The border between ethics and aesthetics in plastic surgery ~ Prof. Antonio Giordano (SHRO)

The key role of the doctor's "no" to patients' "wishes."



The conflict between natural apparency and conformity to contemporary aesthetic standards, influenced by cinema and TV, and personal perception of one's own corporeality, necessitates a collective reflection on the implications of aesthetic surgery from an ethical-deontological perspective.

The use of plastic surgery is more and more frequent and is of fundamental importance in prolonging and, in the consequent dynamic concept of psycho-physical health, justifying and legitimizing, both legally and socially, the request for a modification in a morphological feature not pleasing to the patient, who desires to correct a physical defect, considered as such only by the patient, with a lens to unconscious 'dysmorphophobia,' as pointed out in the excellent contribution of Vito Tenore, Section President of the Court of Auditors and SNA teacher (from Formiche ).

Exterior beauty, an ethical and sociological key to corporeality in the ephemeral contemporary world, represents a "value" that heavily affects the existence of those that consider themselves not part of an “ideal aesthetic. Such mental distress, the desire to 'correct,' finds its solution in the excessive use of cosmetic surgery. In this case, the scientific rigor of the surgeon is the only real mechanism determining that this process goes right, far from the risks of grotesque results that might negatively impact the patient more than the feature that was supposed to be 'corrected.'

The aspiration for a slender body for a young woman, highlighted by busty lips and breasts and the maintaining of muscular tone in adulthood, yet an expression of powerful and plastic sensuality, fuel the search for the artificial recreation of the youthful appearance that fades with age. The Greek myths of beauty and youth, rooted in deep spirituality, are replaced by the myth of the body "alive and perfectly maintained." Youth and immortality, like the gods of Olympus, the gifts to be conquered, the gifts that have fueled legends and novels, from the search for the Holy Grail to Harry Potter's Philosopher's Stone, now are open for everyone's reach, just around the corner, at a low cost and even available in installments!

Aesthetic medicine, in its early years, was the exclusive prerogative of actors and wealthy industrialists. Economic convenience is a prerequisite for recurring to aesthetics. Rapid and infamous access by ordinary people to the golden world of aesthetic medicine, whose results are often the result of homologation, and depersonalization, can only be mitigated by scientific training and honest doctor-patient communication. Thus, the surgeon's 'NO' to the patient's 'WISHES' is the ethical boundary to unnecessary surgical modifications and is the right balance between the perception of distress and an excellent medical and aesthetic result.

The aging process starts from birth, as Seneca's "CotidieMori" reminds us. The real revolution is subverting priorities as part of contemporary society and modifying the distorted messages we receive from the media. The myth of the perfect body leads us to an impossible struggle because, in the end, "time wins over everything", and the denial of aging, decay, and death is an aberration.

It is wise to give yourself peace, fill your list of priorities and values ​​with deep thoughts and good inspirations, and focus on "targeted," "natural" medical-aesthetic results as possible. The most successful surgery is the one “not noticeable," and derives from good doctor-patient communication and from downsizing the desire for change; if not, this is dangerous and stepping into the grotesque.


This article was first published by Dr. Antonio Giordano for La Voce Di New York; click here to read.

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