point The compulsion to change one's body is often a symptom of a deeper mental instability.

It should be treated as a problem, not encouraged with surgery. Research indicating that breast augmentation patients are four times more likely to commit suicide compared to other plastic surgery patients raises 1 questions about the mental health of women who choose implants . It's only a plaster patched over a much deeper problem. There are also studies that show negative psychological effects on patients after their surgery has been completed. For example, a recent analysis 37 studies on patients' psychological and psychosocial functioning before and after cosmetic surgery by social worker Roberta Honigman and psychiatrists Katherine Phillips, MD, and David Castle, MD, found several predictors of poor outcomes, especially for those who hold unrealistic expectations or have a history of depression and anxiety. The researchers found that patients who are dissatisfied with surgery may request repeat procedures or experience depression and adjustment problems, social isolation, family problems, self-destructive 2 behaviours and anger towards the surgeon and his or her staff .
1

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Arlington, Va: American Psychiatric Association Press; 2000. available athttp://www.breastimplantinfo.org/what_know/teencosurgery.html (accessed 11/6/2011) 2 Plastic and Reconstructive Surgery (Vol. 113, No. 4, pages 1,229-1,237) (accessed 11/6/2011)

Counterattack

COUNTERPOINT
However, the vast majority of people who have cosmetic surgery have one procedure and never look back. They're made happier and more secure in themselves because of it. In fact, the same study by social worker Roberta Honigman and psychiatrists Katherine Phillips, MD, and David Castle, MD, also suggested positive outcomes in some patients, including improvements in body image and possibly a boost in their quality of life as well1. Therefore, it would be wrong to say that cosmetic surgery can be psychologically damaging as a rule. Many studies have shown that patients have higher self-esteem after surgery. For example, in a recent study by Sarwer found that a year after receiving cosmetic surgery, 87 per cent of patients reported satisfaction following their surgery, including improvements in their overall body image and the body feature altered. They also experienced less negative body image emotions in social situations2.
1 Plastic and Reconstructive Surgery (Vol. 113, No. 4, pages 1,229-1,237) (accessed 11/6/2011) 2 Dittman, Melissa,. Plastic Surgery: Beauty or Beast? (accessed 11/6/2011)

POINT
Sometimes we must accept those dangers, as they come in the course of necessary medical procedures. But with elective surgery procedures people dont need, but rather merely want the risks cant be justified. These risks apply both to the surgery itself, and to the long term. For example, leaking silicone

breast implants have been a widespread problem and can lead to death. Silicone gel can leak from the implant into healthy breast tissue and go other parts of your body, such as the lungs and lymph nodes, where it could be impossible to remove. Studies published in 2001 by scientists at the National Cancer Institute raised questions about the long-term safety of breast implants. One study found that women who had breast implants for at least eight years were twice as likely to die from brain cancer, three times as likely to die from lung cancer or other respiratory diseases, and four times as likely to commit suicide, compared to other plastic surgery patients A second study found that women with breast implants for at least eight years were 21% more likely to be diagnosed with cancer compared to other women their age.[1] There is also the risk that the person having the surgery will be dissatisfied with the results.

[1]What you need to know, available athttp://www.breastimplantinfo.org/what_know/having_problems.html (accessed 15/6/2011)

improve this

COUNTERPOINT
The risks of cosmetic surgery are negligible.In actual fact, the American Society of Plastic Surgery estimates that there is 1 death in 57,000 procedures, while a study in the medical journal Plastic and Reconstructive Surgery put the mortality rate slightly higher, at about one in 51,459 operations.[1] To put this in perspective, your chances of being injured in a motor vehicle accident are about 1 in 1,000 in any given year and there is about 1 maternal death for every 7692 live births.[2]Therefore cosmetic surgery is a lot safer than people perceive. Furthermore, cosmetic surgery is becoming safer and safer. It is increasingly strictly policed and sky-high legal pay-outs by bad surgeons have ensured that practitioners take more and more care.[3]Technology in surgery and in implants and so forth is forever improving. For example, new non-invasive procedures are being developed such as Liposonix and UltraShape Contour. These procedures use focused ultrasound devices which aim to achieve targeted reduction of fat tissue by focusing ultrasound energy that causes permanent disruption of fat cells without damage to the epidermis, dermis or underlying tissues and organs.[4]Procedures such as this would decrease the risk of infection.

[1]DeBenedette, Valerie,. Risks of Cosmetic Surgery. [2]ibid.

