Plastic surgery derives its name from the Greek word plasticos, meaning "to shape" or "to mold." Today, "aesthetic surgery," often used interchangeably with "cosmetic surgery," is performed by specialists in plastic, reconstructive, and aesthetic surgery. Unlike reconstructive surgery or other surgical disciplines that treat diseases of organs or systems, aesthetic surgery is specifically focused on reshaping the body to enhance (beautify) a person’s appearance.
Aesthetic surgeons, who perform reshaping procedures on otherwise healthy individuals, require an unparalleled level of technical excellence and theoretical knowledge. Since their work is directly related to aesthetic perception, a plastic surgeon must have an understanding of what constitutes a universally positive aesthetic perception of the human body. In other words, because aesthetic surgeries are fundamentally about form and structure, they are inherently intertwined with artistic perception.
The Human Body and Aesthetic Concern
The relationship between the human body and the concept of aesthetics can be the subject of both subjective and objective evaluations. Regardless of the perspective, the pursuit of creating the "perfect representation of the human form" has been central to art—particularly sculpture and painting—since ancient civilizations. It is, therefore, inconceivable for an aesthetic surgeon to remain indifferent to the centuries-long effort of fine arts to establish positive aesthetic judgments.
Our Work Holds Artistic Value
Training in Plastic, Reconstructive, and Aesthetic Surgery is a lengthy process. During this period, residents gain practical experience in evaluating patients in clinics and operating rooms, preparing for surgeries, performing procedures, managing post-operative care, and following up with patients after discharge. However, neither during this training nor in legally permitted external clinical rotations is there formal education on concepts such as proportion, balance, symmetry/asymmetry, or dimensionality from an artistic perspective.
Yet, these artistic principles are integral to aesthetic surgery, whose primary aim is to reshape the body. The ability to bring artistic value to the profession depends on the surgeon’s personal efforts and knowledge.
Precision Planning in Aesthetic Surgery Determines Success
Since the subject of aesthetic surgery is living human tissue, many surgical maneuvers are irreversible. Therefore, careful planning is crucial. Aesthetic surgeons frequently use sketches to plan surgeries, explain procedures to patients and fellow surgeons, and mark the body before surgery. Although the ability to create proportionally accurate anatomical drawings is not a prerequisite for aesthetic surgeons, it provides a significant advantage.
Da Vinci Participated in Over Thirty Autopsies and Created Anatomical Drawings
When discussing drawing techniques and medicine, it is impossible to overlook Leonardo da Vinci. Though widely recognized for his contributions to painting, sculpture, and anatomy, Da Vinci (1452–1519) was also deeply involved in engineering, architecture, mathematics, and invention.
Despite not being a physician, Da Vinci defied the norms of his time by personally attending over thirty autopsies to create anatomical drawings. These sketches, which would serve as references for centuries, were near-perfect anatomical studies. He masterfully integrated his anatomical knowledge with mathematics, painting, and sculpture, producing timeless masterpieces.
The Significance of the Golden Ratio
It is well known that Da Vinci pursued mathematical perfection in his works, particularly through his study of the golden ratio.
While the exact origin of the golden ratio remains unknown, it was first documented by Euclid in the 4th century BCE. He described dividing a line at the point 0.618339... and referred to it as "dividing a line in an extreme and mean ratio." The golden ratio was incorporated into significant architectural structures, including the Great Pyramid of Giza and the Parthenon in Greece.
The Golden Ratio is Everywhere
Today, the number representing the golden ratio is known as the Phi (Φ) number. If we explain it using a line segment: a line between points A and B should be divided at a point C in such a way that the ratio of the smaller segment (AC) to the larger segment (CB) is equal to the ratio of the larger segment (CB) to the entire line (AB). This ratio equals approximately 1.618, known as the golden ratio.
The golden ratio appears everywhere, from the structure of DNA molecules to the shapes of massive galaxies. It also exists in the human body. For example, the ratio of the distance from the head to the navel (umbilicus) and from the navel to the feet is close to the golden ratio when compared to total body height. Similarly, the human face contains multiple golden ratios:
- A horizontal line passing through the tip of the nose and another between the lips divide the distance between the eyes and the chin according to the golden ratio.
- The width of the nose, the distance between the pupils and the tip of the nose, and the distance between the pupils themselves exhibit golden ratio relationships.
- In a profile view, various distances between the oral commissures, eyes, nose tip, eyebrows, and chin align with the golden ratio.
Of course, defining a single universal proportion for the aesthetic appeal of all human body forms is unrealistic. In fact, well-placed asymmetries and slight disproportions can enhance perceived beauty. Sometimes, an individual facial feature may not align with the golden ratio when analyzed in isolation, yet the face as a whole may still appear attractive and harmonious.
Nonetheless, a deep understanding of body and facial proportions provides aesthetic surgeons with valuable insight, allowing them to make more informed and precise decisions during surgery.
Aesthetic Surgery: A Balance of Science and Art
In surgical practice, technical knowledge and experience are of the utmost importance. While correcting deformities or addressing aesthetic concerns, a surgeon must strive for perfection while accounting for various factors, including patient expectations, societal perceptions, and the ever-evolving standards of beauty.
At this juncture, an artistic approach becomes crucial. Because anything devoid of art lacks completeness, and a truly holistic approach is only possible through artistry. This necessity is even more pronounced in the field of aesthetic surgery.
Assoc. Prof. Dr. Çağlayan YAĞMUR
Specialist in Plastic, Reconstructive, and Aesthetic Surgery
