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  • The term addiction has become applicable to numerous habits and vices these days. Sex addiction, internet addiction, plastic surgery addiction. But how can you define addiction when applied to a behavior that in moderation is acceptable, even encouraged? As Dr. Marcel Daniels, a Long Beach, CA Board Certified plastic surgeon says, “Calling any repetitive behavior an ‘addiction’ has become fashionable. Notice how we ‘suddenly’ have all these sexual addicts when previously it was merely felt to be an expression of Darwinian behavior!” Sex, as opposed to say, heroin, is a normal, healthy practice – in fact, if you’re not having sex, people tend to think there’s something amok. So when is someone addicted to sex? The same goes for the internet. The only people not spending many, many hours on the internet in our society are considered backwards. So how much is too much?

    This question is particularly apropos when considering plastic surgery. Dr. Daniels says, “The subject of addiction in and of itself and with regards to plastic surgery is controversial.” With celebrities like Heidi Montag, Joan Rivers, Cher, and Jocelyn Wildenstein making headlines by eliminating fine lines and wrinkles (and maybe getting a breast augmentation, some lipo…and some other nips and tucks), it’s easy to believe that BOTOX and boob jobs have some seriously addictive properties. After all, why else would an already attractive person like Montag go through so much to change herself into some kind of distorted Barbie? Then again, what if Heidi were totally happy with her new self? Would the media and her family be so quick to condemn her surgical alterations if she herself weren’t so clearly dissatisfied? Can you classify a habit as an addiction if it genuinely results in self-improvement?

    Take, for instance, someone like Cher. She’s had some plastic surgery, which nobody can deny. But, she still looks pretty darn good for her age, and nobody’s really calling her an addict. So maybe part of what makes Montag ‘an addict’ is that she’s young and she had so many procedures in such a short time. But why does age have an impact on addiction? And for that matter, why does someone who crams all their doses into one day have any more of a problem that somebody who has the same amount of surgery over a span of years?

    Dr. Shervin Naderi, a Washington DC area facial plastic surgeon, suggests, “There is no ‘number’ that signifies a threshold for becoming addicted to plastic surgery.  A person who has never had a single procedure but constantly obsesses about his or her face and is constantly on chat rooms and spends an excessive amount of daily time thinking about his or her face is more concerning than the person who has had 4 successful cosmetic surgeries with nice and natural results.” With this in mind, it would seem that the psychological concerns associated with plastic surgery are not so much its potential addictiveness, but rather insecurities with body image that go far below the surface. Excessive amounts of plastic surgery might just be a manifestation of a mental disease such as Body Dysmorphic Disorder. In this case, it seems that the procedures themselves have no addictive quality.

    As with any ‘addiction,’ there has to be a supplier that is feeding the sufferer’s problem. People don’t just operate on their own faces – at least not usually, and certainly not with positive results. Dr. Naderi points out that “it is the responsibility of the plastic surgeon to try to get to know the patient as much as possible and understand their motivations.  In certain patients even one surgery is too much while in others, several well thought out and carried out cosmetic surgeries are perfectly fine… [A] patient could be happy with very drastic and disfiguring results and it’s the responsibility of the plastic surgeon to guide patients.” So, even if Jocelyn Wildenstein were pleased with her oddly bloated feline face, her plastic surgeries would still not have been the result of healthy decision making, and hence they can not be considered within the limits of ‘reasonable’ plastic surgery. As Dr. Naderi says, “A more ethical and skilled plastic surgeon would not have done to Michael Jackson what was done to him.”

    However, who determines what’s ‘normal-looking’ and what’s going too far? If Michael Jackson wanted to look pale and gaunt, why shouldn’t he have? Just because other people judged his appearance and decided he was abnormal, did that make his plastic surgery somehow wrong? Dr. Daniels asks, “When does the human desire to improve one’s appearance (a very subjective decision) cross over into an addiction or Body Dysmorphic Disorder?” Indeed, with such a subjective topic as personal appearance, it seems impossible to judge one’s decisions to alter themselves. For all the people who think Michael Jackson or Jocelyn Wildenstein look weird, somewhere there’s probably someone who finds that attractive. And if Heidi Montag naturally looked the way she has made herself look, I somehow doubt that anyone would be calling her ugly.

    Dr. Daniels offers this opinion: “Certainly patients who have been pleased with the outcome of a given plastic surgery procedure often go on to have other procedures, but that does not make them addicts! People who make a living off of their appearance may simply be ensuring future employability, not manifesting a diseased state of mind.” Take Demi Moore for example. Anybody who has seen the before and after photos of her knees would probably agree her results are positive. Yet, like many celebrities, she’s received some flack for not aging naturally. But would someone who relied on their mental sharpness be criticized for taking supplements like Gingko Biloba? The preservation of certain attributes and assets that are essential to a person’s livelihood is certainly a reasonable desire, and to be critical of that just because the attributes happen to be physical is somewhat shallow.

    A habitual user of a product is not necessarily an addict.  I drink tea every day, but I don’t think I’d go through any serious withdrawal without it. In fact, if I wanted to stop drinking tea right now, I’m pretty sure I could. But I don’t want to quit drinking tea. And if I drink a cup of tea every day for the rest of my life, I still don’t think that would make me an addict. Dr. Daniels makes a similar point regarding his own plastic surgery practices: “I have been using Botox for over 15 years and have gone on to get multiple facial peels and laser procedures.  Does that make me an addict? Or does that make me someone who merely wants to continue to look as good as Father Time will let me?”

    That’s certainly the question to consider. With newer, more ‘natural’ plastic surgery procedures arising regularly as cosmetic medicine improves, who wouldn’t want to preserve their physical traits for as long as possible? After all, we do our best to maintain our body’s health well into old age – and certainly long after our bodies would be in such good condition ‘naturally.’ Obviously, self-alteration can be a harmful practice, but such judgment can only be made on a case by case basis, and shouldn’t be based on appearance alone. Perhaps at the heart of this debate is the idea of ‘perfection,’ an elusive concept that should never be held up as a realistic standard, even for gorgeous celebrities. Still, everybody can, and maybe even should, try to live up to their personal best. And when using such weighty words as ‘addiction’ in regards to plastic surgery, one has to consider more than just a number of procedures or the ‘normalcy’ of the results. Because sometimes even plastic surgery goes deeper than surface level.

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    2 Comments so far

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