"Win the makeover of your
dreams with a prize package valued at over $100,000!"
In August, BC residents saw first
hand what the 'extreme makeover' hype was all about.
Vancouver's Extraordinary Makeover Event (VEME) awarded
two lucky winners with over $50,000 each in cosmetic
and plastic procedures, including a "new smile" and
work like "breast enhancement, body sculpting, facial
enhancements and skin rejuvenation" performed by a team
led by BC plastic surgeon Dr Nicholas Carr. Rick Birch
and Dayna Gill were on the road to a new life, and BC
doctors were left with a big moral mess.
"This was a new wrinkle," says
Dr Morris VanAndel, registrar of the College of Physicians
and Surgeons of BC, about the VEME. "We received an
expression of concern from both the public and several
doctors."
SLAP
ON THE WRIST
After the contest, both the BC and Alberta Colleges
of Physicians and Surgeons issued new codes of conduct
concerning "incentives and inducements" condemning the
practice of offering up medical procedures as prizes
in giveaways.
"Ultimately," says Dr VanAndel,
"you're taking a medical procedure and turning it into
a commodity." And this devalues the doctor/patient relationship.
"The judgement of the plastic surgeon who treats this
kind of patient will be affected."
Dr Bob Burns, registrar of the
College of Physicians and Surgeons of Alberta, reinforces
Dr VanAndel's comments. "There was a clear sense that
professionalism can be compromised," he explains. The
colleges' condemnation was meant to send a clear message
to the doctors who participated in this event, and act
as a warning to any future takers.
MALIGNING
THE PROFESSION
What spurred this fascination with these extreme makeovers?
Were television networks responding to a rise in interest
(as they argue) or are they the ones who started the
whole craze?
Wacky as it seems, plastic surgery
reality-TV has become a prime time staple. Millions
of viewers tune in weekly to bear witness to the 'miraculous'
transformations on shows like The Swan and Extreme
Makeover.
"These shows aren't portraying
what's real," says Dr Mitchell Brown, a reconstructive
and cosmetic surgeon in Toronto and owner of his own
plastic surgery practice. "That isn't the kind of person
we see in our offices. They're clearly creating a market,"
he adds. "What television networks have done with these
shows is drive a trend." He believes that extreme makeover
shows have influenced people's opinion and perception
of plastic surgery but "probably not for the better."
According to Dr Brown, the average
cosmetic surgery client is a well-adjusted person looking
to improve on some less-favourable features. These reality-TV
shows pick the most desperate people, he says, and the
fact that they have multiple procedures is very unrealistic.
The shows also try to jam hours of consultations with
surgeons and many more hours in the OR into a 60-minute
format. Naturally a lot gets left on the cutting room
floor.
Dr Brown does see some advantage
to the extreme makeover boom. "I think that there is
some benefit to extreme makeover-type television shows,"
says Dr Brown. "It lets people know what's available
and that it's okay to want to improve something." His
one caveat: "What they do has to be taken with a major
grain of salt."
LOOKING
FOR THE QUICK FIX
It's easy to blame TV, says Michael Atkins, a sociologist
and professor at McMaster University whose latest research
looks at the rapidly increasing number of Canadian youth
and men who choose to undergo cosmetic surgery. He believes
that the driving force behind the rise in procedures
remains how we view ourselves. "We encourage people
to do so much with their body," he says. "It's part
of our cultural habit to use medicine to solve our social
problems."
He takes the example of liposuction,
one of the more popular procedures nowadays. "We could
put people on rigorous dietary and exercise regimes,"
he says, "but people don't want to do that. We are so
acculturated to have a quick fix."
A
MULTIFACETED DEBATE
The profession now has two points to look at: When does
marketing turn a medical procedure into a commodity?
And how should psychological factors like body image
and self-esteem be approached? "I think the concept
of going to a silent auction or buying a gift-certificate
for plastic surgery procedures isn't what we should
be striving for," says Dr Brown. "Patients don't need
that coercion."
Like Dr Brown and the BC and AB
colleges, both the Canadian and American colleges of
plastic surgeons have stated that they disagree with
"giveaway" marketing techniques. But few are ready to
tackle the other issue at hand. "We have to look at
the moral and ethical questions about what cosmetic
surgery can do for the patient," suggests Mr Atkins.
"The whole concept of offering
cosmetic procedures shouldn't be challenged," says Dr
Brown. Does he ever grapple with the ethics of what
he does? "I don't think there's a reason to discuss
the issue," he says. "Someone from a distance should
not criticize what someone else wants done to their
own body."
Dr Burns of Alberta's College of
Physicians and Surgeons finds he doesn't entirely agree.
"One of the questions that has come out for me," says
Dr Burns, "is, at what point in society do we begin
this dialogue of enhancement. That to me is the undercutting
theme here. We have lost the ability to accept our lot
in life."
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