[3]7m payouts for plastic surgery errors. [4]Technology briefs: Focused Ultrasound Body Contouring.

POINT
Only those that can pay for it get it. The most popular surgeries include breast augmentation, liposuction, nasal surgery, eyelid surgery and abdominoplasty.[1] There surgeries cost between 3,000 and 5000, between 2,500 and 6,000, between 3,500 and 4,000 and between 2,000 to 6,000 respectively.[2] So if it has the advantages the opposition claims, the rich will look good, and the poor will not.

[1]Cosmetic Surgery. [2]Cosmetic Surgery prices.

improve this

COUNTERPOINT
You can spend your money how you like. Why shouldn't people be allowed to make the personal choice to change their appearance with their own cash? Furthermore, the appearance division the proposition seeks to suggest between rich and poor is much more dependent on quality of diet. Diet is a universal factor that affects complexion, height, etc. 1, while cosmetic surgery is a relatively insignificant factor in statistical terms and one that only affects the particular thing on which surgery is conducted. 1 Physical benefits of a balanced diet (accessed 11/6/2011)

POINT
The state of Queensland in Australia has a ban on teenagers having plastic surgery. This prevents anyone under 18 having cosmetic surgery unless it is to correct deformities or disfiguring injuries, as well as

allowing for procedures to improve medical, psychological or social well-being. This potentially leaves difficulty drawing the line for what is allowed1. A much more comprehensive ban would avoid this. Cosmetic surgery is already to some extent regulated. In the UK it is regulated by the GMC and practising surgeons have to be enrolled on its specialist register. At the same time all invasive cosmetic surgery and laser treatments are regulated. A healthcare commission inspects all registered establishments and can revoke licences. As such it would not be difficult to expand these regulating bodies to be making sure that cosmetic surgery is only performed when as in Queensland it is to correct deformities and disfiguring injuries. 1 http://abcnews.go.com/Health/BeautySecrets/story?id=4694079&page=1 ">, Childs, Dan, Australian State Bans Cosmetic Surgery for Teens, (accessed 25/8/2011)

improve this

COUNTERPOINT
The desire for cosmetic surgery is driven not by external pressure to seek the acceptance of men, but the internal desire to look and feel better about oneself. There are many who find that their appearance truly troubles them and that improving it would greatly enhance their quality of life. Operation Smile, which fixes oral and facial deformities found in poor children across the world, is doing "cosmetic surgery."[1] You can survive with a hare lip or a cleft palate. But your quality of life your self-esteem, employability, acceptance in a traditional society, etc is much better without one. Following this principle, breast reduction or augmentation or the removal of acne scars can be just as important. For example, Carole Wrigglesworth's breasts shrank after breastfeeding baby girls and as her breasts shrank so did her self-confidence. As a result she opted to have a breast enlargement surgery and reflecting on the experience, Carole has absolutely no regrets I feel sexier, more confident and extremely proud of my body.[2]

[1]Operation Smile [2]Carole Wrigglesworth's breast enlargment.

POINT
There is considerable evidence that women's attractiveness is judged more harshly than men's. For example, in a study by Adams and Huston, 1975, participants were asked to rate the attractiveness of photographs of people of varying ages. They found that although attractiveness ratings of both men and

women declined with age, the rate of decline for women was greater.[1] Researchers report that womens magazines have ten and one-half times more ads and articles promoting weight loss than mens magazines do, and over three-quarters of the covers of womens magazines include at least one message about how to change a womans bodily appearanceby diet, exercise or cosmetic surgery.[2] These views about appearance are damaging because it leads to seriously unhealthy lifestyles that women think they need to look beautiful. For example, in 2003, Teen magazine reported that 35 per cent of girls 6 to 12 years old have been on at least one diet, and that 50 to 70 per cent of normal weight girls believe they are overweight.[3] Cosmetic surgery sends the message that the prejudices some have about appearance are valid.

