“Contours of Beauty: The Power of Surgery to Shape Identity”
Dr Mukundhan Murali
Junior Resident, Radiodiagnosis,
Stanley Medical College, Chennai – 1.
Hello, I’m Dr Thomas ”Tommy” Tucker, an intergalactic transtemporal professor and consultant specializing in plastic and cosmetic surgery. Today in my clinic I’m scheduled to see three patients – a criminal from 600 BC India, a World War I veteran, and a thriving 21st-century California actress. These individuals, diverse in time and circumstance, converge on a common theme—the intricate relationship between appearance and identity, and the transformative power of surgical interventions.
Humans are peculiar creatures. It has been centuries since Shakespeare said “She’s beautiful, and therefore to be wooed” yet humans still judge each other by external appearance. In a world in which we are judged by how we appear, the belief that we can change our appearance is liberating. And what other way to drastically change into one’s own idealized version than with the aid of a knife?
In ancient India, the criminal’s tale unfolds—a punishment of brutal proportions, his nose severed and his dignity trampled as he was paraded on a mule for committing adultery. His shattered sense of self, inseparable from his lost nose, calls for surgical redemption. I myself cannot keep up with such a huge volume of pangalactic patients, you see? I know just the guy I can send him to – a Dr Susrutha from Kashi. In this case, he and his students would raise a flap of skin from his forehead, and without detaching it completely, rotate it downwards and suture it where his nose previously was. Impressive technique, this would help him regain at least some level of dignity and his place in society.
Simultaneously, the war veteran from World War I emerges as a symbol of the profound costs of mechanized warfare. His face, ravaged by bullets and shrapnel, embodies the physical and psychological scars of battle. His inability to close his eyes or mouth worsens his plight, erasing any semblance of normalcy. I’ve heard one Dr. Harold Gillies has been dedicating himself to treating such horrific facial wounds, giving rise to modern plastic surgery on Earth (or as my travel companion The Hitchhiker’s Guide calls it ‘Harmless’ which is pretty ironic in this case). The new field aims to reconstruct the wounded men’s faces as fully as possible so they can hopefully lead normal life.
In the 21st century, a successful actress grapples with a unique set of insecurities. Her beauty, admired by many, is marred by her self-perceived flaw—a nose that she believes holds her back in her career. I have a ton of surgical tricks up my sleeve to help people with their body image – which means a person’s perceptions, expectations, emotions, and feelings about one’s body. Both self-perception and perception of self in relation to others are connected to the degree of satisfaction with one’s own appearance. Many regard aesthetic surgeries as a panacea for their personal and relationship difficulties, thanks to aggressive media influence that has made your society ambitious and globalized the perception of what is attractive. Wrinkles, fat deposits, and sun-damaged skin no longer fit into your concept of a neat society.
Hey, I’m not judging, we are all products of our environments anyway. In your day and age, facial or bodily features that seem undesirable can be taken away, for instance, by liposuction techniques, cosmetic laser surgery for acne scars, hair removal, spot or mole removal, keloid removal, and so on. Desirable features can be added, using fat transplantation, lip enhancements, micro-needling, microdermabrasion for smoother skin, hair replacement procedures, eyebrow reconstruction, breast augmentation or reduction, buttock augmentation, etc.
Many wise humans, from Plato to Pythagoras and Da Vinci to dainty fashion magazines have cracked their brains open trying to define beauty, only to see it change in the next decade, paralleling the zeitgeist of the time.
Facial appearance is a central aspect of a person’s identity and a visible marker of one’s age. In various studies, women were found to seek aesthetic surgery more than men, thanks to the patriarchy assigning value to women based on their age and their attractiveness. Older clients want to appear natural and want to lose their wrinkles and dark spots without others knowing that they’ve gone through the procedure. On the other hand, younger clients like our actress want their treatment to be noticed.
The line between medicine and beauty is blurred. I would refer to the actress as my client, not my patient. Yet the traditional ethics of a doctor would apply to anyone practicing aesthetic surgery or treatments. Navigating these nuances requires a balance of values—respecting client autonomy, acting in their best interests, and adhering to the principle of non-maleficence. For instance, I would not find surgery to improve a client’s self-image and esteem as something unacceptable. I would be reluctant to operate on those with such unrealistic expectations of how the outcome would be, or on those with body dysmorphia, as they won’t be satisfied even after the treatment.
The era of mass media and social networks has posed new challenges. Cosmetic surgeons openly advertise their quick attractive results with before and after photographs. Thus, instead of relying on physician referrals, word of mouth, and academic achievements for seeking a doctor, patients are increasingly turning to social media for information on cosmetic surgery, not always to good ends. A doctor with a higher follower count or a bigger online presence can show up higher in search results and can be perceived as the topmost expert even if the reality is otherwise.
The competition for the cosmetic surgery pie is fierce, with dermatologists, plastic surgeons, and maxillofacial surgeons vying for prominence. The landscape is a dynamic fusion of medical and aesthetic realms, where specialized expertise converges to meet diverse demands. Dermatology in 2023 is partly a surgical field. India has a professional society of Cutaneous Surgeons – the ACSI. The rise of non-surgical aesthetic treatments, often performed by medically untrained personnel in spas and beauty clinics, blurs the lines of expertise and raises concerns about patient safety.
This doesn’t scare me though. If I run out of the market at this age, I shall simply move to a different period in history and perform tummy tucks on Victorian people obsessed with the Consumption aesthetic, or do hip and buttock enhancements on the fertility-obsessed women of Classical Greece. There’s only one life – trust me I’ve been across the universe- and it is no crime to live it the way you want. The narratives of the criminal, the war veteran, and the actress, all reflect the universal pursuit of acceptance, self-expression, and transformation. Helping people see what they could be and manifesting it is my mission—to broaden the spectrum of possibilities, empowering individuals to rewrite their narratives—one incision, one suture at a time.
References:
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- 2. Atiyeh, B., Ibrahim, A. Aesthetic/Cosmetic Surgery and Ethical Challenges: The Social Media Era. Aesth Plast Surg 44, 1375–1377 (2020). https://doi.org/10.1007/s00266-020-01765-4
- 3. Nisha Gupta, BA and others, The Plastic Surgery Social Media Influencer: Ethical Considerations and a Literature Review, Aesthetic Surgery Journal, Volume 40, Issue 6, June 2020, Pages 691–699, https://doi.org/10.1093/asj/sjz329
- 4. Dogra S. Fate of medical dermatology in the era of cosmetic dermatology and dermatosurgery. Indian J Dermatol Venereol Leprol 2009;75:4-7
- 5. A History of Plastic Surgery, P Santoni -Rugiu, P.J. Sykes, Springer – Verla’s Berlin Heidelberg 2007.
- 6. Dermatological Surgery Information, American Society for Dermatological Surgery Website.
