Ideas in the Wild: Why & How Dr. James C. Marotta Aims To Help Remove the Stigma Around Cosmetic Surgery
After fifteen years as a facial plastic surgeon, Dr. James C. Marotta has repeatedly heard patients express shame and guilt about wanting to change their appearance. They second-guess themselves and worry about seeming superficial. They’re afraid of being judged by friends and family. Anyone considering plastic surgery is probably experiencing the same tumultuous emotions — but they shouldn’t feel bad about wanting to look good.
Dr. Marotta wrote You’re Not a Vanity Purchase to offer a deep dive into history, sociology, and psychology to show why plastic surgery is a form of empowerment, not pride. The drive to look good is about far more than vanity. It’s about being psychologically healthy, fulfilled, and confident. I recently caught up with Dr. Marotta to learn more about his new book.
What happened that made you decide to write the book? What was the exact moment you realized these ideas needed to get out there?
I was seeing a long-standing patient of mine in my plastic surgery clinic. She had been coming in for years for a simple treatment of injectable hyaluronic acid for some wrinkles in her cheeks. She had a facelift at another practice which she was happy with but felt that it caused some wrinkles to form around her mouth when she made certain expressions. The woman is in her late 70s and she didn’t want to have a more aggressive procedure like laser resurfacing that could correct this issue more permanently. The procedure is pretty painless but of course involves some physical discomfort because multiple needle injections are required.
While I am injecting her she exclaims: “Why do I do this to myself, why do I care? My husband thinks I am crazy. I am over the hill. Am I just vain?” This isn’t the first time I heard these sentiments from a patient, but it all crystallized for me in that moment.
Why are all people from teens to octogenarians so concerned with their physical appearance? What drives the need to look good? And why do so many people harbor such guilt and even shame around improving or changing their appearance? I realized I needed to find answers to these questions and write this book not only to satisfy my own curiosity but, more importantly, for my patients who routinely struggled with guilt and shame over plastic surgery.
What’s the biggest lesson you’ve learned going through the journey you share in the book?
The biggest lessons I learned from doing the extensive research for authoring the book was the answer to the question: “Is plastic surgery a vanity purchase”? It is clear, as you will see in the book, that the drive to improve one’s appearance goes far beyond “skin deep.” (Cheesy pun intended.) It is not just vanity that motivates people to “go under the knife.”
To care about one’s appearance is an innate human quality with some deeply rooted psychological, biological, and sociologic drives. Some of the drive to look good is learned behavior which is influenced by some of our earliest human interactions. Some of the drive to look good is evolutionarily based and as old as time. Yet some of the drive to appear our best is intrinsic to the function of the human brain and our reliance on interpreting facial appearance.
How we look influences every human interaction and can have profound effects on our lives from cradle to grave. Because to care about how you look is a function being human, and so important to our success and survival, the guilt and shame surrounding plastic surgery is completely unnecessary. In fact, we see that historically and in other cultures around the world an entirely positive, guilt free view of appearance enhancement.
The lesson for the patient is that a positive, guilt free view of their procedure and their choice to change their appearance is one to which they are completely entitled.
How will you apply this lesson in your life moving forward?
I wrote the book for patients and start the book with a story written entirely from a patient’s perspective. I have always realized that my work made a difference in people’s lives but when you work on making people beautiful for a living, at times you question the importance of your work. I gave up curing cancer or reconstructive surgery long ago. What I do is “cosmetic” surgery after all; the very word implies skin deep, superficial, unnecessary.
No one will die if they don’t get their nose job. But diving into the patient’s view, hearing the profound stories of transformation, understanding more fully the drive to look good, gave me an entirely different view of what I do for a living. I am changing people from the outside which can affect them on the inside which can, in turn, change a person’s entire life.
Conversely, not being able to make a change can have a profoundly negative impact on an individual. The book taught me the same lesson I am bringing to the patients who read it: “You’re not a vanity purchase.” It has helped me to see, with new eyes, the importance of the work I do every day and I believe will help me to never take for granted the difference I am making by doing excellent work. The perspective and knowledge I gained from authoring this book, has deepened my commitment to putting the patient at the center of all we do at Marotta Plastic Surgery Specialists. Because what we do transforms lives.