Before the makeover, DeLisa Stiles--a therapist and captain in the Army Reserves--complained of looking too masculine. But on Fox's reality TV makeover show, "The Swan 2," she morphed into a beauty queen after a slew of plastic surgery procedures--a brow lift, lower eye lift, mid-face lift, fat transfer to her lips and cheek folds, laser treatments for aging skin, tummy tuck, breast lift, liposuction of her inner thighs and dental procedures. The Fox show gives contestants plastic surgery and then has them compete in a beauty pageant, which last year Stiles won. "The Swan" and other such plastic-surgery shows, including ABC's "Extreme Makeover" and MTV's "I Want a Famous Face," are gaining steam, but some psychologists are concerned about the psychological impact on those who undergo such drastic cosmetic surgery--and also on those who don't and may feel inadequate as a result. While such radical transformations are rare, some psychologists plan to investigate the surge in cosmetic procedures and whether these surgeries have any lasting psychological consequences. The number of cosmetic procedures increased by 44 percent from 2003 to 2004, according to the American Society for Aesthetic Plastic Surgery. Plastic surgeons conducted a record 11.9 million procedures last year, including nonsurgical procedures like Botox and surgical procedures like breast augmentation or liposuction (see chart). How do such procedures affect patients psychologically? A recent analysis of 37 studies on patients' psychological and psychosocial functioning before and after cosmetic surgery by social worker Roberta Honigman and psychiatrists Katharine Phillips, MD, and David Castle, MD, suggests positive outcomes in patients, including improvements in body image and possibly a quality-of-life boost too. But the same research--published in the April 2004 issue of Plastic and Reconstructive Surgery (Vol. 113, No. 4, pages 1,229-1,237)--also found several predictors of poor outcomes, especially for those who hold unrealistic expectations or have a history of depression and anxiety. The researchers found that patients who are dissatisfied with surgery may request repeat procedures or experience depression and adjustment problems, social isolation, family problems, self-destructive behaviors and anger toward the surgeon and his or her staff. Overall, there are more questions than answers regarding psychological effects of cosmetic surgery: There are few longitudinal studies and many contradictory findings, researchers note. Many studies also contain small sample sizes and short follow-ups with patients, says Castle, a professor and researcher at the Mental Health Research Institute of Victoria in Victoria, Australia. "We really need good, large prospective studies of representative samples of patients, using well-established research instruments," Castle says. "While most people do well in terms of psychosocial adjustment after such procedures, some do not, and the field needs to be aware of this and to arrange screening for such individuals." In particular, the extent to which cosmetic surgery affects patients' relationships, self-esteem and quality of life in the long-term offers many research opportunities for psychologists, says psychologist Diana Zuckerman, PhD, president of the National Research Center for Women and Families, a think tank that focuses on health and safety issues for women, children and families. "These are fascinating issues for psychologists to look at--from the cultural phenomena to the interpersonal phenomena to the mental health and self-esteem issues," Zuckerman says. In addition, plastic-surgery issues will increasingly affect clinician psychologists, and the area will offer new roles for them--such as conducting pre- and post-surgical patient assessments, says psychologist David Sarwer, PhD, director of the Education, Weight and Eating Disorders Program at the University of Pennsylvania. He has studied appearance-related psychological issues, including cosmetic surgery, for the last 10 years.

