A boom in society becoming increasingly concerned about their looks has, for doctors, presented an opportunity like never before for the inclusion of plastic surgery in their work, where it was once modestly hidden from the limelight that held medical procedures. However, research has also demonstrated that patients have a startling lack of awareness concerning the risks of plastic surgery. As medical professionals, this should be a cause for concern.

Increasing acceptance of plastic surgery for cosmetic purposes

In modern times, plastic surgery has begun to shift from restoration towards the augmentation of physical appearance. There is an increasing acceptance of plastic surgery for cosmetic purposes, as well as an increasing desire for plastic surgery to attain the desired appearance. This situation is exacerbated by Korea, the beauty belt of Asia and the every-present Hallyu wave.

At the forefront of plastic surgery today is the ideal of perfection - at least, in the physical form. While people are free to subscribe to the notion of being perfect, its attainability is questionable. Patients often expect unrealistic outcomes from the smallest of procedures, ranging from laser treatment to breast augmentation surgery - but when the consequences fall short of expectations, reactions may range from simple disappointment to full-blown lawsuits. But why do people have such expectations in the first place?

Perception of perfection stems from social media

Firstly, there is a preconception of what the general public thinks is perfection, even if it is physically and surgically unattainable. This stems from the proliferation of social media, where everyone looks near perfect on camera, even if they are not so in real life. Photography techniques and alteration play a huge part in this, but this fact is often not consciously registered while scrolling through social media, creating the impression that one is perhaps in some way inadequate or “below average”, if “average” is determined by what they see online.

Second, there is a lack of understanding of the limitations of plastic surgery. This arises from a lack of research by those who chose to undergo plastic surgery. For one, the lure of instant gratification compromises the ability of the patient to fully grasp the implications of going under the knife. In anticipation of the potential benefits, the subconscious downplays the negative downsides. It is ultimately a form of cognitive bias, worsened by the plentiful accounts of “success stories” accessible through social media.

The use of plastic surgery was for a long time only meant for reconstructive purposes. Now, plastic surgery is considered as a means to augment the physical appearance and this reveals an underlying shift in the cost-benefit perspective of people. To some, physical appearance has become so important that risking their life and health to attain the ideal body image is now justifiable.

Doctors to educate patients on risk of plastic surgery

What this means for doctors is that even greater care must be taken in explaining the true extent and consequences of their decisions to the enamoured patients. Apart from ensuring that the patient is truly acting out of their own free will, and that they are providing informed consent, this is necessary to obviate the potential for medical negligence, if the procedure fails.

Along these lines, doctors must be firm in providing their objective views on the safety of the procedure regardless of what the patient may have “seen” or “heard” from elsewhere. As a doctor, your authority and views on the matter will strongly sway the patient, and hopefully, ensure that the decision was not made impulsively. Indeed, a seven-day cooling off period, during which payment cannot be collected, and the procedure cannot be carried out, is mandatory under the Singapore Medical Association Guidelines.

Lastly, doctors need to ensure compliance with professional standards. In a 2014 liposuction case, it was found that there was a lack of compliance in the administration of Propofol, a sedative. This subsequently led to suffocation of the patient, as a result of the deep sedation coupled with the absence of patient monitoring. A more obvious breach of procedure led to four charges under the Private Hospitals and Medical Clinics Act, where the doctor had performed the procedure without the presence of a registered nurse.

Greater caution in the face of rising demand for plastic surgeries in future

In the coming years, it is foreseeable that there will be more demand for such procedures. The practitioner should take a defensive view and adopt a cautious stance towards patients who are potentially over-enthusiastic. It is, after all, a surgery, and all surgeries carry risk. On the one hand, patients must be thoroughly informed, and this may include dispelling myths and shattering facades of perfection. On the other hand, doctors need to ensure that they are compliant with professional standards and aware of the latest procedures, which are rapidly evolving to meet the changing landscapes of aesthetic medicine. MIMS

Read more:
6 of the world’s first plastic surgeries
Malaysian cosmetic surgeon suspended for sleeping during liposuction procedure
Uncovering the truth behind 8 common plastic surgery myths

Singapore Medical Journal, August 2014, “Cosmestic procedures among youths: a survey of junior college and medical students in Singapore”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294091/
Selina Lum, August 2014, The Straits Times, “Liposuction death: Family seeks $3.5m from docs, clinic”, http://news.asiaone.com/news/singapore/liposuction-death-family-seeks-35m-docs-clinic