Are the Ethical Rules Different in Reconstructive and Aesthetic Surgery?

Conceptually, boundaries of this concept that we encounter in all disciplines in life including law, media, diplomacy, politics, philosophy, management, and architecture, cannot be clearly defined. There are various studies on establishing an ethical framework and drawing borders in health services since Hippocrates, the founder of scientific medicine, within this framework [1].

Reconstruction

Fixing something broken, and rebuilding and restoring it! Alright, aesthetics is always a battle with the youthhood that is hard to gain back, the pursuit of beauty, and even if it is difficult to adopt, ugliness that have been the subject of history! Combining two such different surgeries is very difficult for physicians nowadays. Professionals faced with an ongoing identity crisis and the ethical dilemma it entails. In addition to the professional group trying to perform the art of medicine and real patients, who are waiting for psychological support during the treatment of losing limbs and who are waiting for plastic surgery, it is a solid group of people who want to get ambitious and have surgery for the sake of being even more beautiful with active and aggressive media [2].

In the independent healthcare sector, plastic surgery has gained more popularity and response more to the increasing consumer demands. On the one hand, there are patient consents, work contracts, guaranteed expectation for cosmetic success, and the pursuit of unlimited beauty, on the other hand, replacement of functional losses, prevention of loss of workforce and reintegration of people into society [3]. The most basic element of the patient-physician relationship is the feeling of trust. At this stage, what is necessary to ensure the continuation is to act with the main philosophy of “Primum non Nocera”, that is, “do no harm first”, in line with the physician’s point of view, informing about the intervention to be performed, giving the patient time and professional competence in order not to leave any question marks in mind for surgical procedures [4]. For the patient, it means trying to understand the procedure to be done, the treatment to be applied, questioning the questions in his mind, and submitting properly when he really decides. To prevent any harm in trust feeling, the mutually informed consent form must be signed before the transaction. Observing the personal rights of the patient at every stage requires obtaining the necessary permissions for the use of personal photos and data in training or publications.

It is important to pay attention to privacy the patient need, to take pictures before and after the surgery in such a way that the identity of the patient is not known, except for facial surgeries, and not to take pictures such as tattoos, moles, scars that may reveal the identity of the person during their display or to apply appropriate masking. Likewise, knowing cosmetic procedures should be considered as a secret since it will reveal previous defects of patients [5]. In this context, if surgical intervention generally concerns the patient’s body, the psychological field will mainly be triggered in most of these kind of cases [6,7]. In general, the expectation of aesthetic perfection is a difficult process for the physician to manage. The surgical outcome that the patient dreams of is not possible to achieve all the time. Therefore, it is important that expectation of the patient correlates with the possible outcome. In fact, it can be ensured by the physician’s appropriate evaluation, allocation of the sufficient time to the patient, sufficient information supply about the possible changes that will occur before and after the surgical procedure. Conversely, the physician has the right to “autonomy” against patients whose expectations are higher than normal or who have exaggerated requests from the physician [6].

As it is known, it is natural for a patient to have anxiety and suspicion in any kind of surgery. The surgeon should politely explain to the patient that such an application will be performed. Supplying the adequate information is important for the patients and their relatives to relax and to operate safely. In this relation, the autonomy of the patient and the respect with him/her should be preserved, and it should not be forgotten that accuracy is the main principle in this relationship [8]. The most feared things during the surgery includes some question marks on mind such as whether to be awakened from general anesthesia, whether pain will be felt, and if there is a cancer tumor diagnosis, what is the chance of getting rid of it. All risks should be explained, and it should be assured that the patient understood them correctly. In emergency situations, when the patient is underage or unconscious or cannot decide, the permission of his legal representative should be obtained [9,10].

The concept of ethics is an integral part of not only plastic surgery but also healthcare services. For this reason, a plastic surgeon should always remember that his/her patient has a body-soul existence and should establish the patient-physician relationship on reliable grounds.

None.

No conflict of interest.

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