Plastic surgery: Perspectives from Catholic medical and moral theology

(CGOL) A Christian with a mature conscience, in moral discernment, needs to understand the various aspects of the matter rather than immediately say whether it is guilty or not. And, in the multifaceted complexity of life, it is sometimes difficult to say whether it is “black” (guilty) or “white” (not sinful) but rather “gray”. The article, I hope, helps people who want to have plastic surgery (plastic surgery) to distinguish.

I. Some history of plastic surgery

Since ancient times, people have always cared about beauty, constantly wishing to improve themselves. There are many arguments that surgery procedures, wound recovery or face correction appeared thousands of years ago.

Today, plastic surgery is considered a medical procedure, performed by a specialized doctor (BS), to repair a certain part of the body, such as a birth defect or sequelae. due to accident or injury. Also, surgery is performed on normal healthy people, usually by specialists or surgeons. The boundary between plastic surgery and plastic surgery is becoming increasingly blurred.

Sushruta, the father of orthopedic surgery, used skin grafts in India in the 800s BC. Around 30 AC, a Roman medical writer, Aulus Cornelius Celsus, wrote the book De Medicina, which talks about surgical methods to reconstruct the ears, lips, and nose.

A case of nose correction in the first stage (internet image).

Medical progress accelerated in the 19th century, with a series of groundbreaking orthopedic surgical procedures born. In 1814, Joseph Carpue successfully performed surgery on a British army officer who lost his nose. In 1818, German surgeon, Carl Ferdinand von Graefe, published a study on changing the shape of the nose (Rhinoplastik). In 1845, Johann Friedrich Dieffenbach wrote a complete text on rhinoplasty, called Operative Chirurgie.

In 1891, John Roe, an American otolaryngologist, presented an illustration of his work, a young woman whose tumor was removed by him for cosmetic reasons. The following year, Robert Weir tried unsuccessfully with a tissue graft to rebuild a broken nose. A decade later, James Israel, a German surgeon, and George Monks in the US, successfully grafted soft bone to reconstruct a nasal defect. During the first world war, the number of deaths and injuries was unprecedented. Medical advances in anesthesia and sterilization, orthopedic surgery allow wounded soldiers to integrate into normal life more quickly.

Hollywood stars approach plastic surgery

Marilyn Monroe trước và sau thực hiện cuộc phẫu thuật chỉnh sửa cằm (hình internet)

Plastic surgery appeared in the Hollywood movie capital in the 1920s. However, during this period there were quite a few failed surgeries. Mary Pickford, the mime star, after a facelift in the early 1930s suffered complications and was almost unable to smile. Many stars of Hollywood’s “Golden Generation” also choose “cutlery” to perfect their appearance. In 1949, Marilyn Monroe, after being denied the roles, agreed to have her chin corrected. Just a short time later, she was cast in The Asphalt Jungle and became one of the biggest stars in Hollywood. Not only female stars, many male actors also choose plastic surgery to hope for a more developed career. Burt Lancaster and Gary Cooper facelift, Dean Martin rhinoplasty, John Wayne eyelid lift…

The modern period

The modern history of plastic surgery begins in the 1960s and 1970s. This period saw many important scientific developments. Silicone is a new substance that is considered an important element in aesthetics. In 1962, Dr. Thomas Cronin tested a new breast implant, made from silicone. During the next decade, silicone was developed, used not only for the breasts but also for many other parts of the body such as the face and buttocks. However, silicone leaves many sequelae not small for those who use them. In recent years, when I performed ultrasound examination for patients with silicone breast augmentation, I found that a common complication is that silicone from the breast spreads all over the face and chest wall, making it both unsightly and painful and uncomfortable for the patient. .

