CHAPTER II BEAUTY, SOCIAL RELATIONS AND PLASTIC SURGERY

"That's when it happened, by mere chance, the unexpected: left crepe paper, a lo
t. And the mother of my friend, maybe serving my call mute, the mute despair of
my envy, or perhaps out of pure kindness, as it was left role solved for me also
a fantasy of pink with the remnants of material. At Carnival, for the first tim
e in life I would have ever wanted: would be other than myself ...".
Fragment of chronic "Remains of Carnival", in The Discovery World Lispector, Cla
rice.
Be Different
N
Greek mythology, Apollo was a representation of beauty, truth, intelligence and
harmony, while Venus was the goddess of sexual love and beauty. Were
Page 32
beings who symbolized the perfectionist desires of humans, possessing all that w
as considered good, beautiful, harmonic and able to arouse the envy and sexual d
esire. Narcissus gazed at the reflection of her beautiful face in the fountain,
where was refreshed. Victim of vendetta by Nemesis, due to its insensitivity to
Echo, which had fallen in love with him, Narcissus was to death at the source, d
elighted with his face he saw in the bottom water. In the place where he died, w
as born a flower named for her and today the term narcissism is used to mean muc
h like yourself, with selfish connotation. (Guimarães, 1990). These two excerpts
, taken from Greek mythology, have something in common: the images are attribute
d to beings stage of human desires. What mortal at some point, never thought abo
ut having an image different from what the mirror gives? Narciso Except, perhaps
this desire to be unanimous. It seems to be universal wanting to possess other
qualities considered of greater acceptance for themselves or others when other n
eeds have been met (Maslow, 1954). There are people who, beyond the desire to be
more beautiful, will try, in various forms and practices, to obtain this "beaut
y" in an effective, not only because of the effects it brings, but also because
man has always had a certain atavistic aversion and history for what is consider
ed ugly, unsightly or asymmetrical. One of effective ways to change body or faci
al is CP. For some, the gradual loss of youth is experienced as an encounter wit
h the ugliness or death. On this subject, the Book of Wilde (1975), "The Picture
of Dorian Gray", tells a very interesting story where the main character (Doria
n) made a pact with the devil not to age, using as part of their bargain soul. T
he figure of the protagonist was painted in a picture that, as time went on, she
- the figure - was aging in place of Dorian. The portrait was hidden by it, for
he suffered changes. The fact that Dorian always remain young estranhamento1 ca
used his friends, which was explicit that sentiment. A curious detail is that Do
rian not to age inside, their level of emotional and intellectual development
1ha
assumptions and evidence, including treated by literary critics of the homosexua
l condition of Dorian. In a recent adaptation of the book to film, Dorian, on se
veral occasions, meetings have "mysterious" and avoided marriage.
Page 33
paralyzed from the moment they made the pact. This work shows that the strength
of personal vanity is called can be very strong. Not everyone, however, will hav
e as its priority the achievement or maintenance of beauty. Individuals who cons
ider themselves with few specifics of the physical attraction that others try to
compensate for this greater "disability", striving
masculinity / femininity, physical goods or higher academic performance. (Bersch
eid & Walster, 1973; GIDDON, 1983; GOLDSTEIN, 1983). The word plastic comes from
the Latin "plasticus" derives from the Greek "plastikós" meaning form or shape.
It appears that the usual term plastic does not correspond to their etymologica
l origins, because, currently, its more precise meaning is linked to improvement
or change in ways proportionality of body parts, giving meaning to make beautif
ul and symmetrical. (FARINA, 1946) Man of the forest is used instinctively vario
us types of painting on his body, according to the peculiarities of the ecologic
al characteristics of the particular place inhabited and the kind of ritual. In
some tribal societies, the makeup plays an important role in establishing the st
atus of the individual within the community, providing a "badge" that allows cul
tural label it as belonging to a particular social category. (ADLER, 1961). The
behavior is the pursuit of aesthetic beauty to the body itself, by changing the
environment or a simple purchase of an art object,€because we can not ignore how
people spend and spend time considered free. A precise analysis indicate that h
uman beings, especially women, spend many hours in front of the mirror or in act
ivities directly related to the care and / or body beautification. Add in the fa
ct that beauty and bring several terse rewards will be a wide variety of bodily
changes that aim to aesthetics. One of effective ways to change body (including
face) is CP. (MORRIS, 1977). MORRIS (1977) pointed out the impulse taxofílico (l
ove the classification) as responsible for the appearance of aesthetic behavior.
