- Email: [email protected]
The rise and prospects of medical aesthetics
Sot'. Sci. Med. Vol. 41, No. 8. pp. 1197-1201, 1995
~
Pergamon
0277-9536(95)00162-X
Elsevier ScienceLtd. Printed in Great Britain
THE RISE A N D PROSPECTS OF M E D I C A L AESTHETICS P E N G Q I N G X I N G , W A N G X U E and Z H A O J I A Y E Yichun Medical College, Jiangxi 336000, People's Republic of China Abstract--Since the 1980s, Chinese scholars have been trying to expound and synthethise elementary aesthetical ideas which occur in medicine, in order to treat this area of study as a defined branch of medicine--'medical aesthetics'. It is in this context that the points discussed in this paper arise. We set forth in detail the ideas, objectives and methods adopted within the framework of medical aesthetics and its applied branch--medical cosmetology and expound the relations between them. We think the task of medical aesthetics is to study the human body in its entirety, concentrating on both internal and external beauty and put the findings into practice, whereas the task of medical cosmetology is to study and assess only the external beauty of the human body and to take action on that basis. Medical cosmetology is the enforcement of medical aesthetics, practised in order to give positive results connected with physical beauty, and is therefore easily understood by the layman. It is known that the development of medical cosmetology represents an important breakthrough in the development of medical aesthetics. We think that beauty should not be measured mechanically, always following the same pattern, but that it should be considered individually with everyone's own particular characteristics. The quality of physical attractiveness should be assessed jointly by the doctor and his patient or client, not solely by either of these individuals nor even by a group of doctors. The necessity of defining and developing both medical aesthetics and medical cosmetology arises largely as a result of the increasing numbers of people who pursue beauty and health and is in accordance with the trend for consolidating different aspects of modern science. A main objective of medical advance is to improve the quality of health and beauty; to enhance the quality of life and encourage human beings toward achieving perfection in both health and beauty. We predict that in the future medical aesthetics and medical cosmetology will be amongst those subjects considered to be of major importance in the medical field. We have at last reached a stage where we can define the intentions and applied measures of medical aesthetics and medical cosmetology which differ from those of clinical medicine, preventive medicine, or recuperative medicine. Key words--medical aesthetics, medical cosmetology, medical beauty, the beauty of the human body
INTRODUCTION Medical progress is increasingly directed towards the major purpose of prolonging life, tending towards an approach involving aesthetics, along with a reappraisal of the role of medicine and a renewed definition of 'health' in general. With the recent method of bringing aesthetics into the field of applied science, medicine and aesthetics unite. 'Medical aesthetics' has recently appeared in the Orient as a subject of rising importance.
THERISEOFMEDICALAESTHETICSIN CHINA The pursuit of physical beauty is as old as human history. Mankind has always admired the youthful and the attractive. The ancient Greeks prayed to the solar god or god of medicine, Apollo, for health and happiness and brightness. There were records of 'music being used to treat the patient's illness' in ancient medicine in Greece, China and India. During the Renaissance in Europe, anatomist and artist,
Leonardo Da Vinci surveyed precisely the aesthetic parameters of the structure of the human body. All these reflect the absorption of beauty. Nowadays we are bombarded with advertisements for pills, creams, lotions, and other devices that will smooth our wrinkles or leave the hair soft and glossy. Until recently, the only way to get close to beauty was to be born beautiful or to marry someone who was. Current events have revealed a new choice--buy it. A new surgical specialty (called variously aesthetic or cosmetic) has sprung up to fill and meet an unprecedented but still growing demand. This accounts for the common perception that beautiful people get ahead in life, love and business. People in ancient times did not study medical aesthetics, as an individual subject; they only had a desire for beauty, they also had simple ideas about beauty and judgement of beauty. Modern people have developed and synthesized these elementary aesthetic ideas into a systematic science, that is to say, nowadays more and more people study it as a systematic science of medical aesthetics and cosmetology.
1197
1198
Peng Qingxing et al.
