Cosmetic interventions are experiencing a significant boom, yet many argue that ethical conversations are lagging behind. Technological advancements have made procedures like Botox, fillers, and GLP-1 medications such as Ozempic more accessible, prompting individuals—often women—to grapple with philosophical and ethical implications in their pursuit of beauty, youth, and conformity.
The Personal Struggle
Shula Jassell, a 25-year-old from Southern California, embodies this internal conflict. Insecure about her chin size, she periodically considers filler but hesitates due to the need for repeated treatments. She wonders if a surgical implant might be more practical, though surgery frightens her. "I just try to remember self-love, you know? Beauty is in the eye of the beholder," she says, ultimately talking herself out of any procedure for now.
Call for Broader Conversations
Natalie Carnes, a feminist theologian at Duke Divinity School, emphasizes the need for a wider dialogue. "We need to have a wider conversation about how to think about this in a way where we’re not putting the burden squarely on women, while also not taking away their moral agency," she states. "Beauty is something that’s good. And beauty is something that is good to pursue. Botox and Ozempic and face-lifts, they’re all ways of really narrowing the cultural ideals of beauty."
While major religions offer little official guidance, a growing chorus of theologians, philosophers, and bioethicists is calling for more discussions. In March, the Vatican released a document on Christian anthropology decrying the "cult of the body," stating that modified bodies become "body-objects" where the person "owns" a body rather than being it.
Increased and Younger Demand
Dr. C. Bob Basu, president of the American Society of Plastic Surgeons, notes increased demand across all ages and ethnicities. "Forty years ago, perhaps people would think, ‘Cosmetic surgery is for the superrich or the celebrity elite. It’s not for regular folk.’ That’s not the case anymore," he says. He observes more young people opting for preventive measures like "baby Botox" or face-lifts in their late 30s or early 40s.
Despite its ubiquity, bioethicists say plastic surgery is not prioritized in their training. Arthur Caplan, founding head of the Division of Medical Ethics at NYU Grossman School of Medicine, explains, "If you’re getting into bioethics and you rotate to learn about medicine, you go to the ICU, you go to places where the palliative care is for dying people, you’re looking at transplants. Nobody rotates to plastic surgery." This leaves plastic surgeons to set their own boundaries without specialized ethical training.
Faith in the Operating Room
Religious perspectives vary. Dr. Jerry Chidester, a Mormon plastic surgeon in Salt Lake City, sees a broad spectrum of stances within his church. He advises patients not to worry about others' opinions: "Look, if you want to do this or not, it’s up to you. It’s literally your body. Who cares if they think you’re doing it for vanity or for function or whatever? It is none of their business."
Dr. Sheila Nazarian, a Jewish plastic surgeon, uses her interpretation of the Torah for guidance. "If it’s bringing distress, then it’s OK," she says, noting her patients are well-adjusted but seek help with one issue they'd rather not think about.
Dr. Michael Obeng, a Christian surgeon in Beverly Hills, has seen a dramatic shift in acceptance. "Now people are not even hiding it. They show their plastic surgery as a badge of honor, like somebody wearing their expensive bag," he observes. He rarely feels tension between his faith and work, except when considering gender transition surgeries. After consulting pastors without clear answers, his faith led him to limit practice to some gender-related procedures like breast augmentation, stopping short of genital surgeries he sees as harder to reverse.
Agency Versus Constraint
Ivory Kellogg, a 29-year-old actor in Los Angeles, feels the tension. "There’s this expectation that once you hit 35, you think about doing a mini face-lift. That's a lot of pressure," she says, while also wanting women to feel empowered to make their own choices.
Experts argue that these choices are not purely individual. Abigail Saguy, a sociologist at UCLA, states, "It’s important to think about how those choices are constrained and to think about the social pressures. This is a social issue. It is a collective problem. But it’s continually treated as an individual issue."
Dr. Aasim Padela, who studies bioethics and Islamic thought at the Medical College of Wisconsin, raises concerns about resource distribution. "The profession is supposed to be about restoring health or preventing loss of health. Certain types of procedures, body modifications, interventions—whatever you want to call them—may not meet those goals or even be aimed at those goals," he says.
