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TANIA LECONA

THE ETHICS OF COSMETIC SURGERY

DEVA ARUMUGAM

ENGLISH 1302.5002

APRIL 30, 2012

Plastic surgery is the process of reconstructing or repairing parts of the body by the transfer of tissue, either in the treatment of injury or for cosmetic reasons. Many people would think that plastic surgery and cosmetic surgery are the same thing, but with a different name. In truth, cosmetic surgery is the surgical alteration of tissue for the improvement of your appearance rather than improvement or restoration of bodily function. The few differences between the two are that plastic surgeons are more qualified to do a cosmetic surgery than the cosmetic surgeons are because they are required to have more practice in both reconstructive and cosmetic surgeries before being certified as plastic surgeons while the cosmetic surgeons could have one or two surgeries in their history and they would be certified as cosmetic surgeons. But one has to wonder about the surgeons that perform these surgeries. Yes, they are doctors, and doctors have an ethical code, but do plastic surgeons have an ethical code specifically for themselves? If so, does it change when the patient is underage? Among the reasons I decided to research this topic in the first place was due to a woman named Jenny Lee. Jenny’s husband (at the time) used to insult her about her breasts being too small and her nose not being shaped right. A year and a half after she got breast implants, one slipped out and she had to revisit her plastic surgeon. From then on, she felt the need to improve her body in any and every way. She looks in the mirror and still sees something she wants to change, even if she’s already changed it before. She has appeared on the Oprah Show twice as well as on Larry King Live. Her plastic surgeon remains unnamed ("Jenny Lee - The Plastic"), but receives a lot of criticism for continuing to perform surgeries when Jenny asks for it. Imagine if Jenny was a minor when she got hooked to getting plastic surgeries. A plastic surgeon should have an ethical code regarding something like this. I intended to research this when I first began, and what I found instead was a slightly different result.

I first thought I should start with how many Americans are getting plastic surgery, cosmetic procedures included. Upon searching for information of this in the past five years, I came across The American Society of Plastic Surgeons. Through their site, I found that in 2007, reconstructive procedures fell 2% ("2007 ASPS U.S.A."), increased in 2008 by 3% ("2008 Quick Facts:"), and continued to increase by 5% ("2009 Quick Facts:"), 2% ("2010 Quick Facts:"), and 5% ("2011 Quick Facts:") in the following years. Meanwhile, cosmetic procedures were also increasing; 7% in 2007 ("2007 ASPS U.S.A."), 3% in 2008 ("2008 Quick Facts:"), 1% down in 2009 ("2009 Quick Facts:"), 5% back up in 2010 ("2010 Quick Facts:"), and 5% in 2011 ("2011 Quick Facts:"). Basically, these numbers were saying that more Americans were slowly getting more plastic and cosmetic procedures done in the past five years and compared to 2000, cosmetic surgeries went up by 59% in 2007 ("2007 ASPS U.S.A."). More than double the number of patients for cosmetic reasons in 7 years must mean something for this country. Americans must value appearance more than it’s believed or said to be if they are getting nose jobs and laser hair removals this much.

Out of these percentages, people in the age group 13-19 were 2% of the patients that had cosmetic procedures performed in the entire 5 year span I was researching ("2008-2011 Quick Facts"). While it was a constant percentage of teenagers that had these procedures done, we must remember that in these past 5 years, the number of cosmetic procedures have gone up, so it’s valid to say that the actual number of teenagers also went up. These percent changes from year to year in these 5 years can be seen for just the cosmetic procedures; and while they did go down 2% from 2007 to 2008 ("2008 Cosmetic Surgery"), and 4% from 2008 to 2009("2009 Cosmetic Surgery"), the number started to go back up from 2009 to 2010 by 4% ("2010 Cosmetic Surgery") and 5% from 2010 to 2011 ("2011 Cosmetic Surgery").

There are a multiple of reasons why a teenager would want to get these procedures done, but why do the surgeons perform them knowing that the patients are still developing in mind and body? Enlightened by these statistics, I came to wonder about one of my original questions, “Do plastic surgeons have an ethical code exclusively for themselves?” My question was answered when I came across this article named, “Are Plastic Surgery Advertisements Conforming to the Ethical Codes of the American Society of Plastic Surgeons?” (Walters et al.). I was only able to see the abstract of this article, but from its contents, I believe it was going about the same idea as I was. Now that I knew plastic surgeons have an ethical code of their own, I saw that Walters and his team were questioning the advertisements plastic and cosmetic surgeons use to obtain business. Without the entire article however, there was not much else I could deduce from it concerning the ethics and whether they included an underage audience in their surveys or if the advertisements were using (seemingly) underage actors and if that was ethical itself.

