However, if you probe a little deeper, another question arises: “Why do some people desire such enhancements?” Well, studies have shown that humans respond better to those who are physically more appealing, with better anatomical ratios. Whether we like it or not, such standards have been embedded in our psyche because homo sapiens are biologically programmed to be attracted to a more beautiful man or woman as it typically means that this person is healthy and fertile. So, if we combined genes with him or her, our offspring and future generations would have better genetic make-ups too, it stands to reason.
Although physical perfection is something many covet, very few confess to aesthetic procedures because common thought purportedly puts more value on inner beauty as opposed to physical attractiveness. People who have gone under the knife don’t want to admit to medical enhancements because no one wants to be thought about as shallow or vain.
Despite negative judgement being an impetus for surgical cover-ups, what happens when there’s a lack of awareness? Could that possibly lead to higher instances of black market procedures or increased occurrences of medical complications and social ramifications? To answer all these questions, we round up a panel of international specialists who explain why cosmetic surgery is still taboo, and how plastic surgery’s hush-hush nature affects patients and the industry as a whole. These experts also talk about why patients shouldn’t be ashamed of aesthetic procedures.
Consultant Plastic and Reconstructive Surgeons, Dr. Enrina Diah and Dr. Yap Lok Huei and Cosmetic Dermatologist, Dr. Apratim Goel say there are many reasons why patients are embarrassed to admit to cosmetic surgery. Dr. Enrina explains, “First of all, patients don’t want to be judged by those who believe beauty is based on substance of character as opposed to physical attractiveness.” Dr. Yap acknowledges this statement and reveals there are social conditions such as a consideration of how we’re taught from a young age that beauty shouldn’t be taken at face value, coupled with the belief that more meaning should be ascribed to one’s character as compared to their looks. We’ve been taught to believe that inner beauty or principles such as integrity, personality, honesty and so on should be considered more important than external attractiveness. He opines, “One of the reasons why people feel uncomfortable about enhancements is that if they assign some value to looking good, it’s directly correlated to being shallow as opposed to being a credible member of society.”
Dr. Apratim shares that the desire for plastic surgery and aesthetic procedures aren’t something people openly admit to. And, if we know of someone who’s gone under the knife, it would probably be found out through the grapevine or gossip. She reveals, “This can be the effect of negative plastic surgery portrayals in the media or simply because people don’t want to be viewed as vain.”
Dr. Yap agrees, saying, “Society does sometimes equate valuing physical beauty with having flawed values and admitting to being vain and superficial.” Furthermore, he also maintains that many feel cosmetic surgery is expensive and as a healthcare-based treatment, serves no real purpose. “People may think that patients are spending exorbitant amounts of money on procedures that are not essential and this just doesn’t sit right with some,” Dr. Yap discloses.
Last but not least, Dr. Apratim opines that outright jealousy plays a part in why people mock plastic surgery. Religious beliefs also come into play where spiritual principles promote being content with what God has given you. And, if patients were to alter the physical, they’re defying the divine where the body is no longer an inviolate temple.
Why is working out, applying cosmeceuticals and wearing makeup acceptable, while plastic surgery is not?
Dr. Yap states that he doesn’t have the answer because he asks the same question. However, he does suspect we convince ourselves into accepting certain things because it’s a matter of degree. “When you have degrees of alterations that slowly change over a long period of time, it doesn’t register to our own awareness,” Dr. Yap surmises. He continues, “If one applies face cream, you’re enhancing the appearance without actually crossing the physical barrier.” People believe that if one undergoes cosmetic surgery, you’re also violating the body with incisions. Likewise, and as Dr. Apratim has previously discussed, religious values need also to be taken into consideration, because along with violating the divine, the unnecessary spilling of blood may affect in moralistic disadvantages and religious significance. Dr. Yap agrees and says, “For some patients, the act of undergoing surgery (having a skin incision) has significant religious connotations. However, an injectable treatment, with no cutting involved, might be considered non-invasive.” This might help the patient to attain some modifications without additional personal ethical dilemmas.
Such mindsets are part of the reason why there’s been a boom in minimally invasive treatments like Botox, fillers and facial threads. Yet, even if patients are more comfortable with less drastic therapies, they’re still as embarrassed and continue to deny undergoing injectable treatment. The reason for this – as revealed by Dr. Apratim and Dr. Yap – is because there’s a perceived value to being ‘natural’, as compared to ‘artificial’.
What are the downsides of hiding the fact that one has undergone cosmetic surgery?
Like every medical procedure, it’s always good to have some support from friends and family, Dr. Yap says. In his opinion, if patients are going under the knife, it’s helpful they share this information with a close confidant because every procedure has involved risks. During consultations, friends or relatives can act as your support system, aiding in asking questions you may have overlooked. Furthermore, they can also pick up on answers you’ve possibly forgotten or weren’t paying attention to.
“It’s always preferable to have someone you can speak with to discuss important surgical details like downtime, complications and when you can begin working or exercising again,” Dr. Yap shares. He also goes on to explain that “By doing this, you’ll not only make informed decisions, but also have someone by your side who’ll not only help you with work commitments and household chores, but possible wound care after surgery too.”
The ethical choices about informing friends and/or relatives are sometimes not clear cut. For example, some patients choose to undergo surgery without informing their partners, or to have operations while their partners are not in town. “While the patient should ideally involve partners and close family in the discussion, they have a right to choose to whom the information is disclosed, and as surgeons we have to respect that,” Dr. Yap comments.
The downside of not sharing such ‘secrets’ – besides upsetting your significant other – is of course the issue of a breach of trust. In some situations, husbands assume they can and should dictate a wife’s choices (or vice versa) especially if they are the main breadwinners. There are many reasons why patients may be reluctant to disclose their choices for surgery. These, says Dr. Yap, include abusive relationships and low self-esteem situations, where the victim might mistakenly decide that having plastic surgery is the only way they can cope with feelings of hopelessness and loss of independence. A surgeon’s obligation is to inform and guide patients as to the risks and benefits of each procedure. Ultimately, patients have to decide for themselves what the prime social and medical determinants of their choices for surgery are.
There are situations where social pressures mitigate against full disclosure of surgical enhancements. Clients who are frequently in the public eye – for instance – are uncomfortable with people knowing they have had surgery. This is again possibly due to public expectations and value judgements assigned to such procedures.
In Part 2 of "Unashamed" our editorial team will our medical professionals the below questions: -
1) What are the downsides of celebrities not admitting to surgery?
2) Why do doctors believe that patients shouldn’t be ashamed of plastic surgery?
3) Why are cosmetic surgery and aesthetic procedures still considered uncommon and how does negative public judgement affect patients?
Confidence is Key.
So watch out for Part 2 which will be featured on Sunday (8 November 2020) at 10.:00am