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Confuison Related to Reconstructive Srugery in Modern Society Part 2

misconceptions. Patients who were denied by their own plastic surgeon are often denied because of a legitimate physiological or psychological concern. Patients who bypass this initial denial further the societal need to achieve physical perfection and beauty.


Vast differences and diverse factors between reconstructive and cosmetic surgery have led to society’s confusion between the two surgical disciplines. Reconstructive surgery is aimed at correcting physical malformations such as congenital deformities (birth defects), developmental deformities as a result of an accident, infections or disease. Reconstructive surgeons can perform procedures to remedy infections or disease such as reconstruction after skin cancer. This can range from removing unsightly scars or to adjust changes in facial structures such as the nose, ear or lip. An example of a congenital defect repair is the correction of cleft palate or cleft lip. Reconstructive surgeons are able to eradicate the congenital gap between the infant’s lip or palate (ASAPS 27). Reconstructive surgeons may also be called upon to correct physical malformations as a result of an accident such as a burn, dog attack, or any other unforeseen physical trauma (Reconstructive Surgery 3). Cosmetic surgery however, is aimed at enhancing an individual’s appearance. This can include procedures such as abdominoplasty (tummy tuck), liposuction, augmentation mammaplasty (breast augmentation), mastopexy (breast lift), breast reduction, blepharoplasty, malar augmentation (cheek implant), or rhinoplasty. The preceding procedures represented the top invasive cosmetic surgical procedures (Appendix B). These procedures are not correcting anything that is physically wrong with the patient; they are simply being used to enhance the appearance of the individual (Physician’s Guide to Cosmetic Surgery). Varying goals of the two disciplines are portrayed through the types of surgeries performed in each discipline. Reconstructive surgery is used to correct physical abnormalities or to restore or improve the functionality of an individual. Success of a surgery is judged by whether or not function is restored. Cosmetic surgery is commonly used to improve the way people look and feel about themselves. Success of cosmetic procedures is gauged upon patient satisfaction, improvement of appearance or an increase in self-esteem. Societal confusion related to reconstructive surgery and cosmetic surgery is largely due to the differences between them, but is also due to misrepresentations of reconstructive surgery.

A nationally conducted survey of two hundred members of the public associated reconstructive surgery with predominantly burn victims and aesthetic procedures (Agarwal 7). The results of this survey are due to the fact that reconstructive surgery is commonly misrepresented in modern society. The media is the main catalyst to this problem. A common media misrepresentation is the distortion of a plastic surgeon. Media has imbued the image of a profit making, affluent businessman instead of reality’s caring empathetic doctor (9). “Nip/Tuck, a fictional drama on FX, uses violence, sex and graphically unrealistic portrayals of plastic surgery to boost ratings. The show does a disservice to millions of patients who benefit from cosmetic and reconstructive procedures” (Kendall 9). In addition to “Nip/Tuck” shows such as “Extreme Makeover”, and “The Swan” coupled with magazines that “frame the benefits of cosmetic surgery using gendered stereotypes” (Adams 5) are at risk for many concerns. “With these programs, however, come a host of potential concerns, ranging from the misrepresentation of surgical risks to increased and perhaps unhealthy competition among surgeons to produce the best outcomes” (Atiyeh 835). Within the media cosmetic surgeons are stereotypically represented as affluent and pretentious businessmen. As well, these shows provide a catalyst for competition. With the ever-growing popularity of cosmetic reality television, success standards are being gauged not only between surgeons, but also between surgeons and the media. Competition, however, is becoming an increasing concern. Following the laws of basic economics, as the demand for cosmetic surgery rises, because of media portrayal, more plastic surgeons are needed to meet and sustain the needs of society. A higher prevalence of plastic surgeons in one generalized location, offering the same surgeries, will inadvertently cause the price of said elective procedures to decrease. Thus making cosmetic procedures more readily available to the public. The media not only misrepresents plastic surgery, but it also induces the viewer to have swayed expectations. “The risk that these shows create unhealthy, unrealistic expectations in patients is real and raises serious concerns” (Atiyeh 835). It is blatantly obvious that society’s perception of reconstructive surgery and plastic surgery have been extremely influenced by negative media portrayals. Additionally, it is evident that the surgeons themselves have not escaped unscathed.

Although commonly mis-portrayed and pitted against the media, many cosmetic surgeons donate their time, energy and prosperity into pro bono reconstructive work around the world and in local Emergency Rooms and trauma centers. In regards to an ethical debate presented by Bishara Atiyeh et al, they state, “Unfortunately, the media’s focus on aesthetic surgery and the “flashy” behavior of some aesthetic plastic surgeons encourages this negative opinion” (Atiyeh et al). Additionally, many cosmetic surgeons work with international programs such as Operation Smile, which fixes and corrects cleft lip/ cleft palate of children around the world. Operation Smile shall be referenced and discussed later in the paper. Many reality, drama and soap-opera shows distort the goals and aims of both reconstructive and cosmetic procedures by instilling the mind set that plastic surgery consists of solely aesthetic procedures. These distorted goals also lead to a desensitization of surgery. Society, because of false media portrayals, has begun view cosmetic surgery as a mere commodity rather than life-threatening invasive surgical procedures (Atiyeh et al). A case study presented within the Association of Perioperative Registered Nurses Journal, depicts a man who received neck and facial liposuction and eyelid tightening under a local anesthetic. However, after returning home he noticed a large swelling mass at the sight of incision upon his neck; he was promptly directed to the nearest emergency department after notifying his physician. The study stated that upon arrival to the emergency department he suffered from extreme respiratory distress and eventually was administered a tracheostomy. Suffering from a lacerated external jugular vein, the patient was required to stay within the intensive care unit for a prolonged period of time (AORN). Cases such as these depict the true nature and real dangers of receiving cosmetic surgery. The unhealthy desensitization of surgery as a whole present within today’s mainstream media has twisted and malformed society’s perceptions of the life-threatening risks of cosmetic surgery. “In spite of their extreme surgical training and technical skills, plastic and reconstructive surgeons are more often recognized as performing only cosmetic surgery” (Agarwal 3). The media has caused the public to develop a narrow-minded view of reconstructive surgery, however, though the source of much negativity and misrepresentations the media may also be the ultimate solution to this problem.

