Creating beauty

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The psychology behind cosmetic surgery. The why and how it helps and the dangers of Body Dysmorphia Syndrome.

Transcript of Creating beauty

  • 1. Aesthetic SurgeryCreating Beauty to Cure the Soulby Sander Gilman1998 Review by William C. Brender, MD

2. Aesthetic Surgery Jacques Joseph Nasenplastik und sonstige Gesichtplastik 1931 3. Aesthetic SurgeryWe restore, repair and make whole, those parts which nature has given but which fortune has taken away, not so much that they may delight the eye, but that they buoy up the spirit and help the mind of the afflicted.Jasper Tagliacozzi 1597Father of Plastic Surgery 4. Aesthetic Surgery(Reconstructive Surgery is) an attempt to return to normal,Aesthetic surgery is an attempt to surpass the normal. Harold Delf Gillies 1882-1960 5. Aesthetic SurgerySurgeons were concerned about aesthetic results: careful suturing of edges of facial wounds nasal fractures reduced and splintedPapyrus (3,000 BCE) 6. Aesthetic SurgeryImportance of beautiful suture stressedCornelius Celsius (25 BCE - 50 CE) 7. Aesthetic Surgery(Billroth performed) plastic operations with artistic ability to correct defects of beauty...one could see his joy when he was able to successfully improve the appearance of a damaged person, so that that person was no longer the object of pity or horror. Theodore Billroth (1829-1894) 8. Aesthetic SurgeryBeauty is the outward and visible sign ofhealth - perfection - virtue. Jules Hericourt (1850-?) 9. Aesthetic Surgery Beauty MythThe accepted wisdom is that if youunderstand your body as ugly, you boundto be unhappy 10. Aesthetic Surgery Mens Sana in corpore sano The mark of the healthy body is the happy soulMens non sana in copore insano The mark of the unhealthy body is the sick soul 11. Aesthetic Surgery Modern society - attempt to change ourbody - diet, cosmetics, fashion and surgeons Pursuit of Body Beautiful/Happy Soul. 12. Aesthetic SurgeryPlastic surgery with the aesthetic as wellas the reparative objective, will becommonplace in another five years, asneatness and cleanliness are today Henry Schireson (1881-1949) 13. Aesthetic SurgeryWidespread AcceptanceNo longer limited to RichStatus symbol in South America 14. Aesthetic SurgeryIncreased number of procedures performed liposuction - #1 breast enlargement - #2 eyelid correction - #3 chemical peels - #4 facelift - #6 (breast reduction - reconstructive - #5) 15. Plastic SurgeryMale Cosmetic Surgery1992 13%1997 33% 16. Aesthetic SurgeryBenefit psychologicallyself conscioussocial acceptancepositive change in appearance improve professional chances increased admiration 17. Aesthetic SurgeryThis artistic branch of surgery has long been perceived as frivolous and notserious medicine. 18. Aesthetic SurgeryPerformed nose jobs on three members ofsame family in vaudeville mannerPeople in audience faintedReinforcing the tasteless aspect of advertising J. Howard Crum (1888-c.1970) ?performed first facelift 19. Aesthetic SurgeryCore of the Psychological theory of Aesthetic Surgery:Curing the Physically Anomalous is curing the Psychologically Unhappy. 20. Aesthetic Surgery.did not claim only to cure the pugnose; he claimed also to be curing hispatients unhappiness John Orlando Roe (1849-1915)Rochester, New York 21. Aesthetic SurgeryBeautiful is a sign of the healthy and in modernity the healthy becomes a sign of the happy. 22. Aesthetic SurgeryProzac nicknamed Cosmetic surgery ofthe BrainDecline in stigma associated with Aesthetic Surgery parallels the change in stigma of mental illness. 23. Aesthetic SurgeryPeople have the feeling they cant controltheir own future; that working hard andbeing a good citizen wont get youanywhere, Thats why beauty hasbecome the main value in the market. Marcelo Hernandez Argentinean psychiatrist 24. Aesthetic Surgeryoftencompared catharticpsychotherapy with surgicalintervention.convinced that the patients would benefitif we were more often to hand over thetreatment of these affections to therhinological surgeons. Sigmund Freud (1856-1939)Studies of Hysteria (1895) 25. Aesthetic SurgeryReversal of Traditional Medical Model Classic model - the patient comes to the physicianwho makes a diagnosis and then provides thetreatment. New model - the patient tells the doctor the diagnosisand how they want it treated. 