Talk:Cosmetic surgery

This article is in progress. I'm putting some references in the outline of the article that I plan to come back to very shortly. The overall idea is to not only present an accurate narrative introduction to this field of surgery, but to do so while presenting the idea that "beauty is in the eye of the beholder"- with references!. Nancy Sculerati MD 14:57, 21 February 2007 (CST)

Should be at cosmetic surgery, right? It's not usually capitalized, is it? --Larry Sanger 08:47, 22 February 2007 (CST)

I don't know how to answer that. The field of Cosmetic Surgery is capitalized, but if a person was to undergo cosmetic surgery procedure it is not capitalised. That is true of Plastic Surgery, the field, the residency program-and Surgery, the field (discipline) as well. The field of Medicine, Surgery etc are always capitalized. If I am looking up one of those topics on a search engine, I always capitalize it.Nancy Sculerati MD 09:00, 22 February 2007 (CST)

I think you've answered it, but the issue would then be if one is describing surgery that is done to achieve a cosmetic effect, or whether one is giving an overview of the speciality named (Reconstructive and) Cosmetic Surgery. Since you in the first sentence define the article as being about the field, I'd be comfortable with the capitals. We are going to have the same problem with all the speciality fields of medicine, so at some time one would have to decide about a policy. On the other hand, if it makes no difference to a search for a subject, then it is probably of minor importance - the CZ engine does not seem to mind much, it picks up this article as a first hit for "cosmetic surgery". There is a Plastic Surgeon on board who might wish to wade in: User:Andy Wongworawat. That picture of Jackie looks like a Victorian ghost photograph on my screen, but the comment is right on. I like the outline/sections at this stage. --Christo Muller (Talk) 09:26, 22 February 2007 (CST)

Let us suppose that we are using the Chicago Manual of Style. My copy is packed away in a box... Anyway, the question here is whether names of disciplines are properly capitalized, in general. CMS might shed some light anyway. Often one does see Philosophy, particularly when one is speaking of the field as something formally studied (so, we usually say "Ph.D. Philosophy" rather than "Ph.D. philosophy"). But of speaking of the body of problems and literature about them, and about particular philosophies, we use "philosophy."

If this is correct, then the question is whether, when giving a title to a topic that can be either capitalized (when naming a discipline) or not (when naming what the discipline studies), which should we give it? Well, we may take the Biology article as an excellent example. I think we can agree that its first focus is on what Biology studies, but it nevertheless is organized around what the article calls a "formal science." (By the way, Biology is not a formal science; formal sciences include logic, mathematics, and parts of statistics and computer science. The better phrase in that case would be "scientific discipline.") So, as long as we make it a general habit of focusing articles on these topics at least nominally on the discipline, rather than on what the discipline studies, then we could use the upper case. --Larry Sanger 09:40, 22 February 2007 (CST)

I went shopping at Wikipedia Commons to find pictures, and I liked that portrait because the artist emphasized the square angle of her jaw. But maybe the quality is too poor to use? Nancy Sculerati MD 09:39, 22 February 2007 (CST)

I intuitively prefer a title to be uppercase. To take your philosophy example, if we had an article about "Athenian philosophy", it reads differently to me from "Athenian Philosophy", the former seeming to indicate thinking in the Athenian way, the latter indicating a School of Thought, so to speak (what about Citizendium pilot vs Citizendium Pilot?). As you say, if the focus is on the discipline as an entity, and the discipline is defined reasonably early on in the article, then the uppercase would be appropriate.

I'm sure we'll find clearer pictures, Nancy, but suggest you leave her as is, so that others can see what you wish to illustrate. It is a good example --Christo Muller (Talk) 13:54, 22 February 2007 (CST)

OK now I must ask, Nancy: why Cosmetic Surgery but plastic surgery? --Larry Sanger 11:49, 26 February 2007 (CST)

Top-down sequence of sections?