According to the author, this is a powerful human impulse to classify the envir
onmental elements, including one's own body or parts thereof. GIDDON (1983) beli
eves that each culture determines its
Page 34
members with regard to perception, for details or body fragments that are consid
ered attractive or rejection. There would then have a motivation, based on educa
tion, to improve appearance. Thus, beautiful people and successful professional
or economically would be positive role models and their successes attributed to
beauty. Considering the anxieties of life can be attributed to ugliness or any t
race of the face / body that is not within the accepted standards of beauty to l
iability for problems that life brings. This attribution of causality body can a
waken the desire for change in the trait in question or of physical appearance t
o your overall appearance. (GALVÃO, 1978). The image people have of themselves (
self-image), the image that others have it (straight frame) and the image that s
he thinks that others are against it (stop frame) look the most enlightening ele
ments interpersonal relations. (Berscheid, E. & Walster, 1973). In a very intere
sting study on the trading of feedback, FRITZEN (1978) emphasize the findings of
psychologists Joseph Luft and Harry Ingham psychiatrist regarding the mapping o
f the individual in the group. Interpersonal relationships are strongly determin
ed by the share of physical appearance, although most people react to what they
believe actually see what they see. Thus, in an attempt to understand the person
al interactions, it is more important than the image people have of a particular
individual than self-image. The CP is considered, for the vast majority of thos
e who seek it as a real possibility of transformation to be different. We live i
n a culture of the body, in which he is highly valued and idealized, and there s
pread, in part, from perfect: the body, the "face." In numerous magazines find m
any homemade recipes or miracle products that will try, for example, slow aging
or improve appearance. The world seems important to look good as a fundamental p
rerequisite for achieving the affections of the opposite sex or fondling. Many p
ersonal selections from place to look good as a criterion of choice for assembli
ng candidate's profile. In interpersonal relationships, there is a strong share
of determination by physical appearance: the most beautiful people, according to
studies, it seems they get more attention and positive affect than others. (GOL
DSTEIN, 1983; MACGREGOR, 1982) .
Page 35
Dimensional Numerical
There are indicators that indicate a great need to shift body. There was a 81% i
ncrease from 1981 to 1984 the number of CP in the U.S. (DEATON & Langman, 1986)
and 80% of people in developed countries have sought orthodontic treatment (GIDD
ON, 1983). The Gallup poll revealed that 62% of American women, the vast majorit
y within the normal range of weight, want to lose 5-9 pounds (SEE Magazine 1992)
and this may explain the strong development of liposuction or liposculpture. Th
e CPE, which were previously considered inaccessible to the middle and lower cla
sses of the population, due to the high cost involved, now they are cheap due to
several factors: a) the actual development of the concept of CP is also respons
ible for this greater accessibility, extent that GPP are not considered luxury,
but as important as CPR, b) the existence of free public services (whether for t
raining of residents, either for search), c) the growing number of new plastic s
urgeons to realize the great demand, d) the increase in sub-specialties of CP as
well as the facilities arising from economic competition between the profession
al (split payment of the surgery). It is typical to see people coming to talk or
that they did make certain CP. Unfortunately, in Brazil, there are no studies s
howing this increase. The Brazilian Society of Aesthetic Plastic and Reconstruct
ive Surgery reveals a growing number of surgeons associated with each year,€with
out the percentage. Although the CP still be considered superfluous, the middle
class has gained access to it through free services or private clinics. In gener
al, public hospitals, there is a team of various specialties who attends to the
patient. The financing of surgery, prior savings or partial coverage by the agre
ement of the company (where the person works) are the enablers to CP2. This may
prove
2Algumas
state and private companies allow the member to make payment of 50%
Page 36
that there is a whole social network that favors expanding the practice of body
changes. There, according to the residents themselves, people who even sell pers
onal items and / or jewelry (some with great sentimental value) or make a great
economy for access to CP. CERCIARI (1988) reports that a lady of 47 years, selli
ng standalone jewelry, made the payment to the surgeon with a bad check in order
to get a facial rejuvenation is known also that the press, TV news, radio, maga
zines and specialized books have reported the effects of CP. This great advertis
ing increases the diffusion of knowledge and techniques used by plastic surgeons
. Therefore, there is increasing desire and demand for plastic people. To the ex
tent that their risks are getting smaller, there will be an increase in the prac
tice of it. (ASSUMPÇÃO, 1990; STRAP & ZANI, 1977; Cottin, 1994; GALVÃO, 1978; Ru
zzante, 1986; SCHOR & FREITAS, 1992).
