by Janet Z. Li

Graphic design by Josephine Choi

Surgical and restorative technologies, such as organ transplantation and graft procedures, have increased immensely in frequency over the last few decades. In 2020, there were an estimated 1.4 million cases of restorative intervention in the US, representing a 19% increase compared to 2019.^1,2 In the past, the vast majority of physical or surgical restorations have occurred out of necessity, such as in cases of injury, illness, or handicap at birth.³ However, there is increasing demand for aesthetic or ability-enhancing medical applications. Put simply, the process of human enhancement is evolving towards the goal of bypassing natural human limitations instead of creating equity.⁴ 

This trend comes with notable benefits but equally as many concerns. People like the idea of boosting human productivity by creating efficient workspaces, better work-life balance, and improving overall quality of life satisfaction.^3,4 However, human enhancement also comes with many potential ethical issues, including the endangerment of individual autonomy in the face of surgical improvement. Parents may opt to make their children “better than well” in a number of ways, ranging from biochemistry of height to aesthetics of eye color.⁴ Unjustified and irreversible changes could be forced upon individuals while others may experience the exact opposite, living in the unhappiness of unaltered normality. Yet, beyond ethics and social repercussions, there is an equally if not more significant concern in the psychological component of human enhancement that is less addressed.    

The rules of nature are ever evolving, changing, and adapting. We exist, as human beings, within the context of an environment that is in constant motion. And yet, humans tend to relentlessly strive for perfection. This idea in itself is an oxymoron, since the attainment of a “perfect” form would require us to live in static and highly controlled environment, which we know cannot succeed or sustain for long on a larger scale.⁵ Therefore, by holding tightly to the ideals of perfection, we are setting ourselves up to experience the frustration, self-judgement, and exhaustion of unattainable, unrealistic goals. 

More critically, we can consider the lens of negative perfectionism. As we know, a perfectionist mindset itself can be highly beneficial when applied appropriately and in moderation. However, unrestricted human enhancement may be dangerous in the face of such perfectionist tendencies, leading one down a path that follows destructive patterns of failure, self-criticism, and emotional (and even physical) pain.⁶ Some psychologists refer to this phenomenon as an addiction, appropriately so given that they share many neurological and physiological traits in common.⁶ Of course, considering behavior as an illness is an extreme. As such, the majority of cases are more likely to fall into a milder category and can be address via a mindset shift. 

The Precautionary Principle is a commonly used guide for assessing projects that pose strong environmental risks.⁷  While it has been re-written and devised in different ways, the iteration most often associated with the idea of human enhancement is as follows: when a project or policy is associated with a serious risk, it should not be pursued, regardless of its expected benefits.⁷ In other words, a “better safe than sorry” approach may be the most rational approach to this problematic question. The negative effects of self-oriented perfectionism are dangerous and may feed addictive behavior tendencies even in less radical situations. Research shows that more than 60% of patients undergoing minimally invasive cosmetic procedures are repeat patients.⁸ Coupled with statistics showing that over 15% of patients presenting for aesthetic treatments meet diagnostic criteria for body dysmorphic disorder,⁸ there is increasing reason to be hesitant about the normalization of surgical human enhancement. 

With the existing amount of legal and well-viewed modifications, we are already seeing a tendency for humans to stray farther and farther from satisfaction with their appearances.⁹ One driving force is the field of cosmetic surgery, one that is growing at exponential rates and, as of 2020, was valued at nearly 17 billion dollars in the US alone.¹⁰ A 2012 study by Frederick et al. showed that up to 40% of women and 30% of men are dissatisfied with their body appearance,¹⁰ a number that has only since increased rapidly; certain recent studies have shown body image dissatisfaction to be as high as 79% in 2023.¹¹ Non-surgical measures such as medication for weight-loss are already prominent within the general population. Studies have shown that adults who use anabolic steroids for body image purposes are 3-4 times more likely to experience clinical depression and anxiety when compared to those who don’t.¹² Furthermore, social media and movies have a prolific influence on young people’s concept of body image. Studies have shown that as little as 30 minutes of daily social media use can negatively impact young women’s views on their own bodies,¹² and that girls who read beauty magazines can be 6 times more likely to engage in extreme and dangerous weight control behaviors such as taking diet pills and force vomiting.¹² There is also no shortage of celebrities who have spoken out about their cosmetic regrets. A popular case is Khloe Kardashian regretting her face fillers, saying that even after having them dissolved she felt like she looked crazy and that the “effects were still in there.”^13,14 From my personal experience, I’ve even heard stories about people who have gotten small-scale cosmetic surgeries such as blepharoplasty, better known as double eyelid surgery, and been so unhappy after multiple attempts to reach their ‘ideal’ look that suicide ensued.

