Despite coronavirus shutting down many businesses across the globe, cosmetic plastic surgery is on the rise. People are tired of being locked up at home and don’t like the way they look on Zoom. Additionally, there is the “COVID 19” that many have put on from being cooped up and snacking too much and unable to comply with their usual exercise routines.
Now that things have opened up, people want to address their concerns and try to give themselves a little pick-me-up after a few tough months. They see a window before a possible “second wave” of lockdown, and many are still working from home, allowing them the privacy to recover. According to Dr. Aviva Preminger, a renowned board-certified plastic surgeon, masks are also a great way to hide minimally invasive procedures such as filler, but they also unfortunately draw attention to other areas of the face, such as the forehead and eyes. People have, therefore, become more focused and concerned about the appearance of these areas. Botox and eyelifts are more popular than ever.
Given the increasing popularity of cosmetic surgery, the question sometimes arises as to its permissibility according to Jewish law. Dr. Preminger reports that some patients have a reluctance to proceed with cosmetic surgery for fear that “vanity” is not halachically permissible. She serves people throughour the Orthodox community seeking to look their best, especially before major life milestones such as a wedding or bar mitzvah. Procedures range from minimally invasive injectables and torn earlobe repairs to mommy makeovers. Many of the women in these communities have carried and breastfed multiple children, creating a major strain on their bodies. They simply want to look their best and restore what has been lost. Others just want to turn back the clocks a little in photos or be able to wear special earrings without fear that their favorite diamonds will tear through what remains of a stretched earlobe.
While Dr. Preminger encourages patients to consult with their specific rabbis for halachic concerns, she is certainly well-versed in the relevant issues, having explored them with the ethicist Dr. Eddie Reichman, a well-known authority on Jewish medical ethics, as part of her Harvard honors thesis. The concerns raised by rabbinical authorities and the answers provided might surprise you.
The Torah and rabbinical authorities do not disapprove of physical beauty and methods of beautification. Judaism advocates balancing inner and outer beauty by cultivating the relationship between body and spirit. The Torah presents female role models whose outer beauty is inextricably bound to the radiance of their inner qualities. For example, our Matriarch Sarah is referred to in the Torah as “a woman of beautiful appearance (Bereishis 12:11). Regarding Sarah, Rashi comments on a Torah verse (Bereishis 11:28) that refers to her by the name “Iscah.” Rashi states: “Iscah is Sarah because she saw with ruach ha’kodesh and all would gaze at her beauty.” A second female figure reputed to have been a great beauty is Queen Esther who used her physical appearance as a means rather than an end. Clearly, Esther’s beauty was one of the main reasons Achashverosh chose her to be queen.
Rashi explains that the washbasin in the Mishkan was crafted in its entirety of mirrors as a tribute to the Jewish women of that period. When the Jewish husbands were enslaved in Egypt, their wives beautified themselves in mirrors and visited them. Rashi utilized the importance of physical beauty to explain why Hashem wanted the washbasin formed of mirrors. In this case, beautification was looked upon as something positive, done to ensure the survival of the Jewish nation. The Jewish women of Egypt used their beauty for a lofty goal — a Jewish future that includes our own today.
The Torah’s references to physical beauty are not gender-exclusive. They apply to the attractiveness of male figures as well. Yosef, King David, and David’s son Avshalom are all described as being physically beautiful.
Similarly, the importance of physical beauty in the attraction between the genders and shalom bayis is discussed in many places in the Talmud. Included among these topics are cosmetics, hair dye, attractive apparel, and prosthetics. The Talmud relates that when Ezra brought Bnei Yisrael back to Judea from Babylonian captivity, he permitted peddlers of cosmetics to travel freely within the country, to make cosmetics available to everyone.
Both ancient as well as modern rabbinic responsa reflect these positive views toward the use of cosmetics as a means of achieving and enhancing physical beauty. In a 16th-century Italian symposium, the Maharam, Rabbi Meir Katzenellenbogen, was asked whether a married woman could apply makeup. He replied, “May a curse come upon a woman who has a husband and does not put on makeup for him… The Sages did not forbid the women from wearing makeup. Such a step would be illogical. Certainly, a woman is obliged to put on makeup in order that her husband think about her rather than about other women.”
If the pursuit of physical beauty is not frowned upon, what are the relevant halachic concerns regarding cosmetic surgery and how have rabbinic authorities approached them?
Formal halachic discussion about the ethical and religious issues related to plastic surgery first began in the 1960s. In 1961, Rabbi Immanuel Jakobovits, considered by many to be the father of the discipline of Jewish medical ethics, addressed the American Society of Facial Plastic Surgery at a symposium titled “Religious Views on Cosmetic Surgery.” Rabbi Jakobovits, later chief rabbi of Great Britain, discussed the parameters of plastic surgery from a halachic perspective. After explaining that no responsa had yet been written on the topic, he dealt with the question of whether one may undergo cosmetic surgery for the purpose of improving one’s physical appearance. As Rabbi Jakobovits described in his classic work, Jewish Medical Ethics, “The problem was considered under four headings: the theological implications of ‘improving’ G-d’s work or ‘flying in the face of Providence’; the possible risks to life involved in any operation; the Jewish objection to any mutilation of the body; and the ethical censure of vanity, especially among males.”
These four ethical concerns of Rabbi Jakobovits remained the pivotal issues in all future responsa as subsequent poskim have approached them in different ways. Should plastic surgery be prohibited for tampering with Hashem’s creation? Does it violate the prohibitions against self-mutilation and endangering one’s life? Finally, is plastic surgery inherently gendered and does it violate the law prohibiting a man from dressing like a woman? Vanity was not the overriding issue.
The above concerns have been set aside by most authorities. Concern about risk to life has diminished with the increasing safety of anesthesia. Generally, the problem of mutilation or self-wounding does not pertain to self-wounding performed for a greater purpose. Circumcision is one such example. The most overriding principle invoked by rebbeim to address concerns about plastic surgery is the mind-body connection. Rabbinic authorities are extremely sensitive to the anguish a person may experience from a physical deformity, making it a medical/psychological issue.
For example, Rabbi Jacob Breish, author of Chelkat Yaakov, maintained that the prohibition of wounding oneself does not apply in a situation where the pain is intended to alleviate another, more excruciating pain. The fact that physical appearance and age can affect hiring decisions is well-known and was even presented by Forbes Magazine in 2017 in an article titled, “How Your Appearance Impacts Hiring Decisions.” The role that physical appearance plays in shidduchim, shalom bayis, self-esteem, and employment opportunities is undeniable, as is the psychological anguish that it may cause.
According to Dr. Preminger: “The mind-body connection is a very powerful one and one that is recognized and valued by rabbinic authorities. While the degree of psychological anguish from a perceived physical deformity experienced by each individual may vary, plastic surgery remains a powerful tool to make people appear more attractive to others and to feel better about themselves. One of the best parts of my job is not only the satisfaction I get from being able to achieve a certain result, but the added benefit of the look on the patient’s face and the knowledge that I have played a part in boosting their self-esteem. This to me is a mitzvah, and I feel privileged to have the ability to do it!”
Rochelle Maruch Miller is a contributing editor for the Five Towns Jewish Times. She is a journalist, creative media consultant, lecturer, and educator, and writes for magazines, newspapers, websites, and private clients. She welcomes your comments at Rochellemiller04@aol.com.
