For 15 years Professor Hermann F. Sailer was Professor and Director of the Clinic and Polyclinic for Oral and Facial Surgery at the University of Zurich Hospitals. He conducted thousands of successful operations and today is operating on his patients in his own private clinic on the Zurichberg.
A patient questioned him from a critical point of view about the latest trends in aesthetic plastic surgery.

Patient: Worldwide the beauty business has developed dramatically in the past few years. What is the reason for that?

Professor Sailer: We are living in a post-modern society that has what can be bought and sold as its basis. In a capitalistic world one can buy everything – beauty naturally as well. At the same time we are living in a society that is fixated on youthfulness. Looking young and attractive is playing an increasingly greater role, e.g., in one’s profession; someone who is considered young and dynamic has more future than past and thus better opportunities in life overall.

Beauty as market value?

Absolutely. Someone who improves his own market value through aesthetic surgeries, the longer the more, is considered up-to-date.

Beauty is the last commodity that has not been democratised – different from values, for instance, like education or equal opportunity, which are guaranteed by the state. Perhaps, therefore, one feels legitimised in eliminating the last injustice of nature?

Yes, everyone has the right to change himself. We can improve our social position. Today we want to do the same with our body and our face. Because our world is secularised and very worldly and we do not have eternity but rather our limited time on earth before us, it is natural for us to wish to make this time as pleasant as possible and to control ourselves the process of change due to aging. In the same way we do not accept our body and our face as simply God-given any more.

Under the aspect of the increasing number of aesthetic surgeries worldwide, can one speak of a global conformity of body and facial images?

One can definitely observe a trend toward global body images. One example: about five years ago Brazil and Argentina, although they are neighbours, still had opposing ideals of beauty. Both countries have really been surgical societies for some time. Along with America, they have been in the lead as concerns the number of operations. Argentina has always thought of itself as a white country, which is why the women there have their breasts enlarged primarily, imitating examples from the USA or Germany. On the other hand, in Brazil the most frequent operation for women has been breast reduction. For Brazil is a rainbow society from white to black. And since large breasts are the sign of a black woman, yet no one wants to be considered black, there was a wave of breast reductions. In the past five years the situation in Brazil, however, has changed radically.
Meanwhile, breast enlargement has become the most frequent aesthetic surgery for women there, too. The new body image then no longer has anything to do with local but rather with global presuppositions and ideals

How do things stand as far as facial ideals are concerned? Can you give an example of increasing conformity there?

We can take a look then at the example of Asia; one can speak almost of a Pan-Asiatic face as the ideal there. The surgeons there attempt to fashion faces that do not appear Japanese, Chinese, Korean or Vietnamese but rather “somehow” Asiatic.

Indeed it is apparent that a little ethnicity of appearance does not hurt at the international beauty competitions ...

... but just not too much of it. One may appear Greek, Italian, Jewish or black nowadays, but just not too Jewish, too black.

Why does our era idealise women with large breasts now?

We are living meanwhile in a post-feminist world. Women have become established in business and have equal rights, at least officially. Because of that they can be more feminine once again.

The question remains open as to whether or not control of one’s own body and its cosmetic alteration can lead on the whole to a happier life. After all, with aesthetic surgeries one must put up with high costs and pain.

Most psychological investigations come to the conclusion that about 85 percent of the patients are still satisfied with the results three years after the operation. Aesthetic surgery costs about as much as a small new automobile – and the buyers are usually not so satisfied with that after three years. Therefore, as regards satisfaction, the money is better invested in an aesthetic procedure than in an automobile.

When adults go to an aesthetic plastic surgeon, it may well be the right thing for them. Yet the patients are becoming younger and younger. Do you consider that acceptable?

No. That is a big problem. In Japan, for example, it has become almost customary for girls to have their breasts enlarged during their puberty. Or nose operations: a typical 16th birthday present for Koreans or Vietnamese. That is extremely problematic naturally. For what kind of a relationship does one have to one’s own body at that age? And what does it mean if one receives such a present from one’s parents of all people, who one wishes to accept one as one is? However, if all girls have themselves operated on at an early age, then, naturally, enormous social pressure must be prevalent.

If one begins at such an early age with operating, isn’t the risk great of a real addiction to the latest operations?

Naturally there are cases of so-called “polysurgery”, the addiction to ever more operations. Michael Jackson may be considered an example of that. Such people are better treated psychiatrically. A serious aesthetic plastic surgeon will not continue to operate – for the very reason that he would like to treat patients that are satisfied with his skills and not those that he can never satisfy. Personally I would refer people with such problems to a specialist in the fields of psychology or psychiatry.

Nevertheless, we know from experience in all areas of the market economy that demand itself creates supply. Isn’t that clearly evident also in the development of aesthetic plastic surgery?

We know that wishes can always be risky and that there are opportunities with negative consequences. However, one may certainly not prohibit specific developments for that reason. As every person has the right to smoke or to engage in extreme sports so he also has the right – and today even the opportunities – to change his body and his face. In the process, he naturally risks far less than with smoking or extreme sports.

Professor Sailer, thank you for the interesting discussion!

It was a pleasure.