Commentary: Is the pursuit of physical beauty shallow? Reflections from a plastic surgeon

I have been in medicine for close to 30 years, the last 16 of which were spent in plastic surgery.

In part because my late father was a cardiothoracic surgeon, I was always fascinated by surgery for its artistry, technicality and science.

As a young child, I loved building plastic model kits like figurines and cars, carefully assembling them, then preparing them for painting or airbrushing. I loved how meticulous the work was; the process of getting the project just right needed planning, patience and precision.

As I grew up, I started to appreciate and respect the talents of sculptors who could recreate so accurately the faces of movie characters in 12-inch action figures and the Lego designers who could create brick versions of almost everything one can imagine.

To no one’s surprise, I picked being a plastic surgeon over all other surgical disciplines.

Thanks in part to a Health Manpower Development Plan (HMDP) scholarship, I had the chance to train at the world-renowned Chang Gung Memorial Hospital in Taipei, Taiwan, where I got to delve deep into training in cleft, jaw, general aesthetic surgery and — my passion — ear reconstruction for congenital ear defects, which has been viewed by many to be more of a form of artistry than surgery.

Ear reconstruction is a multi-layered, painstaking process that includes a rib cartilage retrieval then subsequent carving and sculpting it to mimic an ear frame before the laborious process of embedding it under the skin. I simplify the process grossly, but needless to say it takes much planning, patience and precision.

In a world where speed is prized, the practice of plastic surgery reminds me that for beautiful things to bloom, it takes time, much effort and a whole lot of patience. In a time where so many aspire to live the glossy influencer life, my work reminds me that behind a sleek, seemingly effortless exterior, nothing is truly that easy.

In my trainee days, I studied with Professor Yu-Ray Chen at Chang Gung Memorial Hospital. The world knows him for his groundbreaking work in craniofacial surgery, but I will always remember him for his wisdom and thoughtfulness in how he carried out his craft.

At a time where it is quite commonplace for plastic surgery patients to bring in photos of celebrities they aspire to look like, Prof Chen opined that how we look has deep implications on our memories and identity. When we alter someone’s facial features, sometimes, we inadvertently sever the connection between their past and lived experiences from who they are. Science and research backs this.

As a result, I am extremely wary when patients come in wanting me to craft them a face that is an amalgamation of the latest face genius.

It is as though they are discarding the essence of who they are by changing their face, and something in their personality gets lost in the process. Sometimes who we are includes our imperfections.

MORE THAN SKIN DEEP

While most of my patients come in for consultations by themselves, on occasion a couple would come in together.

A common occurrence follows that one party, usually the girlfriend or wife, is the one keen on the surgery, be it to get double eyelid surgery, breast augmentation or a nose job. At some point during the consultation, their partner is clear to lament or declare that they would still love their partner even without the said surgery.

The sentiment is sweet, but it honestly misses the point. For most patients, how their loved ones feel about how they look — the straightness of their nose or perkiness of their breasts — is secondary to how they see themselves. And rightly so.

It is fantastic and useful to be buoyed by the love of others but it is far more sustainable to have our sense of self, self-esteem, confidence and self-love rooted in our relationship with ourselves.

It is easy to assume a woman’s desire for perkier breasts as wanting to be more desirable to her partner. And while there is definitely some truth in that, she first wants to feel more desirable to herself.

Likewise, a balding man seeking a hair transplant may perhaps want to look good for his other half — but at its core, the baldness bothers him.

PREVALENT PURSUIT OF PHYSICAL ATTRACTIVENESS

Given a choice, everyone would want to look good and look better. Wide-reaching media influence, social expectations and the pervasiveness of social media have led to an emphasis of outer appearance.

From enhancing filters on Instagram to in-built beautifying filters as a default on some phones, we live in a world where we are hard-wired to want to put our best foot forward. Add on the rise of influencers, and it’s clear that the pursuit of physical attractiveness has become prevalent.

In this context, wanting to look good is not inherently shallow, but something quite natural these days. Someone once opined that while it is surely wonderful to have a winning personality and a generous portion of inner beauty, it is not like we have a transparent body to show traits such as these off to the world that easily.

If you have ever taken a photo only to want it retaken because you look less than flattering, you’d surely understand wanting to put out the best versions of ourselves.

If someone has been struggling with a bulbous nose that causes them grief, or has been self-conscious about being flat-chested all their lives — there should be no shame in wanting to undergo plastic surgery to become a better version of themselves so as to feel better about themselves.

CELEBRATING UNIQUENESS

The actual surgery itself is but a fraction of the time I spend with each patient. The bulk of the time is spent getting to know the patient, and sometimes, their family members.

Pre-surgery consultations can feel like part project planning, part counselling, part investigative work, and part education. Just as important as the ability to sculpt a good nose-bridge is the capacity to understand the patient: What makes them tick, what drives them, what they are struggling with.

All of that helps me to be a better surgeon to and for them.

Increasingly, I find that it is so important for me to understand and appreciate the interplay between our physical appearance and emotional well-being.

I have seen the positive impact of aesthetic procedures on my patients, and simultaneously appreciate and celebrate the inherent uniqueness of each individual.

I look forward to a world where physical enchantments and inner growth can intertwine to create a harmonious reflection of who we are.

ABOUT THE AUTHOR:

Tan Ying Chien is the consultant plastic surgeon at SW1 Clinic Plastic Surgery and a visiting consultant to the plastic surgery departments at KK Women's and Children's Hospital, Tan Tock Seng Hospital and Singapore General Hospital, providing pro-bono ear reconstructive surgery for teenagers. This piece first appeared in The Birthday Book: Unmasking, a collection of 58 essays on the new individual and collective possibilities for Singapore as people emerge from the throes of Covid-19.