Great Demand
If the CP is still considered superfluous and causes body changes effective, we
can infer that people with asymptomatic or sub-clinical factors that seek to mod
ify plastics, have already gone through several stages since the attempt at self
-acceptance (leaving the body / part as it is) by the use of cosmetics or homema
de methods (true tests of body changes). When looking for specialty plastic, the
patient has already won some internal and external barriers, so it's no surpris
e that there are powerful forces that drive individuals to opt for CP (Polanyi,
1980). By taking the desire for change surgery, the patient will face, among oth
er things, the risk of surgical failure. There are strong indications that the d
emand for CP is very large considering that the patient is: a) absent from their
usual duties and obligations. Example: missing work, school or vacation to make
the plastic (practice
expenditure for the plastic surgeon. Some even share the half, provided that the
employee undergo a social evaluation.
Page 37
predominantly male and
with intent to conceal the surgery)
(SEE Magazine of April 1, 1992), 2) travel long distances to the surgery for fre
e or because of a famous surgeon. Examples: Some Latin American patients traveli
ng in subhuman conditions, for weeks, aiming to plastic in Brazil (PITANGUY, 198
4), 3) face long queues for the screening and interview with the plastic surgeon
(in cases where the candidate seeking public services free of charge) 3, 4) sim
ulate health problems directly linked to where they want to trade, mutilations u
nsightly or cause accidents on the part of the body to achieve a restorative ope
ration. Examples: broken nose so purposeful, it must demonstrate respiratory pro
blems like a deviated septum or spongy flesh to get to operate it through the IN
SS (who only perform CPR) or even say you have back pain for many overweight bre
ast and thereby obtain official permission for reduction mammoplasty (Paillet &
Gate, 1987), 5) offer various gifts, gifts, jewelry or even money for surgeons o
f large public institutions with the aim of realizing a CPE prohibited by the in
stitution; secrecy ask the team doctors or in case of an interdisciplinary CPE "
forbidden" or not covered by medical insurance of the patient (Paillet & Gate, 1
980), 6) perform all preoperative tests, whatever they are and regardless of cos
t and time required (some others are invasive and cause great embarrass the pati
ent) (OTSUKA, 1992), pending the results of these tests. If any of them intended
for restrictive surgery, such as anemia or long time of coagulation, the patien
t will insist that the results are ignored or attempt to correct these factors (
Paillet & Gate, 1980); back to the doctor with the results and wait again to be
served (if public hospital or teaching hospital), 7) to undergo a news conferenc
e in front of students from the chair
3em
São Paulo, there are at least four sites that perform a free CPE) Santa Casa de
Misericordia, b) Hospital and Clinics;€c) and d Hospital São Paulo) Hospital of
the defects of the face. All these institutions have clinics and a long waiting
list. The last one can be regarded as mixed type, because surgery also carries o
ut private pay.
