Health Partner

There’s a fine line to be walked between surgery to improve one’s health and functionality, and going under the knife in pursuit of some ideal of perfect looks.

Thin line between health and beauty When facial surgery is necessary and when not
Wednesday, July 17, 2019 - 11:51


It is a truism that we are faced with ever-increasing pressure to match the beauty standards enforced on us by our society. Market research studies show that the global beauty industry is on a steady rise, valued at over 26 billion USD in 2016, and projected to grow by over 5% every year. And much of this market comes from invasive surgical procedures.

However, warn experts, there’s a fine line to be walked between surgery to improve one’s health and functionality, and going under the knife in pursuit of some ideal of perfect looks. As Dr JA Nathan, maxillo-facial surgeon at Apollo Hospitals, Chennai, observes, “If someone has suffered a fracture, and their jaw has gone from a normal position to an abnormal one, or if they have a deformity, then we make them functional and cosmetically normal through surgery.”

On the other hand, he observes, with cosmetic facial surgery, there is a chance of falling down the rabbit hole in pursuit of the shifting goalposts of beauty.

When facial surgery improves life

Dr Nathan points out that there are several genetic and environmental factors that might result in deformities of the face that severely impact one’s quality of life. “For instance, if somebody has had a thumb-sucking habit in childhood, it pushes on the upper palate so that what should be a u-shaped arch in the roof of the mouth becomes v-shaped. It also doesn’t allow the upper jaw to grow properly. Sometimes, due to genetics, people may have an abnormal facial skeleton.” Besides a protruded upper jaw, he explains that other facial deformities like deficient upper jaw, lower jaw and cheek bones can cause a lot of functional problems like asymmetry of face and restricted respiratory passages.

In such cases, he observes, there are important deficiencies people may suffer from as a result. The number one problem people face in such cases is chewing. As the teeth do not properly align with each other, chewing becomes difficult, and eating and digestion get affected. What’s more, because the teeth don’t align and come together at wrong angles when chewing and biting, they wear out much faster. Another significant problem is in developing speech. “The mouth cavity is a closed cavity, in which the tongue is the manipulator,” he explains. “For us to speak, everything within this cavity has to function in a synchronised manner.” In cases where deformities in the facial skeleton block off parts of a person’s respiratory airways, they could also suffer from sleep apnoea. In such cases, asserts Dr Nathan, facial surgery provides a much-needed corrective.

Surgical beauty an elusive goal

While patients looking to correct drastic anomalies are generally satisfied with the improvements that a single surgical procedure provides, those looking for a beauty upgrade are more likely to want to repeatedly get surgery, explains the doctor.

“This happens with rhinoplasty for example. They come with a bump on the nose. Then they say that they want a straight nose. Then they say their nose is too wide. They keep repeating, they don’t mind going under the knife multiple times.”

One of his patients, a model from Chennai, for instance, first approached Dr Nathan to create a dimple on one cheek corresponding to the one she already had. When Dr Nathan refused, she got the surgery done by another doctor. But with the dimple not turning out how she hoped, she was back to Dr Nathan to have the procedure reversed. “Now she has returned again because she wants some fat in her cheeks. She feels that at one angle, when she smiles, there’s a little deficiency.”

Indeed, says Dr Nathan, when patients present with only a desire cosmetic improvement, doctors counsel them and often refuse to do surgery. “We look at one factor called the motivation for surgery. When the patient comes in with a complaint, one of the first questions we ask them is: do you feel that way when you look in the mirror or did somebody else tell you?” When patients come in with a self-motivated desire to change some aspect of their appearance, he explains, they are more cooperative and accepting of the possible changes. On the other hand, with an externally motivated patient, adverse comments make them unhappy, and they return for more unrealistic facial changes.

Growing pressure of social media

The pressure to achieve the perfect look, studies say, is only growing with the spread of social media. A recent report in an American medical journal argues that with the growing significance of selfies in everyday life, filtered images may be altering people’s perceptions of beauty and their perception of their own facial features. This pressure to look like the filtered, photoshopped images of oneself has even earned a name for itself, Snapchat Dysmorphia.  

However, cautions Dr Nathan, surgery cannot fix such situations, and would only lead down a rabbit hole of impossible expectations. At the end of the day, he adds, it is health and comfort that counts, not social beauty trends. 

This article was created by TNM Brand Studio in association with Apollo Hospitals, and not by TNM Editorial.