Chinese scholars of the 1980s combined medicine with aesthetics as a science and developed a systematic method of research on the subject. They published many articles to discuss the problems of medical aesthetics. For example, in 1982, in the 8th issue of Medicine and Philosophy, Zhao Denwei published his article, "Music, Medicine with Other Things". Later Zhao published his "Biochemistry and Aesthetic" in the second issue of Live Chemistry in 1983. In 1985, in the issue of Medicine and Philosophy, Hu Changxing published his "Medical Art and Medical Science" and Meng Xianwu published "Medicine Seeking Beauty". These articles attracted much attention in both the Chinese medical and aesthetic fields. A fervour for writing and studying medical aesthetic principles was unleashed. In June 1988, a book, "Medical Aesthetics", by Qiu Lingzhi and Peng Qingxing, was published. In November 1989 another book of the same title, by Ding Huishui, was published. Subsequently, various editions of works such as "Aesthetics and Nursing", "Aesthetics on Traditional Chinese Medicine", "Aesthetics on Pharmacology", "Medical Cosmetology" and "Medical Aesthetics on Oralogy", were published, totalling more than 50 [1]. At the same time, such periodicals as the Chinese Medical Aesthetic Bulletin, Journal of Chinese Medical Aesthetics and Cosmetology, Popular Scientific Journal of Medical Aesthetics and Cosmetology, Popular Practical Journal of Aesthetic Plastic Surgery and Journal of Clinical Cosmetology, were printed and published either then or later. Since the 1980s, in China many clinical institutions and treatment centres have applied medical aesthetic techniques to cases, either conscientiously or unconscientiously. Every large hospital carries out the practice of clinical cosmetic techniques. Up to the present, more than 20 medical colleges such as Dalian Medical University, Yichun Medical College, Sihezi Medical University offer courses on medical aesthetics and cosmetology. On 15 November, 1990, a Branch of the Medical Aesthetics and Cosmetology of Chinese Medical Association was founded.
THE CONCEPTION,SYSTEMAND STRUCTUREOF MEDICALAESTHETICS What is medical aesthetics? What are its objectives, systems and structure? Generally speaking [2-5] medical aesthetics is a science developed to maintain or protect against impairment, the beauty of the human body and to reconstruct or alter the appearance and structure of the body. It is also developed to remove blemishes and to reconstruct the perfection of individual beauty with various medical measures according to medical and aesthetic principles. It aims to improve human vitality and sense of beauty. It has
the nature of both humanitarian and technical studies. The reason why it has this dual nature is determined by its intimate relation with traditional aesthetics and its extensive application of medical techniques. It can be applied to such fields as those of cosmetic surgery, nursing, pharmacology and hospital management. It can also be applied in the medical practices of prevention, treatment and surgery. The basic principles studied by medical aesthetics are beauty and theories on beauty, that is, medical beauty and an assessment of beauty with medical and aesthetic measures and principles. What is meant by medical beauty is the beauty of the human body (or physical beauty); health and beauty of the human body. It concerns medical theories and practice for maintaining, achieving and reconstructing this special type of beauty 'physical beauty'--which is the core of medical beauty. The basic forms of medical beauty are divided into four categories, namely, medical natural beauty, medical social beauty, medical artistic beauty and medical scientific beauty. By medical judgement on beauty we say it relates to a sense of pleasure achieved by looking at beautiful things and identifying the requisites for medical beauty and it is an assessment of beauty on the basis of intuition with medical and aesthetic principles. The systems of medical aesthetics are on the facing page. THE CONCEPTIONOF MEDICALCOSMETOLOGYANDITS RELATIONWITH MEDICALAESTHETICS Among the series of subjects mentioned above, medical cosmetology is generally regarded as a 'breakthrough' in the development of the whole of medical aesthetics. Because the application of medical cosmetic techniques is directly perceived through the senses and easily accepted by the public, it is the practice of medical beauty which can directly provoke people's sense of beauty. What is 'medical cosmetology'? Medical cosmetology (also called medical cosmetics) is a new rising medical subject specifically designed to maintain human external beauty, to repair damaged areas and remove blemishes, to reconstruct the perfection of individual beauty by a combination of medical and aesthetic methods. It aims at improving the human vitality and sense of beauty. It is combined with several clinical and non-clinical studies, application (or practice) is regarded as its important characteristic. In view of the above statement, we can say that the factors studied by medical cosmetology are the external beauty of the human body, and all those medical techniques, facilities, practices and basic theories which are adopted for maintaining, achieving and reconstructing it. Through studying, we concluded that the beauty of the human body is composed of
The rise and prospects of medical aesthetics Medicine---,
Medical aesthetics
1199 *-Common aesthetics
The list of basic theory of medical aesthetics
The list of application of medical aesthetics
The list of aesthetics of medical art
Medical aesthetic conception and object and system
Clinic medical aesthetics (including aesthetics of eugenics Technique of medical aesthetics
Aesthetics of medical specimen Aesthetics of medical model
Medical aesthetic history Thought, ideas of medical Aesthetics of medical Aesthetic appreciation prevention, health, environment Psychological mechanism of Aesthetics on nursing medical aesthetic appreciation Medical human body's aesthetics Methods of study of medical aesthetics, etc. Medical cosmetology (including
Aesthetics of medical hanging chart
Medical aesthetics on
illustration, etc.
