Abstract
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. Modern plastic surgery has evolved along two broad themes: reconstruction of anatomic defects and aesthetic enhancement of normal form. The surgical principles of plastic surgery remain focused on preserving vascularity, replacing like tissue with like tissue, respecting anatomic zones, and fostering wound healing by minimizing tissue trauma. As a diverse surgical specialty, the discipline of plastic surgery not only interacts with other disciplines of medicine but also merges medical science with the art of physical restoration. It couples careful evaluation of defects with sophisticated arrangements of tissue to improve the uniformity and natural resemblance of repair. Innovative techniques used in plastic surgery are largely the result of the successful clinical application of advances in tissue engineering, nanotechnology, and gene therapy. There are many controversies involving plastic surgery, especially aesthetic plastic surgery. Aesthetic plastic surgery has become extremely popular. It could be due to an increase in demand by consumers. Some view aesthetic plastic surgery as a solution for issues in their lives. It doesn’t help that media attention focuses on youthful appearance and sexually desirable physical attributes.
Main document
The abuse of ethical principles in plastic surgery has become more noticeable, especially where “the mental and emotional state of the patient is a concern. At what point does a surgeon determine when a patient is displaying signs of addiction to plastic surgery? How does a surgeon respond to a patient who displays evidence of body dysmorphic disorder? Body dysmorphic disorder is a condition in which a patient perceives flaws that do not exist, and wants them corrected.” (Teven, C. M., & Grant, S. B. (2018, April 01). The article, Plastic surgery contributions to surgical ethics by Chad M. Teven, discusses many ethical concerns on plastic surgery. As the demand for plastic surgery is increasing day by day, it has also led to novel and distinct ethical challenges. According to the article “Due to the diversity and complexity of cases treated, plastic surgeons are often confronted with significant ethical challenges. Common plastic surgery ethical dilemmas include: weighing the risks and benefits of and obtaining informed consent for elective cosmetic surgery in otherwise healthy people, devising a moral strategy for marketing aesthetic surgery, considering a fair price to charge for services not covered by insurance, and addressing concerns about identity and the risks of immunosuppression when considering facial transplantation”. The concept of plastic surgery is involved with ethical dilemmas. Many of which risks the health of the patients.
Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. “The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas.” (Medical ethics in plastic surgery) Medical professionals and plastic surgery surgeons should care more about the safely of a patient first. There are a lot of patients who gets addicted to plastic surgery and keep on going under the knife multiple times. A physician should prioritize the health of the patient first and should not do surgeries over and over for a patient which might hurt the patient itself.
Plastic surgery physicians supports aesthetic plastic surgery and sees it as new innovation. The article, Ethics and plastic surgery’s legacy of transforming impossibility into innovation, by Megan Lanem, talks about new innovations that were made through plastic surgeries. The article mentions paul Cederna who is the president of plastic surgery foundation. In one of the speech Cederna said “goal is to give back what was lost—we strive to do the impossible. And many times we achieve that goal”. As members of a diverse specialty that does not claim particular disease processes or areas of the body, plastic surgeons—from Harold Gillies use of staged reconstruction to restore the faces of veterans, to Nobel laureate Joseph Murray’s completing the first successful human kidney transplant, to the advent of hand transplantation have historically defied what was thought to be surgically impossible.” This article reflects the pride and honor a plastic surgeon feels after accomplishing one of the impossibilities. Most of the controversies are moral issues concerning plastic surgery, this article rather talks about the modernization of surgery.
Plastic surgery violates four moral principles of autonomy, beneficence, nonmaleficence, and distributive justice. “Autonomy – is the respect for the patient’s right to self-governance, choice in care, and the right to accept or refuse treatment. The second principle, beneficence, is the obligation to prevent or remove harm while also promoting good by contributing to the welfare and acting in the best interest of the patient. The third principle, nonmaleficence, is the obligation of physicians not to inflict harm or adverse effects on the patient from inappropriate or absent care. The fourth and final ethical principle, distributive justice, means distributing benefits, risks, and costs fairly, equitably, and appropriately, and treating patients with similar cases in a similar manner.” Informed consent also plays an important role in the topic of plastic surgery. “Patients trust surgeons and look to them for guidance about the range of treatment options and recommendations. Surgical informed consent is a cornerstone of the patient-physician relationship and an important expression of respect for patient autonomy. For example, discussion of the treatment risks and benefits and alternatives—including the risks and benefits of the alternatives—is an integral part of the informed consent process. For surgeons of all specialties, including plastic surgery, informed consent should be a process rather than simply an event culminating with a patient’s or surrogate’s signature on an authorization form. The need for a process tailored to individual patients is suggested by evidence that postoperative patients’ retention of information about risks is limited. Evidence also suggests that how long surgeons spend obtaining informed consent matters to comprehension and is highly variable.” (Plastic Surgery’s Contributions to Surgical Ethics) Physicians should go over the risks that involves in a plastic surgery and should not hide anything from the patient to benefit the business of the physicians.
Moral issues in aesthetic plastic surgery is raising questions for the surgeons conduct towards his colleagues and the patients in the light of ethical requirements. The demand for plastic surgery is increasing more than ever before. As a result, physicians are getting more and more requests by patients for aesthetic surgery. The surgery itself has become more like a business to the surgeons rather than a medical surgery. “We have to be careful that our educational efforts do not lead us into producing not surgeons but technicians selling their skills in the marketplace. We are physicians primarily, surgeons by choice and plastic surgeons for the joy of living…The prime purpose of the medical profession is to give trustworthy service of the highest quality in matters of health” (Suresh gupta, Indian J Plast Surg.)
Reference
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