WHY WOMEN CHOOSE COSMETIC SURGERY?

The notion of beauty has been playing important role in human being’s life since creation. Even genius, Greek philosopher Aristotle’s statement proves it: “Personal beauty is greater recommendation than any letter of reference”. (Patzer, 2008) Since our birth each person is approached on the basis of our physical appearance – our weight, height, face features, length and color of our hair – which are the qualities as “physical attractiveness”. Therefore the term “lookism” occurs which means treating people in ways biased by their own perception of physical attractiveness. Physical attractiveness forms the manner how parents act with children. It also affects teachers’ evaluation, grades from kindergarten till graduation (Patzer, 2008). Since the past, the concept of beauty has been changing. Therefore, when we look at the picture of woman who belongs to the ancient periods, we ask – Is she really beautiful? In ancient times, the most important aspect in choosing wife was health. Men chose partner who could cope with birth. So, women with wide hips and large breasts were considered as beautiful. Greek philosophers were the first people who asked and answered what makes a person beautiful (Evoscience, n.d). Plato saw beauty as a result of symmetry and harmony and created the “golden proportion” in which, the ideal face width was considered as representing two thirds of its length, and the face had to be perfectly symmetrical (Evoscience, n.d). And now his theory is proved and current scientists concluded that, Plato was right, because we are attracted by symmetry. White cheeks, pale skin was considered as a sign of beauty in Renaissance. As the centuries changed, neither weak nor fat woman was beautiful; women with thin waist began to be thought pretty. In XXI century, the concept of beauty has extremely changed. Now everything is allowed and nothing is shameful (Evoscience, n.d).

It is undeniable fact that, beauty is not given to us equally. Therefore, as human was developing, he began to find solutions in order to enhance physical appearance. It is considered that, the earliest known cosmetic preparations were invented 3100-2907 B.C. which was used by both men and women to keep skin more flexible and unwrinkled (Patzer, 2008). Later people began to invent things in order to change undesirable shape of body. For example, corset – which was used to get appreciated body shape, but this invention created problems in respiratory system, also caused malfunction of some internal organs. More dangerous than corset, a tool of iron was used to shape the nose.^[1] (Picture 1)

As we see, since the beginning human began to find the ways for looking attractive. So, if we take it into account that everything is on the top of its development, now people seek other, more complex methods. Thus, nowadays cosmetic surgery is gaining popularity worldwide. Sometimes wrongly the notion of plastic surgery and cosmetic surgery are equated among people. Although, cosmetic surgery and plastic surgery are closely related specialties, they are not the same, as both of them have different goals. Plastic surgery is performed to improve the life quality of people who are injured by congenital abnormalities (such as cleft palates or lips), burns, automobile accidents etc. (Cosmetic Surgery vs. Plastic Surgery). Main focus of plastic surgery is on repairing defects to reconstruct a normal function and appearance. Also most of modern plastic surgery methods developed by seeking to reconstruct the damaged bodies, faces occurred due to the war or battle. Whereas cosmetic surgery is a branch of plastic surgery which is performed to improve person’s appearance via surgical procedures on normal parts of body. For understanding their difference better, let’s look at the examples. Plastic surgery includes: breast reconstruction, burn repair surgery, congenital defect repair as cleft palate, hand surgery, scar revision surgery etc. Cosmetic surgery includes: a) breast augmentation, lift or reduction: b) facial contouring as well as, rhinoplasty, chin enhancement; c) rejuvenation operations as facelift, eyelid lift, neck lift, brow lift; d) body contouring, as tummy tuck, liposuction so on (Cosmetic Surgery vs. Plastic Surgery).