During the 1980s, modern advancements brought an amazing development to surgery. Plastic surgeons and advocates have stepped up to change the public perception of this beauty method. The most recent trend in use is non-invasive (no cutlery) cosmetic surgery to reduce the signs of aging. The most commonly used method is injecting fillers or botox under the skin. The stigma that people have for surgery in the early days has been adjusted in a different direction. Plastic surgery has become accessible and popular.1 According to statistics of the American Association of Plastic Surgery, Brazil is the world leader in the number of cosmetic cases in 2013 with 1,491, 721 cases. The United States ranks second with 1,452, 356 cases.2

Some complications of surgery

In medicine, surgery has certain risks of complications, is unpredictable and depends on many factors such as the experience of the surgeon, the technique is performed perfectly or not because it can be touched. damage to adjacent organizations such as blood vessels, nerves… can cause massive bleeding, even threaten the life of people doing surgery. Dr. Le Hanh, Chairman of the Vietnam Association of Plastic and Reconstructive Surgery (VN) said: “In the medical profession, accidents and complications will definitely happen, if a doctor says that they never cause them. If there are complications for the patient, there are two things: one is that you lie and the other is that you don’t do anything”.3

Every day, the press still reports a number of serious complications due to surgery. Here are just a few examples. Tham Thuy Hang, an actress in the 60s of the last century, was once called the most beautiful in Saigon, her beauty made many people dream. Because of wanting to prolong the beauty of the golden age, Tham Thuy Hang abused plastic surgery and became a cutlery disaster. In the days that followed, she was always sad and ashamed of her ruined face. She didn’t want to go out or meet anyone. “I no longer think about the past,” she said. I burned all the pictures of the old days. Now I don’t have any pictures. I don’t even have a mirror in my house. Life is temporary. The body also dissolves, and matter when we die, we cannot take it with us.”4

Tham Thuy Hang now and in the past (internet picture)

In 2006, a female patient died at the clinic of Dr. LBH (former doctor at Binh Dan Hospital, Ho Chi Minh City) while undergoing surgery to replace two deformed breast implants that she had ordered for 5 years. Before that, caused a stir in public opinion for a long time. At the end of 2007, Mrs. N.T.H.N returned from the US to Vietnam to replace her breast implants. After many failed corrections, festering infections, pain, bad scars, 16% injury rate due to loss of nipples, lawsuits for many days, for Mrs. N. it is nothing to make up for!5 Someone died after facelift surgery. A 27-year-old female bank employee went blind after injecting filler to lift her nose 1 million VND/time.6 In the department where I work, there was a nurse who raised her nose, but had complications that had to be corrected many times. always red and painful. From a healthy person, she caused herself a nuisance and became a regular patient of Dr. Otolaryngology! As simple as eyelid surgery, some people have keloid scars and then their eyes can’t be closed! And many more, readers can find countless stories of surgical complications in the media.

II. Definition of “beauty”

The standard of beauty, especially female beauty, has changed over many different periods: from gentleness, shyness, “her body is dewy”, to healthy, active, and open beauty. Nowadays, countless beauty contests have been held based on body standards, facial proportions, talent, intelligence, etc. Information and advertising images of many agencies. The beauty parlor is unconsciously forming in the minds of the masses “models” of female beauty.

Some modern young people have a very open concept of beauty. They believe that each person has their own beauty, their own charm. Beauty is also emanating from beautiful actions, concern for people and the environment, from each person’s own point of view and style. It’s hard to use standards to describe it. For mature women, the concept of beauty has its own nuances. When it comes to having a family and a job, a woman’s beauty depends a lot on her mental state. If they have stable jobs, good economic conditions, and happy families, they exude the beauty of confidence and relaxation. On the contrary, if the job is not stable, the economy is difficult, people who appear to be beautiful on the outside will age quickly.7

Vietnamese ancestors ranked external beauty as one of the four features that make up a woman’s beauty: merit, tolerance, language, and happiness. The ancients profoundly put spiritual beauty on top of physical beauty, “the habit of killing beauty”, “better wood is better than paint”. Indeed, spiritual beauty lasts with time, while external beauty according to material laws will fade over the years.

III. Medical Perspectives on Plastic Surgery

First of all, we need to note: Plastic surgery is not a cure. In the journal Annals of Surgery, surgeon John Davis gave an illustration to distinguish the following: What is the difference between an abdominal surgery (such as removal of a bowel cancer) and a surgical operation (such as a chin reduction) ? Abdominal surgery is an essential treatment for health, even saving the patient’s life, while surgery is not essential but just a beauty technique. Therefore, it can be said that, strictly speaking, surgery does not fall under the category of medicine, although it is usually performed by a doctor.

