MILAN - Some plastic surgery procedures requests must be treated and analyzed with particular attention and sensitivity. Over the last two decades, plastic surgery has been increasing all over the world, often responding to people's desires to look younger

But more and more, cosmetic surgery is performed on those who want to change the distinctive characteristics of their ethnic origins.

The results, usually inspired by Western models, are not just requested by those in higher social classes – but by all kinds of people, especially those who want to emigrate. Can lighter skin and more Western features really hide that they’re from a developing country and help lead to a better job, higher salary, or more prestigious social circle?

The most requested procedures of “ethnic” plastic surgery for Asians – both women and men – are canthoplasties (to reshape eyes, making them rounder), and rhinoplasties (nose jobs to reduce the size of the base of the nose, defining the bridge). Africans, now and then, undergo cheiloplasties (reduction of lip size), as well as liposuction to re-shape the body.

“It’s a phenomenon like no other that marginalizes people and has complex psycho-social implications that cannot be underestimated by doctors,” explains Professor Mario Dini, Director of the School of Plastic and Aesthetic Surgery at the University of Florence. “In reality, many of these practices are carried out on people with low income, who are looking for cheap, and often dangerous solutions. People trust in facilities in their own countries, but often security and hygiene guidelines aren’t strictly applied. Not to mention the huge "do-it-yourself" underworld, or the use of often banned products."

Changing one’s body to change one’s life

So, from an expert’s viewpoint, should changing or minimizing the traces of someone’s origins be completely avoided? “No, or at least not completely,” Dini says. “Here’s an example: a Middle Eastern nose is objectively large and can weigh down the delicate face of a woman or hinder good looks. Rhinoplasty, therefore, can improve the face and enhance good looks.”

He adds: “There are many requests for skin lightening. If a surgeon indulged all the requests he got, the results would be dissatisfaction and disappointment. The media has emphasized that light skin is associated with being successful, but this is the fruit of the marketing strategies of companies who sell skin-whitening products and sunscreens.”

Professor Dini says people often have unrealistic ideas and believe that a change on their bodies will really change their lives too.

“It’s logical to think that a woman with small breasts will be more confident after an augmentation, in a way that her interior image corresponds to the physical one, but when a patient tries to change their ethnicity, the matter is much more profound and delicate," he concludes. "A foreign patient who wants to westernize their face, which is universally considered ‘successful’, hopes that the scalpel will change their culture too – but this isn’t possible.”

This view is shared by Dr. Genevieve Makaping, anthropologist, journalist and writer from Cameroon. “The risk of unconditionally accepting to operate on patients and respond ‘yes’ to all of their requests is to leave them in a cultural limbo," says Makaping. "The people who want to erase, or minimize, their physical origins usually aren’t completely assimilated with Westerners, and are turned away from their own social groups who criticize and stigmatize this choice because they feel their faces are being discriminated against.”

Makaping says this pressure of uniformity was born in part due to the lack of support and social mediation from the originating countries, as well as in those they want to move to. "Very often the emigrants are left to themselves, with a small capacity of developing their talents, and crushed by a stigma that is part of themselves,” she says.