Page 38
Plastic Surgery in order to accelerate its position in the queue espera4, 8) mee
t the legal, ethical and psychological aspects of a particular ZIP code. Example
s: obtain permission from parents or guardian (when the patient is a minor); get
the support from lawyers or judges (cases of sex change), go through brief psyc
hotherapy in cases of hemofobia 5, fear of hospitals or panic during anesthesia
( FARINA, 1982), 9) take photographs (both pre and post-surgical) in part to be
operated under various angles, size and color, for ethical, educational and scie
ntific purposes. These photographs, as well as the enhancement process, are the
achievements of the team or surgeon who operated on the patient. Example: to per
form the CP needed some intimate photographs of the genital areas (MÉLEGA et al,
1992); 10) fix the date of surgery and to submit to pre-surgical procedures. Ex
amples: strict fast of 24 hours in cases of general anesthesia, in some cases ab
domenoplastia (CP abdomen) is required prior use of a tight elastic strap or wit
hdrawing blood to spare the patient himself. In other cases abdomenoplastia, the
patient will be operated only after having the number of children they want. Th
is requirement aims not to bring several complications post-surgery (ASSUMPÇÃO,
1990); 11) face the anxiety pre-surgery, anesthesia and taken to wait for surger
y. It is important to consider that all this could be avoided (CARNEIRO-FILHO &
ANDRADE-FILHO, 1988), 12) dealing specifically with the surgery (most made with
local anesthesia), facing the risks, pain, costs, constraints and adjustments it
causes (CARNEIRO-FILHO & ANDRADE-FILHO, 1988; Paillet & Gate, 1980), 13) cooper
ate closely during surgery. Whereas the vast majority of these are "aggressive"
and "invasive", such as injection of anesthetic, cut the skin and cartilage, bon
e fracture, plastic and seams of bleeding or edema (swelling) during the process
,
4ESS
ability to "jump the queue waiting for surgery is offered, quite secretly, for s
ome applications under ideal conditions of health, good doctor-patient or staff-
patient whose surgery can be extremely educational. The collaboration of anxieti
es and low pre-treatment are factors that make the candidate to increase your ch
ances of operation. These criteria are variable and there is no consensus within
the team itself. 5Medo very strong blood (aesthetic rhinoplasty (film-video), 1
992).
Page 39
patients tend to go over and help surgeons or staff. Where children's floppy ear
s, the parents and the surgeons are intrigued with the cooperation of the vast m
ajority of children for surgery. Often, these patients were very resistant to a
simple dental treatment (OTSUKA, 1992), 14) support the gradual recovery after s
urgery. Examples: some PC nose, the patient will have to use for some time plast
er, bandages, dressings or even two drawbacks caps that prevent the drying of th
e nostrils. During use, the appearance arouses curiosity, besides being uncomfor
table (ASSUMPÇÃO, 1990; Cottin, 1994), 15) bear, in some surgeries, the ban afte
r surgery. Examples: sleeping so as not to push the nose after rhinoplasty; slee
p in the supine position to prevent the traction of the gluteal region, avoid th
e sun for six months in cases of surgical abdomenoplastia or peeling; abstaining
from sexual intercourse after a plastic inner , wear a cap of gauze around his
head, for about a week, where a correction of floppy ears; liquid diet postopera
tively of a chin or become unsightly with an unsightly scar (in the case of brea
st 6), but Breast reduced, increased or aligned (SCHOR & FREITAS, 1992); 16) dea
l with the inevitable changes in the new image for himself, for others and for s
ociety. Examples: destruction of old photographs that "denounce" the CP held, to
avoid social contact with the group is inserted through holidays, travel allowa
nces or "commercial", changing the neighborhood or city to not be a curiosity fo
r part of the neighborhood, do not want to talk about the subject. Some surgical
patients and deny the surgery using arguments unconvincing. Examples: "I massag
e the eyes," "I do not use more mustache€so my nose is different "or" I had a ve
ry strong diet that left me young "(Veja, April 12, 1992, pg. 54-55) 7, 17) demo
nstrate gratitude with the results of free CP (During the interviews, I noticed
the large number of gifts that these professionals gain their patients in any
6A
plastic breasts is also known as mastoplasty (FARAGE and Collaborators, 1992). 7
O surgeon ADLER (1961) exemplified the need for denial by a patient he operated
that after the facelift, said it had not made any plastic, but had passed an exc
ellent peeling based on pure honey that rejuvenated skin.
