Cowboys and Plastic Surgeons, not a movie
Monday, 23 January 2012
Disclaimer: Firstly, I don’t advertise, I don’t work for a private clinic and I have two patients with PIP implants. I am not a paid consultant for any implant company or any private clinic. I am an Aesthetic Plastic Surgeon and a private practitioner.
With respect to the current PIP implant furor, it is extra-ordinary that the Press and the Politicians have trivialised the women involved. Our Western Civilisation has idolized beauty from Cleopatra to Elizabeth Taylor. It is as obvious as it is trite, to have to trot out examples of beautiful women such as Cindy Crawford to Kate Moss who have made their career on their looks. Many other celebrities have either altered their bodies to further their career or engaged in cosmetic surgery to keep them employed. The current marginalizing of these women in the UK media would be political suicide in the USA. Besides which, it is just plain hypocritical.
It has been proved scientifically that not only does cosmetic surgery improve your self confidence and self-esteem but it can actually extend and improve the quality your life. Don’t believe me, read the scientific publications. It is time to throw these male chauvinistic arguments, denigrating women who have cosmetic surgery, into the rubbish bin. They are the musings of intellectual Luddites. Cosmetic surgery has been part of main-stream surgery since the Second World War ended when many of the leading Plastic Surgeons in Europe and the United States turned from reconstructing injured veterans to lifting the faces of High Society. In the modern era, cosmetic surgery is safe, affordable and it works. If it was a dismal failure it would be an intellectual footnote, not the hook for so much of our advertising and media. It is surprising how pervasive it is, not only in the semi-nude culture of the decadent West but also in heart of Islamic such as Iran and the rest of the Middle-East, and in Asia also. Behind the burka is an avid consumer of cosmetic surgery. Rhinoplasty is the most common procedure in Tehran where men and women stroll along the streets with splints on their noses. No small part of the success of Cosmetic Surgery is due to the unlikely invention of breast implants. A synthesis of chemical engineering and medical advances as well as the underlying manifestation of Sculpture in the flesh. An eclectic mix designed by a Plastic Surgeon, which epitomises the synthesis of Art and Science that Plastic Surgery represents.
Invented in 1962 and inspired by the feel of a plastic bag full of blood, a Texan surgeon named Gerow,conceived the idea of breast implants made out of refined silicone which had been shown to be one of the most inert substances known to man. The subsequent explosion of breast implant surgery and its persistence as the most common cosmetic procedure after liposuction, is a tribute to its safety. Not only has it corrected deformities of the breast after cancer as well as developmental deformities but it has also restored self-esteem and confidence to many women with small breasts.
Desmond Morris, in “The Naked Ape” explained the significance of woman’s breasts as being a replacement for the visual cue of the buttocks which were lost as a sexual signal when we adopted the vertical posture of Homo sapiens. Women are no longer the curvy Mae West’s or Marilyn Monroe’s of yester-year. Today, they are breastless and narrow hipped and often wear trousers. Our female models look like boys and our male models look like girls. Sometimes they are transvestites. Sexual differences are blurred. Often, the only remaining sexual indicator is the size of the breasts, To date, the feminization of men and the manifestation of the ‘Metro sexual” has not extended to a desire for male boobs or ‘moobs’, even in gay men. And men, gay and heterosexual still very much prefer their penis to be on the large side, judging by the underwear ads. However the genital area is still off limits as a public display of gender, though as waistlines get lower, this is probably the next boundary to be crossed.
The recent health crisis associated with PIP implants is seen by some as a failure of cosmetic surgery and a demonstration of unfair trade practices taking advantage of unsuspecting (read stupid) women. Although there is much to be criticized about the exploitive advertising and sharp sales practices of some private clinics, the cause of the problem has nothing to do with this. In fact these issues are completely irrelevant. This is quite obvious. What is surprising is that the media has not made the connection or lack of connection between the two. These are not back street abortions we are talking about although media pundits and MP’s try to characterize them as such. These implants were legal. They were implanted by licensed practitioners in accredited facilities. The only lapse of oversight is by the agencies responsible for monitoring the safety of the implants. To use a metaphor; if BP manufactured a petroleum product that was tested and approved for use in vehicles that then resulted in engines exploding, the Government would choose to replace the cars owned by the government employees, or perhaps in this case simply confiscate them, and would consider it the ‘moral duty’ of all drivers to take an annual driving test and of all car manufacturers to recall the old cars and replace them, if they so chose.
The British Association for Aesthetic Plastic Surgeons has now come forth with an agenda to regulate the cosmetic surgery industry. Many of their recommendations are common sense, such as avoiding advertisements which promise surgery as a prize in a raffle (this has long been prohibited by my own Society, the American Society for Aesthetic Plastic Surgery, in the USA). I don’t think there is anything inherently wrong with truthful advertising or with affordable surgery. There is even a suggestion that has been voiced, that any surgeon who chose these PIP implants, committed a failure of judgment. There are multiple references to the ‘Wild West’ and ‘Cowboys’ by the same group which seems somewhat farcical when set in the context of the stuffy London Metropolis where there are few Stetsons or tumbleweeds... I feel a little bit like Ronald Regan when I say that I have known a lot of cowboys in my time (having written a scientific paper on Rodeo Roping Injuries during my Hand Fellowship in Denver, Colorado) and believe me when I say that none of the characters involved in this drama remind me of them. Besides which, the likes of John Wayne are still eulogized in Orange County California along with the cowboys and the Wild West he represented. They embodied values of accountability and righteousness which seem to be lacking in this current gun fight in the media corral. It might be worthwhile recalling some words that John Wayne had engraved on a plaque, ‘'Each of us is a mixture of some good and some not so good qualities. In considering one's fellow man it's important to remember the good things ... We should refrain from making judgments just because a fella happens to be a dirty, rotten SOB.”
There is a persistent group of media and politicians who trivialise the value of cosmetic surgery and the men and women who seek it. Denigrating our colleagues damages the reputation of the whole profession. We certainly should be preventing unlicensed practitioners from doing surgery and injections but using pejoratives such as ‘Cowboys’ just serves to make us all look like clowns.
Ulrika Jonsson recently stood up for women who have found or are looking to achieve confidence with the help of cosmetic surgery. Jonsson also emphasised that it was important for women in the public eye to be open about how they achieve their body shapes, and not try to dupe impressionable women into thinking such figures were always achievable by diet and exercise alone.
Kira Cochrane in the Guardian pointed out the double standards we apply to these women stating that ‘As the PIP story has unfolded, some have commented that they can understand why mastectomy patients might want the operation, but not women who have it solely for cosmetic reasons. This seems slightly disingenuous. Because if it is, of course, understandable that someone might want a breast that had been removed to be reconstructed, it's surely not such an enormous leap to imagine why someone with very small breasts might want the operation too.
And so we are now left with particularly unsatisfactory solution promoted by the Health Authority which even Joseph Heller had not foreseen. The message, if you can figure it out, is that women should have their implants removed, but except for 5%, the rest will have to see their own doctor (who is unwilling to take care of the problem) or their GP who is suddenly co-opted as an expert on the subject of breast implants. My father was a very good GP but believe me, he not only knew nothing about cosmetic surgery but he used to make a joke about me being one. I loved my father and I don’t hold a grudge against him but if he were still alive, I would not send my PIP patients to him.
LK 23 January 2012.
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Posted byLaurence Kirwan at 22:00
Labels: advertising in the cosmetic industry, cowboys and aliens. PIP implants
