The growing obsession with cosmetic dermatology: Are we endorsing artificial beauty?

Ms. C.R., a 22-year-old young lady, was a YouTube content creator and a budding Kannada actress hailing from Bengaluru. She asked her father’s permission to undergo “fat-free” plastic surgery, as promised to her by a well-known cosmetic center. Her father refused permission, saying the surgery was not necessary, yet she went ahead. On the fateful day, May 17, 2022, her surgery developed complications resulting in pulmonary edema, as her father was told that her lungs had filled with water, and consequently, she succumbed. She could not breathe and later died. Her father was devastated and was left with many unanswered questions.^[1] Why did she go ahead with the surgery despite his refusal? Why did the cosmetic center not need parental consent to perform the surgery? What is “fat-free,” and can any surgery ever promise a “fat-free” body?

According to a study conducted by Fortis Healthcare (2019) among 1244 women across 20 cities in India to gain perception of women toward the concept of body image, 90% women reported body shaming as a common behavior, 47.5% reported body shaming at school or workplace, 76% felt media portrayal of beauty contributes toward promoting the prevalence of body shaming.^[2]

The reasons for the prevalence of body shaming and the answers to Ms. C.R.’s father’s questions in the simplest terms are this:- The multi-billion-dollar capitalistic empire of cosmetic dermatology can only thrive by creating and perpetuating the notion of artificial beauty. There is little concern, even if the externality involved includes distorted self-esteem of the entire younger generation or complications and deaths in some cases.

This article will focus on how a growing obsession with cosmetic dermatology is a result of the endorsement of artificial beauty and the various negative effects associated with it. It is structured into 4 parts. First, we explain what cosmetic dermatology is. Second, this would be followed by detailed reasons for exponential growth in the consumption of cosmetic dermatology services and how it is linked to the notion of artificial beauty. Third, we will discuss the negative impacts of the same. Finally, we end with suggestions on how to find a balance between the practice of cosmetic dermatology and beauty.

According to WebMD, Cosmetic dermatology is a subspecialty of dermatology that includes providing services to patients such as correcting skin tone, smoothing wrinkles, removing hair on the face or body, reducing surface fat, skin tightening, and removing tattoos. It also treats cellulitis, acne, and acne scars. The procedures offered by Cosmetic Dermatology include Botox injections, dermal fillers, exfoliating treatments such as physical exfoliation, microdermabrasion, chemical peeling, and laser skin treatment. It also encompasses induced pulsed light therapy, laser hair removal, and tattoo removal. It is an amalgamation of both medical and surgical aspects.

But why has the practice of cosmetic dermatology been on such a rise today? According to a study titled “Factors that motivate people to undergo cosmetic surgery” published in Canadian Journal of Plastic Surgery 2012 Winter; 20 (4): e47–e50, authored by Adrian Furnham, and James Levitas, lower ratings of self-esteem and life satisfaction, increased media exposure to cosmetic surgery via television shows, time spent watching television and religiosity were all significant predictors of the likelihood of taking services of cosmetic dermatology.^[3] Real-life biases for “attractive women” and discrimination against less attractive women, in several different domains of society, are other factors. This itself defeats the humanistic need for achieving inner beauty based on human conscience. Self-ratings of physical attractiveness have a significant effect on the likelihood of undergoing cosmetic surgery. Biased popular media is equally condemnable and adds oil to the furnace. Consider the following lines from one of the highest-rated series on a common OTT platform.

• The title character, Ms. M, relays that she was excited to have a fat roommate in college because “I’ll have someone to eat with who won’t steal my boyfriend.” It’s a throwaway line that immediately implies no one would want to love or adore someone who is not thin.

It is not difficult to understand that the notion of artificial beauty, intensified by media and society, has agonized men and women with the constant evaluation of their looks. This has led to a significant increase in the consumption of cosmetic dermatology.

But is cosmetic dermatology or wanting to look “beautiful” bad? No, it is not. Between 1000 BC and 800 BC, the great ancient Indian plastic surgeon, Sushruta, performed nasal reconstruction plastic surgery. Since then, the science of cosmetic dermatology and plastic surgery has come a long way, helping patients who have suffered deformity due to birth-related, medical conditions, accidents, etc. It has helped patients regain their lost confidence. The issue, however, arises when we accept an ethnocentric view of beauty. “White is beautiful.” “Fair and Lovely makes beautiful.” In doing so, we condemn a whole population who are genetically disposed to have darker shades (like those living near the equator, to protect them from harmful sun rays. Unfortunately, society tends to associate all positive notions with something considered beautiful and all negative notions with things that are not. Hence, for society, a “black” person is more likely to commit a crime than a handsome, muscular white person. Racial slurs often degenerate to physical violence, where “white supremacist” would attack “blacks” just because of color and the misplaced notion of beauty based on color. A white supremacist terrorist organization is a classic example of decade-long attacks on African Americans. On the other hand, many innocent and gullible people, such as Ms. C.R. and many others, underwent unnecessary procedures, sometimes life-threatening, to conform to norms that a zero figure/thin is beautiful.

Furthermore, due consideration is needed in case people who are suffering from body dysmorphic disorders and anorexia nervosa, both of which are characterized by dissatisfaction with the body and preoccupation with its perfectionism. Since, in both disorders, the patients are convinced about the abnormality of their physical features, it is easy for them to indulge in cosmetic surgeries, which may not be necessary.

This brings us to the question of what the way forward is. In simple terms, the answer is we need to shun the ethnocentric idea of artificial beauty and endorse the cultural relativistic view of it. The concept of beauty should not be defined by the people who hold sway over public opinion. The concept of the beauty of the Karen tribe in Africa, who wear neck rings to get their necks elongated, or Kalbeliyas of Rajasthan, who like to wear beaded jewelry, is equally important and should be respected in its entirety. Then, there is also a need for a strong moral compass in the practice of cosmetic dermatology. Without doubt, creating a false and unachievable narrative of artificial beauty (fair complexion, thin figure, perfect jaw line, etc.,) will be a market/business opportunity for the whole population who would like to achieve those goals, but at a severe cost of loss of self-esteem and depression. The idea of beauty, as an aggregate quality of the person, should be promoted by the media and society along with the concept of spiritual and inner strength.

To conclude, we have defined cosmetic dermatology as a subspecialty of dermatology that encompasses providing a wide range of services to patients. We have seen that the ratings of self-esteem and life satisfaction, increased media exposure, time spent watching television, religiosity, and popular media portrayal of beauty were all significant predictors of the likelihood of taking services of cosmetic dermatology services. We have since then established that, whereas the practice of cosmetic dermatology is very much important and needed, an ethnocentric view of beauty has led to the endorsement of artificial beauty and is harmful for both the individual and society. The answer lies in having strong moral values in the practice of cosmetic dermatology and embracing a psychocultural relativistic view of beauty.