Cosmetic surgery

Cosmetic Surgery (also called Aesthetic Surgery) is the field of surgery in which operations are aimed to improve appearance, that is, to create beauty.

"Aesthetic surgeons, in the normal practice of their specialty, routinely alter the otherwise acceptable physical form of the patient toward the arbitrary and stylized visages thought desirable either by the patient or by the community in general" (Isenberg JS. The legacy of Narcissus.[comment]. [Comment. Letter] Plastic & Reconstructive Surgery. 110(7):1815; author reply 1815-6, 2002 Dec. UI: 12447085). Although these procedures do not cure disease, they can have a tremendously beneficial effect for the patient who has them, providing expectations are reasonable and a satisfactory result can be obtained. When self-image is improved, a real benefit is conferred. In the case of people whose livlihood depends on photogenicity, or personal appearance, aesthetic surgery can offer the same kind of advantages as exceptional grooming or eye-catching fashion, and is often viewed as a business expense, whether or not it is deducted as such.

Cosmetic surgery has been offered to prisoners by philanthropists and in some surgical training programs. Removal of gang related tattos, reduction of scars, and repair of nasal deviations and other physical momentoes of trauma can, at least theoretically, help individual rehabilitation.

Cultural & ethnic considerations

Lips

In the Twentifirst Century very full lips are considered to be so attractive that procedures to "fill out" the lips are frequently requested of aesthetic surgeons. Not only are varous fillers injected into the lips, but traditional surgical techniques employing V-Y advancement flaps are used to give more lasting results than the fillers provide. (Mutaf M. V-Y in V-Y procedure: new technique for augmentation and protrusion of the upper lip. [Journal Article] Annals of Plastic Surgery. 56(6):605-8, 2006 Jun. UI: 16721070). All of these procedures are generally safe and effective in expert hands, but none of them had much call for a generation ago because the fashionable face was different then.

Fifty years ago, what are now considered beautifully full lips were often viewed as excessively thick lips, instead, and "lip thinning operations" to make the mouth smaller and more delicate were performed to reduce them. These operations were an important part of the facial plastic surgeons repetoire in the 1960's and 1970's, and were featured in the surgical literature of those times. Currently, as demand has changed, such procedures receive scant mention in textbooks and articles in the medical literature.

Noses

"Correction" of the ethnic nose

In the 19th and for much of the 20th century, a Northern european Caucasian nose of a certain quality was the aesthetic ideal. In the earlier portion of that period, outright discussion of the unattractiveness of semetic and negro noses were openly discussed in publications, in the later portion, the wide and hooked noses previously identified as ethnic xxx were no longer consciously seen as a mark of ethnic origin, but still, such features were routinely described as showing "deformities" and patients sought corrections that surgeons were willing to provide. "A 1996 manual describing procedures for altering ethnic noses, for example, indicates that correction of the "Jewish nose" requires "a classic rhinoplasty with lowering of the dorsum, narrowing of the bony pyramid, refinement and elevation of the excessively long hanging tip." 7Another recent manual, while refraining from explicitly using the Jewish nose as a diagnostic category, notes that 2 patients with noses that "have acute nasolabial angles, plunging tips, or foreshortened nasal tip pyramids" were "of Jewish ancestry" or of "Jewish descent." " (reference for quote:Preminger B. msJAMA: The "Jewish nose" and plastic surgery: origins and implications. [Journal Article] JAMA. 286(17):2161, 2001 Nov 7. UI: 11694162). The recognition of beauty can change over time, as ethnic characteristics that were once seen as "ugly" because yhey were a mark of a difference that was held undesireable by the general society become appreciated as intolerance disipates. For example, the actress Jennifer Grey experienced a set-back in her career when she had a cosmetic rhinoplasty that changed her distinctive natural nose from one with a delicate downward hook into one with a diminuitive button tip.

Jaw lines

Whereas a square angle of the jaw is a mark of great beauty in both men and women of all races in the West, in Asia, in women, the opposite is true. A strong jaw, with a square angle, is traditionally viewed as unsightly. "An operation to correct a square angle into a round, smooth angle" is offered by aesthetic and reconstructive surgeons practicing in the East.(reference for quote:Satoh K. Mandibular contouring surgery by angular contouring combined with genioplasty in orientals. [Case Reports. Journal Article] Plastic & Reconstructive Surgery. 113(1):425-30, 2004 Jan. UI: 14707669) Baek, S. M., Kim, S. S., and Bindiger, A. The prominent mandibular angle: Preoperative management, operative technique, and results in 42 patients. Plast. Reconstr. Surg. 83: 272, 1989 Lee DG. Song CW. Kim SG. Lee YC. Cho BO. A simple technique for reduction gonioplasty. [Letter] Plastic & Reconstructive Surgery. 111(2):951-2, 2003 Feb. UI: 12560737

Botulinum toxin

"What is so different about the injection of cosmetic botulinum toxin from other injections? Simply stated, neurotoxin injections are a surgical procedure—because the results depend entirely on the injector's knowledge of the underlying muscular anatomy and pharmacology as well as the principles of aesthetics." (reference for quote:Carruthers JD. Caveat emptor (buyer beware).[comment]. [Comment. Editorial] Archives of Dermatology. 138(9):1243-4, 2002 Sep. UI: 12224991)