"As the popularity of plastic surgery continues to grow, many psychologists likely already have--or will encounter--a patient that has thought about or undergone a cosmetic procedure," he says. Therefore it will be increasingly important for psychologists to be able to talk with patients about their appearance concerns and what may make some one a good or bad candidate for cosmetic surgery, he says. Research directions Equally pressing, however, is the need for research that sheds light on plastic surgery's psychosocial effects, many psychologists agree. To help fill in the gaps, researchers suggest further studies on the following questions: Does plastic surgery make patients feel better? Studies have shown that people report increased satisfaction with the body part they had surgery on, but results are mixed on whether plastic surgery boosts their self-esteem, quality of life, self-confidence and interpersonal relationships in the long term. In a recent study, Sarwer--also an associate professor of psychology at the Center for Human Appearance at the University of Pennsylvania School of Medicine--found that a year after receiving cosmetic surgery, 87 percent of patients reported satisfaction following their surgery, including improvements in their overall body image and the body feature altered. They also experienced less negative body image emotions in social situations. The study, which was supported by a grant from the Aesthetic Surgery Education and Research Foundation, appeared in the May/June issue of the Aesthetic Surgery Journal (Vol. 25, No. 3, pages 263-269). Sarwer and his colleagues plan to follow up with the patients next year. However, Castle's team found in their literature review--besides some positive outcomes--a link between plastic surgery and poor post-surgical outcomes for some patients, particularly for those with a personality disorder, those who thought the surgery would save a relationship and those who held unrealistic expectations about the procedure. Some studies have even gone as far as linking dissatisfaction with cosmetic surgery procedures to suicide. For example, in one study, the National Cancer Institute found in 2001 that women with breast implants were four times more likely to commit suicide than other plastic surgery patients of the same age as the women who underwent breast implants, says Zuckerman, who in April testimony to the Food and Drug Administration (FDA) urged the FDA to deny approval of silicone gel breast implants because of a lack of longitudinal research ensuring their safety. The other three studies on the topic found the suicide rate to be two to three times greater. Neither of the studies, however, identified a causal relationship between breast implants and suicide. Some researchers speculate that some of the surgery recipients may hold unrealistic expectations of it or have certain personality characteristics that predispose them to suicide. How does cosmetic surgery affect those around the recipients? Physically attractive people often receive preferential treatment and are perceived by others as more sociable, dominant, mentally healthy and intelligent than less attractive people, according to research by psychologist Alan Feingold, PhD, in the March 1992 issue of APA's Psychological Bulletin (Vol. 111, No. 2, pages 304-341). "It's not like looking good doesn't have real advantages--it does," Zuckerman says. "If some people get plastic surgery and other people don't, is that going to put the people who don't at all kinds of disadvantages, such as in finding a job or spouse?" Nearly 30 years ago, many mental health professionals viewed patients who sought cosmetic surgery as having psychiatric issues, but many studies since then suggest that those who seek cosmetic surgery have few differences pathologically with those who don't have surgery, Sarwer says. Most people are motivated to undergo cosmetic surgery because of body-image dissatisfaction, says Susan Thorpe, a lecturer in psychology at the University of Surrey in Guildford, Surrey, who conducts cosmetic surgery research. "They want to look normal--that is, they don't want to stand out in an obvious way or to have features which cause comment or make them feel self-conscious," Thorpe says. "They also want their physical appearance to be more in line with their personalities and feel that they want all the bits of their bodies to match." What effect does plastic surgery have on children and teenagers? In 2004, about 240,682 cosmetic procedures were performed on patients 18 years old or younger, and the top surgical procedures were nose reshaping, breast lifts, breast augmentation, liposuction and tummy tucks. However, very few studies have been conducted to examine the safety and long-term risks of these procedures on adolescents--an age in which teenagers are still developing mentally and physically, Zuckerman says. When does changing your appearance qualify as body dysmorphic disorder (BDD)? BDD, first introduced in the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1987, is characterized by a preoccupation with an aspect of one's appearance. People with BDD repeatedly change or examine the offending body part to the point that the obsession interferes with other aspects of their life. Several studies show that 7 to 12 percent of plastic surgery patients have some form of BDD. Plus, the majority of BDD patients who have cosmetic

surgery do not experience improvement in their BDD symptoms, often asking for multiple procedures on the same or other body features. Sarwer often works with plastic surgeons to help them identify such psychological issues as BDD, so surgeons then can refer patients to mental health professionals. He encourages them to look for the nature of the person's appearance concern, such as whether a patient has an excessive concern with a body feature that appears normal to nearly anyone else. Part of that also includes accounting for patients' internal motivations for surgery--are they doing it for themselves or out of pressure from a romantic partner or friend? And, he encourages surgeons to ensure patients hold realistic expectations about the procedures, rather than expecting the surgery to end long-standing personal issues. Psychology's role Apart from research, psychologists can find clinical roles in aiding cosmetic surgery patients too, such as helping plastic surgeons conduct such assessments. For example, they can help plastic surgeons identify patients who may not adjust well psychologically or psychosocially after surgery, researchers say. Castle says that empirically based screening questionnaires will help plastic surgeons select cosmetic surgery patients likely to experience positive psychosocial outcomes. Sarwer has teamed with other psychologists and plastic surgeons to develop such screening questionnaires, which are included in the book "Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical and Ethical Perspectives" (Lippincott Williams & Wilkins, 2005). The book, to be published this month, features a chapter on how to help both surgeons and mental health professionals screen for BDD, as well as explore the relationships among physical appearance, body image and psychosocial functioning. Sarwer believes more psychologists will begin to examine issues related to cosmetic surgery because of its increasing popularity and the link between appearance, body image and many psychiatric disorders, such as eating disorders, social phobia and sexual functioning. "Scientifically, we're just starting to catch up to the popularity of [cosmetic surgery] in the population," Sarwer says. And, as more studies commence, Castle says they need to characterize the population being studied, clearly identify outcome variables and use standardized and state-of-the-art measures. "There may be strong cultural pressures that are so unrealistic in terms of how we're supposed to look," Zuckerman adds. "Psychologists should...figure out why this is happening and what we need to know to make sure that people aren't going to be harmed by this."