Globally, 65% of people over age 80 are women (Dingman, 2012). Physical appearance is a female’s main identity, especially throughout their adolescence. Life expectancy in Azerbaijan is 68.7 years for men and 74.1 years for women (WORLD HEALTH RANKINGS ). As women live longer, find partners later in life, and enter into multiple relationships across a lifetime, being attractive may become more important to them (Dingman, 2012). In cosmetic surgery women accept potential pains, side effects after it and spend big amount of money. So the motives, which make women do it are interesting. Common reasons why women choose cosmetic surgery are: lack of self-confidence, body, face feature dissatisfaction, desire to look more attractive to men, wish to look younger etc. According to the survey organized by The International Society of Aesthetic Plastic Surgeons (ISAPS) in 2013 demonstrates that gender distribution among people who had cosmetic procedures is 87.2% females and 12.8% males (ISAPS, 2013).

Statement of the problem

As every surgery, cosmetic surgery carries certain risks. After operation complications can occur such as, asymmetry, infection, allergic reactions etc. The risks and complications associated with cosmetic procedures are mostly due to the use of general anesthesia. But different complications can also occur: abnormal heart rhythm, airway obstruction, blood clots, brain damage, heart attack, nerve damage, stroke even temporary paralysis (Kaire, 2013).

The complications which can be avoided via 2^nd or 3^rd operations require extra risk and money. Also, besides remaining aesthetic blemish, permanent functional damage or even death may happen – Reyhan Muslumova case can be sample. She was well-known Azerbaijani singer who had diabetes and was suffering from overweight. Therefore she decided to have liposuction surgery in 2002. As we know, any surgery constitutes danger for diabetes people, so her desire to be pretty came at the expense of her life (Muradli, 2010). Thus, while cosmetic surgery some complications occurred and she died. All of these, also unexpected, bad reactions, dissatisfaction by others can damage patient’s psychology. Women get the celebrities as example and want to look like them. Therefore, this desire move them away from their natural views, even they become unrecognizable. There are a lot of celebrity cases that can be example, such as The Duchess of Alba, who is Spanish royalty, Michaela Romanini, who is Italian socialite, Joan Van Ark, who is soap opera actress, Jocelyn Wildenstein, who is New York City socialite, Priscilla Presley, who is American actress and business magnate and we can extend this list (Lutz, 2012). Also, cosmetic surgeries create a big amount of women, who have very similar faces. This desire also creates difficulties for plastic surgeon. Experts say that, choosing not to perform surgery on difficult patients is better than face unfavorable consequences afterwards (Nataloni). An important member of the Cosmetic Surgery Institute team, Dr. Clark Taylor states that, when someone brings a page from a magazine and says, “I want this nose or face or breast”, that is a red flag, because in all likelihood, you are not going to meet their expectations, because they obviously have a very specific picture in their mind’s eye of what they want to look like (Nataloni).

In the information taken from Forbes official website, it is said that, nowadays many people who choose cosmetic surgery do not understand gravity and potential risks of these operations. “People think it’s like going out to lunch,” says Anne Wallace, chief of plastic surgery at University of California, San Diego Health System (Goudreau). She insists that, as other surgery, it must be taken seriously. Patient must discuss with his/her doctor all possible complications, side effects and must weigh the advantages and disadvantages of operation, then should decide if worth it or not. Thus, a patient must consult with psychologist before cosmetic surgery: why he/she goes under knife? Does she/he really need it or not?

 

Literature review

The study implemented by Jelena Nikolic, Zlata Janjic and 2 others who work in different clinics in Serbia during a 3-year period (2008-2010) was involved 52 patients who were operated in the Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina. 50 of them who constitute experimental group and were performed breast augmentation surgery before, agreed to participate in study and filled a package of questionnaires. Control groups included 70 women who did not have any aesthetic operations before and did not want to change their breast appearance. Due to this study it was determined that, to feel more feminine and more confident shares 1^st and 2^nd places among motivational factors for breast augmentation (Jelena Nikolic, 2013).

