The Physical Examination in Cosmetic Surgery


The Physical Examination in Cosmetic Surgery:

Communication Strategies to Promote the Desirability of Surgery

First, it is appropriate to state the purpose of the essay, and then look into how the objective of the writer is met. The purpose of the essay is to thoroughly investigate interactive sessions between surgeons as practitioners and their clientele who want or desire to have corrective procedures performed on them. The statement of the essay emerges clear enough as the writer does not just state, but goes further to explain, based on data sources, of how plastic surgery has had an up surge and people are increasingly opting for this procedure. The average income of plastic surgeons has also greatly increased. As a means to achieve the purpose of the essay the writer has gone ahead to record video sessions of this interaction between the two parties, being the doctor and the client. Then, further, the writer goes ahead to critically analyze the sessions based on observation, verbal and nonverbal communication then goes deeper to make a conclusion.

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Before addressing the extent of the argument's clarity, it is in order to observe the thesis itself. The writer introduces this in the first paragraph of this essay and goes ahead as quoted to say "the core analysis shows how the patient's body and its features may collectively be used, capitalizing on its flaws to crate a desire for surgery.
Expressively, this is reviewed as means of manipulation by the surgeons to create an image of dire need and inevitability of surgery. As shown in other parts of the essay, that this is a series of calculated steps serving as a means to a clear end and that is, to make the client to part with a large sum of money in the long run.

A literature review is a body of text aimed at reviewing critical points of current knowledge and methodological approaches on specific issues in any field mostly academic, and may form the basis of another goal (Wikipedia. 2010). This section has been well handled by the writer, first citing statistics. For example, in 2004, 9.2 million procedures were performed. Though, the writer does not clearly state the source of this information and the reader therefore may not judge clearly the realities of these statistics, and may not know exactly where to look for this information if need be. The essay needs applause here. Though the writer indicates that plastic surgery is a practice acquainted with controversy, not many scholars have taken the initiative to address this need, and this forms the backbone of the writer's investigation. This section also gives an overview of the whole essay as the surgeon being manipulative as shown in the latter parts of the essay and this is a plus for the writing of this section.

The methods of collecting data by the author are first, over 30 hours of video recording of occurrences of interactions between the surgeons and the clients who made visits to the facility. This automatically includes audio sources from the video as the author cites conversations between the two parties.  There is also the use of observation and on-site presence and field notes of the on-goings. Finally, the writer uses interviews as a means of collecting data. These two semi-structured interviews between the two surgeons cover a large span of time. Also covered is the 9-month field work, the surgeons' work practice and their patients care philosophy.  The writer's explanation of the method of analysis of the collected data is that it was guided by AIDA (action implicative discourse analysis). As the writer is quoted, this is a "theoretical -methodological approach used to reconstruct institutional members' communication problems, challenges and dilemma". These are termed as "ideals" in modes of action regarding practice. This is like a code of ethics and a guiding standard for practitioners, researchers, communicators and the like. It gives a methodology of how to perform reaserch, analysis and study as it is 'ethnographic' in its impulse and interpretive in its analytic argument."

The strengths and weaknesses of the writer's analysis are hereby laid down. The author begins the argument of the essay's purpose as follows; the surgeon introduces the term ptosis, explains its meaning, makes an inference and then goes ahead to show visible signs of his meaning. The surgeon slowly unfolds the medical condition in bits, gathering momentum and letting it settle on the candidate the dire need for the procedure in a manner of indirect autosuggestion that it may seem that the patient arrives to this conclusion by him or herself.
The act of pointing; This is a strategy of communication that one party, in this case the doctor, trying to establish a meaning and further confirming what has already been verbalized and medicalized.

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This is a communicative strategy that serves to lay emphasis on a focal point seeking to crate attention to a particular direction by the person performing the act, in this case, the patient's breasts. The surgeon is not just trying to suggest, he prescribes the need, enacting the surgery and its value. Here the surgeon airs the benefits of the procedure and its remedies, citing an enticing picture to further disarm the subject of all probable means of resisting the bait laid. The comment the surgeon gives after watching a recorded session clearly points out the goal of driving home the worth of the surgical procedure, actually marketing it.

