset of a disorder in his psyche triggered by traumatic events," and that after he underwent gender transformation, Heyer was diagnosed with dissociative disorder- "The underlying disorder was appropriately treated, my desire to change genders faded away like a mist in the bright light of day. One of the hardest things was to admit to myself, my family, and my friends that the whole surgical change had been unnecessary."  Hopefully Bruce Jenner is making a decision that will alow him to live with "herself", but this is why certain psychological disorders need to be addressed and treated prior to operation when the very permanent results take effect. Cosmetic surgeons and spokespersons should make treatment and information regarding psychological conditions regarding personality, body image, and self-esteem avaliable to prospective clients. This way individuals are aware that the very painful process of cosmetic transformation not only permanently affects the physical self, but the psychological self as well. 

Tune in next time for: Rehabilitation of Self Image- Solutions to Decisions Made in Vainity



  1. I do feel that changing one's body permanently won't fix the mind because in the end people who do this will find something else wrong with their body. They just want more and more and more, never content.

  2. This is an important ethical issue, and a paradigmatic one: clearly there is profit to be made, in exploiting people's body insecurities. Is it wrong to do so, even if they are satisfied with their cosmetic enhancements? Can it be rationalized as bringing people a step closer to recognizing the real roots of insecurity as lying not in the body per se, but in how they think of it? We do still officially live in a supply-&-demand society, after all.

    1. And one more thought: it's too easy to focus on women's attraction to cosmetic enhancement. If reconstructive procedures for certain aspects of the male anatomy were as reliable as breast enlargement, who doubts that plenty of men who mock female vanity would be lining up for their own enhancement? (I don't imagine many would go for reduction.)