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Scientific and Ethical Aspects of Beauty and Modifying Appearance Bernadette Moreno, Sundeep Srivastava and Sarah Wolf Introduction Cosmetic surgery or procedure including dental Diet pills or other supplements Hair products or make-up Reasons why? Science and Technology Plastic Surgery Rhinoplasty Breast Augmentation Liposuction Chin and Cheek Implants Blepharoplasty Brow Lift Abdominoplasty Etc. Rhinoplasty One of the most common cosmetic surgery procedures Reduce or increase nose size, change shape of tip or bridge, nostril size, angle between nose and lip, or correct breathing problems Cost: $5,700 “Modern Rhinoplasty Techniques and Facial Plastic Surgery” <http://ent.pote.hu/course12.htm> 22 March 2006. Breast Augmentation Enhances the size of the breasts using inflatable saline or silicone implants Implants placed behind breast or pectoral muscle tissue Cost: $5,850 (saline) $7,050 (silicone) “Breast Augmentation Surgery in Los Angeles” Personal Image Center <http://www.plasticsurgerysource.com/plastic-surgery/breast-enlargement.cfm> 22 March 2006. Breast Augmentation Side Effects Temporary soreness, swelling, change in nipple sensation, bruising, breast sensitivity to stimulation; lasting up to a few weeks Scarring lasts from several months to a year or more Risks Implants may need removal or replacement for problems such as deflation or the formation of scar tissue around the implant Liposuction Sculpts the body by removing unwanted fat Typically removed from abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck Narrow tube inserted through tiny incision and suctioning out fat cells Cost: $9,900 “Lipoplasty/Liposuction” American Society of Plastic Surgeons <http://www.plasticsurgery.org/public_education/procedure s/Lipoplasty.cfm> 22 March 2006. Facial Implants Used to improve facial contours Implants made from different materials including silicone Implant inserted into small incision; often performed in conjunction with other facial surgery, i.e. face lift Incision taped to reduce swelling and discomfort Cost: $3,000-$5,000 “Facial Implants” American Society of Plastic Surgeons <http://www.plasticsurgery.org/public_education/procedures/FacialImplant s.cfm> 22 March 2006. Blepharoplasty and The Brow Lift Blepharoplasty: the removal of fat, excess skin and muscle from upper and lower eyelids Does not remove “crow’s feet”, wrinkles or dark circles Brow/Forehead Lift: corrects drooping brows and smoothes forehead Cost: $5,000 Left: “Blepharoplasty” and Right: “Brow Lift” American Society of Plastic Surgeons <http://www.plasticsurgery.org/public_education/procedur es/Browlift.cfm> 22 March 2006. Abdominoplasty Removes excess skin and fat from middle and lower abdomen Long incision from hipbone to hipbone above pubic area Skin separated from abdominal wall and muscles stitched into new position Extra skin removed and new hole cut for navel Cost: $6,500 “Abdominoplasty” American Society of Plastic Surgeons <http://www.plasticsurgery.org/public_education/procedures /Abdominoplasty.cfm> 22 March 2006. Plastic Surgery and Recovery Scars may be pink for up to six months after surgery Risk of post-operative infections and blood clots Fluid loss Nerve damage Microdermabrasion Sandblaster-like device used to spray high pressure stream of aluminum oxide or salt crystals across face and suction used to remove dead outer layer of skin. Stimulates skin cell and collagen production. “Microdermabrasion” Skinet. <http://www.lasercareclinics.co.uk/Treatments/Display.asp?ID=17> 22 March 2006. Microdermabrasion Affects only outer layer of skin Used to reduce fine lines, “crow’s feet”, age spots, acne scars Effective for all skin types “Lunch hour procedure” Multiple treatments required for visible results 5 to 12 treatments 2 to 3 weeks apart Microdermabrasion Few complications Treatment extends only to outermost layer of skin and so scarring is unlikely and recovery is rapid. Use of eye protection during procedure prevents ocular complications such as redness, sensitivity to light, and crystals adhering to the cornea typical of early microdermabrasion treatments. Chemical Peel Uses a solution of phenol (deep peel), trichloroacetic acid (medium depth peel) and alphahydroxy acids (light peel) to remove damaged outer layers of skin Wrinkles, blemishes, uneven pigmentation or sun damage “Chemical Peels” BGPMA Department of Aesthetic Medicine <http://www.bgpma.com/html/aesthetics/peels_mai n.htm> 22 March 2006. Chemical Peel Side Effects Temporary throbbing, tingling, swelling, redness, sensitivity to sun, whiteheads With Phenol peel: permanent lightening of skin and loss of ability to tan