Reprinted with permission from the author’s book Jewish Living: A Guide to Contemporary Reform Practice , published by the UAHC Press (Union of American Hebrew Congregations), 2001.
Jewish law prohibits us from causing physical injury (havalah) to ourselves without sufficient justification. The debate over cosmetic surgery within the tradition accordingly centers upon the precise definitions we give to this prohibition.
Some assert that, so long as a particular cosmetic procedure is not unusually risky and is being contemplated for honorable reasons, the surgery does not violate the guidelines set forth by our sources and sages.
Others, however, argue that cosmetic surgery, like all other medical treatment, is permissible only for r’fu’ah, for healing, for legitimate medical purposes. The desire to improve one’s physical appearance is, in and of itself, not such a “legitimate medical purpose.” Indeed, it may be viewed as an act of arrogance, a desecration of the human form, and an example of misplaced values: with all the important work that we need to do in the field of medicine and healing, is the enhancement of physical beauty a proper end to which we ought to apply our knowledge and resources?
Reform responsa view the latter position as the better interpretation of Jewish teaching. Our reverence for the sanctity of the human body prohibits us from the capricious manipulation of its form, and surgery intended merely to improve one’s physical appearance should be discouraged.
Not All Plastic Surgery is Merely Cosmetic
There are, of course, exceptions to this general rule. We believe that reconstructive surgery, the restoration of one’s appearance to an approximation of its former state, is a proper medical objective and not merely cosmetic. Surgery to correct what are generally regarded as regarded as physical deformities is also permissible.
Moreover, for some persons “mere” cosmetic surgery may serve a useful medical purpose in enhancing a sense of psychological and emotional well-being. This is a determination which must be made in each individual case, although we think the argument is too frequently raised and too easily exaggerated. As we understand it, Judaism admonishes us to place less emphasis than we are prone to do on material values and to concentrate upon the development of deeper and more lasting measurements of self-worth and satisfaction. We ought to resist undertaking surgery intended solely for the improvement of physical appearance.
By “surgery,” we do not refer to such comparatively non-invasive procedures as the piercing of the ear. In such a case, since the community has long accepted these for cosmetic purposes, we would have no objections, provided that the procedure poses no significant health risk.
On the other hand, tattooing and more extreme forms of body piercing, when not undertaken as part of a regimen of medicine or reconstructive surgery, are most difficult to reconcile with Jewish tradition, which commands us to strive for holiness and to treat our bodies with reverence and respect. They are to be regarded as havalah, as pointless manipulation of the human form, rather than adornment.