This is the first of five short lessons delivered by Ustādh Rafī’pūr – a teacher of khārij – in the city of Mashad, in Madrassah Ayatullah Khūi, on the topic of cosmetic surgery. The lessons are from 18^th – 22^nd June, 2022.

—

One of the most popular surgeries around the world, including Iran, is cosmetic surgery. Many people, depending on their age and societal expectations, decide to undergo this surgery to alter some part of their body. In fact, some people decide to do this surgery multiple times during their lifetime.

Shi’i jurists do not have any issue with reconstructive plastic surgery when done in the case of necessity, from the perspective of treating injuries or other physical ailments. However, there exists a discussion on the topic of plastic surgery performed for purely aesthetic reasons. Is such a surgery allowed or not? If it is allowed, does such a procedure not go against this verse of the Quran:

وَلَأُضِلَّنَّهُمْ وَلَأُمَنِّيَنَّهُمْ وَلَـَٔامُرَنَّهُمْ فَلَيُبَتِّكُنَّ ءَاذَانَ ٱلْأَنْعَـٰمِ وَلَـَٔامُرَنَّهُمْ فَلَيُغَيِّرُنَّ خَلْقَ ٱللَّهِ ۚ وَمَن يَتَّخِذِ ٱلشَّيْطَـٰنَ وَلِيًّا مِّن دُونِ ٱللَّهِ فَقَدْ خَسِرَ خُسْرَانًا مُّبِينًا

[4:119] “I will certainly mislead them and delude them with empty hopes. Also, I will order them and they will slit the ears of cattle and alter Allah’s creation.” And whoever takes Satan as a guardian instead of Allah has certainly suffered a tremendous loss.

If Allah (swt) chose for us to look a certain way, but we grow up and think we can make ourselves look better than the way Allah (swt) created us, does this not go against the aforementioned verse? Satan confesses he will mislead us and will delude us into changing Allah’s creation. Is performing cosmetic surgery not an instance of changing Allah’s creation?

This is the topic we wish to discuss briefly over the next few lessons. Before giving an overview of some of the particular topics we will try and address over the course of these lessons, let us look at some of the literature written on this subject:

a) A book titled, Jarrāḥī Zībāyī az Manẓar-i Fiqh wa Ḥuqūq, by Khānum Marjān Kāzemī

b) An article written around 14 years ago titled, Jarrāhī Zībāyī az Manẓar-i Fiqh wa Ḥuqūq-i Pezeshkī, by Ayyūb Amarjī and Maḥmūd ‘Abbāṣī¹

c) An article titled, ‘Amal-i Zībāyī wa Jarrāḥī Plāstic dar Sāḥat-i Fiqh, by Khānum Tayyibeh and Ḥusayn Ṣāberī²

d) An article titled, Jarrāḥi Zībāyī az Manẓar-i Fiqh, by Khānum Zohreh Ṣafātī³ and Marjān Kāzemī.⁴

e) Transcripts on this topic from Ayatullah Shūpāyī’s lessons, which he was delivering in Mashhad before the coronavirus pandemic; I have these transcripts with me.⁵

Other than these works, I did not come across anything else of significance.

Historically speaking, bodily surgical procedures are not a new phenomenon. In fact, some forms of surgical procedures on limbs and body parts can be traced back to India around 600 BA. One of the earliest references to such surgeries is a form of nose surgery, but it is important to note most of these procedures were being done on people who had been injured, many times at war, and they were not being done merely for cosmetic purposes.

The Ahl al-Sunnah have a report in their ḥadīth literature that says a person had lost a part of his nose in one of the battles, and the person attached a piece of silver to his nose to cover it. However, after some time the silver attained a bad odour and the Prophet (p) tells him to attach a piece of gold instead. Even if this report is correct, it is still in the context of treating an injury.

The topic of our discussion is specifically cosmetic surgery done purely for aesthetic reasons and has become popular in the last few decades. It is also a widespread phenomenon in Iran and has become a profitable business for surgeons.

In our lessons, I will address this topic based on two contemporary, yet distinct approaches to jurisprudence. We will see that when one follows the traditional approach of Najaf which relies heavily on procedural principles, how easy it is to conclude the permissibility of cosmetic surgery, however, if you follow the more contemporary approach to Fiqh which is based on expediency, maqāṣid, and Quran-centrism, a jurist will run into some hurdles – though I am not saying they will arrive at prohibition necessarily. This is what we will try to explore in our lessons and look at the issue from both approaches.

A few more related questions we will try to briefly address – if time permits – are:

i) If the surgeon causes harm to the patient, are they responsible for it or not? If they are responsible for it, to what extent?

ii) What if a surgeon performs the surgery, but the patient is not completely satisfied with the result? Do they still owe the surgeon compensation, and if so how much? Is the surgeon charging for the procedure or are they charging for the final result?

iii) A few pertinent issues that can arise after the procedure for the patient are matters likes wuḍū’ and ghusl. How do they deal with them? What if pig skin is used – as it often is – in these procedures, what are the implications of that for the patient afterwards? Is that skin considered part of the human body and treated as pure, or is it treated as impure?

iv) What if a part of the skin and limb of another human is used for the procedure, does that person have to know and be satisfied with the patient who will be using those parts?

On a side note, in some of the literature referenced earlier, some authors went into the history of circumcision as that is also a surgical procedure. They have explored not only its history but also the narrations on the topic. However, we will not be going into it as we do not believe it is relevant to our discussion.

We will end our first lesson by outlining a few scenarios for cosmetic surgery done for beautification:

i) Beautification is done by adding something to the body, but this additional thing can be removed if need be. Some of those things added to the body can be removed easily, while others may be removed with a little more difficulty. For example, a wig or hair extensions that are attached to the scalp. We have a few narrations on this subject and this practice was called wāṣilah as some women during the time of the Prophet (p) would use hair from other women and attach it to their heads to hide bald spots.

ii) Beautification by removing something from the body. For example, if someone has hair on a certain part of their body and wants it removed; laser hair removal would be an instance of that.

iii) Beautification by things that remain on the body, such as tattoos.

iv) Beautification by surgically reconstructing a body part. This is the scenario that we are concerned with, but we will also cite the few narrations that are relevant to the first scenario in our lessons, as some aspects of those reports can be meaningful for us in our discussions.

It is interesting to note that the majority of Ahl al-Sunnah jurists consider this fourth scenario prohibited, while most Shi’i jurists considered this permissible. God-willing, in the next lesson we will begin to look at the evidence for and against this procedure.

1. Reference: https://www.noormags.ir/view/fa/articlepage/63885/87
2. Reference: http://fvh.journals.miu.ac.ir/article_1603.html
3. She is the wife of the deceased marja‘ Ayatullah Mīrzā Muḥammad Ḥasan Aḥmadī Faqīḥ and a jurist herself who delivers baḥth al-khārij in the seminary
4. Reference: http://noo.rs/DMReV
5. His official website: http://shoopaii.ir/