Page 40
stage surgical procedure); 18) again make another CP if the results are not sati
sfactory to himself or to the surgeons. In most cases, the patient is required t
o pay again, with the fees for further proceedings or join the queue. In some ca
ses, the patient will seek another surgeon most famous and collecting much more
expensive in the hope of obtaining the desired outcome and quality (PITANGUY, 19
84), 19) consider the CP as a "super-present," either for yourself either to the
other. Examples: Some people seek the CP as if they were present (inner joy). B
ecause the floppy ears cause unwanted attention and bring interaction difficulti
es at school, many parents have the belief (reinforced by the surgeons) that the
fix for your child will be considered an excellent gift. Thus, especially at Ch
ristmas, surgery is offered to children in this way. Others argue that men spend
 a fortune doing home improvement or replacing a car, why not make a "reform" of
the body? (Cottin, 1994 and Ruzzante, 1986); 20) perform various PC anywhere in
the body. Examples: women who dream of eternal youth and make several mini-lift
s (CP that gently removes traces / signs of old age without giving the appearanc
e of stretch), or even to undergo two or more techniques in a single surgical in
tervention, aiming not only the cheapening of the process, but a quick approxima
tion to the desired image (STRAP & ZANI, 1977); Paillet & Gate (1987) addressed
the social cost of beauty indicating that several CPE will be fully reimbursed b
y social security, depending on the skill surgeon in providing a diagnosis to su
rgery as needed. One might suspect that there are surgeons who make a pact with
the patient - a stunt - because they believe doing good for these patients when
they do a CPE. Performing "Championships Rhinoplasty" or even Congress specific
CPE, as well as high-rated television programs when the subject is treated CP8,
are also indicative of the great interest existing in the population.
8O
same as noted in the distribution or sale of cosmetic rejuvenating. (See Journal
of March 18, 1992)
Page 41
The fact that plastic surgeons are always so easy to volunteer their experiences
or patients who accept to be operated, either for recording or even instruction
al videos for training residents, or testing a new technique or device, it is al
so disclosing the great motivation. Example: the beginning of liposuction race w
as marked by a number, much higher than needed for research, obese volunteers. S
ince it is "experience," such treatment was offered so gratuita9 (AVELAR & Illou
z, 1986). The accelerated development of CP in an attempt to respond to the dema
nds of beauty patients, is also an indicator of high motivation. Examples: a mic
rodermabrasion with the promise of quick and painless end of stretch marks, age
spots and disfiguring scars (keloids); microsurgery that allows the transfer of
tissue flaps and vessels to an area of great loss, liposuction that hi-tech aban
doned the process of removing the fat mechanically (suction) to incorporate lase
r or ultrasound, which "melts" the fat before making her exit, the use of hydroq
uinone for lightening pele10; surgery of the buttocks ( still undergoing validat
ion), the use of carbonate hydroxyapatite (coral derivative that works as a matr
ix for bone growth natural) to replace the silicone prosthesis and the creation
of banks of skins, bones and cartilage (ARIES, 1991; Cottin, 1994; PITANGUY, 199
0).
Tr a n s f o r m a t i n Te c o l o g i c a
For Maisonneuve (1988), Aesthetic Surgery is the last answer that technology and
modern medicine provide the individual in terms of achieving the ceremonial bod
y transformation.€This response is very similar to the tribal rituals of adornme
nt, or purification
9O
same happened to a temporary technical slimming in the USA in 1986, which consis
ted in the use of gastric bubble that prevented mechanically eating to excess. I
t was abandoned by its side effects and the need for constant use of antacids. (
Folha de São Paulo, 03/05/86) 10DE indirectly, that the privilege Cosmetic Medic
ine also has, is an indicator of motivation to change Body. When Cosmetology off
ers for trial, an ointment or cream, for example, rarely is refusing to particip
ation by the subjects (evaluators). In some cases, it is necessary or draw a sel
ection of subjects, not only for medical reasons, but because the number of volu
nteers exceed the actual need of the experiment (SEE Magazine of July 23, 1986).
Page 42
the rise in social class. The individual then has more a ritual of beautificatio
n body at its disposal, which would go from a simple eating control regime or di
et, past the swimming, gymnastics, cosmetics and clothing, even to the technolog
ical sophistication of the CP and painless. Within this specificity of a ritual
that is the PC, people can take social cues from old age, rejection or ugliness,
considered signs of death, but with a psychological price to be paid: the secre
t feeling of guilt for having transgressed the commandment "natural (phenotype)
to their destination. This feeling of guilt has its roots in the Middle Ages, a
time when surgeons were considered demonic entities by changing the divine law.
