Art versus science in plastic surgery

I have always felt that my formal training in art, coupled with a belief in the scientific method, gives me a unique aptitude in plastic surgery. However a recent debate has emerged about whether plastic surgeons should be artists or strictly scientists. You know where I stand on this, but there are some things worth considering before you decide what’s important o you.

The debate goes something like this: Surgery is the practice of medicine, and increasingly medical care relies on evidence-based standards. These in turn derive from prospective and objectively conducted clinical trials. In the absence of such data, surgical techniques may or may not be adequately validated and patients have no way of knowing whether they are getting the best treatment. In plastic surgery, the problem is especially troublesome, with everyone touting the next best thing before it can be evaluated for effectiveness and how long the results last.

But the artists among the ranks point out that beauty cannot be readily defined by science, and without a sense of proportion and aesthetics, technical expertise and rote adherence to protocol are inadequate. Plastic surgeons are not merely technicians, and our practices are more than a menu list of standardized operations. We are creative by nature, and patients expect customized approaches guided by a sense of the subtleties that define natural beauty. Drawing and painting the human subject informs surgical technique.

The answer of course is that both are important. The “science first” point of view assumes that measureable outcomes can be defined in ways that generate the statistical evidence on which clinical studies rely. And doing such studies is expensive and can take years, by which time some new development will command interest. On the other hand, the artistic approach has to respect the fact that manipulation of living tissues is not the same as sculpting in clay; paintings are not people. Does it really matter if your surgeon is an artist? Maybe someone should do a clinical trial to find out once and for all.