How safe is cosmetic surgery?

COMMENTS (1)

By Sonya McGilchristBBC News health reporter

Cosmetic surgery procedures rose by 5% last year

Continue reading the main story

Related Stories
UK 'buttock injection' woman dies Warning over UK cosmetic surgery

Cosmetic surgery is becoming increasingly popular - there are now around 100,000 operations in the UK each year. But for those tempted to improve their looks surgically, how safe are the procedures? Claudia Seye Aderotimi's tragic death in Philadelphia this week followed an operation using an unapproved substance. Liquid silicone was injected into her buttocks in a procedure designed to enhance her bottom. The operation is believed to have been arranged over the internet and took place at a hotel near Philadelphia International Airport. But now that cosmetic surgery is becoming more common, are the risks associated with even standard procedures being under-estimated? 'Have-a-go' surgeons Last September, a report by an official review body, the National Confidential Enquiry into Patient Outcome and Death found many centres in the UK offering cosmetic surgery were failing to assess and care for patients properly.
Continue reading the main story

The risks from cosmetic surgery, as with any surgery are great
Fazel FatahPresident, British Assocation of Aesthetic Plastic Surgeons

Patients were at risk from a culture which saw teams "have a go" at operations they rarely performed. The report by the National Confidential Enquiry into Patient Outcome and Death looked at 361 sites in the UK. It found that some teams were too inexperienced to be offering some cosmetic procedures.

With the exception of breast enlargement operations, the majority of sites were not carrying out enough procedures to keep their skills up. To be safe, sites should be carrying out more than 20 operations a year - in order to give them enough experience. But only a fifth had managed this for breast reductions and a quarter for facelift. Other problems identified by the report included psychological evaluations often not being carried out, and more than half of the operating theatres not being properly equipped. Monitoring before and after treatment was also not sufficient in many cases.

Regulation
Last October, the Care Quality Commission (CQC) was put in charge of regulating the cosmetic surgery industry in England. All independent clinics and hospitals that provide cosmetic surgery must be licensed with the CQC to provide services. A spokeswoman for the CQC said that even with enhanced regulation, patients should take care. "Cosmetic surgery of any sort should not be undertaken lightly. It's important to remember that all surgery, including cosmetic procedures, involves risks." She advised would-be patients to find out as much as they can about the provider and the procedure. The CQC now has the powers to fine and prosecute cosmetic surgery centres that are not up to standard and gives advice on its website for people considering cosmetic surgery. Plastic surgeons should also be registered with the General Medical Council (GMC).

'Trivialised'
The British Association of Aesthetic Plastic Surgeons (BAAPS) represents around a third of cosmetic surgeons in the UK.

Its president, Fazel Fatah, said that problems arose because of the attitude towards cosmetic surgery. "It has become trivialised to the extent that people do not understand that they are having surgery - and undergoing the same risks as with any other operation." He said that the boundaries between cosmetic medicine and cosmetic surgery had become blurred and that people now believed that cosmetic surgery was somehow simple. However good surgeons should go through all the risks with any patient, and give them time to change their mind. "Complications can include infection, bleeding, thrombosis and clotting of the veins," Mr Fatah said. "A patient needs to weigh-up the benefits against the risks." Some cosmetic surgical procedures are more risky than others. As with other surgery, longer operations that involve a general anaesthetic are more risky than those that need only a local anaesthetic. A tummy-tuck is one of the surgical procedures which has higher complication rates because mobility is restricted after surgery. The buttock augmentation procedure that Ms Aderotimi had is not very common in the UK, though there are some surgeons who perform the operation. However, the liquid silicone with which she was injected is not used here as surgeons realised years ago that it could cause problems. Solid silicone implants are now used instead. Cosmetic surgery 'holidays' However, going abroad for treatment has become an increasingly popular option over the years as it can be cheaper. But surgeons warned it could also be riskier. A survey by BAAPS in 2009 found that a quarter of surgeons said they had seen an increase in the numbers of patients who had experienced complications stemming from cosmetic surgery "holidays". The organisation advises anyone thinking of going for surgery abroad to think carefully and beware of internet sites offering to set up patients with surgeons.