(SCHOR & FREITAS, 1992). Physical attraction, or, in general, interpersonal attr
action may explain, at least in part, this increase in EPC, because people are w
orried about the appearance, belief or fantasy that they are more beautiful and
/ or more attractive will have more success or happiness in life. What pleases t
he eye or gives the experience of beauty just exerting an influence on attractio
n. (Berscheid & Walster, 1973). For HEIDER (1970), suggests what is beautiful is
good. Perhaps, even without the intention of doing so, the physical appearance
is culturally programmed. For RECTOR & THIRTY (1990), the cultural norms have a
great relationship with their own individual "I", ie the transformation of self
in a socially planned mask. This explains some social behaviors related to the b
ody: the clothing as an extension of the body and subject to moda11, sex, social
class and level of prestige; gymnastics as a form of body molding, dyeing or st
raightening hair as a "camouflage" temporary and the use of perfumes as disguise
the smell of their body. All these practices are temporary forms of body change
s. The Human Body announces the identity of being, personal appearance is concen
trated on the face and subject to daily care, reflecting the lifestyle of the pe
rson acquiring, for a communication that is indistinguishable from life itself.
The good appearance, besides being part of the communication nãoverbal, is a bas
ic need of people interacting with their
11Talvez,
to a different treatment or discriminated against on the connotation of good or
better, the fashion will gain ground in terms of imposition of forms of dress. A
recent television advertisement placed that the world is better who dresses wel
l and dressing well was the use of brand name clothing in focus.
Page 43
similar, and the rosto12 the instrument most expressive of this interaction desp
ite the limitations imposed by the cultural socialization process. (RECTOR & THI
RTY, 1990). The CP would then be a means of access technology to achieve, for ex
ample, a more tapered nose or without the ability to arouse unwanted attention,
a more harmonious lip, a look more attractive or oriental features, a more youth
ful face and joyful, seductive and symmetrical breasts, change in color of olhos
13, a less protruding belly, a chin that looks like aggressiveness or masculinit
y, a smaller area of baldness or a virginity lost in a violent act. This proves
the technological sophistication of CP and how it arbitrates on the body.
New-Patient Relationship Ciru RGY
The soap opera The Owner of the World (Globo, 1991) showed a remarkable characte
r, played by Antonio Fagundes, for being extremely ambitious and have the CP as
a profession: Felipe Barreto. This character has not hesitated to make money, fa
me and power. Through professional practice unethical, held a CP track to change
the facial identity of a criminal. Even as a fictional, this telenovela indicat
ed a small negative image of the CP, concentrated in the figure of the plastic s
urgeon: ambition without scruple. For the CP exists,€Physicians are required to
choose a specialty. It should be a little clearer explanation of the motivations
of these professionals have gained in personal contacts and / or phone, during
this research: 1) the desire to help the patient with respect to its image tarni
shed by malformations, congenital defects and acquired deformities (accidental o
r sequelae), 2) the need to be recognized, to have fame, either through
12Como 13A
someone has said: "The face is the mirror of the soul." change in eye color can
be achieved in two ways: 1) use of cosmetic lenses and / or corrective (disposab
le and increasingly thin), 2) transplant surgery of the iris (dangerous and expe
nsive). Another way to change the color of the rainbow that is still in phase of
validation is the use of an eye coloring that is changing, so slow and gradual,
the pigments of the iris, like a rinse. The interruption of use of such eye dro
ps cease the color effects quickly. (Paillet & Gate, 1987 and PITANGUY, 1972).
