Cosmetic surgery in Australia

The word "cosmetic", originates from the Greek term Kosmetike, meaning the "art of beautifying".[3]

Ill shaped nose of a young girl suffering from syphilis.

The history of cosmetic surgery can be linked back to that of plastic surgery, as the debate persists, around the blurred lines of the two.[4] Plastic surgery originated in 600 BC when Hindu surgeons performed rhinoplasty with the use of segments of cheek tissue.

At the end of the fifteenth century when syphilis was prevalent, came the introduction of debatable reconstructive surgery to rectify the ill shaped nose, a prominent feature of Syphilis sufferers. The sixteenth century saw an Italian by the name of Gaspare Tagliacozzi adopt the method of using upper arm tissue to reconstruct the nose during rhinoplasty, granting him the nickname 'the father of plastic surgery'. Although Tagliacozzi's approach left patients required to have their arm raised to their nose for several months, requiring numerous surgeries, with excessive Scaring.

England was exposed to the Hindu techniques of rhinoplasty by a practitioner in 1815, who clearly defined the use for the surgery, limited to those who were physically affected by the horrors of Napoleonic Wars. Towards the end of the century in the 1880s John Orlando Roe, a New York surgeon, developed a technique which prevented scarring by operating from inside the nostrils.

World War I was the most costly war to Australia in regards to fatality. The brutality sparked the generation of plastic surgery within Australia introduced by a man by the name of Harold Gillies. Gillies oversaw the development of the first unit to treat the returned battle scared veterans of the war. This led to the relocation of the Red Cross to the Queen Mary Hospital in Sidcup, England. The Queen Mary Hospital opened in 1917 was a six hundred bed hospital which focused solely on plastic surgery. It was here that Gillies trained not only Australian plastic surgeons but surgeons from all over the globe. The return of these surgeons to their home countries such as Australia, saw the spread of the plastic surgery trade across the globe.[4]

The war gave the dishonoured trade a respected name through the treatment and resurrection of returned war veterans, with shattered physical traits. The century gave rise to anaesthetics and Antiseptics prompting an increase in the number of surgeries being performed. But with this heroic status and development of techniques came the taboo ideology cast upon cosmetic surgery as the trade filtered into the population, with civilians un-pleased with their aesthetic appearance undergoing surgery.[5] In turn the need for secrecy arose as people felt the need to hide the truth about their surgical endeavours. From here a surgeon by the name of Henry Junius Schireson, acquired his license to practice throughout multiple states of America, who became known in 1923 when he performed rhinoplasty on a Jewish actress Fanny Brice in her New York apartment,[6] giving birth to the booming trade of cosmetic surgery for everyday civilians.

Benjamin Rank was an Australian trained by Gillies himself who in the 1940s governed the Royal Melbourne Hospital which was the first plastic surgery unit within Australia. It was in 1956 that plastic surgery was acknowledged by the Royal Australia College of Surgeons as a separate specialty trade of plastic surgery.[4] Today, the Australian Society of Plastic Surgeons Inc. founded in 1917, commonly known as ASPS, was founded in 1970 with the aim to uphold the integrity of the plastic surgery field (inclusive of cosmetic and reconstructive surgery) within Australia. Today, the deliverance of the highest quality surgeries is at the forefront of their work. They govern the AMC accredited Surgical Education and Training (SET) Program within Australia.[4]

Walter Yoe, a patient of Harold Gillies who received flap surgery.

Due to cosmetic surgery being an elective surgical procedure it is of common assumption that the risk factors around these surgeries are lower than that of other surgeries. The invasive procedures have numerous risk factors as it is still a medical procedure, all of which come with a level of risk. The non-invasive treatments also come with a level of risk although lower than invasive methods. This common impression can be linked to the controversies surrounding the trade as critics struggle to see the link between the benefits and the risk facts. Surgeries are generally linked to, although not restricted to, risk factors affecting the area in which the surgery is performed. Some of the common risks are the development of a hematoma, organ damage, deep vein thrombosis, seroma, excessive bleeding, swelling, bruising, ectropion (optical), blindness (optical), obstruction of airways (nasal), loss of sensation, excessive scarring (including of keloid scars), a shift in position of hair line effecting symmetry and nerve damage.[9]

The most common reason behind one's choice to undergo cosmetic surgery is due to dissatisfaction with their body image. Body image issues are commonly allied with lower levels of self-esteem and psychological well-being.[10] These issues are the cause of many women turning to cosmetic surgery. In today's world viewers are flooded with images and advertisements, showing generally, naturally unobtainable faces and bodies. There is a growing trend of reality television shows broadcasting makeovers of ordinary civilians undergoing cosmetic surgery to enhance their aesthetic image. Viewpoints grow around the link between the climbing figures of cosmetic surgery and the constantly changing world of media. There is a constant stream of connection developed via social media outlets such as Facebook and Instagram which hold a high level of importance within people lives. Other viewpoints circle the growth of public awareness of the topic is increasing becoming a direct link to this growth spurt in popularity of surgery. Many of the patients who undergo cosmetic surgery have been found to have low levels of self-esteem and use cosmetic surgery to rectify the issues they have with their body image. Numerous studies have focused on the final outcome of cosmetic procedures and the level of satisfaction which patients have with their results showing a large portion of patients look for additional surgeries to rectify the issue. Cosmetic surgery in a lot of cases will enhances the problems patients have with their self-esteem issues instead of depressing them as first desired.[10] Studies show that patients who undergo cosmetic surgery who have been made aware of the risks involved along with the technical side of the procedure, have higher levels of satisfaction with their outcome post-surgery.[11]

The controversies surrounding cosmetic surgery are plentiful. The stigma that exists around the practice has been evident since its introduction into the modern world. The taboo stigma around these types of surgery is beginning to fade as we see the trend of cosmetic surgery growing.[7]

Silicone breast implant.

Faulty breast implants

In 2011, concerns were expressed as information arose in regards to the quality of the material being used in silicone breast implants. Industrial grade silicone was being used in the replacement of medical grade supplies by a French firm by the name of Poly Implant Prothese (PIP). The silicone being used was found to be suitable for uses within the production of mattresses.[15] In 2011, it was reported that in twelve years of production, more than 300,000 PIP implants were sold globally.[16] In the case of rupture the dispute around safety risks arose with parties debating the increase cancer risks due to the poor grade materials. To date there has been no scientific evidence proving the implants should cause safety concerns linking to toxicity or cancer. The debate surrounds whether the removal of the implants is required due to safety concerns around rupture and toxicity.[16]

Laser being used within the field of tattoo removal.

• Body modification

• Beauty's New Normal - 4 Corners