LAUSR

FIGURE 1. a. Egyptian beauty. 1b. The women doctors of Salerno. W hatever the def metology, the art of beautifying the body, has been practiced historically mainly by women, hairdressers or barbers, rarely by physicians. Improving the appearance of a person by a physician is not listed nor condemned in the Hippocratic oath. However, if a few doctors have practiced aesthetic medicine and surgery since Antiquity, many have considered that the prime duty of medicine is to cure diseases or relieve suffering and that doctors should not use their knowledge and spend their time for cosmetic care which increases the vanity of some patients who can afford it and the fortune of the medical practitioners. As plastic surgeons, we have all received one day or another an open or hidden criticism by colleagues who would praise our reconstructive work, but make fun or consider trivial the cosmetic part of our specialty. In 2002, following an editorial in the Plastic and Reconstructive Surgery Journal by Robert Goldwyn, former plastic surgeon J Scott Isenberg wrote a provocative letter: ‘‘the aesthetic surgeon, as a physician, has an ethical mandate, to cure disease and relieve suffering and the alteration of otherwise normal physical features (minor deformations or senescence) does not meet these criteria. Equally problematic, by his own activities (including aggressive marketing disguised as patient education) the aesthetic surgeon contributes to the community-wide dissatisfaction and anxiety centered on physical appearance, he claims to relieve’’. As could be expected, Goldwyn reacted by presenting his own experience, implemented by a number of studies showing that the psychological and social well being of most patients has improved following aesthetic procedures, and although these treatments do not cure a disease, they help individuals who feel ill at ease in their environment.