DC-Area Plastic Surgeon Responds to Piers Morgan’s Daily Mail Piece on Dr. Fredr

Robert K. Sigal, M.D. Says Dr. Brandt Helped Others in Pain, Even as He Lost the Battle Against His Own.

Piers Morgan's opinion piece on Dr. Fredric Brandt's death in the Daily Mail online included this line:

"If Tina Fey is guilty of anything, it's holding up a merciless mirror to the utter futility of the plastic surgery industry."

Ah, Piers. Where to start?

Like most who've heard of Fredric Brandt's death, I was saddened to learn of his suicide. Like Piers Morgan, I didn't know him. Dr. Brandt was, by all accounts, a kind, sensitive, caring man who had a large practice and was loved by many of his patients. He was obviously a complex man and struggled with demons that ultimately overwhelmed him -- whatever the near-term event was that gave those demons too much power.

But unlike Piers, I am a plastic surgeon who specializes in cosmetic surgery. And, unlike Piers, I would have loved to have met Dr. Brandt. While our specialties are different (Dr. Brandt was a cosmetic dermatologist and I am a plastic surgeon) and our approaches to our patients' concerns would have differed, I wager our perspective on the human condition would have been very similar. Both specialties see patients bothered, sometimes tortured, by physical concerns. We both practice in that nexus between the physical and the emotional that brings patients to us. I would guess that Dr. Brandt, like I do, struggled with our Hippocratic vow to "Do no harm" in that difficult context.

If I were to meet Piers, I can guarantee you I, and probably Dr. Brandt, would not "peer at (his) face, exact a slight wince, and start suggesting ways in which (he) could 'improve' (him)self." If Piers lived as a doctor in our world for any amount of time, he would know how carefully we tread on that delicate ground. People are fragile and the world can be a very harsh place. The idea of creating more issues for someone already focused on a physical imperfection is anathema to us.

Piers seems to think that "plastic surgery crushes self-acceptance, and therefore self-dignity, by perpetuating a myth of everlasting youth."

I think he gives plastic surgeons a little too much credit. Do some people bet too much emotional capital on the plastic surgery card? Sure. Would it be better if everyone were well-adjusted to the world around them? Absolutely. But in this real world, there are so many things crushing self-acceptance (and the world is particularly harsh to women), that we plastic surgeons are often put in the position of restoring a soul.

When the physical defect is obvious, everyone loves plastic surgery. Even Piers.

"I'm all for people who've suffered some form of hideous facial disfigurement via birth defect or accident having plastic surgery to try and help them."

The problem is where to draw the line. A cleft lip -- fine, fix it. Mastectomy? Ok, rebuild the breast. But how about massive weight loss and abdominal skin that hangs to mid-thigh? Maybe. Or breasts that form asymmetrically in a teenage girl? Or prominent ears in a third grader? Or, and here's a hard one, a beautiful woman that used to be able to control the room just by walking into it and is now invisible?

Our culture, for too many reasons, over-values beauty and devalues age. Piers Morgan, a wealthy loquacious white man, sits at society's apex and is in no position to judge the choices made (mostly by women) regarding beauty and age as people swim upstream against life's currents. "But the reality of most plastic surgery is that it's deployed on people with perfectly normal faces who just want to defy the ageing process." Perhaps in Mr. Morgan's world life gets easier as you get older, but perhaps not in Mrs. Morgan's.

Mr. Morgan concludes, "But I hope his untimely death prompts all those who see plastic surgery as the Utopia of joy and fulfillment to pause today and reflect on the abject futility of pursuing such a phony dream."

Nonsense. It is the rare individual that would ever think of plastic surgery that way. The vast majority are just trying to make life less hard and painful. Toward that end, Dr. Brandt's life should be celebrated for what it was -- a valiant effort to help those in pain even as he struggled mightily with his own.

Dr. Robert Sigal is a plastic surgeon and the managing partner of Austin-Weston, The Center for Cosmetic Surgery, in Reston, VA.