Orthopedic surgery (reconstructive surgery) to help regenerate damaged organs in patients is a medical intervention, such as facial plastic surgery for patients with acid splashes, fires, helping patients to have can return to normal life. Plastic surgery has a simple goal of beauty (according to the person’s wishes, but not necessarily beautiful by a certain standard); while the goal of medicine is to prevent, cure disease, relieve pain, care, save the patient’s life. Dr. C. Siebert, a famous esthetician, said: “It’s amazing that we are dissected on normal people. The idea of ​​having surgery on a completely normal person is an incredible privilege.”8

IV. The morality of commercial surgery from the point of view of Moral Theology

1. Christus Vivit and the Youth of the Trinity in the Face of Christ

. . . Towards An Aesthetic Theology

God (TC) is Truth, Compassion, Beauty. Pope Francis sent Chapter IV of Christus Vivit (CV) as “A great message for all young people”. He opens up to young people a new perspective on the Triune God, who is Perfect Love. He wanted to lead the thinking of young people and the whole Church towards what we might call “a theology of aesthetics”, contemplating the beauty of the Father, Son and Holy Spirit.

In the creation account (Genesis 1:1-4a), the expression: “God saw all that he had made, and it was very good” is used six times. The account of creation reveals to us God, the Creator of beauty, but He is also the One who enjoys, appreciates and loves perfection. All good things come from God and share in His infinite beauty, but only man can bear God’s image (Gen 1:27). To bear the image of God is to bear His incalculable beauty. The beauty we share with God, they themselves cannot see and cannot be exhausted by the limited human reason and senses, but God, who made us, He knows.

Of course, it must wait for the revelation of Christ, the beloved Son of the Father, to know how God the Father loves beauty, creates and preserves it: “Behold the lily of the field growing. how to draw lessons: they do not work, do not spin; yet, I tell you, even King Solomon, in all his glory, was not dressed as beautiful as that one flower. So if the flowers and plants of the field are still there today, and they are thrown into the oven tomorrow, and God still dresses them like this, how much more so are you” (Mt 6:28-30).

By loving their enemies and praying for their persecutors, Christ’s disciples reflect the Father’s own goodness and perfect love. God tells us that He sees in us a beauty that no one else can see: “For you are precious in my eyes, and I hold you in high esteem and love” (Is 43:4). Before God’s endless love is the source of truth, goodness and beauty, the Pope also reminded young people never to forget that they are the irreplaceable work of the Most Beautiful One: For him, the you are valuable; you guys are remarkable. You are important to him, because you are the work of his hands (Acts 115).

Another divine beauty is “Christ save you”, salvation in Christ, (Acts 118). The pope wanted young people to read the Gospel to meet the One whose sublime beauty was described by the psalmist thousands of years earlier: “Among the world, he was incomparable in beauty, his charming charm bloomed on his lips. him” (Ps 45:1-2). Saint Paul saw the beauty of the Cross and was so captivated by the Crucified One (cf. 1 Cor 1:18-25) that he exclaimed: I live, but it is no longer I, but Christ lives in me. . Now I live a mortal life by faith in the Son of God, who loved me and gave his life for me (Gal 2:20).

In order to fully experience the beauty of the Redemptive Cross, according to the Pope, young people must take the time and enable themselves to read the “love story” (Acts 120) that the Redemptive Love of Christ wrote. Candlestick. The end of this love story is that forgiveness and salvation become a gratuitous gift. Christ’s sacrifice on the cross is so great that we can never repay it, but can only receive it with endless gratitude and the joy of a loved heart (cf. Acts 121). It is the Cross of Christ that shows young people their worth and beauty. The Holy Spirit, who is present wherever the Father and the Son are, fills the heart of the resurrected Christ that will flow through the lives of young people. The Holy Spirit will draw young people deeper into the heart of Christ, so that they can grow in his love, life and power (Acts 131).9

2. Delimitation

First of all, it is necessary to recognize the positive side of shopping mall. This beauty method has helped some people “change their lives” such as artists and actors to receive more valuable shows, girls to be more confident when they have more perfect beauty, even save happiness. family when they are able to bring back their adulterous husband… In addition, the surgery is trying to respond to an emotional deficiency, feeling very uncomfortable about himself with medical methods to seek acceptance. from others or attract attention.

