Dr Rhona Knight looks at the current fad for cosmetic surgery
The Ben Sherman advert states ‘Looking good isn’t important, it’s everything’.
In our society looks and image appear to define who we are. Visual images bombarding us daily show us that young, slim and beautiful is the order of the day for women, and a lithe, well-muscled and toned Adonis is the ideal male. Failing to achieve perfection, we can resort to Botox, hair transplants, breast enlargement and even buttock implants. Why not? Cosmetic interventions are advertised freely on the Internet and in tube stations. A phone call to the hair transplant clinic is as easy as attending a Botox party.
Make up, clothing, footwear and tattooing have been used for years to ‘enhance’ appearance. Sushruta (600 BC), the ‘father of plastic surgery’, first described nose surgery for cosmetic reasons. Now, according to Metro, 30% of people feel most judged by body shape and Francesca Martinez’s five step advice on how to appear normal in today’s society includes ‘be dissatisfied with your body’.
The costs
‘No one ever lost money by over-estimating women’s vanity’– and now this also seems true for men. In 2011, the UK cosmetics product industry was valued at £8.3 billion and the estimated worth of the cosmetic interventions business will be about £3.6 billion by 2015.
While plastic surgery typically describes procedures aimed to heal or restore – removing of skin cancers in a way that minimises disfigurement, or restoring breast contours after a mastectomy, cosmetic surgery aims to enhance and ‘comprises operations or other procedures that revise or change the appearance, colour, texture, structure or position of bodily features to achieve what patients perceive to be more desirable’. Yet what is desired is not always achieved. The Mail Online tells of ‘bungled boob jobs’ and ‘Why two thirds of Britons (and Katie Price) say regret they having cosmetic surgery’. Procedures do go wrong and it is often left to the NHS to pick up the pieces and the costs.
Safety and regulation
Much of the booming cosmetic intervention industry resides in the poorly regulated private sector. Good information on outcomes is hard to find. While doctors and dentists are regulated by professional bodies, many cosmetic procedures are provided by unregistered practitioners from varied backgrounds.
The 2013 Department of Health review suggested that ‘a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush’. The regulation and safety of cosmetic intervention is therefore concerning. Also, the Expert Group
on the Regulation of Cosmetic Surgery: Report to the Chief Medical Officer, concluded that ‘Although there is no one authoritative source of evidence to show that significant harm is caused to patients by cosmetic surgery, evidence from numerous bodies, as related in this report, suggests that there are grounds for concern’.
The benefits
Yet there are benefits to cosmetic surgery. Many of us will know people who suffer severe social, physical, spiritual or psychological pain due to their appearance – and whereas breast enlargement appears to increase suicide risk, lack of access to breast surgery can also have a similar impact.
Kerrie Jewel, for example, felt suicidal as a result of her 40HH breast size. Asking unsuccessfully for a NHS breast reduction for 25 years she said: ‘I don’t want to look like a top model. I only want to be like normal people and not get teased’.
Men with obvious breast tissue and children with prominent ears are usually not seeking surgery to enhance their appearance, but instead hope to avoid adverse emotional and social pain from, for example, bullying and teasing. They wish to appear more ‘normal’. After all, with any physical attribute there are some appearances that are more common, ‘normal’, than others, whether it be the shape of a nose, the position of ears, or the size of breasts. There does seem to be a difference between Kerrie wishing to have an operation to reduce her breast size from an uncommon 40HH cup size because of pain and someone wanting a facelift to make themselves look 15 years younger, when their face looks ‘normal’ for their age.
An ethical issue
Cosmetic surgery is a complex ethical issue. A procedure that for one person might minimise suffering can, for another, cause unnecessary harm. For society it appears that the ethical question is: on what basis can it be decided whether a cosmetic procedure should be offered or expected as a treatment option, bearing in mind each unique situation?
As a Christian, a doctor and a patient, I find it useful to consider the following four things. Firstly, how far from the ‘norm’ is the ‘concerning’ appearance? Secondly, what is the impact of the ‘concern’ on the health and wellbeing of the individual? Thirdly, how safe and effective is the cosmetic procedure? And finally, are there any unexplored safer alternatives?
A procedure that is safe and highly effective, for someone whose wellbeing is significantly compromised by the appearance of an attribute at the extreme of normal, where there are no unexplored alternatives, would be deemed to be more acceptable than a risky procedure, on a person with an appearance nearer the ‘norm’, who is experiencing minimal adverse impact.
Beauty in the Bible
The Bible has many references to beauty – beautiful women, places and actions. God has ‘made everything beautiful in its time’ and God has created humanity to appreciate and care for his beautiful world. Yet, as Proverbs reminds us, ‘Charm is deceptive, and beauty is fleeting’. Even Isaiah indicates that Jesus ‘had no beauty or majesty to attract us to him, nothing in his appearance that we should desire him.’
For Christians, beauty is not skin deep. It is about the whole person: heart, soul, mind and strength. It is witnessed to in the life and character of the Christian, described so well in Paul’s letter to the Galatians as the fruit of the Spirit: ‘Love, joy, peace, forbearance, kindness, goodness, gentleness and self-control.’
Made in God’s image
While Christians may well find themselves advocating for better regulation of, and access to, cosmetic surgery for those who need it, they may also agree with Richard Poupard’s warning: ‘We should be discerning regarding our motivations for pursuing cosmetic plastic surgery… we should be careful if our motivations for surgery are principally to increase our self-esteem’. Is our motivation to promote Christ likeness or holistic wellbeing? Is it to enable the best use of the gifts we have been given? Or is it about seeking worldly identity or security in our own image?
The world’s concept of beauty is unattainable – even highly paid models have their ‘imperfections’ airbrushed out. Yet 1 Peter 3:3 tells us that in God’s eyes we are beautiful and our beauty comes from our ‘inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight’. While man may look at outward appearance, we know God looks at the heart.