Fazel Fatah said quality standards in the UK, set by the CQC were high, but this was not the case in all countries. "If you go abroad for surgery it is much harder for you to research a surgeon's record or the safety of the hospital you will be visiting, even if they are members of that country's association of surgeons. "Aftercare will also be much harder - it can take weeks, even months for someone who has had cosmetic surgery to realise that there is a problem. By that time they are back home again."

Cosmetic surgery views sought after bre implant scare

COMMENTS (223)

By Michelle RobertsHealth editor, BBC News website

Sir Bruce Keogh, head of the review: "There are some pretty grubby practices going on" Continue reading the main story

Related Stories
Q&A: Breast implants health scare PIP implants not toxic - report Woman's pain after PIP implants

People are being asked for their views on the cosmetic surgery industry after the recent PIP scandal, where thousands of women were given breast implants containing substandard material. The review, requested by the health secretary, will look at whether tighter regulation is needed in England. And it will ask if people are given enough information about surgery. About 7,000 women in England are having checks for faulty breast implants and hundreds have now had them removed. Although the unauthorised silicone filler used in the PIP breast implants is not thought to be toxic or cancer-causing, there were safety concerns.
Continue reading the main story

I am concerned that too many people do not realise how serious cosmetic surgery is and do not consider the lifelong implications it can have
Sir Bruce KeoghNHS Medical Director

They were found to have double the rupture rate of other implants. Around 47,000 women in the UK have PIP breast implants, mostly done privately rather than on the NHS.

Lessons to learn
The problem came to light at the end of 2011, shortly after the French government recommended all women with PIP implants have them removed as a precaution. But there were warnings made by surgeons to UK authorities about adverse effects for many years before this. Prof Sir Bruce Keogh, who is leading the English review which will report in early 2013, said: "The recent problems with PIP breast implants have shone a light on the cosmetic surgery industry. "Many questions have been raised, particularly around the regulation of clinics, whether all practitioners are adequately qualified, how well people are advised when money is changing hands, aggressive marketing techniques, and what protection is available when things go wrong.

"I am concerned that too many people do not realise how serious cosmetic surgery is and do not consider the lifelong implications it can have. That's why I have put together this review committee to advise me in making recommendations to government on how we can better protect people who choose to have surgery or cosmetic interventions.

Cost an issue
"We want to hear views from everyone, particularly people who have experience of the cosmetic surgery industry or of other cosmetic interventions - good and bad - so we can learn what works best." A poll by ComRes of 1,762 people shows that many people consider the cost of surgery more important than the qualifications of the people doing it or how they will be looked after. Two-thirds of those questioned considered cost as a factor when deciding whether or not to have cosmetic surgery. Half said they would take the qualifications of their doctor into consideration and less than half would consider the quality of their aftercare when reaching a decision. And as a result of the PIP breast implant scandal, almost half of women who said they would have considered cosmetic surgery before, say that they are now less likely to have it.

Background and context

Cosmetic surgery (also known as plastic surgery) is surgery that is unnecessary from a medical perspective, but is carried out to improve appearance. Cosmetic surgery is an ancient practice. In the 8th century BC, the Indian surgeon Sushruta Samhita described what is known today as rhinoplasty (surgery to the nose) and otoplasty (to the ear).

Body alteration more generally has been carried out by all peoples, from tribal tattoos to the neckextending Kayans of Thailand. But modern medicine has made the possibilities of cosmetic surgery far more extensive.

Anaesthesia has made procedures less unpleasant and less dangerous. In the aftermath of each of the two World Wars, cosmetic surgery leapt forwards as the demand for reconstructive surgery created skills and techniques that could be as easily applied to (perceived) improvements to image as to medical necessity. Consequently, cosmetic surgery has become increasingly popular. In 1948, fewer than 300 board-certified plastic surgeons were in practice in the USA; today the number is more than 4,000. In 2004 12 million cosmetic operations were conducted in the USA alone. Where America has led, much of the world has followed. Television shows and newspaper supplements are now devoted to cosmetic surgery and makeover programmes advocate it. Today more and more parts of the body can be improved. Once the possibilities for surgery were relatively restricted, now almost anything can be the subject of cosmetic surgery. To name but a few, common operations include abdominoplasty (a tummy tuck or reshaping/firming of the abdomen), blepharoplasty (eyelid surgery), buttock implants/reductions, chemical peels (removal of acne scars and sagging skin), chin and cheek augmentation, lipectomy (or liposuction removal of fat from the body), and rhytidectomy (aface lift) Among the most popular procedures are the otoplasty and rhinoplasty mentioned earlier, and finally and most commonly, surgery for the breasts: both mammaplasty ("breast enlargement/reduction") and mastoplexy (breast lift) collectively known as boob jobs. Cosmetic surgery to genitalia is increasingly common. This article considers only cosmetic surgery carried out purely to improve appearance, and does not address plastic surgery for medical reasons, for example post-disfigurement reconstruction or remedial surgery.

