Reply

Abstract

Sir: We are delighted that our article stimulated Dr. Singh's thoughtful response and positive comments. The idea of the article originated in a question first posed by Dr. Goldwyn when he wondered how common the practice was of plastic surgeons performing aesthetic surgery on family members. When my daughter, Sara, was considering topics for a senior year project in psychology, her undergraduate major, she reviewed the literature on this topic but could not identify publications in plastic surgery. Thanks to her diligence, and the cooperation of the American Society for Aesthetic Plastic Surgery, an investigative survey was conducted and this article emerged. We did not address specifically the issue of should (a moral judgment) plastic surgeons perform such procedures. Rather, we sought to identify the reasons—best plastic surgeon, financial incentives, surgeon's experience, and patient request—for these operations and their results. However, many important ethical issues can be raised in the context of this article relating to informed consent, management of complications, and burdens of judgment, and even guilt felt by the surgeon or patient. Thus, Dr. Singh's first point about whether we should be making patients out of lovers (or loved ones) is on the mark. That we hold our surgical skills and ourselves in such high esteem (above average, as one might say) is a reflection, I believe and hope, more of our arduous training than surgeon ego. Confidence in one's skills is a necessity; overconfidence and arrogance can be an undoing. We are gratified that our article has struck so many chords. Sumner A. Slavin, M.D. Sara A. Slavin, B.A. Brookline, Mass.