COSMETIC SURGERY. - In the broad sense it means that part of surgery which is concerned with improving the appearance of patients, correcting the anatomical imperfection or the outward form of the body disfigured or destroyed by traumas or diseases.
Understood in this way, aesthetic surgery includes numerous operations that belong to other specialties, already well defined and by now completely detached from their common mother, general surgery, in which the aesthetic aim is intimately combined with that of functional restoration. This holds for "orthopedics," which deals with the deformities of the locomotor apparatus, as well as for "orthodontics" (dento-maxillo-facial orthopedics), which deals with dental malpositions and deformations of the maxillo-facial complex. While it treats the alterations, both in excess and in defect, of the development of the maxillary skeleton, the latter corrects certain important functions (respiration, mastication, phonation) and establishes a better harmony of lines in the face. Likewise, a specialty in its own right is the plastic reconstructive surgery of the facial mask destroyed or disfigured by traumas and congenital or acquired diseases, which also has an aesthetic and functional aim at the same time. Plastic surgery does not limit its activity to the face, but extends it to other regions where, for example, the point is to remedy the aesthetic and functional consequences of a cicatricial retraction from a burn.
It is by now generally accepted that the surgery pertaining to these specialties is not in conflict with the laws of natural morality.
On the contrary, objections are raised by some against those operations whose indication is found not in the consequences of disease, or congenital malformation, but in the desire to improve the harmony of lines in the human person, altered by conditions that lie on the border between the normal and the pathological.
This surgery could be called "cosmetic" (from κοσμέω = I adorn, I beautify) if one wished to consider it in its aesthetic function alone. But there is no doubt that the boundaries between plastic surgery and purely cosmetic surgery are extremely indeterminate and that the latter is, like the former, at the same time aesthetic and functional. It deals, for example, with the correction of the shape of the nose (saddle, hooked, etc.) and of the ear (loop ear), with plastic surgery of the breasts and abdomen, with the removal of wrinkles, etc. Many of these conditions can be troublesome, give rise to disturbances or to genuine pathological states (e.g. hypertrophy of the breasts, hyperadiposity of the abdomen) and therefore fall within plastic surgery; others, which seem not to disturb any function, always disturb the harmonious fusion of the various features of that design which tends more or less toward the ideal of human beauty and which constitutes the normotype (v.).
God, who created man without sin and in his own image and likeness, cannot have fashioned him other than beautiful, and beauty should therefore be normality; every deviation is to be considered as the result of the transmission and perhaps the accentuation of degenerative traits. "Beauty," says H. Bohn, "is it not a characteristic of the divinity?" (op. cit., p. 500). Let it be added that every deviation from the norm can be a cause of obstacle in social life and a source of dangerous psychic complexes. This holds also for the removal of wrinkles, a product of the loss of elasticity of the skin, a consequence and symptom of old age, but sometimes a disease that arises prematurely, at an even youthful age, and which men often regard as a condition of inferiority; for this reason, at least in many cases, the attempt to erase its signs is justified.
From the moral point of view it must therefore be concluded that, whenever the individual is not exposed to serious danger or harm (which at present is to be excluded for the totality of cases, provided they are treated by a skilled person and with correct technique), the operation of aesthetic surgery (even if for a purely cosmetic purpose) is intrinsically moral and therefore licit, if the individual proposes a subjectively honest end.
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Emanuele Scavo