Medical Halacha – Plastic Surgery

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Rabbi Yehuda Finchas 

 

Ely was visibly concerned. He took a couple of deep breaths and shared his dilemma with me. “My brother-in-law asked for a twenty-thousand-dollar loan to undergo cosmetic surgery in Mexico. I feel that not only is he gambling with his health, but quite frankly, it is completely unnecessary. I’m not even sure if this is permitted according to halacha. He says that every time he looks in the mirror he squirms, but he looks absolutely fine to me. What do I do?” 

 

In a fascinating responsum (Yabia Omer CM, 8:12), Hacham Ovadia, zt”l,  outlined three potential halachic issues with plastic surgery: self-harm, self-endangerment, and whether plastic surgery is considered to be part of the halachic mandate of healing. Let’s outline his approach and see how it applies to Ely’s question.  

 

  1. A person has no right to harm himself or herself (“chabala”) as is clearly articulated in the Talmud (Baba Kama 90b), Rambam (Hovel 5:1), and Shulchan Aruch (CM 420:31). Generally, this applies to injuring yourself in a harmful way. Plastic surgery, however, even though it technically starts off by harming the body, is meant to be therapeutic. Does the prohibition apply here as well? Hacham Ovadia explains that self-harm is only prohibited when done in a destructive fashion. Therefore, in the context of surgically removing a blemish or for other cosmetic reasons, the prohibition of “chabala” would not apply.

 

  1. Every surgery carries certain risks and potential complications, such as infection, bleeding, scarring, nerve damage, and potentially more serious issues with anesthesia. Generally speaking, we are not permitted to unnecessarily place ourselves in dangerous situations. However, Hacham Ovadia elucidates that with the advancements of medicine and the safety measures in place, experience has shown that these procedures are generally safe and are therefore permitted.

 

  1. Hacham Ovadia’s final concern was whether cosmetic surgery qualifies as “healing” and therefore is within the Torah’s mandate of “VeRapoh Yerapeh.” Rabbi Eliezer Waldenberg objected to performing surgery except when it is considered medically curative and qualifies as healing; otherwise, it is forbidden. Hacham Ovadia, however, disagrees and demonstrates that the Talmud (Ketubot 74b) already describes the removal of blemishes as healing. When the Talmud (Shabbat 50b) explains that removing scabs is allowed to alleviate pain, Tosafot (Bishvil) extends this to include psychological or emotional pain. Even if the type of pain is experiencing embarrassment in the company of others, “there is no greater pain than this.” Hacham Ovadia concludes that cosmetic surgery is certainly permitted for reasons of “shalom bayit” or to help marriage prospects. 

 

Having said that, great caution is needed, as some people may have unrealistic expectations about what plastic surgery can achieve, and those expectations can have serious psychological consequences, especially if they do not achieve the desired results. This is especially true with those with body dysmorphic disorders or those who have an unhealthy excessive preoccupation with their appearance. 

 

In regard to Ely’s question, there is no one-size-fits-all answer. It is a complex issue that depends on a variety of factors, including the individual’s motives for seeking surgery, the potential risks and benefits, and the specific procedure in question. It is certainly worthwhile to find out why he is travelling to Mexico and not having the surgery in the USA. Sometimes, people travel to areas where cosmetic surgery is less regulated, which would increase the level of risk and endangerment and would potentially be prohibited.  

 

When reconstructive surgery is performed after an accident or illness, it is certainly permissible. So to rhinoplasty, when the goal is to improve breathing or correct a deformity that causes significant distress. However, if one’s general appearance is not out of the ordinary, it may be a case of unrealistic expectations, and the surgery may ironically cause more harm than good. 

 

King Solomon writes in Mishlei (31:30), “Grace is false and beauty is vain.” The Gaon from Vilna (Kol Eliyahu, Bereshit 29:17) asks, but doesn’t the Torah praise the beauty of the “Imahot” – Matriarchs? If so, why is beauty frowned open? He answers that it depends on the context. Beauty in of itself is vanity and is false. But when complimented by the end of the verse – “a woman who fears Hashem she should be praised” that refers to inner beauty, which is something altogether different. That was the uniqueness of Sara, Rivkah, Rachel, and Leah, who possessed both inner and outer beautiful qualities, and only when those qualities are combined are they praised. 

 

 

Rabbi Yehuda Finchas is a worldwide expert, lecturer, and writer on medical halacha, and is the head of the Torat Habayit Medical Halacha Institute. His latest book is entitled “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, email rabbi@torathabayit.com.