During the survey that was organized by The International Society of Aesthetic Plastic Surgeons (ISAPS) in 2013, invitations were sent to approximately 35.000 certified plastic surgeons, while final data were gathered from 1.567 plastic surgeons. The survey was focused on the number of surgical and non-surgical procedures performed by people in USA, Brazil, Mexico, Germany, Spain, Colombia, Italy, Venezuela, Argentina and Iran, also it contained the total data about world-wide. According to this survey, world-wide plastic surgical procedures were 11,599,336 and this indicator was 11,874,937 for non-surgical procedures. Taking into account our religious, traditional, national similarities it would be interesting to demonstrate the data about Iran. The indicator containing surgical and non-surgical procedures for Iran was accordingly 118,079 and 56,699. In the table depicting surgery popularities, although mostly in different categories, such as liposuction, eyelid surgery, breast augmentation etc., Iran placed in the last place among 10 countries mentioned above, however it was in the 4^th place in the nose surgery category (ISAPS, 2013).

Purpose of the study/ Research Question

The purpose of the study is to identify if the cosmetic surgery is personal choice or compulsion of others. Even if women (who performed cosmetic surgery) saw themselves ugly in the mirror, but their close environment made them feel beautiful since childhood, would they still choose plastic surgery or not?

Hypothesis

Cosmetic surgery choice of women is correlated with surrounding environment – relatives, friends, especially parents, because they choose it to be approved by others. More hearing: “You are beautiful” by your environment leads to less desire to get plastic surgery. My hypothesis is that women choose cosmetic surgery in order to look beautiful to others rather than to look pretty in the mirror.

Conceptualization

This research will try to show that surrounding environment is the reason that makes women choose plastic surgery. The environment includes several factors as family, classmates, relatives, colleagues, and friends. In my research I will conceptualize «cosmetic surgery» as an optional surgery that alters or enhances a part of your face or body that you want to change.

Methodology

Thereby adding to literature review, I decided to test my hypothesis in two ways: conducting a survey for understanding the reasons why women mostly choose cosmetic surgery and holding an interview with plastic surgeon.

Survey

The survey was conducted among 50 women who want to perform plastic surgery. My sampling method is reliance on available subject, which is one of the nonprobability sampling methods. My respondents were patients of Dr. Dilqam Maharramov. The questionnaires were self-administered. The survey was formed to identify the fact that, woman’s close environment, such as parents, friends, partners play an important role in her plastic surgery choice. These people’s behaviors towards her constitute the main reason why woman choose surgery. But this survey showed interesting, unforeseen results. 86% respondents said that, when they look in the mirror they see themselves beautiful, also they consider themselves attractive. 78% women said that, their friends make them feel beautiful. 76% of respondents were not single, they were in relationship, as engaged, flirting, 7 of them were married and the rest of them were single. 66% of women, who were in relationship with opposite sex, said that their partners made them feel beautiful. But the most interesting result is that, 86% of respondents answered “No” to the question: Does your family (parents, brothers, sisters) make you feel beautiful? There were both single and married women among respondents who answered this question likewise. 37 women out of this 86% acknowledged that, in childhood they have never heard “You are beautiful” sentence from their parents. Also the rest of this 86%, 6 women reported that, they have heard this sentence rarely. 82% of respondents chose rhinoplasty (nose reshaping) and said that, they had chosen surgery, because they thought their noses were looked badly from one side. They also claimed that, they do not feel something abnormal in their noses when they look in the mirror, because they have normal front shape. Also 40% women claimed that, they are about to get their next surgery and its main reason is other’s dissatisfaction with the previous result. The diagram below shows the most important aspects of this survey.

