Humanity is in part characterized by the pursuit of harmony, beauty, and generally pleasant sensations, which is why achieving an aesthetically satisfying result is a fundamental aspect of reconstructive surgery. According to Kant (The critique of judgement-1790), the appreciation of aesthetics is a universal emotion: “what is beautiful is appreciated universally without concept.”
“Plastic” comes from the Greek word Πλαστιϰὸς, to form, originally used to describe sculptures and representations of the human body. Plastic surgery is therefore the surgery of the shape of the human body, and includes all procedures intended to improve the shape of the body, regardless of the technique used.
Although plastic surgery always existed, most of its development occurred in the early 1900’s with the discovery of anesthesia and asepsis, as it was important for the procedures to be painless, with no subsequent complications. Both cosmetic and reconstructive surgery were truly created during the first World War, with the repairing of the “gueules cassées” (broken faces), and during the roaring twenties. It was at this time that surgeons invented the basis of techniques still used today to reconstruct faces, hands, and breasts, and to improve their aesthetic aspect.
The practice of surgery, originally only intended to save lives, had now acquired a new purpose in restoring non-vital functions and improving the visual aspects of the human body.
It is this type of restoration that is involved when repairing a cleft lip or a broken nose. Medical doctors naturally attempt to treat damages like the aging of body tissues. For instance, heart fatigue is treated with heart stimulants, a sagging aorta is replaced with new valves, in order to extend life.
The treatment of cataract, an eye disease usually caused by aging, has been performed through surgery since antiquity, and today consists of replacing the lens with an implant to preserve vision. Reconstructive and cosmetic surgery repairs holes in the skin caused by skin cancer, wraps skin and tissues distended by aging, and transfers tissues to repair breasts. Although it is evident that repairing damages caused by a severe disease or accident is necessary, the need to repair an aging face or an inharmonious body is often misunderstood or criticized.
It is because we feel good on the inside that operating a healthy body seems to be an act that is out of our control, as if it was going against the laws of nature; it is either challenging death (treatments to combat aging), or challenging natural human creation (treatments for non-pathological defects).
These challenges are the roots of many fantasy stories, full of imaginary events challenging basic laws of western and middle-eastern cultures. In certain parts of Asia and South America, cultural beliefs do not align with the negativity of the western perception of altering the human body, and therefore do not include a sense of culpability regarding plastic surgery. Does this mean that the only limitations on the transformation of human appearance are purely technical?
It is the doctor’s responsibility to set limitations, as demonstrated by Hippocrates and his oath. Medecine is an art practiced by surgeons, but surgeons are not artists. The plastic surgeon studies human beauty, knows Albrecht Dürer’s Four Books and Leonardo Da Vinci’s proportion scale, and understands the harmony and functions of the human body. He is not a creator, he is a reconstructor. My work as a medical doctor and surgeon consists of analysing requests by listening, questioning, and remembering, of analysing the flesh and bones that constitute bodies and faces, and of knowing medical, surgical, and regenerative techniques proven to be effective. Knowing does not mean being able to do everything, for example, although I have ceased to perform microsurgery a long time ago, I still know how it functions and can give advice to my patients and direct them to a surgeon that practices it.
I do what is indicated, I avoid unnecessary and excessive risks and I favor what looks natural. I believe that the goal of my work is to allow each of my patients to align their physical appearance with their mind in order to achieve internal and external harmony. My work usually results in a feeling of liberation from an inadequate body or from a bothering imperfection, leaving patients ready to fully devote themselves to other aspects of their lives. This is true for single, one-time surgeries meant to treat a specific concern, like for example breast reduction, as well as periodic interventions meant to treat recurring imperfections and anomalies related to aging, allowing patients to free their minds from ongoing concerns.
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