Argument #1
[ ] [ ]

[Edit]

[Edit]

Yes
We live in a world that is image obsessed, and this kind of procedure panders to that. We should promote the idea that appearance is not as important as character. People should be content with themselves and not be so hung up on their looks. [Edit] [ [ [ [ [ ] ] ] ] ]

No
Thats nice. But given that the reality is that were judged on our appearance all the time, its perfectly rational to want to look good. Nobodys forcing anyone to have cosmetic surgery the market is driven by demand.

Argument #2
[ ] [ ]

[Edit]

[Edit]

Yes
There are dangers involved in any kind of surgery. Sometimes we must accept those dangers, as they come in the course of necessary medical procedures. But with elective surgery procedures people dont need, but rather merely want the risks cant be justified. These risks apply both to the surgery itself, and to the long term. For example, leaking silicone breast implants have been a widespread problem and

No
We should not restrict freedom of choice. Certainly theres an element of danger involved. But we let people box. We let people bungee jump. They undertake these dangers for fun or for money. Why shouldnt we let people undertake dangers in the pursuit of beauty, and higher self esteem? Furthermore, cosmetic surgery is becoming safer and safer. It is increasingly strictly policed and sky-high legal

can lead to death. Once, paraffin was often injected into the face to smooth wrinkles, with disastrous effects. Silicon often finds its way into other parts of the body, such as the lymph glands, and can prevent the early detection of breast cancer as doctors often think real lumps are silicon leakage. Who today knows the full future implications of injecting the highly dangerous poison Botox into ones face? [Edit] [ [ [ [ [ ] ] ] ] ]

pay-outs by bad surgeons have ensured that practitioners take more and more care. Technology in surgery and in implants and so forth is forever improving. The scare stories the proposition talk about are the worst examples of thirty years ago theyre nothing to do with cosmetic surgery today.

Argument #3
[ ] [ ]

[Edit]

[Edit]

Yes
To attempt to dress cosmetic surgery in the flag of feminism is absurd. If anything, cosmetic surgery is the latest phenomenon in the long history of the objectification of women in society. Women are driven to meet male standards of beauty, exaggerating their shape and seeking to remain youthful lest their partner leave them for (often literally) a younger model. Today many operations are arranged by male partners rather than by the women themselves. Cosmeticallyenhanced celebrities are redefining definitions of

No
This freedom issue is particularly important to women, who have historically been subjugated by men, their bodies regarded as owned and for the use of men. Cosmetic surgery the ultimate control over ones body, perhaps is the latest stage in the emancipation of women and their ability to decide what happens to their bodies. Cosmetic surgery is empowering.

attractiveness for new generations, leading young girls who would have been considered naturally beautiful in past decades to see themselves as plain and to seek their own surgical remedies. [Edit] [ [ [ [ [ ] ] ] ] ]

Argument #5
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[Edit]

[Edit]

Yes
Doctors should heal, not waste their talent on appearance. Precious talent and resources are spent on this frivolous activity. Surgeons should do medical operations that are needed, not cosmetic procedures that are desired.

No
People pay handsomely for cosmetic surgery. It costs the state nothing, except in situations in which the operation is necessary medically. Cosmetic surgery can turn a profit for hospitals that is put towards more general medical areas. And doctors receive training and practice in difficult techniques which can then be used to help patients in genuine need.

[Edit] [ [ [ [ ] ] ] ]

Argument #4
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[Edit]

[Edit]

Yes
The pressures of appearance apply particularly to women. Pregnancy and ageing have predictable effects: they should be accepted with grace, not fought against. The messages sent when some women have procedures are firstly that the prejudices some have about appearance are valid, and secondly that those women secure enough not to contemplate going under the knife are letting themselves go. [Edit] [ [ [ [ [ ] ] ] ] ]

No
If women or anyone else are secure enough not to bother with cosmetic surgery, then fine. But there are many who find that their appearance truly troubles them and that improving it would greatly enhance their quality of life. If they can afford it, let them.