Often, the key factors that contribute to societal confusion can be utilized to remedy the problems for which they are the causative agents. For example, vaccinations utilize small traces of viruses to prevent diseases. Therefore, utilizing the media, may remedy societal confusion regarding reconstructive surgery. By establishing television programs, commercials and awareness campaigns over the air, on the radio and in print the public will be able to better understand the separate discipline of reconstructive surgery. Television programs that depict a plastic surgeon with the dignity and respect that they deserve will also educate society. Teaching everyone that plastic surgeons are hard working and caring, compassionate doctors and not the money swindling scoundrels the current media portrays them as. Coordinating not only awareness campaigns and positive media portrayal of not only the surgeons themselves, but portrayals of the surgical discipline as a whole is a necessity.

Established throughout the world, countless charity programs are in place to depict the positive outcomes of reconstructive surgery. Operation Smile, for example, is a far-reaching organization based out of Norfolk, Virginia that specializes in the correction of cleft palate and cleft lip in underprivileged nations and privileged nations alike. Founded in 1982 by Dr. William Magee, Operation smile has been able to benefit children exceeding numbers 135,000 children in more than fifty countries around the globe. Operation Smile has been established to benefit nations such as India yielding upwards of thirty-three thousand orofacial clefting abnormalities per year (Mossey et al). Operating under the slogan “Changing Lives One Smile at a Time” Operation Smile is combating the adverse effects of orofacial clefting throughout the world. Children suffering form orofacial clefting encounter feeding difficulties at birth due to problems with oral seal, swallowing and nasal regurgitation, hearing difficulties due to abnormalities in the palatal musculature and speech difficulties due to nasal escape and articulation problems (Mossey et al). However, Operation Smile does not stand alone in combating orofacial clefting. Parallel organizations such as the SmilesTrain are also heavily involved with benefiting underprivileged children through facial correction and reconstruction. Approximately every two minutes a child is born with orofacial cleft, thus any effort to combat these malformations is a required necessity throughout the world (Mossey et al). Organizations such as these, through media coverage, may help to eradicate the growing superfluous portrayal of plastic surgery within mainstream media.

In reference to a study concerning media representations of body modification processes conducted by Josh Adams, he states “While media outlets have the ability to frame social issues and direct public discourse, they often rely on preexisting understandings of ideas and simply reproduce symbolic meanings rather than overtly reinterpreting them, problematizing the media’s role as both information provider and moderator of collective dialogue” (Adams 104). From this study, in relation to the undermining of plastic surgery, I garnered that because of the media’s natural dual polarity in regard to ethical and social issues, media portrayals are often misinterpreted or misunderstood by the general public. Thus another method, already in place, to recalibrate societal views toward reconstructive surgery is to limit the availability of cosmetic surgery for minors and disabled minors alike. In dealing with non-cognitively impaired minors, the state of Queensland, Australia has made it illegal for teenagers under 18 to have elective cosmetic procedures and countries such as Germany, and The Netherlands have drafted similar laws (Gilbert 14). However, in regards to cognitively impaired minors, there exists a large ethical debate over the consents of cosmetic surgery (Opel et al). Research states that because the children lack cognitive awareness, they themselves will perceive the surgery as having no psychological benefit. Through the limitation of aesthetic surgery performed on cognitively impaired minors, a reduction in non-life threatening surgical procedures is achieved. This reduction may ultimately influence society’s views on cosmetic and reconstructive surgery alike. Limiting these cosmetic procedures may alleviate the influence of personal appearance, beauty and perfection in our society, thus making the public more aware that cosmetic surgery is not the sole discipline of plastic surgery. Through the possible use of our legal system, and effective awareness campaigns many societal views of reconstructive surgery may be disbanded.

Misconceptions of reconstructive surgery in modern society can easily be eradicated through effective awareness campaigns and the imaginative use of the media. By raising knowledge that the surgical specialty of plastic surgery is more complex and diverse than most people have come to believe, society will be able to show more respect for the hard-working doctors who are able to repair children’s cleft lip and cleft palate, and save a burn victims face from incomprehensible damage. Not only shall society be able to appreciate the talent and intelligence of plastic surgeons, society will also be able to comprehend how beneficial charity programs, such as the SmilesTrain and Operation Smile, are to privileged societies and underprivileged societies alike. With an educated society people will be able to not only appreciate the meticulous work of plastic surgeons, but also appreciate themselves more and the natural beauty everyone possesses within them.





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