Page 44
their patients, either by recognition within the specialty (participation in the
Championships for a particular surgery, are pleased to provide interviews to th
e media and need to write explanatory booklets to patients or technical books, a
nd 3) wanting a rapid enrichment due to great demand by CP (expensive, but funda
ble), 4) not wanting to work in emergency rooms, which would deal with the pain
emergency, violence or several to death (shot, victims of traffic, domestic acci
dents etc.). 5) to know will work mainly within particular with a differentiated
clientele population that has a certain level of culture and finance, 6) want t
o take the prejudice that exists in the medical profession in relation to plasti
c surgeons and the CP, 7) professional work that requires an artistic skill, gif
t (intrinsic motivation) in favor of patients, and 8) enjoy working in the opera
ting room more than in a clinic or outpatient (teamwork). In relations between d
octor and patient, it should be mentioned that the candidate CP has characterist
ics different from other patients. One binds to the fact that all the CPE is not
an emergency, meaning that both the surgeon and his patient have the time neces
sary for the initial interview, test requests (if there is indication for surger
y) and marking the surgery desired. The field of CP is located outside the dange
r vital, not minding the individual with pain or problems in the somatic / funct
ional, hence the name of clean surgery: "Surgery is clean all those who do not l
eave pathologies such as ulcers, tumors, etc. . Aesthetic Plastic Surgery offers
the only regions free of illness, so the aesthetic plastic surgery is a clean s
urgery. "(Cottin, 1994, PG 46) (bold by the author) Thus, the specialty is not d
ealing with individuals with pain or problems Order somatic or functional. Opens
the field for negotiations, bargains, symbolic exchanges, collusion etc.. The m
ost common dynamic of this relationship requires that the patient
Page 45
should seek the specialty, choose a plastic surgeon, to invest in the figure of
him to say what they want to change or have in terms of facial appearance or bod
y. Then, the surgeon should clarify what can be done and what he can effectively
operate. (MÉLEGA et al, 1992). This appointment may also be called expectation.
The fact that patients seek out and choose your plastic surgeon, investing in t
his figure will improve its appearance, makes plastic the patient agreed to pay
a high value for surgery in some cases, just waiting for something good or posit
ive for you . Another difference is possible only under particular, and public h
ospitals, where the CPE is offered free of charge, the candidate undergoes surge
ry for the surgical team initially and then to a surgeon in particular, which do
es not prevent the investiture No surgeon. According Paillet & Gate (1980), the
vast majority of specialty physicians do not charge initial consultation and ask
their patients who find the fees to the secretary because money tends to interf
ere negatively in the patient-surgeon. Delegate this function seems, according t
o the authors, that "clean field" and remove the commercial nature of the legal
relationship. No wonder there are plastic surgeons famous, sought after by inter
national stars, or the newspaper reported that this particular patient is suing
a surgeon to find the victim of malpractice or surgical error. (ASSUMPÇÃO, 1990;
Paillet & Gate, 1980, and Ruzzante, 1986) These differences in relation plastic
surgeon - surgical candidate,€allow the investigation of the characteristics an
d expectations of patients seeking the CP, because without doubt there are many
motivational factors that appear in seeking treatment, surgery and the instituti
on. The election of one of these elements can not be disregarded from the total
psychological field and should take into account that the psychologist can take
that field, working in collaboration with the surgeon, giving psychological advi
ce in the role of consultant or even helping the patient clarify your desire. (D
EATON & Langman, 1986). Of course the development of CP is the feeling that we c
an achieve a higher degree of physical beauty socially shared, please see to con
firm this technical development, liposuction hi-
Page 46
tech, liposculpture, tissue expanders, skin and bones, silicones for prostheses
without risk of rejection, replacement of plastic by the glue point of skin graf
ts, suction-gland, microsurgery, hyperpigmentation (giving the appearance of a h
airy chest or reconstitution eyebrows), the CP for baldness, the gold thread aga
inst aging, CP etc. of the buttocks. Computing itself is contributing to the fur
ther refinement of the consultation and diagnosis of CP. By projecting the video
image of a patient, as if he were already operated by both the surgeon and the
patient may make changes to a detail. This technique allows the surgeon to come
near the real desire for transformation of the patient and that both can establi
sh consensus opinion regarding the type of CP, minutiae to be altered, its exten
sions and sizes. In parallel, the resources of Computers allow a streamlining of
the process, because the time of registration is reduced to a simple typing of
patient data. Photographs of compulsory pre-surgery, after inserted into the gra
phics program, may be worked on and are filed in the bank of images of patients.
These activities provide a last generation increased marketing power of the CP.
It is fundamental consensus in the diagnostic phase. Can view the changes will
allow the patient to know what are the CP technically possible, and if the surge
on agrees that meets with changes effected area and has the intended operation.