Argument #6
[ ] [ ]

[Edit]

[Edit]

Yes
The black market argument applies to everything illegal. Of course that risk exists, but the number of those undertaking the activity will be smaller, as you concede. Lack of legal safeguards and

No
Cosmetic surgery happens because people want it often, desperately. If banned, cosmetic surgery will flourish on a black market. It will still happen, but it will be very expensive (and therefore only

medical accountability, and the probability that only badly qualified doctors will offer illegal operations will deter almost everyone from risking black market surgery. Fewer operations must be desirable if it is agreed that the activity concerned should be banned. Black market activity will be vigorously policed and after all, its usually pretty obvious if someone has had surgery. [Edit] [ [ [ [ [ ] ] ] ] ]

available to the very rich) and it will be much more dangerous as it will be done by unscrupulous doctors and outside all the safety precautions the legal environment provides.

Argument #7
[ ] [ ]

[Edit]

[Edit]

Yes
Cosmetic surgery is addictive: look at Michael Jackson, or Lolo Ferrarri, who got breast implant after breast implant despite the harm it did her body. The compulsion to change ones body is often a symptom of a deeper mental instability. It should be treated as a problem, not indulged and encouraged with surgery. Its only a plaster patched over a much deeper problem. [Edit]

No
This is patronising, insulting and wrong. The vast majority of people who have cosmetic surgery have one procedure and never look back. Theyre made happier and more secure in themselves because of it. Its fine to oppose cosmetic surgery, but dont falsely portray those that have it as being mentally unstable.

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Argument #8
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Yes
Pointing to accidental side-benefits of cosmetic surgery will not cover up the fact that its intention is to make money, not make people better. If a fraction of the efforts pumped into it went into proper medicine, the medical world would be much more advanced than it is today. And the fact that the benefits arise from chance merely serves to highlight the greed that constitutes the essential nature of cosmetic surgery: those benefits ought to be all of medicines aim, not an accident resulting from it. Certainly people make money and careers in normal medicine, but they are giving treatments that aim to make people well, not look different.

No
The development of cosmetic surgery over the years has been intertwined with that of reconstructive and more general medical surgery. Cosmetic surgery has greatly aided reconstructive surgery. For example, maxillofacial surgery, or surgery of the jaw, has developed with insights from both plastic surgeons and oral surgeons. Its impossible to say in some areas who contributed the greatest advances, the cosmetic or the mainstream. To shut down cosmetic surgery would be to cut off a valuable outlet for research and discovery. The market can sometimes create great benefits: people work hard in pursuit of profits and often their work can help us all. Plenty of people make a good living from normal medicine and they are not criticised, the same should be true for privately provided medicine: theres nothing wrong with turning a profit.

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Argument #9
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Yes
Theres a fair debate to be had here about what we all know we mean when we talk about cosmetic surgery. Balloon-breasted Barbie-doll models and self-indulgent collagen boosters are the issue, and trying to squirm out of defending them by pointing to sad children is pretty weak. Because the answer is obvious - hare lip correction is legitimate surgery. Collagen injection to hide aging is not.

No
How do you define cosmetic surgery? Much of the cosmetic work done greatly improves not just appearance, but quality of life. Operation Smile, which fixes oral and facial deformities found in poor children across the world, is doing cosmetic surgery. Sure you can survive with a hare lip or a cleft palate. But your quality of life your self esteem, employability, acceptance in a traditional society, etc is much better without one. Following this principle, breast reduction or augmentation or the removal of acne scars can be just as important.

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Argument #10
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If the opposition is right and plastic surgery is desirable, then such surgery is unfair. Only those that can pay for it get it. So if it has the advantages the opposition claims, the rich will look good, and the poor will not.

No
You can spend your money how you like. Why shouldnt people be allowed to make the personal choice to change their appearance with their own cash? Better that than ask others to contribute through the state. Furthermore, the appearance division the proposition seeks to suggest between rich and poor is much more dependent on quality of diet. Diet is a universal factor that affects complexion, height, etc, while cosmetic surgery is a relatively insignificant factor in statistical terms and one that only affects the particular thing on which surgery is conducted.

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Argument #11
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In fact, often, people look appalling after plastic surgery. Celebrities with trout pout overblown lips, or absurd, balloon-like breasts, are only the most well known examples.

No
That might be true. Let people choose what happens to their bodies for themselves. For every horror story, there are hundreds of people who are happier with their appearance after surgery whether you prefer their new appearance or not.