Some Thoughts on Plastic Surgery by Barbara Nadel

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Because I’m in the process of writing something about the First World War and its aftermath, I’ve been reading a lot about The Great War lately. As well as all the stories we are accustomed to hearing about the horrors of the trenches, I’ve been touched by the accounts I’ve read of the terrible facial disfigurement a lot of the troops were left with. Of course ‘going over the top’ as advancing out of a trenches towards the enemy was known, made one’s face immediately and particularly vulnerable to grenade, shrapnel and bullets. Some men lost noses, some eyes and chins, others their whole faces. And to add insult to injury, when they returned to their home countries, many of these facially disfigured ex-servicemen were shunned by their own people. This was certainly the case in the UK where such men were given little hope until a young New Zealand surgeon called Harold Gilles opened up the first hospital ward dedicated to facial injury in Aldershot in 1918. This was really the birth of what we call ‘plastic’ surgery today. It was Gilles who worked out how to rebuild shattered structures, like noses, by taking tissue from other, healthy parts of the body. He also developed techniques for effectively anaesthetising those who sometimes could not inhale and exhale with ease. It was great, groundbreaking work and medicine would be poorer today without it.

Now I’m as much a victim of modern beauty and celebrity fascism as the next person. I do spend some (if not much!) time wondering if my ‘bum looks big in this’ and whether it is actually possible to eliminate 70% of fine facial lines (probably not). I get bothered by the fact that like 99.9% of all women ever, I am not perfect. We are encouraged, after all, to believe that we can and should indeed be perfect – whatever that is. Personally I don’t think that having breasts the size of Jupiter is particularly appealing but there are millions who would beg to differ. The ‘Barbie doll’ image for women is very pervasive and there are a lot of people out there who will pay vast sums of money to have plastic surgeons make them look just like that. It’s their money, it’s fine. What I question is the casualness with which all this is done. Plastic surgery is viewed as routine, risk free and essential. It isn’t.

Things have moved on from that first ward that Gilles opened in Aldershot. But operations, even those performed in nice modern germ free private surgeries in Beverley Hills are still not risk free. When I had to have my broken leg operated on back in December 2009, I was given a consent form to sign which very clearly laid out the risks involved. Mishaps, problems with anaesthesia and sudden, unexpected cardiac failure are rare occurrences. But they do exist as does post-operative infection and just outright operative failure. For instance if too much fat is suctioned out during a lipo-suction procedure, the patient can die. These things; breast implants, lipo, face-lifting and tummy tucks are not to be taken lightly. Apart from anything else, the people who originally developed these techniques didn’t do that just so some ninety year old film studio executive can have his face made to look like that of a fifty year old. It was done to give those in terrible distress some quality of life.

I’m not a kill-joy, don’t get me wrong. With all my vices, past and present, that would be hypocritical. I’m not saying that people shouldn’t have plastic surgery to improve their appearances if that is what they want. I am saying that it shouldn’t be taken for granted or treated as routine. The fabulous face-lifts of today owe everything to the work of Gilles and the pain and suffering of his brave band of First World War patients.

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