Visible fragilities: the new narrative of the body between ethics and communication

Showing a sick, imperfect, or transformed body today is no longer a private gesture. It is a statement. In an era in which everything is filtered, retouched, and made desirable, choosing to tell a story of fragility means breaking an implicit pact, the one that demands the body always be performative and compliant. When illness enters social media, when pain becomes visible, the image ceases to be merely aesthetic and becomes language.

The pairing of cancer and digital communication, once considered inappropriate or even unseemly, has turned into a legitimate and ever-expanding narrative space. Public testimonies, shared through interviews or social platforms, do not follow a logic of exhibitionism but rather respond to a need for meaning: to tell in order to exist, to inform, to normalize what for too long has remained on the margins of public discourse.
In many cases, this form of storytelling goes beyond institutional language and reaches audiences often distant from traditional channels of health communication.

Body aesthetics and ethics: the subtle boundary of care

This new way of narrating the body is also reflected in medical practice, particularly in aesthetic and reconstructive fields, where image is an integral part of the care pathway. Dr. Chiara Botti, plastic surgeon and medical director of the Brescia-based Villa Bella Clinic, with teaching appointments at the Universities of Verona and Padua, draws attention to the ethical foundations of the profession: «Plastic surgery, like every branch of medicine, must be guided by fundamental ethical principles that regulate medical practice. The first of these is primum non nocere, that is, do no harm to the patient. This implies deep technical expertise and a strong sensitivity in understanding patients’ needs and motivations».

Doctor–patient communication plays a central role. It is not merely an informative tool, but a means of understanding expectations, fragilities, and needs that often do not emerge from a superficial reading of physical discomfort. Botti continues: «Talking with the patient is essential. Often, behind a physical problem lies a deeper discomfort. My experience has taught me that dialogue is crucial to correctly interpret requests and to assess whether an intervention can truly improve the patient’s quality of life».

Saying no to a request thus becomes an integral part of professional responsibility. When aesthetics conflict with functionality, the physician’s role also involves setting limits and explaining what is realistically possible without compromising health.

Social media and expectations: the risk of excess

The pressure exerted by social media amplifies the desire to conform to idealized images. Dr. Adriano Santorelli, a plastic surgeon based in Naples, explains: «Excessive requests are always just around the corner. Unfortunately, in my profession, I believe the best approach is to educate the patient».

Explaining the risks, limits, and consequences of procedures becomes essential to maintaining control over the therapeutic pathway. Communication, in this sense, is a form of prevention. «Beyond certain limits – Santorelli continues – one risks entering a ‘no man’s land,’ losing control of the process».

The book Diastasis of the Rectus Abdominis Muscles, published by Griffin Editori, by Dr. Daniele Bollero, a plastic surgeon from Turin, fits into this broader reflection by shifting the focus from purely aesthetic aspects to the functional and symbolic dimension of the body.

In the volume, diastasis is defined as a “wound that does not heal.” This means acknowledging its complexity and moving beyond a reductive narrative. «The goal is not to eliminate the distance between the rectus muscles entirely, but to bring it back within physiological limits, below two centimeters. It is essential that patients understand this: even after a perfectly successful operation, one does not return to an ‘absolute zero», Bollero explains.

Conscious choice in the digital age

In a landscape dominated by online visibility, Dr. Maurizio Pisapia, head of the Plastic Surgery Department at the Military Polyclinic of Rome “Celio” and lecturer at the School of Specialization in Plastic Surgery at the University of Rome Tor Vergata, emphasizes the importance of a structured and informed decision-making process. Digital communication can facilitate access to information, but it also risks oversimplifying complex choices. “An attractive website or a well-curated Instagram profile is not enough. It is essential to choose a qualified professional and to verify that they are part of prestigious associations, such as the Italian societies of plastic surgery.”

The surgeon thus becomes a mediating figure between desire, reality, and responsibility, called upon to manage expectations increasingly shaped by the aesthetics of social media.

Body image, identity, and mental health

The dissemination of accurate information highlights how delicate it is to communicate issues related to the body and health effectively. Body image and self-perception cannot be separated from the emotional and psychological dimensions of the patient, as in the case of obesity.

Dr. Marco Pastorini, psychologist and psychotherapist specializing in eating disorders and sexual health issues, underscores the need for personalized pathways that help individuals realign expectations with reality: «Very often, the self-image that the patient has and the body image they would like to achieve need to be brought into the present. Therefore, we work on emotions, on time management, and on body image, in order to update and enhance one’s own body».

When the outcome is not enough

Despite the increase in educational content, communication around prevention remains uneven. Dr. Alessandro De Luca, specialist in General Surgery, university lecturer at Sapienza University of Rome and researcher in the Department of Surgery, highlights that participation in screening programs is still partial and varies across regions: «To date, on a national scale, adherence among women to regional screening programs and diagnostic pathways reaches about 60–65%. There is significant heterogeneity across the country when considering different regions. This is because educational and informational activities are not equally present throughout the territory».

This difficulty in effectively conveying health information intersects with another crucial aspect of communication about the body: the emotional consequences of physical changes.
As Dr. Fulvio Palmieri, a plastic and aesthetic surgeon in Zurich, points out, even a technically perfect aesthetic procedure may not coincide with a patient’s psychological well-being. «It happened that a 19-year-old woman with tubular breasts underwent reconstructive surgery with bilateral implants. The operation had no complications and the natural result was beautiful. However, at follow-up, the patient was dissatisfied because the insecurities she previously had due to the malformation had increased – Palmieri explains – She now struggles to manage the new attention she receives from men. Paradoxically, she feels even more insecure».

In the contemporary narrative of the body, communication and aesthetics can no longer be considered separate domains. The storytelling of illness, transformation, and care unfolds in a complex public space, where images carry enormous weight, but words remain the decisive tool for providing meaning, measure, and responsibility to change.