Once I found the ethical code itself for plastic surgeons ("Federation Repository Ethics"), I noticed it had no mention of underage patients, minors, or any kind of phrase that singles out patients under the age of 18. So when a 14 year old boy wants to have a breast reduction or if a 15 year old girl wants to have a face lift, the plastic surgeon only sees another patient, not a minor. We can assume that the parent(s) or guardian(s) are usually next to the child in question when going to see the surgeon, plastic or cosmetic, but there is the odd chance that the child will go alone. As a surgeon, there are questions to ask if the minor goes in alone, but what makes the surgeon agree to perform the plastic procedure if everything checks out? The money can be a motive, and the legalities have all be handled with, so why not do the procedure? The fact that it is a minor, regardless if he or she is emancipated, on his or her own, or any other kind of situation that leaves his or her parent(s) or guardian(s) out of the decision, should be considered. It is proved that people of the age of 21 are still developing their mind and sometimes body, so why implicate that development before the age of 18 by choice?

In order to understand the doctor’s side of this, I decided to conduct an interview to a future plastic surgeon. He felt very strongly about underage cosmetic procedures because of the same reasons I point out above; the child in question isn’t fully developed in body or mind and is therefore not qualified to make the decision of getting cosmetic surgery done. He does however, agree with the reconstructive procedures, regardless of the age of the patient. In the scenario of the child being bullied or having a serious self esteem problem, he said he would honestly consider and suggest every alternative before agreeing to do the cosmetic surgery that the child wants, but (if and) when it came down to it, he would do what he thought would be best for the patient, which could differ from case to case. For the cosmetic surgery addicted, he said he would deny their request to perform the surgery himself, but if the patient insisted for a referral of another surgeon, he would advise them strongly against getting any more procedures done, but refer the patient to a trusted colleague so the patient won’t go find an inexperienced surgeon and risk getting harmed because of that decision.

He also commented that he would not perform any surgeries on his friends or family because it would be completely unethical, regardless if it was legal. But he would however, advise them if they should have any interest in getting plastic surgery done or refer them to a trusted colleague. When I asked him about cosmetic surgery being up 19% in the last five years, he felt a bit conflicted. While that might mean good news for the economy, it meant that more Americans were becoming more plastic than Barbie. He did agree to the idea of changing the law of cosmetic surgery, whether at the state or federal level, in regards to minors; that if cosmetic surgery was to be performed on a minor, it should be for reconstructive purposes and only with the consent of the child, and parent or guardian and if neither of those were available to give consent, the state. While he agrees this is an issue many should be concerned with, he believes other more pressing issues are to be given priority over this in Congress, but would be a part of the movement to change the law if it should come into existence.

As proven by the interview, the topic of underage cosmetic surgery is not without opinion, but the fact that there is nothing (known) being done about the laws, whether to change them completely or merely improve them, means that not everyone cares about the topic enough to make it an issue on the four o’clock national news. Still, awareness is the first step in resolving a problem. The more people that become informed on the topic, the more publicity it will obtain and will come to a decision.

The numbers of all the surgeries done in the past five years were obscenely too high for me. Over 230,617 teenage Americans had some cosmetic surgery performed in 2011 ("2011 Cosmetic Surgery"). In only one year, over 230,000 teenagers changed their appearance in some way, before their body finished developing, before they decided what to study for in a career, before they even decide if they want to go to college, and before they know who they really are. If one does not have a plastic procedure done before he or she reaches a more stable time of development, he or she won’t be burdened with the possibility of being confused even more about who he or she could be or what he or she should look like. But if he or she do have a plastic procedure done, there is always the possibility of realizing an additional unnecessary confusion to his or her life. I believe it is highly unethical if a plastic surgeon chooses to participate in such a decision to perhaps make life and its development even more difficult than it already is.

Works Cited

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Code of Ethics . American Medical Association , 2012 . Web. 24 Apr. 2012.

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with Plastic Surgery. Slideshare Inc., 4 June 2009. Web. 24 Apr. 2012. .

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the American Society of Plastic Surgeons?" NCBI: National Center for

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