I was thinking about the rather random way in which articles about cosmetic surgery are structured. Generally they seem to go from major to minor, or common to uncommon. But we have a body to work with, so one can sequence things in the way one sees the body. For the sections describing the specific areas, my suggestion for a general top-down article structure would be:

• Facial Cosmetic Surgery
  • Whole face; hair transplant; forehead; eyes; nose; ears; cheeks; lips; chin; jaw; neck
  • (For each?) Tissue resection; implants; injections
• Facial Rejuvenation
  • Injections: Botulinum toxin; fillers
  • Resurfacing: Dermabrasion; Chemical Peels; Laser
  • Thermage (a trademark?)
• Body Contouring
  • Arms: lift
  • Breasts: Reduction; Lift; Implants; Gynecomastia
  • Abdomen: Abdominoplasty; suction
  • Hips and thighs: Liposuction; Implants; Lift
  • Calves: Lift
• Sclerotherapy - could fit in anywhere one wants veins reduced, bottom of legs common.

The sections clearly have some overlap, specifically as far as the face work is concerned, but this would give something to hang the content on. --Christo Muller (Talk) 14:09, 22 February 2007 (CST)

I'm happy with that- there will be a Reconstructive Surgery article as well, working on them in parallel. Nancy Sculerati MD 14:32, 22 February 2007 (CST)

Tone

I took the liberty of cleaning up the first section. The section was a long diatribe against our society's current tendency to proceed willy-nilly with cosmetic surgery. While I agree that cosmetic surgery has become a disgusting free-for-all, I'm not sure a diatribe against that belongs in a scholarly reference material. I'm not sure that CZ has as strict a policy about NPOV as wikipedia, but maybe a lot of the ethical background is better reserved for a medical ethics article. I thought a lot of the key points of the diatribe could be summarized in a set of bullet points, or someone can make a table. A long narrative about the complexities of patient selection for cosmetic surgery is probably better off in an editorial, unless it can be referenced by the literature. For example, maybe a section on the psychology of cosmetic surgery would be an interesting feature of the article. Just my $.02.--Michael Benjamin 14:36, 25 February 2007 (CST)

Citations

I think we should use the tools granted by MediaWiki for citations. There is a website that allows you to input a PMID and get back a "Wikified" citation template. For example, PMID 12447085 turns into "Isenberg J (2002). "The legacy of Narcissus". Plast Reconstr Surg 110 (7): 1815; author reply 1815-6. PMID 12447085. ", then you put \<ref\> \</ref\> (take the backslashes out) markups around that, and finally you put at the end of your page to print the references. The page for the template generation is: http://diberri.dyndns.org/wikipedia/templates/?type=pmid. This way we can establish a uniform system for citing references.

I think this article will be adequate when it has about 200 references. So far, we have 8. It's such a broad topic that you could spend a week just writing about saline breast implants, for example.

Lips

I think there's a lot of subjective stuff here, most of which is not that scientifically valuable. I deleted some, but if we want the rest to remain here, it should really be cited. As it stands now, a bunch of the info is unsubstantiated opinion. While a discussion of the differences between Grace Kelly's and Angelina Jolie's lips, for example, may be suitable for the pages of People magazine, readers of an encyclopedia may not benefit much from that knowledge.--Michael Benjamin 19:23, 25 February 2007 (CST)

This article is entitled Cosmetic Surgery and I disagree that a discussion of aesthetics and patient selection is "unscientific". The reason Angelina Jolie and grace Kelly are used is because there are pictures available, and because it is possible to refer to both women in a respectful manner while making an important point. The whole point of cosmetic surgery is subjective. The sections on patient selection and scope of surgery are very important, and are the topics that are stressed in the training of cosmetic surgeons, as well as focused on in the literature. I am sorry that they have been removed, and the tome taken about their removal offends me because of its arrogance. I don't know who wrote the above statement denigrating the value of what I have written, but the points being made in the comment show a lack of experience and training in cosmetic surgery. For example, the discussion of the aesthetics of the ideal feminine lips, and how those ideals are culturally biased, are standard in the field. Further, the most important aspects of cosmetic surgery. as important as actual techniques, lay in choosing patients who will benefit, and tailoring the appropriate operation for each. I do not know why these topics have been deleted and find it very frustrating to find the article changed in this manner. I have only done a few dozen cosmetic procedures myself, but have had close interactions in two of the most respected Plastic Surgery programs in the United States over a period of many years, and spent hundreds of hours in the operating rooms and in the surgeon's lounges discussing these issues, I have read the literature -much of which was written by the colleagues with whom I have had these discussions with, and, again, I do not understand why this article has been gutted. If you look at my plan for the article, it was to present cosmetic surgery in a form that was understandable to lay people and interesting to professionals. I find collaboration stimulating, but not "correction" of the beginnings of a legitimate article in this fashion. Nancy Sculerati MD 18:51, 25 February 2007 (CST)