The visible results before surgery puts patients more motivated for the event, t
hey help to solve the doubts after surgery. Whatever the technique of the surgeo
n for diagnosis, it should remind your patient that any surgery will always have
a portion of risk and not always the changes made in the video are possible for
practical implementation. (ASSUMPÇÃO, 1990; MÉLEGA et al, 1992). The surgery is
very important not only for the patient but for their own specialty. The result
s of the CP, for now, are not totally perfect, predictable or reliable. Any CP i
s made in a living matter (skin, cartilage, bone, fat and areas suffering tracti
on). Unfortunately, there is consensus among surgeons that there will always be
errors in diagnosis, incorrect application of the technique, post-surgical risks
and a further subjective evaluation of it. (Pitanguy, 1992). If ever the CP acq
uire the degree of confidence that has the
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Dentistry, who also performs estéticas14 interventions, there will be another vi
ctory specialty: many to seek, if they feel this need to change or maintain the
youth and people who would benefit from a facelift and still have been reluctant
to seek such services, must find other arguments for maintaining such an attitu
de. The same is happening with the surgical correction of myopia that every day,
being most requested. This can be explained by the surgery to be gaining popula
r credibility: abandonment of eyeglasses and lenses, no risks or complications a
fter surgery. (OTSUKA, 1992).
Search Patient Plastic
The beauty and is considered an abstract entity, allows the subjective appear: e
ach individual, because of their socialization and life history, and the excess
of dissemination of models, and individual will have a composition on what is be
autiful or handsome in terms facial and / or body (MELLO-FILHO, 1991). The CP is
a specialty fairly distributed and with great technical advances. Its procedure
s are painless and promise to increase the degree of physical and psychological
comfort of the individual. The most common result is a large demand for cosmetic
surgery, and for this reason it is very important to select the correct patient
. The plastic surgeon should have knowledge and personal aspects of their patien
ts, because, otherwise endanger your image€without counting that could compromis
e the patient physically forever. Neglecting their psychological aspects can mar
k negatively specialty. For PITANGUY (1972), the plastic surgeon's work is only
complete if it is driven beyond a technical mentality, taking into account the p
sychological and social aspects of patients: ease of physical perfection (Beauty
), ethnicity and time of life. It
14A
Orthodontics, for example, possess events that require many hours of interventio
n. The actual product Buco-Maxillo transactions in post-surgical risks as large
or even larger in some cases.
Page 48
need to be clear, both for the surgeon and the patient, what the real motives fo
r seeking the CP and its financial and technical viability. But is this the real
expectation of the patient? That is, be more beautiful or attractive? To what e
xtent psychotherapy would not benefit the patient more than the scalpel? Do the
patients do not seek the CPE for a better relationship with yourself and others?
What are the personal strengths and the environment that push the candidates to
seek a rhinoplasty? What is the weight that the candidate for rhinoplasty gives
personal factors and / or environmental? To what extent a "new" nose would brin
g significant changes? The cortex of man has a large portion reserved for the vi
sion and it seems that this is the sense used by him, resulting in the natural b
ehavior of adornment and / or beautification body (Berger, 1972). Thus, the CP c
an be understood as a predominantly visual specialty that has generated new form
s of behavior ranging from simple curiosity about technical issues or news, unti
l the search and implementation of effective surgical procedure desired. You cou
ld say that these new social relations are marked by the expectation of acquirin
g a body or part of it attractive, beautiful or competitive by the patient. The
surgeon, in turn, have the possibility to be able to effectively assist the pati
ent in the aspect body. (AMARO, 1985). WOLF (1992) argues that women are victims
of the ideal appearance or beauty of the dictatorship, citing the bodybuilding
obsession: race to regular hair salons, the demand for aesthetic treatments, exc
essive buying of cosmetics, sports practice aggressive diets lead to anorexia an
d incessant demand for plastic surgery. All these practices, according WOLF (199
2), resulting in a lowering of self-esteem of women, preventing it from competin
g with men on an egalitarian basis of time and money. Individual behaviors, as w
ell as the whole social network built around the practice of CP, demonstrating t
hat it can not be regarded as superfluous (Polanyi, 1980). Further analysis of t
he relations clarifies that this specialty has psychological and social influenc
es that are beyond their area of competence. Many surgeons are intrigued by the
great collaboration of the patients in the act
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or surgery with positive effects on personality coming from a simple plastic cor
rection. It can be concluded that plastic surgery is far from being just a super
ficial change, a frivolity or a procedure naive. (Paillet & Gate, 1980).
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