Aesthetics about pharmacology Medical aesthetics on recover Aesthetics of medical experiment
aesthetic health, aesthetic surgery, aesthetic medicine aesthetics of instruments, etc.) Education and accomplishment of medical aesthetic appreciation
two things; one is the 'external beauty' such as the beauty of bodily form, physique, appearance (or looks), movement, etc., the other one is the 'internal beauty' such as beauty of function and temperament, etc. [6]. 'Cosmetics' aim at changing this 'external beauty' by cosmetic measures. Now many people want to have both youth and beauty. The young want to change their appearance because they are dissatisfied with their 'external beauty' such as looks (or face), they hope for beauty achieved by alteration using cosmetic measures such as operation, massotherapy, and physiotherapy. Comparing the definitions and explanations above, we find a natural association between medical aesthetics and medical cosmetology, they both aim to maintain, achieve and reconstruct the beauty of the human body; they aim at improving human vitality and sense of beauty. But there are three differences between them: (1) The basic factors studied by medical aesthetics are medical beauty and medical theories on beauty. In other words, the principle behind it is the beauty of the human body in its entirety, including the 'internal' beauty and 'external' beauty, because this is the core of 'medical beauty'. Whereas the factors studied by medical cosmetology are 'external beauty' of the human body and all medical techniques, facilities, measures and practices adopted for
cosmetic purpose such as operation and massotherapy. (2) 'Medical aesthetics' is a science intended to study and improve the beauty of the human body, to increase the sense of beauty in life, from the aspects of physiology, psychology and social adaption. 'Medical cosmetology' on the other hand is designed to improve the beauty of the human body and sense of beauty in life in accordance with formal beauty, and it aims to solve aesthetic problems about psychology and social adaption. (3) 'Medical aesthetics' is a science with the dual characteristics of humanitarian and technical studies, in other words it deals with both theoretic and practical qualities. Medical cosmetology, on the other hand, regards only application (or practice) as its character, that is to say, it shoulders the task of performing cosmetic operations. By comparing the two concepts of medical aesthetics and cosmetology, we find that the former is wider than and incorporates the latter.
HOW IS BEAUTY MEASURED OR COMPARED?
In order to answer this question, consider an example: An attractive 22 year old girl is selfconscious about her flat nose and feels that it has curtailed her career opportunities and consequently she wants to be reconstructed. Accordingly, she
1200
Peng Qingxing et al.
presents at the plastic surgeon's office. After the operation she feels that her appearance has been improved and consequently feels very good about herself. Feeling good about oneself often implies that a result is satisfactory. Moreover, the surgeon (or doctor) considers the operation to be a success as it makes the girl look better and allows her to feel good about herself. In this case, both the doctor and his patient are involved, consequently the assessment of the girl's beauty should be between those two individuals. Thus we maintain that beauty can be assessed or measured between the doctor and his patient because the matter involves them both. We should conclude that every person in the medical field, including medical practitioners and patients, are both the subject and object of the assessment of physical perfection. Consider, for example, a client as the subject of the assessment of physical attraction. Before the operation he will tell the doctor why he wants an aesthetic operation, what feature he wishes to have 'fixed' or 'repaired', what he demands of the operation and his own feelings on the matter. Following an aesthetic operation, the patient is the ultimate arbiter of the result; he is the best judge of what is best for himself. However, as the object of physical assessment, he is repaired and restored or reconstructed to achieve physical perfection as a result of the skill used by aesthetic surgeons with medical measures according to medical and aesthetic principles. Naturally, beauty should not be measured mechanically according to a rigid pattern, but should be assessed according to different individuals and their own characteristics. Consider the case of eyelid surgery. The doctor must design his operative plan carefully according to the facial features and individual demands of the patient. In a word, the doctor and his patient together participate in and deliberate on the requirements of the operation as an enhancement of physical beauty. In other words, the matter is between the doctor and his patient, it is not solely within a doctor's, or a client's, or even a group of doctors' discretion. But one thing that must never be forgotten is that the assessment of beauty is not only how the patient looks to the surgeon, nor a comparative analysis of before and after photos, but whether the aesthetic operation is satisfactory to the patient himself. If the patient expresses pleasure in the operative result then the patient's pursuit of beauty has been achieved. WHAT PROCEDURES TAKE PLACE BEFORE A CLIENT EVENTUALLY UNDERGOES AESTHETIC MEDICINE?