26. Aesthetic SurgeryReversal of Traditional ModelClassic model - operation is performed on a deformedpatient to make them look normalNew model - operation is performed on a healthy patientto enhance the way they look 27. Aesthetic Surgery the idea that we get a permit tooperate on someone who is totallynormal is an unbelievable privilege. In a way its the ultimate surgery. Joseph M. Rosen MD Dartmouth-Hitchcock Medical Center 28. Aesthetic SurgeryDefinition of heath - a state of complete physical, mental and social well-being. World Health Organization 29. Aesthetic SurgeryCosmetics -adjunct of treatment (disguise) of illnessOrigin of cosmetic surgery - late 19th century subspecialty of medical cosmetics - disguise of syphilitics symptoms (i.e. missing nose or ulcerated lesion ) 30. Aesthetic Surgery Medicamenti facieimake up as a form of medication for the soul Ovid (43 BCE - 17/18 CE) 31. Aesthetic SurgeryThe study of the ugly is to the examination of beauty what the study of pathology is to illness. Karl Rosenkranz (1805-1879) 32. Aesthetic SurgeryCaveat: One cultures normal is another cultures ugly.Rod Sterling (1924-1975)The Twilight Zone 11/11/60Eye of the Beholder 33. Aesthetic Surgery CharumMen who are flat-nosed or snub-nosed are forbidden from becoming priests.Aimed against those with leprosy who were seen asritually unclean. The unclean is also the ugly, and theunhappy.Leviticus 21:18 34. Aesthetic Surgeryabsence of the nose is a horrible thing tolook at.Erik, the PhantomPhantom of the Opera (1911) Gaston Leroux (1868-1927) 35. Aesthetic SurgeryAll lost noses, in the age of syphilophobia,were signs of sin. Syphilis marked theface of the nave and the innocent aswell as the lecher and hypocrite. 36. Aesthetic SurgeryBig noses cannot mate with little noses Edmond Rostand (1868-1918)Cyrano de Bergerac 1897 37. Aesthetic Surgery The Jewish Visage The unmanly bodily infirmity The tubercular Jewish womanTHE JEWISH NOSE 38. Aesthetic SurgeryNostrilityThe anatomy of the Jew in which the hooked nose represents the first visual representation of the Primitiveness of the Semitic race Dr. Celticus Anti-Semitic Pamphleteer 39. Aesthetic SurgeryThe Nose was a Sign of the Jews Nature.A sign that does not vanish when the Jew is acculturated.Being seen as a Jew meant being persecuted, attacked, and harassed.Alteration of the body through surgery was seen as the cure. 40. Aesthetic SurgeryTradition of the Sweet Sixteen NosejobAesthetic Surgery comes to be understood as Somatopsychic Therapy 41. Aesthetic SurgeryThe Deformity affects the Conscious Mind through the Patients Reception in Society.The Operation alters the Perception of the Body in others and thus alters the Patients Consciousness. 42. Aesthetic SurgeryThe focus of the patients unhappiness is on their fixed (racial) physiognomyImage of the African Face: low forehead, flat wide nose Enrico Morselli (1852-1929) 43. Aesthetic SurgeryWe, belonging to the higher races,regard as ugly all noses whichapproach that of the apePaolo Mantegazza (1831-1910) 44. Aesthetic SurgeryPLUMPNESS - Double Edged Sword 45. Aesthetic Surgery PLUMPNESS - Double Edged SwordNormal women can be plump and are thereforehealthy.Criminal women, such as prostitutes are plump, a signof their natural tendency to their craft.Cesare Lombroso (1835-1909) 46. Aesthetic Surgery Micromastia? Real Diagnosis? American CultureFeel less of a WomanDesire the fullness of pregnancy 47. Aesthetic SurgeryIdeal patient is someone who, in theaesthetic sense, is less than optimal,but who otherwise is well adjusted.Jim Pietraszek, MD , La Jolla, CA 48. Aesthetic SurgeryAbility of the patient to tell a complete narrative is a predictor of positive outcome.Inability to narrate is a sign ofpsychological instability. 49. Aesthetic SurgeryUnhappiness is a problem of your fictive life, rather than your ill organs. You are what you imagine yourself to be.Hans Vaihinger (1852-1933) 50. Aesthetic SurgeryThe anomaly of the unhappy patient.isexplained as a too heightenedsensitivity to beautyJacques Joseph (1865-1934) 51. Aesthetic SurgeryJosephs Psychological ScaleHypo-aesthetic - unfazed even by gross deformitiesOrtho-aesthetic - normals who can objectively evaluate their deformitiesHyper-aesthetic - extremely unhappy with strongly developed sense of beauty such as painters, sculptors, and others with artistic naturePara-aesthetic - pathologic aesthetic sensibility focus on imagined deformities. Have normal or even beautiful features that do not need change. 52. Aesthetic Surgery Bad Patient Qualitiesmale, unmarried, twenty to thirty-five. low self esteem,grandiose ambitions, hyposexual with no long termrelationships, extremely obsessive yet passive withsurgeon, aggressive when not accommodated, anxious,vague about goals of surgery, dissatisfied followinginitial postop enthusiasm, minimized problemKnorr, Edgerton, and Hoopes John Hopkins University 53. Aesthetic SurgeryDependent and Controlling Females who Hate the Aging ProcessAny violation of the body engenders exacerbation ofneurosis even with the normal patient.Evidence of depressive symptoms preoperatively willbe intensified in the immediate postoperative period Erich Lindermann (1900-1974) 54. Aesthetic SurgeryNegative Result of Surgical InterventionExacerbation of unhappiness through the patientsexperience of trauma awaken existent psychicpatterns. Helene Deutsch (1884-1982) 55. Aesthetic Surgery MonomaniaMale patients requested multiple nasal proceduresThe normal nose still made the patient unhappy1892 paperRobert F. Weir (1838-1894) 56. Aesthetic SurgeryPolysurgeryThe demand for repeated surgery A sign of psychopathology 57. Aesthetic Surgery Dysmorp