• Who consider themselves pretty
• Who have never heard “You are beautiful” by their first family
• Who are about to have next cosmetic surgery

Interview

Interview was held with the surgeon of Medilux Clinic in Baku, Dr. Dilqam Maharramov who is one of the most famous plastic surgeons in Azerbaijan (Dilqam Maharramov, personal communication, 23.11.14). At the beginning, my interviewee stated that, mostly his patients chose plastic surgery for feeling comfortable and beautiful. He claimed that most of his patients applied him for body shaping surgeries and rhinoplasty (plastic surgery on nose part). He told that women at the age between 18-30 years, especially single women constituted the majority of his patients. Doctor also reported that during the examination he always talked about psychological issues, reasons of patient’s desire to get plastic surgery. He claimed very interesting fact that several times he could convince his patient that she did not need this operation and the patient gave up. Maharramov told that he faced the cases in which patients were unpleased with the previous surgery’s result and applied him for the next operation. Towards the end of our conversation, he said that usually his patients shared the reason why they wanted surgery. Although, at the beginning he told differently, finally, he acknowledged that, the main reason of his patients is to be looked beautiful by others. Dr. Dilqam reported that, in order to decrease the meaningless plastic surgeries, it would be great to remove needless advertisements about plastic surgeries from TV and radio. He also mentioned that surgeons had to be honest. Also obligatory consulting with psychologist before the surgery would be useful in order to avoid undesirable results for both surgeries and patients. Although this paper does not involve men’s plastic surgeries, but within my interview I also found out that men’s plastic surgeries were less than women’s and they were much more function oriented. For example, they choose plastic surgery after car accidents, burn, etc.

Data analyses

Thus, the survey proved my hypothesis, but partially. The results let me say that, our parents, brothers, sisters – first family make us choose plastic surgery mostly. As mentioned above, physical appearance is very important in all relationships. But, it is undeniable fact that we choose our friends, partners ourselves, but not our children. Thus, you feel sympathy for someone and choose her. So, if you choose someone as partner, it means that, this person is special for you and you like her. Therefore, you must make her feel beautiful. Thus, it is understandable why our parents’, close relatives’ behavior is more important in our plastic surgery choice.

My interview with surgeon also proved the hypothesis. Because he claimed that, most of his patients applied him for body shaping surgeries and rhinoplasty. (Plastic surgery on nose part) It means that they mostly want to avoid defects, which can be seen by others. As the women at the age between 18-30 years, especially single women constitute the majority of his patients, this age interval lets me say that, woman who still has not got her position in private and professional life chooses cosmetic surgery. As my interviewee claimed that several times he could convince his patients in order to change her mind. These patients did not want cosmetic surgery anymore. Again this fact proves that other’s opinion is essential in woman’s cosmetic surgery choice, because, if she decided it only in order to see her pretty in the mirror, nobody would change her mind. From the interview I got the fact that, Dr. Dilqam faced the cases in which patients were unpleased with the previous surgery’s result and applied him for the next operation and he claimed that its main reason was others’ dissatisfaction with previous result. Thus, all these facts, also his own thought about women’s cosmetic surgery reason, as well as, the survey’s results let me prove the hypothesis: Cosmetic surgery choice of women is correlated with surrounding environment – relatives, friends, especially parents, because women choose it to be approved by others.

Ethical issues

During the survey, the anonymity of respondents was provided. The purpose of the questionnaires was explained to them. Also, it was asked from the interviewee whether to include his name in the paper or not.

Recommendation for future studies

According to the time limit I conducted the survey only among fifty women, however this indicator can be increased. Also within this research only one plastic surgeon let me hold an interview. Therefore, if it is possible, the number of interviews can be extended in order to ensure the diversity of thoughts.

Conclusion

When we’re born, our parents give us certain genes. These genes do not only give us hair or eye color; they also give us absolutely no control over physical appearance. But nowadays this “no control” is almost eliminated via different methods, including cosmetic surgery. Beauty is in the eye of the beholder (Patzer, 2008). As the research proved, the eye of other beholder is more important for women rather than their own eyes. Therefore, we can make woman feel beautiful and must start it since her childhood. Due to it, we can prevent needless plastic surgeries and can decrease these surgeries’ all possible complications, side effects including death. We can reduce the risks in women’s lives, which are important, valuable for us.