Firstly, the client must explain to the doctor why she (or he) wants an aesthetic operation and what feature she wishes to have 'fixed' or 'repaired'; secondly, the cosmetic surgeons are advised to question carefully what are the patient's hopes and fears and
to analyse her reasons for wanting the operation before offering her an aesthetic diagnostic suggestion; thirdly, it is important to carefully design an aesthetic operative plan; fourthly, an agreement must be signed before an aesthetic operation; fifth, to perform the aesthetic operation; sixth, observe the operative result carefully and visit the patient at any time to see whether the cosmetic end result is normal or satisfactory. If an 'unsatisfactory' result appeared, the client has a right to ask for reparation according to the agreement, but this needs the involvement of the department concerned. Of course, every client must pay the doctor if she (he) needs an aesthetic operation for alteration of his/her appearance, but how much he/she will pay varies from city to city. For example, an eyelid operation (recently popular in China) ¥500 to 2000 was required in coastal cities such as Guang Dong and Fu Jiang, ¥200 to 300 in big cities such as Beijing and Shanghai, and only ¥100 in small cities. So the salaried middle classes are able to afford the operation. NECESSITY OF THE FORMATION OF MEDICAL AESTHETICS AND COSMETOLOGY
Human beings recognise beauty in their own creations and in nature, but most of all each individual sees it (or its lack) in himself. More and more people hope to alter their appearance and bodily form, in order to achieve perfection of both health and beauty through surgical methods. An investigation in Xian, China in 1991 showed that the average number of patients is 7036, which is 2.2% of the whole number of out-patients in one month in this city, and that there is a trend of continuously increasing [7]. The public not only require damaged areas of skin to be restored or the removal of the outward signs of ageing and the removal of blemishes but also they wish the perfection of individual beauty to be achieved or reconstructed, in other words, to obtain perfection in both health and beauty. This trend is becoming a social foundation for the definition and development of 'medical aesthetics' and 'cosmetology'. The definition and development of medical aesthetics and medical cosmetology is in accordance with the trend towards consolidating current scientific methods. With the trend, some traditional medicine is gradually dividing into several new branches relating to the maintenance of physical beauty and repairing or altering the appearance and bodily form. It is also directed at removing blemishes and reconstructing the perfection of individual beauty, such as aesthetic surgery, a new branch of plastic surgery; prosthetic surgery, a new branch of plastic surgery and osteoiogical surgery; skin cosmesis, a new branch of dermatology; medical aesthetics in oralogy, a new branch of stomatology; nursing aesthetics, a new
The rise and prospects of medical aesthetics branch of nursing; physical cosmetic techniques, a new branch of physiatrics, etc. These new branches, all deriving from different traditional medicine, face a common object--the beauty of the human body, and have a common aim--achieving beauty on the basis of health, that is to say, achieving perfection of both the health and beauty of the individual. The common object and aim will be to support each new branch in order to become a systematic science. One point not to be ignored: Current medicine is at a specific stage of transformation from a biological medical model to a biology-psychology-social medical model. It reminds us how to recognise the general goal of medical study and practice. The old biological medical model proceeds exclusively from the human biological character and aims at meeting human physiological needs, that is, maintaining human existence or preventing people from dying, but the new medical model tries hard to meet human requirements and needs, and hopes to approach this from all aspects such as biological, psychological and social. It aims at improving the quality of health and beauty, improving human vitality, achieving the perfection and unity of both health and beauty. We take this to be the higher goal of development of medicine, generating the formation and development of medical aesthetics and cosmetology and causing this rising science to become one of the leading subjects in future medical structures [8]. As was stated above, medical aesthetics and its applied branch--medical cosmetology--have three specific characters: (1) They define their object of study--the beauty of the human body which past traditional medical approaches failed to do. (2) They aim at meeting the demands of the pursuit of physical beauty of the individual through cosmetic surgery. (3) The medical methods which they use come from clinical medicine, preventive medicine, and recu-
1201
perative medicine and are combined with different aesthetic practices on the basis of traditional techniques. Generally speaking, preventive medicine aims at preventing illness from occurring and keeping people healthy, its 'customers' are 'healthy people'. Clinical medicine aims at treating the patient for his illness, healing the wounded and rescuing the dying, its 'customers' are 'sick people'. Recuperative medicine aims at helping these malfunctional or disordered people to return to normal or near normal conditions, its 'customers' are 'recuperating people'. In fact, there are some 'people who are healthy but not beautiful', they belong to the 'people failing to achieve both health and beauty' and are called 'pursuers of beauty', they have a strong need to alter their appearance and bodily form through aesthetic methods of surgery to achieve the perfection of individual beauty. They are undoubtedly a group of special customers. Who serves this group of customers? Aesthetic doctors have shouldered the heavy load. REFERENCES
1. Peng Qingxing and Chang Zhenlu. Discussion on the development of medical aesthetics. J. Tong Ji Med. Sci. Univ. Wuhan (Social Scientific Edition) 2, 98, 1990. 2. Peng Qingxing. Medical aesthetics and medical cosmetology. J. Med. Phil. Dalian 3, 37, 1991. 3. Peng Qinxing. The relation of medical aesthetics and medical cosmetology. J. pract, aesthetic Plastic Surgery, Shengyang 1, 43, 1991. 4. Peng Qinxing.Medical Aesthetics in development. Aesthetic J. Chin. Med. Aesthetics. Xian 1, 6, 1993. 5. Guo Tianwen. The rising of medical aesthetics. Aesthetic J. Chin. Med. Aesthetics. Xian 1, 6, 1993. 6. Peng Qinxing. The general contents of medical human body's beauty. J. Med. Phil. Dalian 8, 44, 1992. 7. Lu Kaihua et al. The investigation and analysis on the current condition of aesthetic plastic surgery in Xian city. J. aesthetic Plastic Surgery 3, 60, 1991. 8. Peng Qinxing. A new rising subject--medical aesthetics. J. reed. Educ. Beijing l, l, 1990.