No disrespect intended, certainly, but a lot of what you included in the original draft of the article was based on unsubstantiated opinions. I thought the whole point of Citizendium was to get away from the anticredentialism of wikipedia--the net result is that wikipedia is an amateurish document full of unsubstantiated opinions. The value of the scientific literature is that it is referenced--one may see where a particular idea comes from and read more about it from the source material. I think that's a valuable concept for an encyclopedia, and it's one that was not present in the article. You can see that I added placeholders for the statements you made on the page that could use citations. The fact that I happen to agree with a lot of your opinions did not make those opinions relevant for inclusion in the article, in my opinion. --Michael Benjamin 19:43, 25 February 2007 (CST)

You asked me to edit this article, and I took that to mean that you wanted serious critical review. As it says below, "If you don't want your writing to be edited mercilessly and redistributed at will, then don't submit it here." --Michael Benjamin 19:43, 25 February 2007 (CST)

I also thought that an important principle here is "neutral point of view." To me, this means that the author should take a tone of not coming down on one side of an issue or another, only presenting facts as reported in scientific literature. Again, I find that this article had a lot of problems with maintaining a neutral tone.--Michael Benjamin 19:43, 25 February 2007 (CST)

I think finding citations in the literature for your thoughts would make the article much stronger, and would make it less like original work (with certainly a lot of merit as such), and more like the reference piece it purports to be. Perhaps the piece should focus on more fact-based information, such as different techniques of cosmetic surgery and the history of the field, and less on long discussions of the psychology of cosmetic surgery and patient selection. Resources for patients are valuable, but so is providing information based on objective facts.

I do not represent myself to be an expert in cosmetic surgery--if you look at my talk page you will see that I am board certified as an internist, hematologist, and oncologist. My board certification and experience only count for so much, though. Even a credentialed expert, even one who has had long discussions in doctors lounges, and even one who has performed many of the procedures they are writing about can produce unsubstantiated opinion; the trick is to find justification for one's opinions in the literature!--Michael Benjamin 19:43, 25 February 2007 (CST)

If you disagree with my edits, it's relatively easy to revert them to the original using the history button. Your words are not lost forever when I edited the article. I do not intend to get into a "revert war" with you; if you can't live with my criticism, I will back off and leave your pages alone. I think I have made some valid arguments about why I did what I did, but if you don't agree that my reasoning here makes the Citizendium project stronger, feel free to edit your articles in any way you see fit. --Michael Benjamin 19:43, 25 February 2007 (CST)

A new start

I'd hate to revert because some of the things you've added, Michael, are important and I didn't think of them- if I revert, I might forget to put them back and so I will replace what I feel must be replaced. The topic of patient selection is not besides the point in Cosmetic Surgery but a major point that requires emphasis. Also, and I write this with a smile, the article should very much be of interest to the readers of People Magazine- as well as to Cosmetic surgeons. Some of your corrections are just plain errors- reconstructive surgery is not "function" whereas cosmetic is "appearance", for example. A woman who has a partial mastectomy on one side for a tumor and a breast reduction on the other side to correct the assymetry has not had cosmetic surgery at all-but reconstructive surgery. A woman who had the identical appearance of the breasts who did not have a tumor but who underwent a bilateral mammoplasty might end up with nearly the same result- done strictly for "beauty", and that's pure cosmetic surgery.

