Abetted by his father, he added three years to his age and was admitted to the local medical school at 15. After a residency in Rio, he traveled abroad to further his studies, completing a fellowship at Bethesda Hospital in Cincinnati, and then studying with leading surgeons in London and Paris. In those post-WWII years, the field of plastic surgery was developing rapidly. “If you look at the history of plastic surgery,” he notes, “it always goes with trauma, with destruction comes reconstruction.” In the course of his work, Pitanguy realized that the techniques used in reconstructive operations could be used for purely aesthetic purposes as well—not a common idea at the time. He decided to make it his life’s work to erase the distinction between the two. Patients in both instances, he believes, are in pain, and if that pain stems from dissatisfaction with the appearance of one’s nose or chin it is no less real. “To be happy with yourself is by no means a superficial desire,” he insists. “My operations are not just for my patients’ bodies. They are for their souls.”
Pitanguy returned to Rio in 1952. After serving as head of plastic surgery at the city’s oldest hospital, Santa Casa, for six years, he founded a teaching program at Pontifical Catholic University that soon became one of the most influential in the field. More than 500 doctors from 40 countries have since received degrees there. Top New York plastic surgeon Gerald Imber, who met Pitanguy at a scientific gathering 25 years ago, describes the doctor as “perhaps the most significant cosmetic surgeon of the second half of the 20th century” and “an inspiration” to the current generation of plastic surgeons.
Pitanguy takes a heavily psychoanalytic view of plastic surgery, to the extent that, he says, “I have always worked like a psychologist with a knife.” Before he agrees to perform an operation (Pitanguy still wields his scalpel, but usually with a team of doctors), he has a conference with the prospective patient to make sure his or her expectations are grounded in reality. “The way that you see your image may not be the way that I or others see it,” he says. “Many people have dysmorphia; they see themselves as much worse than they really are. Many people sublimate problems that are inside them and project them onto, say, their nose.”
In many cases, Pitanguy arranges for the patient to meet with his daughter, Gisela, 49, who is the director of the clinic and a psychotherapist. In some cases, following counseling, patients realize that surgery is not an answer to their problems. One gentleman, Pitanguy recalls, came to the clinic extremely unhappy with his face, which Pitanguy thought was fine. The problem, it eventually became clear, was that the man very closely resembled his father, for whom he harbored a deep, but theretofore repressed, hatred. “When he realized this, he was cured and didn’t have to be operated on,” says Pitanguy.