However, a new Vatican document has condemned women’s surgery, calling it “an attack on female identity.” This document was conceived by a group of women who advise the Pontifical Council for Culture. The document warns that “plastic surgery that is not motivated by medical necessity can be a blow to feminine identity. It shows a rejection of the body to the point of denying the ‘taste’ that should be respected in life.” Critics of plastic surgery are part of a broader analysis of the challenges modern women face in the Church and in society.

The Christian Post noted that the Vatican’s plastic surgery document was released to coincide with the statement of Brazilian supermodel Andressa Urach, who asserted that cosmetic surgery is a sin. Andressa Urach, a presenter of many Brazilian television programs, told the Daily Mail that she had crossed the line between life and death due to surgery, and met God. Andressa Urach says it’s hard to fight the “addiction” to women’s beauty in Brazil, but she will fight against this mentality to her last breath.10

The Bible does not specifically mention surgery. However, surgery that transforms the body of a normal healthy person proves to be unnatural, and there is always the risk of side effects, both physical and psychological. No one should allow himself to be put at risk of even death without first carefully examining all the possibilities.

It is necessary to clearly define the goal when you want to have surgery. There are many people who are physically deformed, either from birth or from an accident like cleft palate… then it makes sense for them to want to have their defects repaired. This falls under the category of orthopedic surgery and is morally acceptable.

The most commonly performed surgery includes breast implant, tummy tuck, facelift, eye lift, buttock augmentation/buttocks and other body parts, botox or filler injections, eyelid surgery, rhinoplasty, face fix. In fact, many people tighten their face and then their face becomes stiff, losing their natural expression. About two million people undergo such procedures every year, costing money, sacrificing time and comfort. When self-esteem motivates a person to endure surgery, that person becomes an idol to himself. The Bible warns us not to be arrogant or conceited (Philippians 2:3-3) nor to seek to be physically attractive to others (1 Tim 2:9). Another related problem is that the cost of surgery is very expensive. Careful consideration must be given to the economic needs of the family and neighbours, against how many poor people there are. Two years of the COVID-19 pandemic have taught us a real lesson about what is essential in life, especially for Christians. The Bible also tells us that we need to use wisely the money God has entrusted to us (Proverbs 11:24-25; Lk 16:10-12).

“Destiny is deceitful, form is empty. But the woman who fears God will be praised” (Proverbs 31:30). Even successful surgery cannot prevent the effects of time, which is aging. Body parts that are lifted will also sag, and parts that have been stretched will also wrinkle.11

So, on the one hand, we do not take our emotional defects lightly, feel uncomfortable about a physical feature of ourselves, on the other hand, we must carefully distinguish before choosing surgery. In medicine, no one can guarantee that even small procedures will not have complications, as mentioned above. Above all, let us take care of cultivating our inner beauty, and enhancing our talents to contribute to life, take care of our families and children, and give ourselves confidence and self-esteem. That is just the righteous and lasting beauty. St. Peter admonished: “May your grace not depend on the outward appearance such as braiding your hair, wearing gold bracelets, or dressing lavishly; but a secret inner man, with ornaments that never fail is meekness and meekness: that is what is precious in the sight of God” (1 Peter 3:3-4).

Besides the possibility of a number of complications that disturb the life of people with surgery, surgery also has the risk of leading to death. Therefore, from a Catholic moral perspective, from a perspective that surgery can be considered as putting oneself at risk of death, this is a serious mistake, because no one is allowed to put his or her life in danger other than to protect one’s own life or defend the legitimate public interest. The Catechism of the Catholic Church teaches: “Each person is responsible for his life before God who gave him life. It is He who is still the Sovereign Lord of life. We are obliged to accept life with gratitude and preserve it to honor Him and to save our souls. We are stewards, not masters, of the life that God has entrusted to us. We have no right to make decisions about life” (CCC 2280); “The moral law forbids putting someone in danger of death without serious reasons” (CCC 2269).

Doctor Tran Nhu Y Lan – GPMT