1. The aspects of cosmetic surgery that are important to plastic surgeons and those that are important to patients, and to interested readers all should be covered.
2. The scope of this article is not likely to allow discussions of saline v other kind of implants, for example- but an article on Breast Implants could include that in detail

We've developed a way of collaboration on Citizendium that has been pretty workable- if somebody has made a reasonable start on an article, but another author or editor (and those are pretty much synonyms except to when it comes to approval) thinks there are errors or problems in style about what has been written- that gets discussed on the talk age, before or along with, changes. Additions to the text are always welcome, but even more welcome with some discussion. So please return and continue, and we can learn better how to work together. Nancy Sculerati MD 09:58, 26 February 2007 (CST)

reply to Larry

That's easy. I wrote the article title "Cosmetic Surgery" when starting the article, but Plastic surgery was an article or stub that got to Citizendium via Wikipedia at the start. ;-) Nancy Nancy Sculerati MD 12:10, 26 February 2007 (CST)

Well, we should make it all one way or the other, no? Or at some level of generality does the name of a medical process stop being the name of a discipline as well? --Larry Sanger 12:14, 26 February 2007 (CST)

I think it should be Plastic Surgery. Can you change it? Nancy Sculerati MD 12:53, 26 February 2007 (CST)

References

In Citizendium, we have been using footnoted references for quotes but not for statements that are generally accepted in the field. None the less, having a list of references is usefule nad important. In Snake venom, we kept a running list. It would be great if we could have a reference tab. Anyway- I'm starting a running list here of references read. Please add to it as needed.Nancy Sculerati MD 15:45, 26 February 2007 (CST)

Patient Selection

Edelstein J. Of chickens and red flags. [Editorial] Plastic & Reconstructive Surgery. 112(2):684-5, 2003 Aug. UI: 12900634 (editorial in which a plastic surgeon discusses ethics, funny)

Sarwer, David B. Ph.D. 1; Crerand, Canice E. M.A. 2; Didie, Elizabeth R. M.A. 2 Body Dysmorphic Disorder in Cosmetic Surgery Patients. Facial Plastic Surgery. Multi-Specialty Facial Plastic Surgery. 19(1):7-17, 2003.

Rohrich RJ. Mirror, mirror on the wall: when the postoperative reflection does not meet patients' expectations. [Journal Article] Plastic & Reconstructive Surgery. 108(2):507-9, 2001 Aug. UI: 11496196

Muhlbauer W. Holm C. Wood DL. The thersites complex in plastic surgical patients. [Case Reports. Journal Article] Plastic & Reconstructive Surgery. 107(2):319-26, 2001 Feb. UI: 11214044 (a surgeon's view of body dysmorphism- some case histories "aesthetic surgery addicts")

Perugi, G., Akiskal, H. S., Gianotti, D., et al. Gender-related differences in body dysmorphic disorder (dysmorphophobia). J. Nerv. Ment. Dis. 185: 578, 1997.

Anonymous. Aesthetic plastic surgery for teenagers: when is it appropriate?. [Journal Article] Plastic Surgical Nursing. 17(2):91-2, 1997. UI: 9275789 (Reviews guidelines from national organizations)

Hutchison RL. Patient selection caveats. [Letter] Plastic & Reconstructive Surgery. 98(3):575, 1996 Sep. UI: 8701008 (letter: discuses the cosmetic surgery patient who tries to hide underlying serious illness, along with humurous advice)

Ritvo, Eva C. M.D. 1,2; Melnick, Ilan M.D. 1,2; Marcus, Gina R. D.M.D. 3; Glick, Ira D. M.D. 4 Psychiatric Conditions in Cosmetic Surgery Patients. Facial Plastic Surgery. 22(3):194-197, August 2006.

Smoking

Netscher DT. Clamon J. Smoking: adverse effects on outcomes for plastic surgical patients. [Journal Article] Plastic Surgical Nursing. 14(4):205-10, 1994. UI: 7732100

Rohrich RJ. Coberly DM. Krueger JK. Brown SA. Planning elective operations on patients who smoke: survey of North American plastic surgeons.[see comment]. [Journal Article] Plastic & Reconstructive Surgery. 109(1):350-5; discussion 356-7, 2002 Jan. UI: 11786838