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Debate: Cosmetic surgery

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Should cosmetic surgery be banned?

Background and context

“Cosmetic surgery” (also known as “plastic surgery”) is surgery that is unnecessary from a medical perspective, but is carried out to improve appearance. Cosmetic surgery is an ancient practice. In the 8th century BC, the Indian surgeon Sushruta Samhita described what is known today as rhinoplasty (surgery to the nose) and otoplasty (to the ear).
Body alteration more generally has been carried out by all peoples, from tribal tattoos to the neck-extending Kayans of Thailand. But modern medicine has made the possibilities of cosmetic surgery far more extensive.
Anaesthesia has made procedures less unpleasant and less dangerous. In the aftermath of each of the two World Wars, cosmetic surgery leapt forwards as the demand for reconstructive surgery created skills and techniques that could be as easily applied to (perceived) improvements to image as to medical necessity. Consequently, cosmetic surgery has become increasingly popular. In 1948, fewer than 300 board-certified plastic surgeons were in practice in the USA; today the number is more than 4,000. In 2004 12 million cosmetic operations were conducted in the USA alone. Where America has led, much of the world has followed. Television shows and newspaper supplements are now devoted to cosmetic surgery and makeover programmes advocate it. Today more and more parts of the body can be “improved.” Once the possibilities for surgery were relatively restricted, now almost anything can be the subject of cosmetic surgery. To name but a few, common operations include abdominoplasty (a “tummy tuck” or reshaping/firming of the abdomen), blepharoplasty (eyelid surgery), buttock implants/reductions, chemical “peels” (removal of acne scars and sagging skin), chin and cheek augmentation, lipectomy (or liposuction – removal of fat from the body), and rhytidectomy (a“face lift”) Among the most popular procedures are the otoplasty and rhinoplasty mentioned earlier, and finally and most commonly, surgery for the breasts: both mammaplasty ("breast enlargement/reduction") and mastoplexy (“breast lift”) – collectively known as “boob jobs.” Cosmetic surgery to genitalia is increasingly common. This article considers only cosmetic surgery carried out purely to improve appearance, and does not address plastic surgery for medical reasons, for example post-disfigurement reconstruction or remedial surgery.
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Argument #1

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Yes

We live in a world that is image obsessed, and this kind of procedure panders to that. We should promote the idea that appearance is not as important as character. People should be content with themselves and not be so hung up on their looks.

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No

That’s nice. But given that the reality is that we’re judged on our appearance all the time, it’s perfectly rational to want to look good. Nobody’s forcing anyone to have cosmetic surgery – the market is driven by demand.

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Argument #2

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Yes

There are dangers involved in any kind of surgery. Sometimes we must accept those dangers, as they come in the course of necessary medical procedures. But with elective surgery – procedures people don’t need, but rather merely want – the risks can’t be justified. These risks apply both to the surgery itself, and to the long term. For example, leaking silicone breast implants have been a widespread problem and can lead to death. Once, paraffin was often injected into the face to smooth wrinkles, with disastrous effects. Silicon often finds its way into other parts of the body, such as the lymph glands, and can prevent the early detection of breast cancer as doctors often think real lumps are silicon leakage. Who today knows the full future implications of injecting the highly dangerous poison Botox into one’s face?

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No

We should not restrict freedom of choice. Certainly there’s an element of danger involved. But we let people box. We let people bungee jump. They undertake these dangers for fun or for money. Why shouldn’t we let people undertake dangers in the pursuit of beauty, and higher self esteem? Furthermore, cosmetic surgery is becoming safer and safer. It is increasingly strictly policed and sky-high legal pay-outs by bad surgeons have ensured that practitioners take more and more care. Technology in surgery and in implants and so forth is forever improving. The scare stories the proposition talk about are the worst examples of thirty years ago – they’re nothing to do with cosmetic surgery today.

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Argument #3

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Yes

To attempt to dress cosmetic surgery in the flag of feminism is absurd. If anything, cosmetic surgery is the latest phenomenon in the long history of the objectification of women in society. Women are driven to meet male standards of beauty, exaggerating their shape and seeking to remain youthful lest their partner leave them for (often literally) a younger model. Today many operations are arranged by male partners rather than by the women themselves. Cosmetically-enhanced celebrities are redefining definitions of attractiveness for new generations, leading young girls who would have been considered naturally beautiful in past decades to see themselves as plain and to seek their own surgical remedies.

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No

This freedom issue is particularly important to women, who have historically been subjugated by men, their bodies regarded as owned and for the use of men. Cosmetic surgery – the ultimate control over one’s body, perhaps – is the latest stage in the emancipation of women and their ability to decide what happens to their bodies. Cosmetic surgery is empowering.

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Argument #5

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Yes

Doctors should heal, not waste their talent on appearance. Precious talent and resources are spent on this frivolous activity. Surgeons should do medical operations that are needed, not cosmetic procedures that are desired.