 

By: Leyla Abbaslı

                                                 

                                                                          Bibliography

Cosmetic Surgery vs. Plastic Surgery. (n.d.). Retrieved November 21, 2014, from American Board of Cosmetic Surgery: http://www.americanboardcosmeticsurgery.org/patient-resources/cosmetic-surgery-vs-plastic-surgery/

Dingman, S. (2012). Cosmetic Surgery: Feminist Perspectives. Women & Therapy, 181-192.

Evoscience. (n.d). Retrieved November 23, 2014, from http://www.evoscience.com/concept-women-beauty-centuries/

Goudreau, J. (n.d.). The Hidden Dangers Of Cosmetic Surgery. Retrieved November 9, 2014, from http://www.forbes.com/sites/jennagoudreau/2011/06/16/hidden-dangers-of-cosmetic-surgery/

ISAPS. (2013). Retrieved November 19, 2014, from http://www.isaps.org/Media/Default/global-statistics/2014%20ISAPS%20Global%20Stat%20Results.pdf

Jelena Nikolic, Z. J. (2013). Psychosocial characteristics and motivational factors in woman seeking cosmetic breast augmentation surgery. Military Medical & Pharmaceutical Journal of Serbia & Montenegro, 940-946.

Kaire, M. (2013, July 25). Retrieved December 1, 2014, from FloridaMedMalLaws: http://floridamedicalmalpracticelaws.com/cosmetic-plastic-surgery-death-statistics/

Lutz, A. (2012, August 7). Retrieved December 1, 2014, from Business Insider: http://www.businessinsider.com/17-celebrity-before-and-after-plastic-surgery-disasters-2012-8?op=1

Muradli, K. (2010, February 26). Lent.az. Retrieved December 5, 2014, from http://news.lent.az/news/38731

Nataloni, R. (n.d.). When to say ‘No’. Cosmetic Surgery Times, 10-12.

Patzer, G. (2008). Looks. New York: AMACOM.

WORLD HEALTH RANKINGS . (n.d.). Retrieved November 17, 2014, from http://www.worldlifeexpectancy.com/azerbaijan-life-expectancy

 

 

 

 

 

 

                                                         Appendix

Questionnaire questions.

1. When you look in the mirror do you see yourself as beautiful?

Yes       No

2. Does your family (parents, brother, sister) make you feel beautiful?

Yes       No

3. Do your friends make you feel beautiful?

Yes       No

4. In your childhood have you ever heard this question by your parents, close relatives? ”You are beautiful”

If Yes: How often? Rarely     often     very often

No

5. Are you in a relationship with opposite sex?

No

If yes  __married   __ engaged  __flirting

If yes: Does your partner make you feel beautiful?   Yes    No

6. Do you consider yourself attractive?

Yes       No

7. Why did you choose cosmetic surgery? Is there an important story that made you choose cosmetic surgery? Please describe it concisely
8. Which cosmetic surgery have you chosen?

Nose     Liposuction     Breast      Other:

9. Do you know all possible complications of this surgery?

Yes      No

10. Is this your first plastic operation?

Yes

If no:  __Why you want the other one?

Interview questions

1. Why do your patients usually choose cosmetic surgery? To feel themselves beautiful or to look beautiful to others?
2. Which type of cosmetic surgery constitutes the majority?
3. Which age level constitutes the majority among your patients?
4. Single, married or widows are dominating among your patients?
5. Do you talk about psychological issues before surgery?
6. Have you ever been able to change patient’s decision about cosmetic surgery? For example, you see that there is no need for such surgery and could make patient give up the surgery.
7. Do your patients usually share with you the reason why they want cosmetic surgery?
8. Have you had such patients who seek to have next surgery? What was the reason? – because they did not approve previous result or their environment did not like?
9. Let’s assume that all women who want cosmetic surgery must apply psychologist before doing it. If after several consults, a patient still insists on doing this surgery, you will be allowed to implement. How would you react?
10. Finally, what would you advice in order to decrease meaningless cosmetic surgeries?