In some countries, there are doctors who doubt whether elective cosmetic surgery is really medicine at all, since it doesn’t heal anything. But not in Brazil, where “plástica” is a national obsession like among rich and poor alike, where newstands feature Plástica & Beleza, next to Marie Claire, and where the legendary Dr Ivo Pitanguy is second only to Pelé.

Pitanguy, 85, is revered as one of the world’s most skilful plastic surgeons and doctors come from all over the world to study at the Ivo Pitanguy Clinic. Unusually, perhaps, for a surgeon, he is a speculative thinker and a prolific writer, the “philosopher of plástica”, and a member of the Brazilian Academy of Letters. In his own words, ““My operations are not just for my patients’ bodies. They are for their souls.”

Recently “the Michelangelo of the scalpel” was the subject of a feature in the New York Times by anthropologist Alexander, of the University of Amsterdam. Dr Alexander explains the philosophy—which he finds “disturbing” -- at some length.

“He argues that the real object of healing is not the body, but the mind.  A plastic surgeon is a “psychologist with a scalpel in his hand.” This idea led Pitanguy to argue for the ‘union’ of cosmetic and reconstructive procedures.  In both types of surgery beauty and mental healing subtly mingle, he claims, and both benefit health.”

Why not speak to a psychologist if psychological help is what is needed? It seems that in Brazil the cheaper option is cosmetic surgery. Furthermore, cosmetic surgery offers possibilities for social advancement:

“For many consumers attractiveness is essential to economic and sexual competition, social visibility, and mental well being.  This ‘value’ of appearance may be especially clear for those excluded from other means of social ascent.  For the poor beauty is often a form of capital that can be exchanged for other benefits, however small, transient, or unconducive to collective change.”

Under Pitanguy’s tutelage, cosmetic surgeons have set up practices throughout Brazil, catering for all social classes. In 1999 he received what may be the ultimate accolade for a cosmetic surgeon: he was guest of honour at one of Brazil’s most famous samba schools and rode the float through the crowd as a singer praised “the scalpel guided by heaven”. ~ New York Times, Aug 13