Risks Infection, scarring, flare-up of skin allergies, fever blisters, cold sores In rare cases, heart irregularities with phenol peel New wrinkles may form as skin ages Collagen Injections Plump creased, furrowed or sunken facial skin Add fullness to lips and backs of hands Risks and Side effects: Stinging, throbbing, burning sensation, redness, swelling, excess fullness, allergic reaction, rash, hives, flu-like symptoms, infection, connective tissue or autoimmune diseases Botox Botulinum toxin is a product of the bacteria Clostridium Botulinum Wrinkles caused when a muscle tightens. Botox is injected through the skin into the muscle and keeps the muscle from tightening; when the muscle can't tighten, the wrinkle is less prominent Effective for about 4 months, after which wrinkles may reappear Botox Side effects Droopy eyelids, flu-like symptoms, headache, upset stomach, risk of botulism (a potentially fatal disease which often results in difficulty moving the arms and legs and difficulty breathing – risk is low if Botox is used properly) Obesity Review 300,000 to 400,000 obesity/overweight related deaths per year and climbing Gastric Bypass Performed when patient has BMI >40 or a life-threatening, weight-related condition and other weight loss treatments are unsuccessful Makes stomach smaller and allows food to bypass part of the small intestine Fewer calories are absorbed resulting in weight loss Gastric Bypass Regular Digestion: Gastric Bypass: Laser Eye Surgery LASIK: Laser Assisted In Situ Keratomileusis Reduce or eliminate dependency on contacts or glasses Not strictly considered cosmetic, but still an elective procedure LASIK Procedure 1. 2. 3. 4. 5. Anesthetic eye drops to numb eye Suction ring applied to hold eye steady Corneal flap-outermost 20% of cornea-raised and lifted to side UV light and high-energy pulses reshape internal cornea Flap returned to original position and observed for 3-5 minutes to ensure cornea bonds correctly After LASIK Burning, itching, discomfort, watery eyes, blurred vision, sensitivity to light and bloodshot appearance immediately afterward 3 to 6 months for vision to stabilize Glare, haloes, difficulty driving at night Further correction may be necessary Cosmetic Dentistry Whiten teeth Correct gum line Seal gaps Fix chips or cracks Correct rotations Replace worn down or discolored teeth Cosmetic Dentistry blends function with beauty by combining tooth reconstruction and plastic surgery procedures on the mouth tissues (gums, jawbones, facial muscles, lips, and skin) to result in a better-looking smile Before After Cosmetic Dentistry Crowns: artificial coverings for teeth made from ceramic/porcelain metal composite, gold, or a tin/aluminum mixture Veneers: similar to crowns except they cover the forward part of the tooth only and are used exclusively for aesthetic purposes Cosmetic Dental Costs Orthodontics: $5,000 to $8,000 Crowns: $700 to $1,300 Whitening: $300 to $520 Veneers: $250 to $2,500 per tooth Hair Removal Many cultures have an aesthetic "ideal" amount of hair for males and females. For some of us, unwanted hair that exceeds this arbitrary standard can cause real or perceived problems with social acceptance. Hair Removal Methods Depilation (removing part of the hair above the skin's surface) Shaving or trimming Depilatories (creams or shaving powders which chemically dissolve hair) Friction (rough surfaces used to buff away hair) Epilation (removing the entire hair) Tweezing Waxing Sugaring (similar to waxing but with a sticky paste) Threading (twisted thread catches hairs as it’s rolled across skin) Rotary Epilators (devices which rapidly grasp hairs and pull them out by the root) “Permanent” Removal Methods Electrolysis: permanent for most Laser: permanent reduction for some Flashlamp: permanent reduction for some Prescription oral or topical medications: requires continuous use More “Extreme” Methods X-Ray: banned in the United States Photodynamic therapy: in the experimental stage Other methods with doubtful promise Electric tweezers, transdermal electrolysis, transcutaneous hair removal, photoepilators, microwaves, dietary supplements, nonprescription topical preparations Pharmaceuticals and Appearance Diet Pills Many Diet Pills and Weight Loss Products are Fraudulent According to Fat - Exploding the Myths ( Lisa Colles), Americans are reported to spend between $30-50 billion each year on diet and weight loss programs, products and pills; $6 billion of this is said to be spent on weight loss products and pills that are fraudulent. Diet Pills Prescription diet pills regulated by the FDA Meridia (Sibutramine), Xenical (Orlistat), Adipex, Bontril, Didrex, Phentermine and Tenuate Over