Cosmetic Surgery: Going Too Far?

Cosmetic Surgery: Going Too Far?

When plastic surgery is used to repair bodily harm or birth defects it clearly makes sense to everyone. Media Watch is wondering at what point should the American Medical Association step in to stop doctors who exploit people’s self-hate and insecurity about how they appear to others? Consider the many surgeons who perform labioplasty, removing nerve-filled labia, for women who want their genitals to “look younger”

for their sexual partners? Many patients are known to bring in images from pornography to show the doctors how they want their crotch to look. What about the trend in underage teens who have breast implants well before their bodies are even mature or are given implants as a high school graduation present from parents? What about those who fetishize the stump left after limb amputation asking doctors to remove healthy limbs to increase their sexual arousal? Some people with what is known as Apotemnophilia, prefer to remove the limb themselves or with someone outside of a doctor’s office. What about the Barbie Flu women who get surgery to resemble Anime characters and appear as unreal as possible? If a paying adult consents to body modifications should a surgeon’s action and profit go unquestioned?
At what point is taking a knife to healthy people because they are seeking “perfection” unethical? Where should the line be drawn or should it never be stopped? We want to know your thoughts.


  1. Your bottom line is correct. No one has the right to decide. But I do believe we as teachers and parents can try to instill a broader acceptance for the many types of differences –rather than adhering to stereotypes the fashion/beauty industry makes next to impossible to imitate. If we had more interest and acceptance of the variety found in the human species, then should a doctor of medicine perform dangerous surgeries for every perfection seeking whim expressed? Should the hippocratic oath hold an exception for perfection seeking individuals and do harm to them?

  2. V, The Rogue Philosopher

    Hi there. You asked several very philosophical questions concerning ethics. As philosopher, I think it’s important to provide philosophical answers to these questions.
    You grant that it’s morally permissible for surgeons to perform cosmetic procedures on those who experience bodily harm or birth defects, but yet you question whether it is ethical for these surgeons to perform these same procedures on the general public. To begin, we need to look at what makes it morally permissible in the first instance, but what might make it morally impermissible in the second. Those who have birth defects or have been disfigured in an accident have issues that are generally outside their control, so perhaps that’s the criteria we can use to make a moral distinction between the former and the latter. But no, that won’t work.
    First, some people who have been disfigured in accidents do have some responsibility for their condition. A man whose face is disfigured in a motorcycle accident did make a choice to get on the motorcycle, knowing the risks. Therefore, even if he didn’t intend to crash, he still bears some responsibility for the accident.
    Second, everyone’s appearance at birth is outside their control. This includes people with birth defects and people with small breasts. So it cannot be the case that moral permissibility is contingent upon culpability- if we adopted that principle, we would exclude those disfigured in many accidents, but include otherwise normal people who desired elective procedures, clearly not the outcome you want.
    Perhaps, the permissibility has to do with the motive driving each individual. After all, you claim that those who seek breast augmentation and other elective procedures are self-hating and insecure. But what evidence do you have to make that judgment? The only evidence that you have to conclude that these women are “self-hating” and “insecure” is that they seek surgery. BUT WE HAVE THE SAME EVIDENCE FOR THE PEOPLE WITH BIRTH DEFECTs AND ACCIDENTAL DISFIGUREMENTS. If we have the exact same evidence of self-hatred in both groups, on what grounds do we conclude that one is morally permissible and the other not?
    In both cases, the individuals seek a surgical means to improve their appearance and make themselves feel more attractive. In many instances, the features they want to improve are outside their control. In addition, they both seek to conform to societal “norms” of beauty. Someone who wants to repair a cleft lips doesn’t ask for a set of double lips, they ask for a “normal” set of lips. We also cannot say to women who seek breast implants that they should just like themselves. After all, shouldn’t those with birth defects like themselves too? Are they inherently less likable than women with small boobs? Of course not!
    Perhaps it’s the risks- but that doesn’t work either. Anyone undertaking these procedures is at risk, regardless of their motive. In addition, it’s inconsistent to claim that morbidly obese individuals can undertake health risks, but not women who want large boobs. If a woman can chose to be obese (with all the associated risks) why can she not chose to have an elective surgery (with all the associated risks)? Should we demand that the AMA also legislate against morbid obesity, smoking, drinking, swimming pools, pet dogs, driving, swimming in the ocean, and other number of potentially risky activities? No. You’re conflating distinct questions; 1) whether someone should do x and 2) whether someone should be allowed to do x. You might feel that woman should not get breast augmentation surgery or labioplasty, but that does not automatically license the move to “therefore she should not be allowed to”. Why? Because we think that liberty entails allowing individuals to assess risk for themselves, and that disallowing all risky activites (like those listed above) is ridiculously paternalistic.
    What seems to be at work is an unspoken principle that we may seek surgical alteration or pursue risky behavior if and only if it leads to a “normal” or “subnormal” level of attractiveness. Therefore, you think it’s permissible for people to be overweight (below the cultural idea of a normal level of attractiveness) or to repair a birth defect, bringing them up to a normal level of attractiveness. However, it’s morally impermissible, according to your reasoning to seek to exceed “normal” and become beautiful. It’s cheating, because it gives these individuals access to rewards they are presumably not entitled to. Let’s explore that shall we.
    First, if we add nothing, this seems immediately false. After all, I might be “normal” but I might decide to workout. In that instance, I’m improving my attractiveness, but it doesn’t seem immoral for me to do so. It has to be the case that surgery is removed from exercise and make-up because it is independent of one’s personal abilities. If I exercise, great, but in this case, my own determination and work is what elevates me above “normal”. It isn’t “cheating”. In the case of surgery, the person is not improving themselves through their own merit.
    But this falls apart too. Here’s why. First of all, money is an advantage. Those who seek plastic surgery are merely exchanging one advantage for another; the advantage of possessing the disposable income required to pay for the surgery is exchanged for the increased social capital that comes from being beautiful. In addition, we think it’s permissible for those with money to make this kind of exchange in other areas. Money can buy luxury goods which command status. Money can buy elite education and training, which can open all kinds of doors. I could go on, but it seems unnecessary. Why should we discriminate against this kind of exchange of money and social influence in this instance?
    The bottom line is the you do not have the right to decide what other people do with their bodies, what constitutes an acceptable motive for seeking to change one’s appearance, or what is an acceptable risk for others to take. I pose a question for you: if women have the freedom that you claim to make decisions about their bodies, why must they only exercise it at your discretion?