All these acts of touching, stretching and squeezing of tissue, a simple message, though complicated considering the end result in mind, is being passed from the doctor to the subject in a subtle and unnoticeable manner, and the patient is led to opt for the surgical procedure by his/ her own volition.
The surgeon uses carefully selected words like "to make it look more youthful" (p 164). This is accompanied by moving parts of the breast like repositioning the nipple and the fold, clearly bringing out a picture of how the corrective surgery may alter the appearance of the breast, to make one look more youthful, make the breast more attractive using words like "it looks like an upside down tear".

In the discussion and conclusion, the essay suggests that surgeons perform examinations in ways that promote the value of proceeding with an expensive, fully elective surgery (p 166). To attract clients, the surgeons move in four steps. They:-
(a) Make the subject notice undesirable features
(b)   Give the condition medical terms (medicalizing)
(c) Cite a diagnosis
(d)   Suggest a corrective surgical measure and procedure.
All this has a long term end in mind, to make the surgery seem inevitable. The examination has several goals, them being; gathering information that would be used to manipulate the subject into the variety of procedures and they aren't conducted naturally as the writer argues (p 166). One may not fail to notice, as the writer puts it, the absence of "reassuring and supportive behavior" that is common in other physicians' practice and interaction with their patients (p 166), enhancing an ideology in plastic surgery that "the human body can always be surgically enhanced".

In the discussion, the writer puts thoughts as though knowing the ideology that can easily creep in one's mind, that the plastic surgeons are acting in a way that is not appropriate. Being convincing does not really suggest malice or craftiness as it is highly reported that people who have undergone these procedures have been noted to have enhanced self esteem and psychological wellness after being at peace with their latter appearance.The surgeons only examined body parts as suggested by the patients and this tends to quell the notion that the surgeons are suggestive and have their own ends, the money, in mind. The surgeons did not just prescribe surgery. On other occasions they declined, based on the subjects' unsuitability for the operation. This further negates the idea about plastic surgeons marketing the trade. The writer shows that in ordinary circumstances, the subject/patient is most of the time more active than the doctor and plays more in a consumerist attitude as opposed to the fact that the doctor is on the higher marketing side.

In considering the strengths and weaknesses of the writer/ author's writing, first of all, we need an analysis of the whole document. This therefore brings us to the beginning of the document as the author introduces the subject of plastic syurgery. For many not acquainted with medical practition, should have been introduced by the meaning of or defining plastic surgery. This being the medical specialty concerned with the correction or restoration of form and function (Wikipedia. 2010). It includes types of reconstructive surgery, hand surgery, microsurgery and treatment of burns. The author gives statistics of the rise of the practice of plastic surgery, giving an example of 2004. Also, the author introduces the literature review by stating that this field has hardly been investigated, meaning the interaction between the surgeons and their patients. Also the author doesn't fail to indicate the purpose of the essay. But after this, the author does not give a clear introduction as to what exactly ignites his/her initiative to research in this area, or if he/she does, it does not come out clearly in the beginning of the essay.
The flow of ideas from the author to the readers in terms of arguing out the course does not come out clearly in the beginning, but rather, it appears to the readers that this author is trying to impose idealistic views to the reader, rather than arguing out the course and convincing the reader.

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At the conclusion, the author starts by summarizing the findings in the research, but later ends up contradicting him/herself. This leaves one wondering the exact implication for the writer's purpose of the research. One would wonder if the author is merely playing with words or is trying to suggest something that the reader did not grasp in the body of the essay. An example is found in page 167, where the author says "it would be easy to jump to the conclusion that plastic surgeons are behaving inappropriately, perhaps unethically, by promoting surgery. To argue that plastic surgeons are persuasive, does not suggest that it is wrong or deceitful" and later suggest that in the interaction, patients are always more active in suggestiveness to surgery. That, it is the patient of a prospective surgery that finds the doctor and not the other way round, and that sometimes doctors play to dissuade some patients for reasons of the unsuitability of the procedure (to the patients). Therefore, the argument of the purpose of the essay is diluted. It is my view that the author needs to improve on this, to try and stick to his or her side of argument, to try to be more convincing instead of imposing, and this is how the author can improve his/her writing.

Basing on the author's introduction to the essay, the literature review, the body of the document, citing the argument brought forward, it is a well written account of a research well done. It is also worth noting that the author uses clear and concise wording. It would therefore be appropriate to rate/grade this article at 80%. This seems befitting, considering the idealistic expression, use of language and general expression in understandable language. It is also noted that the writer's grammar and command of English is commendable and this earns the article a mark.