Facial disfigurement

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7086.991 (Published 05 April 1997) Cite this as: BMJ 1997;314:991

The last bastion of discrimination

  1. D A McGrouther, Professor of plastic surgerya
  1. a Department of Surgery, University College London Medical School, London W1P 7LD

    Facial disfigurement and deformity are common causes of human suffering, much more common than a walk down the high street may suggest as many afflicted will choose to hide from public gaze. Accurate figures do not exist, but–given the known incidences of congenital, traumatic, and malignant facial conditions, together with skin diseases–every general practitioner will frequently encounter this problem.1 At the root of the patient's distress lies the pressure in modern cosmopolitan society to confirm to an idealised appearance.2 Image and beauty are marketing tools portraying a particular “supermodel” as the desired “look,” diminishing the value of individuals who deviate from the face or form of the moment.

    Stigmatisation by appearance is reinforced at every stage in education, from characters children's books such as Big Ears or Mr Nosey. Pantomime Ugly Sisters equate ugliness with evil, and film and video villains such as Freddy (in Nightmare on Elm Street) reinforce this definition. Were film makers to tackle race or sex in the way …

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