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Plastic Surgery: A Free Society Is a Beautiful Society

Mises Daily: Monday, February 28, 2011 by

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The division of labor is what society is built on. As we cooperate with others, everyone is allowed to specialize in what they do best. Instead of spending hours each day on tasks that are necessary but that we're not good at, we can hire others who specialize in those tasks and spend time doing what we enjoy and what we're most efficient at.

Murray Rothbard explains in Man, Economy, and State, "the further an exchange economy develops, the further advanced will be the specialization process." And so the world has come a long way since Plato theorized about the division of labor 2,400 years ago. Plato, in Guido Hülsmann's words,

pleads for a division of labor and gives three reasons:

  1. there are natural productive differences between the individuals, which make one person a better tailor, while another one might be a better farmer, and so on;
  2. the daily exercise resulting from specialization improves the workmanship;
  3. many jobs need to be done at the right moment in time and therefore require permanent availability of some person charged with this task.

All of this leads to increased productivity, and, as Professor Hülsmann writes, "make it more beautiful."

Beauty is something most everyone wants more of. Even the best-looking people are annoyed by what they characterize as some imperfection they see staring back at them in the mirror each day. And while there is plenty of handwringing about healthcare not being affordable in the United States, cosmetic surgeons are doing fine, despite the recession.

These doctors, by the way, are paid directly by the patient. So for those who haven't been in a cosmetic surgeon's office, as opposed to a general practitioner's or the like, there's a stark difference. The typical doctor has to devote precious office square footage to files and staff working the phones continuously, dialing for reimbursements and preauthorizations from insurance companies or Medicare, because that's where the doctor receives payment. As a result, the typical doctor's office waiting room is cramped and dingy with tattered, months-old magazines lying about and a TV in the corner turned up too loud so the older patients can hear.

Cosmetic surgeons treat people like they are the ones paying the bills (because they are). The waiting rooms I've been in are clean, roomy, and serene, even though you don't spend as much time there waiting for overbooked physicians as in the paid-from-insurance doctors' offices.

Specialization has led to cosmetic surgeons in New York catering to various ethnic groups. Business is booming, reports the New York Times, with plastic surgery among the Latin population doubling over the past decade and tripling for Asians according to the American Society of Plastic Surgeons.

Dr. Jeffrey Yager has tripled his business since 1997 by catering to the Dominican population in New York. Yeager speaks Spanish and that may help his business, but what he really knows how to do is give Latin women the curves they crave and weren't born with. So while on Long Island the majority of the business is removing fat from the legs and buttocks, in Washington Heights, "it's the opposite — they just want their rear ends enlarged and rounded," says anesthesiologist Dr. Holly Berns, who puts patients under all over the city.

"We Latinas define ourselves with our bodies," Italia Vigniero, 27, a Dominican patient of Dr. Yager's tells the NYT. "We always have curves," adding, "My personality doesn't go with small breasts."

"When a patient comes in from a certain ethnic background and of a certain age, we know what they're going to be looking for," said Dr. Kaveh Alizadeh, the president of Long Island Plastic Surgical Group, which has three clinics in the city. "We are sort of amateur sociologists."

Italian women want their knees done, making them more short-skirt worthy; Iranians want nose jobs; Egyptians are looking for face lifts; Russian women are after breast implants; Chinese men want bigger ear lobes, and the most sought-after procedure by Asian women is double-eyelid surgery, believing large eyes accentuate beauty.

There is likely no individual cosmetic surgeon in New York, or anywhere else, who can perform all of these procedures as well as the individual doctors who execute them day in and day out. Doctors specialize to garner a reputation in the marketplace as the specialist at lifting this or tucking that, but also, by doing familiar surgeries, they lower the potential for botched operations, keeping insurance costs and liability as low as possible. Also, specializing physicians can do procedures faster and more efficiently, again lowering the cost. Lowering costs makes operations more affordable — which is important, because cosmetic patients are paying for this work from their own pockets.

Cosmetic physicians don't necessarily specialize in the procedures that are demanded by people of their own ethnicity, illustrating Ludwig von Mises's point that the division of labor is a unifying influence. These doctors and their patients are comrades seeking beauty, just one tiny example of the division of labor making "friends out of enemies, peace out of war, society out of individuals."

Plato couldn't have fathomed cosmetic surgery or certainly the ability of working-class people being able to afford having their looks altered surgically. However, his insight assures us that, in a free society, the cost of cosmetic surgery would fall to allow everyone to have the body and face they want, making society free and beautiful.