the Counter Pills and Supplements Classified as “food supplements” instead of “weight loss drugs” and are unregulated (i.e. not subject to advertising, dosage or labelling requirements) Some supplements have amphetamine-like properties or serious side effects including death Others are just plain useless! Side Effects Pills that work on the brain, i.e. reduce appetite Pills that work in the gut, i.e. reduce calorie or fat absorption raised blood pressure, chest pain, fever, hair loss, depression, impotence, heart damage diarrhea, unexpected fecal discharge and oily stools Herbal diet pills “Herbal” or “natural” do not equal “healthier” Some associated with major health concerns Cosmetics Enhance beauty of the human body Simulate appearance of health and youth as well as sexual arousal (wide eyes, flushed cheeks and red lips) Types: Lipstick, foundation, powder, rouge, mascara, eyeliner, eye shadow, nail polish, concealer, etc. Cosmetic Ingredients “Pearl essence” in lipstick: shimmery substance in fish scales and is a byproduct of large-scale commercial fishing industry More commonly, pearlescent quality comes from mica coated with a thin layer of titanium dioxide Red color of lipstick: iron oxide (rust) or organic pigments Eye shadow: carmine dye which comes from crushed bodies of cochineal insect (though rarely) Skin Care Products Moisturizers Sunblock Protect skin from UV damage Self-tanners And other lotions Hide imperfections such as acne, wrinkles, dark circles, etc. Ethical Considerations Topics for Discussion What is Beautiful? What is beautiful? Why do we find certain attributes beautiful? How has the notion of beauty changed over time and what are some of the social implications? Beauty and Morality Certain images or ideas may be considered inherently immoral and hence do not create a valid aesthetic experience Sexual content? Politically motivated? (That which does not encourage adherence to dictates of the state) Religious/Philosophical Views What does it mean to worship your body or to view your body as a temple? Taking care of your body, doing what is best for it Treating your body with respect, compassion and care Not the same as being obsessed with appearance Cultural Considerations What is acceptable fashion/use of cosmetics in one culture may be inappropriate or offensive to another Implications for a multicultural society? Botox Many cases of botched Botox Four cases of botulism poisoning occurred at a Fort Lauderdale Clinic and then expanded to California. Doctors received their materials form a biological laboratory that supplied the botulinum toxin. How can doctors know for sure that what they are providing to their patient does not harm them? Plastic Surgery Medical evidence shows no correlation between cancer and breast implants Should we be concerned about long term health risks that we are not aware of for other procedures? Gastric Bypass Surgical and long term health risks associated with gastric bypass surgery University of Washington study found that 1 in 50 people die within one month of having gastric bypass surgery Another Question: The holiday season brings an increasing number of people giving plastic surgery as a gift, i.e. $15,000 face lifts, $500 Botox treatments, and $40,000 porcelain tooth veneers Some doctors and social critics have raised ethical and psychological questions about the consequences of amending someone else's appearance, especially if the gift was not requested. Patients may also overlook the medical risks of the procedures if they receive them as gifts. What are your thoughts? Other comments? References American Society of Plastic Surgeons <http://www.plasticsurgery.org> 22 March 2006. Balsam, M. S. Cosmetics, Science and Technology Bandy, Way. Designing Your Face Colles, Lisa. Fat - Exploding the Myths “Cosmetics.” Wikipedia The Free Encyclopedia <http://www.wikipedia.org/> 22 March 2006. Elsner, Peter. Cosmeceuticals: Drugs vs. Cosmetics Emory, Elliott. Aesthetics in a Multicultural Age Estrin, Norman. The Cosmetic Industry: Scientific and Regulatory Foundations Hasler, Clare M. Regulation of Functional Foods and Nutraceuticals: A Global Perspective The United States Agency for Healthcare Research and Quality. Pharmacological and Surgical Treatment of Obesity http://www.webmd.com/hw/weight_control/hw252819.asp http://www.forbes.com/home/feeds/ap/2006/03/08/ap2581371.html http://www.infoplasticsurgery.com/costloftus.html http://weightloss.about.com/od/obesityhealth/a/bl_gastcost.htm http://www.allaboutvision.com/visionsurgery/cost.htm http://www.nbc6.net/health/3994046/detail.html http://www.cbsnews.com/stories/2005/01/21/earlyshow/contributors/melindamurphy/main668323.shtml