Fillers and Botox to rejuvenate, nose and décolleté touch-ups, liposuction to reshape the figure. “Men and women have always tried to improve their appearance,” he comments Albert Massirone, president of Agorà – Italian scientific society of aesthetic medicine. «Never before in this historic moment, however, thanks to the pandemic and the intensity of messages amplified by social networks and the media, beauty is idealized generating a massive and often spasmodic rush to retouch. This suggests a reflection regarding whether or not the doctor should comply with the requests of those in front of him.
Indeed, if there are legitimate desires that can find an answer in an aesthetic medicine oriented towards a harmonious and natural improvement, there are others that open up a discussion from an ethical point of view. In fact, it is one thing to strive towards a 360-degree well-being that also involves the physical aspect, another is to embrace the chimera of perfection or eternal youth: the fundamental role of the aesthetic doctor is to orient the patientafter an adequate medical examination and a consequent precise diagnosis, towards suitable and personalized treatments that respond to needs and desires by enhancing the elements of individual harmony without ever losing sight of the goal of maintaining expressiveness and naturalness».
Cosmetic surgery: what are the contraindications?
“The first assessment that a professional has the task of making when requesting a touch-up concerns the essential physical requirements to undergo medical or cosmetic surgery in total safety”, he specifies Sergio Noviellocosmetic surgeon, specialist in microsurgery and experimental surgery, president of Simoe (Italian Society of Doctors, Surgeons and Aesthetic Operators), lecturer at the postgraduate high school of aesthetic medicine in Milan Agorà and founder of the Sergio Noviello Academy.
«Safeguarding health is always a priority and even more so when it comes to medicine and cosmetic surgery which, despite being very important areas, are never life-saving practices. This means that, in the absence of certain necessary conditions, your doctor may decide not to proceed explaining in total transparency to the patient the reasons for his choice”. Each case is unique, but there are situations that generally discourage the use of aesthetic practices.
“I am above all the pregnancy, breastfeeding and the moment when a woman expresses the desire to get pregnant» comments Noviello. «The intervention also excludes the presence of specific allergies to be evaluated case by case (the one with eggs suggests, for example, a lot of attention in the case of treatments based on botulinum toxin), of serious autoimmune and neurological diseases such as myasthenia gravis, of important dermatological diseasesOf inflammatory processes in the areas affected by the treatment and finally of infections at the injection sites, as in the case of herpes labialis which represents a contraindication for lip fillers. The international scientific literature, on the other hand, does not report particular contraindications on cancer patients, except for the periods in which they are undergoing chemotherapy or radiotherapy”.
When should the doctor say no?
The key moment in which the professional should decide whether to proceed or not is the first meeting with the patient. A preliminary phase that should always be punctual and never rushed so that the doctor, in addition to verifying the state of health and prescribing any necessary tests, can explore the reasons that push towards the retouching. «The request for an intervention generally arises from willingness to correct a physical defect or imperfection which can be present from birth or take over over time», continues the specialist.
«But this is not always the case and the scenario presented to the doctor is more complex. The professional therefore has the delicate task of understanding, by listening carefully to the patient, the correlation that exists between the defect and the discomfort felt. In fact, it may happen that the latter is disproportionate to the extent of the problem for which a correction is requested. In these cases, the hypothesis of an intervention should be rejected or in any case postponed.
For example, if a woman or a man perceives a small hump on the nose as a defect that precludes a normal social life, surgery does not work from the outset, because in most cases even the best possible result would never compensate for the discomfort. disproportionate that the person perceives pushing towards further interventions in a practically endless spiral. Faced with this situation, the doctor should deny consent to the intervention and evaluate together with the patient a different path that provides psychological support ».
Beware of psychological reasons
«Continuous recourse to retouching, when not justified by a real indication, can be a possible sign of a personal insecurity leading to a disorder termed body dysmorphia,” he echoes Maria Zaccagnino, EMDR psychotherapist in Milan. «The person is pushed towards the scalpel or the filler apparently only to improve their appearance, but in reality to feel better about themselves and with others. However, the satisfaction she gets after the surgery is minimal and soon the desire for a new touch-up resurfaces, which almost certainly won’t be the last. In these cases, in fact, the use of medicine and cosmetic surgery represents only an escape route from the obsession that is perceived towards one’s appearance: no intervention can be decisive until the underlying psychological problem is addressed”.
Cosmetic surgery: when you want to look like a famous person
More and more people show up at the doctor’s or cosmetic surgeon’s office with a photo of a famous person. «Especially women do it, but it’s not worrying if the image is used as a support to best express one’s desires», Noviello points out «An alarm bell should instead go off when the person asks to have an intervention or a procedure done of aesthetic medicine with the express purpose of looking like a celebrity. A request that should never be indulged since the influence of social media can raise expectations leading to asking the professional for solutions that are distant from the real ones and from that concept of naturalness that should always guide the professional’s work”.
After all, even in this case, behind this desire one can hide a sense of psychophysical inadequacy which it would be better to analyze before proceeding. “In fact, there is always the risk that the person will never be satisfied with the result, triggering an insane rush to perfection that can push towards adjustments that they don’t like and which they can later regret over time,” confirms the psychologist.
interventions on minors
Usually the turning 18 it is the prerequisite for undergoing major surgery such as the insertion of prostheses to augment the breasts, but also for invasive treatments such as acid peels. “However, there are some cases in which, with the prior consent of the parents, it is possible to intervene before the age of majority, and they are those in which the blemish that you want to correct is a source of profound psychological discomfort», explains the aesthetic surgeon Sergio Noviello. «The most classic case is that of so-called protruding ears: at the age of 12-14 the ears have reached anatomical maturity and can be subjected to cosmetic surgery in order to help the adolescent acquire self-esteem and improve relationships with others».
However, great caution is needed. “If some physical problems can be a real source of discomfort, it should not be forgotten that adolescence is a delicate phase in which the desire to please others and the difficulty in accepting oneself can push one to load the retouching with excessive values”, explains the psychologist Maria Zaccagnino. «It is essential that the doctor detects this dynamic and tries to direct the adolescent towards other professional figures who can intercept the emotional fragility that hides behind the desire for an early retouching».