Nasal Breakdowns

Most ivory-tower plastic surgeons are concerned with correcting some of mankind's more serious deformities--not with making "cosmetic" repairs such as nose bobbing or face lifting. This attitude is too narrow and too stuffy, according to Dr. Adolph Abraham Apton of Manhattan's Mount Sinai Hospital: anything that makes a person feel uncomfortably conspicuous leads to mental upsets and ought to be corrected if possible. Dr. Apton's motto: "Plastic surgery is a surgical method of psychotherapy."

In a new book, Your Mind and Appearance (Citadel; $3), Dr. Apton defends his theory. Many children's personalities are warped, he argues, because they happen to be born with jug ears, and get teased about them. Often the nose is the worrisome feature--and it does not have to be as big as Cyrano de Bergerac's. The passion to possess a sort of U.S. standard nose, says Dr. Apton, brings him patients who want their broad, flat noses built up with a bit of ridge, others who want their ridges taken down a notch. Dr. Apton generally obliges.

Pure vanity is not the only motive that sends people running to the plastic surgeon. Often it's a matter of cold business. Apton cites case after case (but without mentioning names), e.g., actresses who were able to go on playing youthful roles after face lifting, while others of the same age, with unlifted faces, got only middle-aged parts or none at all; a pediatrician who had a port-wine birthmark removed from his face because it scared the kiddies; a rabbit-eared radio announcer who had to have an operation to get a job on television.

Strongly as he believes in plastic surgery, Dr. Apton warns that it should not be used in purely trifling cases, or when a patient's depression is actually rooted in something deeper. And with approval he quotes a Canadian colleague: "Scars obtained in honest toil or in battle for a righteous cause are not dishonorable. In fact . . . they should be regarded as a badge of honor."

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