"The media has created the idea that our face is our identity. But even in a full face transplant, the face would fit over your own bone structure and although you'd greatly resemble the other person, you would not look exactly like them."
Ethical responsibilityBut Dr. Gilman does believe that cosmetic surgeons have a great ethical responsibility to patients seeking such a drastic identity change.
"They should be told: Surgery may change your nose, it may change your chest, but it won't change your life. It's bad medicine when a surgeon makes false promises," he tells Cosmetic Surgery Times.
Dr. Gilman concedes that this is an issue that cosmetic surgeons will be facing with increasing frequency.
"One very interesting phenomenon that has appeared over the last decade is this desire to look like celebrities who have themselves been surgically enhanced," he says. "It's a great irony. You become a copy of a copy of a copy. It leads you to wonder if there are any authentic, original faces or bodies out there today. And the answer is: Very rarely. We live in a plastic surgery culture. We live in a diet culture. We live in a bleaching culture. If you don't go to the surgeon, you go to the hairdresser. Everything is enhanced."
And what about those patients who seek out multiple plastic surgeries? "Almost all polysurgical patients are searching after some kind of imagined perfection," he says. "For the past 100 years, surgeons and physicians have agreed that these people should be sent for a psychological consultation."
But Dr. Gilman is quick to point out a modern twist.
"There is a whole class of people who live off of the celebrity of having multiple procedures. They are completely aware of what they are doing; they're selling their image. They understand that if they have 50 procedures they'll be able to sell books and be on talk shows."
New York City-based cosmetic surgeon Edmund Kwan, M.D., also believes that surgeons have the ethical responsibility to turn down polysurgery patients with unreasonable requests.
"Some of these patients will not take 'no' for an answer," he says. "If you refuse, they go to another doctor and another until someone relents."
And the result? Jocelyne Wildenstein, the Manhattan socialite whose infamous multiple surgeries left her looking like a feline.
"She kept on going and going with surgeries and ended up looking like a cat," he says. "And Michael Jackson has ended up with almost no nose."
Dr. Kwan has dealt with patients who not only wish to alter their appearance, but also to wipe away their ethnicity.
Although he strongly believes in preserving ethnic identity, he has had several Asians who want to look more Caucasian, often because they think it will open up personal and professional opportunities. And he has even had a Puerto Rican woman undergoing multiple surgeries to look Asian.