Plastic surgery versus aesthetic surgery over the course of time
What comes to mind when you hear the term “plastic and esthetic surgery”? If you think that plastic surgery is just for models and millionaires, you are wrong. If you are not only thinking of esthetic surgery, but also a reconstructive, burn and hand surgery, then you have a good knowledge of the matter.
The assertion that “the genius of creation is unsurpassable” is undisputedly correct, and yet it has been 530 years since any correction of the God-given exterior was considered blasphemy and iniquity. Times have changed, modern plastic surgery can look back on a proud age of over 530 years.
Its actual history is quite exciting and begins more than 2800 years ago, 800BC, in ancient Indian medicine, when the very first form-reproducing interventions were carried out. It was not until much later that such procedures were named surgery of congenital and acquired defects of form and function. The term “plastic” means “shaping” and was first used in that context in the “Handbook of Plastic Surgery” by Eduard Zeiss from 1838.
The World Health Organization (WHO) defines health as a complete physical, mental and social well-being.
The liberation of medicine from philosophy and the orientation towards research as well as the general structure of knowledge made it clearer that general health and well-being also include an intact external appearance. This insight led to the development of plastic surgery. In the centuries in which it has been practiced, it has developed not only as a methodologically-oriented discipline, but also as a domain that has always to some extent mirrored the state of society.
Esthetic surgery is a part of plastic surgery that exclusively deals with the external appearance. Esthetic surgery interventions are determined exclusively by the patient’s wishes. When translating the term “esthetics”, one tends to associate it with something like “beautification”, and before you now it, everyone is talking about “cosmetic” or “beauty surgery”, which does not exist as such. This designation does not sufficiently express what is meant.
Terms like “physical integrity”, “beauty” and “youth” became decisive for the efficiency of a modern, fast-moving person. The fairy tale question “Mirror, mirror on the wall, who is the fairest of them all” became louder and louder. Thus an “Eldorado” was created, and the unmedical business of so-called “cosmetic surgery” thrived. There was a danger of the actual plastic surgery being degraded to a “beauty treatment with a scalpel”. In 1968, a union of plastic surgeons (formerly VDPC, now DGPRÄC) was founded as a countermeasure in order to protect patients from the botch-up and mere cosmetic services by educating them and to maintain the high standards of plastic and esthetic surgery.
Every year, over 3 million people around the world resort to plastic surgery to improve their appearance and to correct either congenital or acquired esthetically displeasing defects. In Germany, the estimated number of esthetic surgeries among women is well over 100,000 per year. For men, the number is 20,000 per year. The trend is rising.
The ideals of beauty have changed considerably over time. The maxim, “de gustibus non disputandum est” is truer than ever and goes back a long way. Greek culture discovered the shapeliness of the body and created its own ideal of beauty. This is how the ancient “laws of proportion” came into being, later giving rise to the “laws of beauty”, which define the demand for harmony and esthetics as follows: “Perfect beauty is based on perfect health and on the perfect cultivation of all the assets which nature has bestowed on the human organism”.
The concepts of physical integrity, beauty and youth essentially shape the subjective feeling of each individual person who expects help paired with success from the plastic surgeon. Therefore, the essential medical task of a plastic surgeon performing esthetic surgery is to educate the patient. This includes risk assessments, complications and performance expectations, which are to be discussed well in advance of the planned surgery. The subjective decision to be operated on must be understood free of social, economic and psychological constraints and lies with the patient. The strict standards of the indication must be adhered to.
Despite the high momentum of esthetic surgery, it has effectively remained a pillar of plastic surgery, requiring special, meticulous knowledge, skill and experience. As a physician, the plastic and esthetic surgeon should remain autonomous, be aware of their responsibility towards nature and society, and stand against pseudomedical advertisements and the flood of misinformation with both their personality and their expertise in order to protect their patients from any harm.
Do you know the difference between a general surgery patient and a plastic surgery patient?
A general surgery patient comes to the surgeon in the hope of being told that no surgery is necessary, whereas a plastic surgery patient hopes that they will be operated on.
And now the question arises what modern esthetic surgery can do.
The most popular procedures on the head are correction of the lobes, facelift, nose correction, hair transplantation, ear correction, BTX therapy, wrinkle treatment, and laser therapy.
The most frequent operations on the torso are breast augmentation, breast reduction and breast lifting, abdominal lifting, abdominal liposuction, buttock enlargement and lifting, and body lifting.
The most frequent operations on the extremities are liposuction, inner thigh lifting, calf augmentation, and upper arm lifting.
Thus, the maxim, “beauty must be promoted, for few have it, and many need it”, still rings true.
On October 14, 1958, Pope Pius XII declared, “If we consider physical beauty in its Christian light, and if we respect the ethical conditions, then esthetic surgery, by restoring the perfection of the great work of creation, of man, is not in contradiction with the will of God”.
Plato’s beauty, which he considered second to health but more important than happiness, is badly defined. What is beauty? What do the books say? Encyclopedias? Philosophers? Our experts from the “Pearl of Esthetic”, a private clinic for esthetic and plastic surgery at the Breidenbacher Hof in Duesseldorf, will inform you about this in our next issue.
Dr. med. Branislav Matejic
Specialist for Plastic and Esthetic Surgery
Specialist for Surgery / Hand Surgery
Mobile: +49172 243 44 88