ETHICS AND/OR AESTHETICS? REFLECTIONS ON
COSMETIC SURGERY FOR ADOLESCENTS
¿ÉTICA O ESTÉTICA? REFLEXIONES SOBRE LA CIRUGÍA
ESTÉTICA EN ADOLESCENTES
GIANLUCA MONTANARI VERGALLO, ENRICO MARINELLI,
SIMONA NAPOLETANO, NATALE MARIO DI LUCA, SIMONA ZAAMI
Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome.
Viale Regina Elena 336, 00161, Rome, Italy
Cosmetic surgery entails various ethical issues, even more so in cases involving adolescent patients.
Cosmetic surgeons need to take into account how modern societies consider physical appearance an
essential component of everyday life, as well as the vulnerability of youths and adolescents. For that
reason, it is imperative to thoroughly assess the psychological and emotional states, in addition to the
motivations, of minor patients. That goal can be achieved through the use of the DAS-59, (the Derriford
Appearance Scale)1, an effective and dependable tool devised to evaluate the psychological difﬁculties and
distress experienced by people living with problems of appearance. Prior to undergoing cosmetic surgery
procedures, adolescents should be required to go through adequate counseling, over multiple sessions
and extended to their family members as well, on account of the complex issues inherent in evaluating the
risk-beneﬁt ratio and a prospective patient’s decision-making capability. A concerted effort on the part of
surgeons, psychiatrists or psychologists is key in determining the real motivations behind a minor’s decision
to opt for cosmetic surgery in the ﬁrst place. Possible psychiatric conditions may in fact prevent a minor
from making a free, informed decision. From an ethical standpoint, cosmetic surgery procedures should be
geared to serve the best interest of the minor patient, who may experience distress over his or her body
image, from a health and psychological balance perspective and improve his or her social, affective and
working life. Besides, cosmetic surgery should not be overly invasive compared to its potential beneﬁts.
Those procedures aimed at achieving “ideal beauty” are not desirable and ought to be banned. By virtue
of such criteria, the authors have set out to evaluate the ethical admissibility of some aesthetic treatments.
Thus, doctors should not consent to any request coming from their patients, but rather, intervene only
in presence of an objective physical ﬂaw or deformity, e.g. protruding ears, which have a potential to
negatively affect social life and interactions.
1 Cogliandro, A.; Persichetti, P.; Ghilardi, G.; Moss, T.P.; Barone, M.; Piccinocchi, G.; Ricci, G.; Vitali, M.; Giuliani, A.; Tambone, V. “How
to assess appearance distress and motivation in plastic surgery candidates: Italian validation of Derriford Appearance Scale 59 (DAS 59)”.
European Review for Medical and Pharmacological Sciences.2016
Cuadernos de Bioética. 2018; 29(96): 177-189
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