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No

People pay handsomely for cosmetic surgery. It costs the state nothing, except in situations in which the operation is necessary medically. Cosmetic surgery can turn a profit for hospitals that is put towards more general medical areas. And doctors receive training and practice in difficult techniques which can then be used to help patients in genuine need.

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Argument #4

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Yes

The pressures of appearance apply particularly to women. Pregnancy and ageing have predictable effects: they should be accepted with grace, not fought against. The messages sent when some women have procedures are firstly that the prejudices some have about appearance are valid, and secondly that those women secure enough not to contemplate going under the knife are “letting themselves go.”

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No

If women or anyone else are secure enough not to bother with cosmetic surgery, then fine. But there are many who find that their appearance truly troubles them and that improving it would greatly enhance their quality of life. If they can afford it, let them.

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Argument #6

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Yes

The black market argument applies to everything illegal. Of course that risk exists, but the number of those undertaking the activity will be smaller, as you concede. Lack of legal safeguards and medical accountability, and the probability that only badly qualified doctors will offer illegal operations will deter almost everyone from risking black market surgery. Fewer operations must be desirable if it is agreed that the activity concerned should be banned. Black market activity will be vigorously policed – and after all, its usually pretty obvious if someone has had surgery.

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No

Cosmetic surgery happens because people want it – often, desperately. If banned, cosmetic surgery will flourish on a black market. It will still happen, but it will be very expensive (and therefore only available to the very rich) and it will be much more dangerous as it will be done by unscrupulous doctors and outside all the safety precautions the legal environment provides.

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Argument #7

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Yes

Cosmetic surgery is addictive: look at Michael Jackson, or Lolo Ferrarri, who got breast implant after breast implant despite the harm it did her body. The compulsion to change one’s body is often a symptom of a deeper mental instability. It should be treated as a problem, not indulged and encouraged with surgery. It’s only a plaster patched over a much deeper problem.

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No

This is patronising, insulting and wrong. The vast majority of people who have cosmetic surgery have one procedure and never look back. They’re made happier and more secure in themselves because of it. It’s fine to oppose cosmetic surgery, but don’t falsely portray those that have it as being mentally unstable.

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Argument #8

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Yes

Pointing to accidental side-benefits of cosmetic surgery will not cover up the fact that its intention is to make money, not make people better. If a fraction of the efforts pumped into it went into proper medicine, the medical world would be much more advanced than it is today. And the fact that the benefits arise from chance merely serves to highlight the greed that constitutes the essential nature of cosmetic surgery: those benefits ought to be all of medicine’s aim, not an accident resulting from it. Certainly people make money and careers in normal medicine, but they are giving treatments that aim to make people well, not look different.

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No

The development of cosmetic surgery over the years has been intertwined with that of reconstructive and more general medical surgery. Cosmetic surgery has greatly aided reconstructive surgery. For example, maxillofacial surgery, or surgery of the jaw, has developed with insights from both plastic surgeons and oral surgeons. It’s impossible to say in some areas who contributed the greatest advances, the cosmetic or the mainstream. To shut down cosmetic surgery would be to cut off a valuable outlet for research and discovery. The market can sometimes create great benefits: people work hard in pursuit of profits and often their work can help us all. Plenty of people make a good living from normal medicine and they are not criticised, the same should be true for privately provided medicine: there’s nothing wrong with turning a profit.

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Argument #9

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Yes

There’s a fair debate to be had here about what we all know we mean when we talk about cosmetic surgery. Balloon-breasted Barbie-doll models and self-indulgent collagen boosters are the issue, and trying to squirm out of defending them by pointing to sad children is pretty weak. Because the answer is obvious - hare lip correction is legitimate surgery. Collagen injection to hide aging is not.

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No

How do you define cosmetic surgery? Much of the “cosmetic” work done greatly improves not just appearance, but quality of life. Operation Smile, which fixes oral and facial deformities found in poor children across the world, is doing “cosmetic surgery.” Sure you can survive with a hare lip or a cleft palate. But your quality of life – your self esteem, employability, acceptance in a traditional society, etc – is much better without one. Following this principle, breast reduction or augmentation or the removal of acne scars can be just as important.

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Argument #10

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Yes

If the opposition is right and plastic surgery is desirable, then such surgery is unfair. Only those that can pay for it get it. So if it has the advantages the opposition claims, the rich will look good, and the poor will not.

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No

You can spend your money how you like. Why shouldn’t people be allowed to make the personal choice to change their appearance with their own cash? Better that than ask others to contribute through the state. Furthermore, the appearance division the proposition seeks to suggest between rich and poor is much more dependent on quality of diet. Diet is a universal factor that affects complexion, height, etc, while cosmetic surgery is a relatively insignificant factor in statistical terms and one that only affects the particular thing on which surgery is conducted.

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Argument #11

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Yes

In fact, often, people look appalling after plastic surgery. Celebrities with “trout pout” overblown lips, or absurd, balloon-like breasts, are only the most well known examples.

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No

That might be true. Let people choose what happens to their bodies for themselves. For every horror story, there are hundreds of people who are happier with their appearance after surgery – whether you prefer their new appearance or not.

See also

External links and resources

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