~
Pergamon
0277-9536(95)00162-X
Elsevier ScienceLtd. Printed in Great Britain
THE RISE A N D PROSPECTS OF M E D I C A L AESTHETICS P E N G Q I N G X I N G , W A N G X U E and Z H A O J I A Y E Yichun Medical College, Jiangxi 336000, People's Republic of China Abstract--Since the 1980s, Chinese scholars have been trying to expound and synthethise elementary aesthetical ideas which occur in medicine, in order to treat this area of study as a defined branch of medicine--'medical aesthetics'. It is in this context that the points discussed in this paper arise. We set forth in detail the ideas, objectives and methods adopted within the framework of medical aesthetics and its applied branch--medical cosmetology and expound the relations between them. We think the task of medical aesthetics is to study the human body in its entirety, concentrating on both internal and external beauty and put the findings into practice, whereas the task of medical cosmetology is to study and assess only the external beauty of the human body and to take action on that basis. Medical cosmetology is the enforcement of medical aesthetics, practised in order to give positive results connected with physical beauty, and is therefore easily understood by the layman. It is known that the development of medical cosmetology represents an important breakthrough in the development of medical aesthetics. We think that beauty should not be measured mechanically, always following the same pattern, but that it should be considered individually with everyone's own particular characteristics. The quality of physical attractiveness should be assessed jointly by the doctor and his patient or client, not solely by either of these individuals nor even by a group of doctors. The necessity of defining and developing both medical aesthetics and medical cosmetology arises largely as a result of the increasing numbers of people who pursue beauty and health and is in accordance with the trend for consolidating different aspects of modern science. A main objective of medical advance is to improve the quality of health and beauty; to enhance the quality of life and encourage human beings toward achieving perfection in both health and beauty. We predict that in the future medical aesthetics and medical cosmetology will be amongst those subjects considered to be of major importance in the medical field. We have at last reached a stage where we can define the intentions and applied measures of medical aesthetics and medical cosmetology which differ from those of clinical medicine, preventive medicine, or recuperative medicine. Key words--medical aesthetics, medical cosmetology, medical beauty, the beauty of the human body
INTRODUCTION Medical progress is increasingly directed towards the major purpose of prolonging life, tending towards an approach involving aesthetics, along with a reappraisal of the role of medicine and a renewed definition of 'health' in general. With the recent method of bringing aesthetics into the field of applied science, medicine and aesthetics unite. 'Medical aesthetics' has recently appeared in the Orient as a subject of rising importance.
THERISEOFMEDICALAESTHETICSIN CHINA The pursuit of physical beauty is as old as human history. Mankind has always admired the youthful and the attractive. The ancient Greeks prayed to the solar god or god of medicine, Apollo, for health and happiness and brightness. There were records of 'music being used to treat the patient's illness' in ancient medicine in Greece, China and India. During the Renaissance in Europe, anatomist and artist,
Leonardo Da Vinci surveyed precisely the aesthetic parameters of the structure of the human body. All these reflect the absorption of beauty. Nowadays we are bombarded with advertisements for pills, creams, lotions, and other devices that will smooth our wrinkles or leave the hair soft and glossy. Until recently, the only way to get close to beauty was to be born beautiful or to marry someone who was. Current events have revealed a new choice--buy it. A new surgical specialty (called variously aesthetic or cosmetic) has sprung up to fill and meet an unprecedented but still growing demand. This accounts for the common perception that beautiful people get ahead in life, love and business. People in ancient times did not study medical aesthetics, as an individual subject; they only had a desire for beauty, they also had simple ideas about beauty and judgement of beauty. Modern people have developed and synthesized these elementary aesthetic ideas into a systematic science, that is to say, nowadays more and more people study it as a systematic science of medical aesthetics and cosmetology.
1197
1198
Peng Qingxing et al.
Chinese scholars of the 1980s combined medicine with aesthetics as a science and developed a systematic method of research on the subject. They published many articles to discuss the problems of medical aesthetics. For example, in 1982, in the 8th issue of Medicine and Philosophy, Zhao Denwei published his article, "Music, Medicine with Other Things". Later Zhao published his "Biochemistry and Aesthetic" in the second issue of Live Chemistry in 1983. In 1985, in the issue of Medicine and Philosophy, Hu Changxing published his "Medical Art and Medical Science" and Meng Xianwu published "Medicine Seeking Beauty". These articles attracted much attention in both the Chinese medical and aesthetic fields. A fervour for writing and studying medical aesthetic principles was unleashed. In June 1988, a book, "Medical Aesthetics", by Qiu Lingzhi and Peng Qingxing, was published. In November 1989 another book of the same title, by Ding Huishui, was published. Subsequently, various editions of works such as "Aesthetics and Nursing", "Aesthetics on Traditional Chinese Medicine", "Aesthetics on Pharmacology", "Medical Cosmetology" and "Medical Aesthetics on Oralogy", were published, totalling more than 50 [1]. At the same time, such periodicals as the Chinese Medical Aesthetic Bulletin, Journal of Chinese Medical Aesthetics and Cosmetology, Popular Scientific Journal of Medical Aesthetics and Cosmetology, Popular Practical Journal of Aesthetic Plastic Surgery and Journal of Clinical Cosmetology, were printed and published either then or later. Since the 1980s, in China many clinical institutions and treatment centres have applied medical aesthetic techniques to cases, either conscientiously or unconscientiously. Every large hospital carries out the practice of clinical cosmetic techniques. Up to the present, more than 20 medical colleges such as Dalian Medical University, Yichun Medical College, Sihezi Medical University offer courses on medical aesthetics and cosmetology. On 15 November, 1990, a Branch of the Medical Aesthetics and Cosmetology of Chinese Medical Association was founded.
