Cosmetic procedures can be prone to some bad press, especially from those who like to dramatize mishaps and failures when they occur. Cosmetic procedures tend to attract celebrities and other folks who spend a lot of time in the limelight; CEOs, newscasters, and anyone who spends a lot of time in front of a camera or a wide audience. Of course, most people engage in some form of cosmetic procedure or another; skin care, makeup and the like exist for mostly aesthetic reasons. For this post, we’re going to focus on cosmetic procedures conducted by dermatologists, including procedures that have to be done under anesthetic. It’s also worth noting that one blog post isn’t sufficient to deal with all of the ethical questions about appearance, beauty standards, and medical procedure, so we’ll focus on one question in particular: is it ethical to conduct medical procedures with health risks to alter someone’s appearance?
Let’s unpack that question a little bit. The first thing that comes to mind is an adage oft misattributed to the Hippocratic Oath: “First, do no harm”. That particular quote is, of course, incomplete; if a physician could truly do no harm, they wouldn’t be able to perform life-saving surgery, because the procedure involves cutting a person open, which harms them. What is truly meant is something more akin to “Do as little harm to a patient as possible while helping them as much as possible”.
Cosmetic procedures certainly embody the first element of that principle; over the years, cosmetic procedures have seen potential harms reduced drastically. Long gone are the days of botched Botox and spurious surgical procedures; a Beverly Hills Botox procedure is extremely safe and effective, as are the surgeries that are performed, when they even need to be performed. Most wrinkles, scarring and other surface level conditions can be resolved with microdermabrasion or stem cell lifting.
The second part of the statement is to help the patient as much as possible; weighing the procedures on a moral scale, we must help patients in a way that the benefits significantly outweigh the risk. This is where some well-meaning folks overmoralize; they worry that addressing cosmetic concerns will lead to a lifetime of overuse of cosmetic procedures. Those folks probably don’t understand the psychological stress that comes with having a deformity that constantly draws unwanted attention, or the worry that accompanies having to live your life in the limelight. There’s no doubt that a reduction in beauty-associated pressures would benefit our society, but while we continue to evolve and adapt, beauty will continue to be an important signifier of status and worth. Imagine a person who smells bad all the time; they might have a medical condition, but those around them will likely assume they just don’t wash themselves properly. The same goes for beauty; you might have marks from acne you had as a teenager, but people won’t look at your whole life story, they just look at the marks and assume you didn’t take care of yourself.
We want to reduce the very real psychological damage that can result from feeling shunned by your peers; that’s why we help people feel like they fit in and belong. We are helping, and reducing harm, with little risk to our patients and verifiable benefits. Cosmetic procedures are undoubtedly ethical.