Sunday, February 26, 2012

Cosmetic surgery to reconstructive surgery

I’m sure many of us have heard of Hang Mioku, better known as the “Fan Lady,” a middle-aged Korean woman whose face became abnormally large after she pursued countless operations of cosmetic surgery. The Fan Lady got her first cosmetic surgery when she was 28 and gradually became obsessed with it, never satisfied with the way she looked. She would get more and more operations until finally, even her own parents couldn’t recognize her disfigured face anymore.
The Fan Lady isn’t the only person who has experienced the drastic addictive nature of cosmetic surgery. In the United States, the number of cosmetic surgery operations has increased from 6.9 million in 2002 to 11.7 million in 2007, with a 9% further increase in 2010 alone.
Cosmetic surgery is indeed dangerous for its disastrous effects on the physical and psychological state of a person. The most risky operations often lead to permanent damage or even death. Cosmetic surgery is often misunderstood as a means to boost self-esteem, but it’s not the solution to fixing emotional diseases. In fact, due to post-surgical depression and dissatisfaction with the outcomes, women who underwent cosmetic surgery in the past 30 years have been 3 times as likely to commit suicide compared to those who didn’t. That’s not to mention that cosmetic surgery is, by principle, against many of our established ethical standards for the practice of medicine: Helsinki, Belmont, the basic Hippocratic Oath, you name it. The third line of the Hippocratic Oath states: “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.” Far from being a medically necessary operation, cosmetic surgery is done for the purpose of enhancing beauty. Far from improving patients’ health, it damages them both physically and emotionally.
So it seems that the harms of cosmetic surgery could call for an international ban on it. But of course, making cosmetic surgery illegal has too many problems associated with it: underground operations which would make it more dangerous than it already is, putting cosmetic surgeons out of their jobs, etc. just to name a few. What we should do instead is make use of these resources and turn them towards a different effort: reconstructive surgery. Just to be clear, cosmetic surgery is done purely to enhance beauty when the patient has not had a disease, accident, etc. that calls for a restoration, while reconstructive surgery is done to cure diseases, restore bodily functions, or correct disfigurements. Both require similar skill sets in terms of surgical procedure.
In developing countries today, there are an overwhelming number of people in need of reconstructive surgery. However, billions of dollars spent every year in countries such as the US demonstrate that the resources that could be used to meet the needs of these people are instead wasted on cosmetic surgeries that try to fulfill the never-ending demands of people who continuously strive to enhance their aesthetic appearances.
For example, The WHO estimates that there are over two million women who suffer from obstetric fistula, a pregnancy-related complication, worldwide. Especially in developing countries such as Sudan, there are 50 thousand to 100 thousand new cases every year. Even though obstetric fistula is curable through reconstructive surgery, the women in southern Sudan cannot afford or access it. In January 2004, for example, a woman with obstetric fistula was brought to a local hospital in southern Sudan, but due to the dearth of reconstructive surgeons, she had to wait for hours, suffering prolonged pain. As similar cases abound, thousands of women in developing countries die each year in need of surgery while being unable to access it, counting women with obstetric fistula alone. If cosmetic surgery resources were redirected, not only would monetary resources be used more wisely, but also more cosmetic surgeons would be available to perform similar surgeries but for a different purpose so that they can benefit the people in need.


2 comments:

StarTrek said...

The point you make is well made. I agree with you – purely cosmetic surgery is medically unnecessary and it would be really great if we could reallocate resources toward reconstructive surgery. In this response, I will explore the reasons cosmetic surgery is so common and propose a solution to the problem.

First, the reasons for cosmetic surgery. Much of it is aesthetics, as you point out; indeed, “cosmetic” surgery implies that the operation is merely superficial and has no functional value. People who get cosmetic surgery do so out of vanity (except for transgendered people who do so for their psychological wellbeing, and other similar examples). But this brings up another point entirely: people who get cosmetic surgery pay a pretty penny. Indeed, your average breast implant surgery costs $4,000 (1). And all that the surgeon does is implant some silicone – a completely inert substance – in the patient. Nothing fancy, and certainly nothing fundamentally necessary. Yet doctors flock to plastic surgery. Why? Because it pays. In fact, the median salary for a plastic surgeon is just over $200K (2). In short, there is a strong economic incentive for doctors to cater their services to a class of patients who can pay through the nose to have superficial cosmetic surgery.

Next, a solution. The goal, as mentioned above, is to reallocate social resources (i.e. surgeons) to reconstructive surgery, rather than cosmetic surgery. I propose that any solution must be incentive-based – after all, if it is money that draws doctors to cosmetic surgery in the first place, it is only logical to use money to draw them to reconstructive surgery. With this in mind, I suggest the following solution: slap a heavy tax on all cosmetic surgeries. Doing so can solve the problem in two ways. First, taxation dissuades young doctors from specializing in cosmetic surgery. Second, assuming that doctors pass on the cost of the tax to patients, then prices for surgeries will go up, reducing demand. If demand falls, plastic surgeons will switch to reconstructive or other types of surgery.

(1) http://cosmeticsurgerypricesrevealed.com/
(2) http://www.payscale.com/research/US/People_with_Jobs_as_Surgeons/Salary

Unknown said...

StarTrek has it right (excellent reply btw) and Buyan should consider incorporating some of the reasons why people/doctors flock to cosmetic surgery if she uses this for R4. But, overall, excellent post.