THE CONCEPTION,SYSTEMAND STRUCTUREOF MEDICALAESTHETICS What is medical aesthetics? What are its objectives, systems and structure? Generally speaking [2-5] medical aesthetics is a science developed to maintain or protect against impairment, the beauty of the human body and to reconstruct or alter the appearance and structure of the body. It is also developed to remove blemishes and to reconstruct the perfection of individual beauty with various medical measures according to medical and aesthetic principles. It aims to improve human vitality and sense of beauty. It has
the nature of both humanitarian and technical studies. The reason why it has this dual nature is determined by its intimate relation with traditional aesthetics and its extensive application of medical techniques. It can be applied to such fields as those of cosmetic surgery, nursing, pharmacology and hospital management. It can also be applied in the medical practices of prevention, treatment and surgery. The basic principles studied by medical aesthetics are beauty and theories on beauty, that is, medical beauty and an assessment of beauty with medical and aesthetic measures and principles. What is meant by medical beauty is the beauty of the human body (or physical beauty); health and beauty of the human body. It concerns medical theories and practice for maintaining, achieving and reconstructing this special type of beauty 'physical beauty'--which is the core of medical beauty. The basic forms of medical beauty are divided into four categories, namely, medical natural beauty, medical social beauty, medical artistic beauty and medical scientific beauty. By medical judgement on beauty we say it relates to a sense of pleasure achieved by looking at beautiful things and identifying the requisites for medical beauty and it is an assessment of beauty on the basis of intuition with medical and aesthetic principles. The systems of medical aesthetics are on the facing page. THE CONCEPTIONOF MEDICALCOSMETOLOGYANDITS RELATIONWITH MEDICALAESTHETICS Among the series of subjects mentioned above, medical cosmetology is generally regarded as a 'breakthrough' in the development of the whole of medical aesthetics. Because the application of medical cosmetic techniques is directly perceived through the senses and easily accepted by the public, it is the practice of medical beauty which can directly provoke people's sense of beauty. What is 'medical cosmetology'? Medical cosmetology (also called medical cosmetics) is a new rising medical subject specifically designed to maintain human external beauty, to repair damaged areas and remove blemishes, to reconstruct the perfection of individual beauty by a combination of medical and aesthetic methods. It aims at improving the human vitality and sense of beauty. It is combined with several clinical and non-clinical studies, application (or practice) is regarded as its important characteristic. In view of the above statement, we can say that the factors studied by medical cosmetology are the external beauty of the human body, and all those medical techniques, facilities, practices and basic theories which are adopted for maintaining, achieving and reconstructing it. Through studying, we concluded that the beauty of the human body is composed of
The rise and prospects of medical aesthetics Medicine---,
Medical aesthetics
1199 *-Common aesthetics
The list of basic theory of medical aesthetics
The list of application of medical aesthetics
The list of aesthetics of medical art
Medical aesthetic conception and object and system
Clinic medical aesthetics (including aesthetics of eugenics Technique of medical aesthetics
Aesthetics of medical specimen Aesthetics of medical model
Medical aesthetic history Thought, ideas of medical Aesthetics of medical Aesthetic appreciation prevention, health, environment Psychological mechanism of Aesthetics on nursing medical aesthetic appreciation Medical human body's aesthetics Methods of study of medical aesthetics, etc. Medical cosmetology (including
Aesthetics of medical hanging chart
Medical aesthetics on
illustration, etc.
