The following post is an article from the Plastic and Reconstructive Surgery Journal.
This is my favorite plastic surgery letter to the editor. It is a simply brilliant and thoughtfully stated paper on “beauty” that all plastic surgeons and prospective plastic surgery patients ought to read.
The notion of beauty, in its different meanings, goes through the entire history of Occidental thought, as a concept linked to aesthetic, logical, ethical, and religious values. The idea of the affinity between the beautiful and the good is present in Socrates (470 to 399 bc), Plato (428 to 347 bc), and Plotinus (205 to 270 ad), and is developed more extensively by Aristotle (384 to 322 bc).
Beauty as harmony, proportion, and unity also appears in Thomas Aquinas (1224 to 1274). The will seeks the good (final cause), whereas sight and intellect seek beauty (formal cause) (Summa theologiae, I, q. 5, a. 4; I–II, q. 27, a. 1 ad 3): in beauty, from an aesthetic point of view, intellect notices elements of integrity, completion, and perfection, proportion among parts, adherence to the subject, and hence a particular clarity and intelligibility.
The Platonic notion of beauty (Phaedrus and Symposium) leads the Renaissance discussion about love and is present in the works by Winckelmann (1717 to 1768), Schelling (1775 to 1854), and Schopenhauer (1778 to 1860).
The aesthetic value of beauty is central in the Critique of Judgment by Kant (1724 to 1804), where the beauty of nature becomes an independent concept that comes true in elements of reality, such as plants, flowers, animals, and landscapes, as well as in people, in their mental and moral acts. Beauty is linked to the feeling of sublimation, instrument for the appreciation of perfection and of the sense of the world, of nice and ugly things and therefore access key to the mysterious perfection of the cosmos and God. In this meaning, beauty, conceived as harmony and cosmic proportion, is a means of interpretation shared by philosophy and science, in their research for the simplicity of a principle; the former through the language of transcendence, the latter through the language of mathematics and interpretation of natural laws in terms of order, coherence, and unification.
Within this general framework and with regard to medical care, beauty is intended as one of the four features that classic culture indicates when expressing all reality: we refer to the so-called four transcendentals of being, namely, the one, the true, the good, and the beautiful. Accordingly, the reality of an object is not meant to be divided or dissected into four different realities: my clock has in itself individuality, truth, goodness, and beauty as its own characteristics, which, melting together, give its “way of being.”
In classic culture, this confluence and unification are termed convergence of the four transcendentals into unity. In other words, in our common experience, what is good is better if beautiful (importance of decoration in the art of cuisine) and is not as good if ugly or invisible (the experience of eating in complete darkness).
In our opinion, as far as our surgical art is concerned, one of these correlations is very important, and that is the one between beauty and truth.
Beauty, meant as harmony among the parts, encompasses all its aspects within the human being, the quantitative and sensitive as well as the qualitative one, the somatic material part and the psychological-spiritual one. In this way, beauty, its defense and its restoration, must always imply the recreation of somatic harmony, bearing in mind a person’s interior and relational complexity (restoring beauty in a statue is not the same as doing so in a living person).
This is why the reference to the truth of a human being should represent a reference and guidance with a normative and deontological meaning to us.
In these terms, medicine aims at curing or foreseeing a pathology, being able to distinguish beauty from what is simply “pleasant” or “agreeable.” In fact, what appears pleasant or agreeable can occasionally be pathologic. Plastic surgery is not the Medicine of Desires 3 and must remain within the epistemological frame of Scientific Medicine, maintaining the correct indications for aesthetic or reconstructive procedures as its objective reference.
Thus a sensible work aiming at beauty cannot correspond to something that is not in tune with the truth of the person. Such a risk may be run in a society where “appearing” prevails over “being.” In this context, plastic surgery must be founded on consistent ethical grounds so as not to be overwhelmed by the distorted demands of the market.
In contradistinction to other medical specialties, plastic surgery is usually misinterpreted by laymen, who tend to concentrate their attention on its formal aspects, commercializing the goals of this discipline, namely, the surgical achievement of beauty through the understanding of the human being in its entirety.