So yes, while surgical human enhancements have the allure of promised beauty and perfection, it’s important to remember that perfection is a man-made idea. Because the concept only exists in our minds, it cannot simply be actualized in real life. We are constrained by reality, and therefore, perfection is impossible to achieve fully. As such, as we strive to become better and better, we may ultimately end up burning ourselves out in the process. In the end, we have to consider if what we want is worth losing what we have, because sometimes it really is better to be safe than sorry.

References

1. Wilson, J. (n.d.). Cosmetic Surgery Is On The Rise With Technology And Hollywood Is At The Center Of It. Forbes. Retrieved January 10, 2024, from https://www.forbes.com/sites/joshwilson/2023/01/18/cosmetic-surgery-is-on-the-rise-with-technology-and-hollywood-is-at-the-centre-of-it/?sh=4f2e65b01d91
2. The American Society of Plastic Surgeons ® Procedural Statistics Data Insights Partners: 2022 ASPS Procedural Statistics Release. https://www.plasticsurgery.org/documents/News/Statistics/2022/plastic-surgery-statistics-report-2022.pdf
3. Human enhancement: Is it good for society? (2019). ScienceDaily. https://www.sciencedaily.com/releases/2019/02/190211114300.htm
4. Almeida, M., & Diogo, R. (2019). Human enhancement: Genetic engineering and evolution. Evolution, medicine, and public health, 2019(1), 183–189. https://doi.org/10.1093/emph/eoz026 
5. Pascal, S. (2019, March 31). Why Perfectionism Isn’t Nature’s Way. Maria Shriver. https://mariashriver.com/perfectionism-natures-way/
6. Krull, E. (2021, July 21). What’s the Relationship Between Perfectionism and Addiction? GoodRx; GoodRx. https://www.goodrx.com/conditions/substance-use-disorder/perfectionism-and-addiction
7. Douglas T. (2015). The harms of enhancement and the conclusive reasons view. Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees, 24(1), 23–36. https://doi.org/10.1017/S0963180114000218 
8. Sarwer, D. B. (2021). Returning for Aesthetic Procedures: Compliance or Compulsion? Aesthetic Surgery Journal, 41(6), 744–745. https://doi.org/10.1093/asj/sjab157
9. Grossman, S. (2021, March 24). Nature and Perfectionism. Medium. https://medium.com/@stevegrossman821/nature-and-perfectionism-f56d5d2979d4
10. Frederick, D. A., Jafary,  A. M., Gruys,  K., Daniels, E. A. Surveys and the epidemiology of body image dissatisfaction. In: Encyclopedia of body image and human appearance. Amsterdam: Academic Press; (2012). p. 766–74.
11. American Society of Plastic Surgeons. (2020). PLASTIC SURGERY STATISTICS REPORT 2020. https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf
12. Gestsdottir, S., Kristjansdottir, H., Sigurdsson, H., & Sigfusdottir, I. D. (2021). Prevalence, mental health and substance use of anabolic steroid users: a population-based study on young individuals. Scandinavian journal of public health, 49(5), 555-562 
13. Chandler, K. (2023, June 22). Women and Body Image Statistics – New 2023 Data. Healthcare Data Management Software & Services | Harmony Healthcare IT. https://www.harmonyhit.com/women-and-body-image-statistics-new-2023-data/#:~:text=Body%20Image%20Issues%20in%202023&text=Overall%2C%2079%25%20have%20dealt%20with
14. Plastic Surgery Gone Wrong: Celebs Who Regret Going Under the Knife and Other Cosmetic Procedures. (2023, November 28). Yahoo Entertainment. https://www.yahoo.com/entertainment/plastic-surgery-gone-wrong-celebs-195707948.html