Aesthetics about pharmacology Medical aesthetics on recover Aesthetics of medical experiment
aesthetic health, aesthetic surgery, aesthetic medicine aesthetics of instruments, etc.) Education and accomplishment of medical aesthetic appreciation
two things; one is the 'external beauty' such as the beauty of bodily form, physique, appearance (or looks), movement, etc., the other one is the 'internal beauty' such as beauty of function and temperament, etc. [6]. 'Cosmetics' aim at changing this 'external beauty' by cosmetic measures. Now many people want to have both youth and beauty. The young want to change their appearance because they are dissatisfied with their 'external beauty' such as looks (or face), they hope for beauty achieved by alteration using cosmetic measures such as operation, massotherapy, and physiotherapy. Comparing the definitions and explanations above, we find a natural association between medical aesthetics and medical cosmetology, they both aim to maintain, achieve and reconstruct the beauty of the human body; they aim at improving human vitality and sense of beauty. But there are three differences between them: (1) The basic factors studied by medical aesthetics are medical beauty and medical theories on beauty. In other words, the principle behind it is the beauty of the human body in its entirety, including the 'internal' beauty and 'external' beauty, because this is the core of 'medical beauty'. Whereas the factors studied by medical cosmetology are 'external beauty' of the human body and all medical techniques, facilities, measures and practices adopted for
cosmetic purpose such as operation and massotherapy. (2) 'Medical aesthetics' is a science intended to study and improve the beauty of the human body, to increase the sense of beauty in life, from the aspects of physiology, psychology and social adaption. 'Medical cosmetology' on the other hand is designed to improve the beauty of the human body and sense of beauty in life in accordance with formal beauty, and it aims to solve aesthetic problems about psychology and social adaption. (3) 'Medical aesthetics' is a science with the dual characteristics of humanitarian and technical studies, in other words it deals with both theoretic and practical qualities. Medical cosmetology, on the other hand, regards only application (or practice) as its character, that is to say, it shoulders the task of performing cosmetic operations. By comparing the two concepts of medical aesthetics and cosmetology, we find that the former is wider than and incorporates the latter.
HOW IS BEAUTY MEASURED OR COMPARED?
In order to answer this question, consider an example: An attractive 22 year old girl is selfconscious about her flat nose and feels that it has curtailed her career opportunities and consequently she wants to be reconstructed. Accordingly, she
1200
Peng Qingxing et al.
presents at the plastic surgeon's office. After the operation she feels that her appearance has been improved and consequently feels very good about herself. Feeling good about oneself often implies that a result is satisfactory. Moreover, the surgeon (or doctor) considers the operation to be a success as it makes the girl look better and allows her to feel good about herself. In this case, both the doctor and his patient are involved, consequently the assessment of the girl's beauty should be between those two individuals. Thus we maintain that beauty can be assessed or measured between the doctor and his patient because the matter involves them both. We should conclude that every person in the medical field, including medical practitioners and patients, are both the subject and object of the assessment of physical perfection. Consider, for example, a client as the subject of the assessment of physical attraction. Before the operation he will tell the doctor why he wants an aesthetic operation, what feature he wishes to have 'fixed' or 'repaired', what he demands of the operation and his own feelings on the matter. Following an aesthetic operation, the patient is the ultimate arbiter of the result; he is the best judge of what is best for himself. However, as the object of physical assessment, he is repaired and restored or reconstructed to achieve physical perfection as a result of the skill used by aesthetic surgeons with medical measures according to medical and aesthetic principles. Naturally, beauty should not be measured mechanically according to a rigid pattern, but should be assessed according to different individuals and their own characteristics. Consider the case of eyelid surgery. The doctor must design his operative plan carefully according to the facial features and individual demands of the patient. In a word, the doctor and his patient together participate in and deliberate on the requirements of the operation as an enhancement of physical beauty. In other words, the matter is between the doctor and his patient, it is not solely within a doctor's, or a client's, or even a group of doctors' discretion. But one thing that must never be forgotten is that the assessment of beauty is not only how the patient looks to the surgeon, nor a comparative analysis of before and after photos, but whether the aesthetic operation is satisfactory to the patient himself. If the patient expresses pleasure in the operative result then the patient's pursuit of beauty has been achieved. WHAT PROCEDURES TAKE PLACE BEFORE A CLIENT EVENTUALLY UNDERGOES AESTHETIC MEDICINE?
Firstly, the client must explain to the doctor why she (or he) wants an aesthetic operation and what feature she wishes to have 'fixed' or 'repaired'; secondly, the cosmetic surgeons are advised to question carefully what are the patient's hopes and fears and
to analyse her reasons for wanting the operation before offering her an aesthetic diagnostic suggestion; thirdly, it is important to carefully design an aesthetic operative plan; fourthly, an agreement must be signed before an aesthetic operation; fifth, to perform the aesthetic operation; sixth, observe the operative result carefully and visit the patient at any time to see whether the cosmetic end result is normal or satisfactory. If an 'unsatisfactory' result appeared, the client has a right to ask for reparation according to the agreement, but this needs the involvement of the department concerned. Of course, every client must pay the doctor if she (he) needs an aesthetic operation for alteration of his/her appearance, but how much he/she will pay varies from city to city. For example, an eyelid operation (recently popular in China) ¥500 to 2000 was required in coastal cities such as Guang Dong and Fu Jiang, ¥200 to 300 in big cities such as Beijing and Shanghai, and only ¥100 in small cities. So the salaried middle classes are able to afford the operation. NECESSITY OF THE FORMATION OF MEDICAL AESTHETICS AND COSMETOLOGY
Human beings recognise beauty in their own creations and in nature, but most of all each individual sees it (or its lack) in himself. More and more people hope to alter their appearance and bodily form, in order to achieve perfection of both health and beauty through surgical methods. An investigation in Xian, China in 1991 showed that the average number of patients is 7036, which is 2.2% of the whole number of out-patients in one month in this city, and that there is a trend of continuously increasing [7]. The public not only require damaged areas of skin to be restored or the removal of the outward signs of ageing and the removal of blemishes but also they wish the perfection of individual beauty to be achieved or reconstructed, in other words, to obtain perfection in both health and beauty. This trend is becoming a social foundation for the definition and development of 'medical aesthetics' and 'cosmetology'. The definition and development of medical aesthetics and medical cosmetology is in accordance with the trend towards consolidating current scientific methods. With the trend, some traditional medicine is gradually dividing into several new branches relating to the maintenance of physical beauty and repairing or altering the appearance and bodily form. It is also directed at removing blemishes and reconstructing the perfection of individual beauty, such as aesthetic surgery, a new branch of plastic surgery; prosthetic surgery, a new branch of plastic surgery and osteoiogical surgery; skin cosmesis, a new branch of dermatology; medical aesthetics in oralogy, a new branch of stomatology; nursing aesthetics, a new
The rise and prospects of medical aesthetics branch of nursing; physical cosmetic techniques, a new branch of physiatrics, etc. These new branches, all deriving from different traditional medicine, face a common object--the beauty of the human body, and have a common aim--achieving beauty on the basis of health, that is to say, achieving perfection of both the health and beauty of the individual. The common object and aim will be to support each new branch in order to become a systematic science. One point not to be ignored: Current medicine is at a specific stage of transformation from a biological medical model to a biology-psychology-social medical model. It reminds us how to recognise the general goal of medical study and practice. The old biological medical model proceeds exclusively from the human biological character and aims at meeting human physiological needs, that is, maintaining human existence or preventing people from dying, but the new medical model tries hard to meet human requirements and needs, and hopes to approach this from all aspects such as biological, psychological and social. It aims at improving the quality of health and beauty, improving human vitality, achieving the perfection and unity of both health and beauty. We take this to be the higher goal of development of medicine, generating the formation and development of medical aesthetics and cosmetology and causing this rising science to become one of the leading subjects in future medical structures [8]. As was stated above, medical aesthetics and its applied branch--medical cosmetology--have three specific characters: (1) They define their object of study--the beauty of the human body which past traditional medical approaches failed to do. (2) They aim at meeting the demands of the pursuit of physical beauty of the individual through cosmetic surgery. (3) The medical methods which they use come from clinical medicine, preventive medicine, and recu-
1201
perative medicine and are combined with different aesthetic practices on the basis of traditional techniques. Generally speaking, preventive medicine aims at preventing illness from occurring and keeping people healthy, its 'customers' are 'healthy people'. Clinical medicine aims at treating the patient for his illness, healing the wounded and rescuing the dying, its 'customers' are 'sick people'. Recuperative medicine aims at helping these malfunctional or disordered people to return to normal or near normal conditions, its 'customers' are 'recuperating people'. In fact, there are some 'people who are healthy but not beautiful', they belong to the 'people failing to achieve both health and beauty' and are called 'pursuers of beauty', they have a strong need to alter their appearance and bodily form through aesthetic methods of surgery to achieve the perfection of individual beauty. They are undoubtedly a group of special customers. Who serves this group of customers? Aesthetic doctors have shouldered the heavy load. REFERENCES
1. Peng Qingxing and Chang Zhenlu. Discussion on the development of medical aesthetics. J. Tong Ji Med. Sci. Univ. Wuhan (Social Scientific Edition) 2, 98, 1990. 2. Peng Qingxing. Medical aesthetics and medical cosmetology. J. Med. Phil. Dalian 3, 37, 1991. 3. Peng Qinxing. The relation of medical aesthetics and medical cosmetology. J. pract, aesthetic Plastic Surgery, Shengyang 1, 43, 1991. 4. Peng Qinxing.Medical Aesthetics in development. Aesthetic J. Chin. Med. Aesthetics. Xian 1, 6, 1993. 5. Guo Tianwen. The rising of medical aesthetics. Aesthetic J. Chin. Med. Aesthetics. Xian 1, 6, 1993. 6. Peng Qinxing. The general contents of medical human body's beauty. J. Med. Phil. Dalian 8, 44, 1992. 7. Lu Kaihua et al. The investigation and analysis on the current condition of aesthetic plastic surgery in Xian city. J. aesthetic Plastic Surgery 3, 60, 1991. 8. Peng Qinxing. A new rising subject--medical aesthetics. J. reed. Educ. Beijing l, l, 1990.