Teaching plastic surgeons about beauty

A rat's tail morphs into the stem of a flower. A vase contains brushes for calligraphy - and cleaning the toilet. In Michael Esson's drawings, "pretty" comes with a strong side of unpleasant.

Over a scratchy Skype connection, the artist, who is lecturing in Wuhan, China, explains his aesthetic.

"There's a term they use here, which I won't try to pronounce, but it means the relationship between ugly and beauty. I like the intersection, or the juxtaposition."

Which is all well and good for the pen-and-paper practitioner. But Esson has a curious resume. Alongside his work as director of the University of New South Wales' International Drawing Research Institute, he runs courses for plastic surgeons; the people who cut and sculpt human flesh, arguably, in pursuit of perfection - and beauty.

"I'm always suspicious of surgeons who quite categorically state that the results are much more beautiful than the patient was before," says Esson. "That worries me, that they're very definite in their opinions."

Esson is in New Zealand next week (March 14-16), speaking at Art, History and Plastic Surgery, a symposium celebrating 100 years of modern plastic surgery. He'll take two sessions, and, on Friday, deliver a public lecture at the Auckland Art Gallery.

Mike Klaassen, Auckland plastic surgeon and symposium organiser, says Esson was an "obvious choice".

"He understands the critical ingredient of art and artistic skills required by plastic surgeons. Plastic surgeons are either born with this skill set or need to learn it."

Esson, described as a world renowned artist whose drawings concentrate on the study and interpretation of the human figure, has been credited with changing the way surgeons work, following their participation in his three-day Art of Reconstruction courses.

"The purpose behind them is to try to develop their perceptional and observational skills. I teach them drawing and I teach them modelling in clay and we do a whole range of different exercises, which is just training them to see things in a slightly different way from how they might normally look at their patients . . . it's just about tuning the eye, I suppose, or tuning the decision making. Not just making the same old nose, or the same old breast."

YouTube clips show Esson at work - his surgeon students draw a bust draped with striped fabric and wrapped in string to create contour lines. They produce large-scale portraits of the four quarters of their own faces, and then attempt to merge the pieces together. And they mould three-dimensional breasts on to a plaster cast of a real mastectomised chest.

One surgeon, Megan Hassall, observes: "Living tissue is not clay - if you take too much away, you can't just put it back" - but also says that thanks to Esson's classes, she now moves around the operating table more.

"Sometimes they can model the breast from the front view, and it can actually look OK, and from the side elevation it can look OK as well," says Esson. "But what they seldom did was look from above. What I try to get them to do now, in their operating theatre, is to sit their patient up, still under anaesthetic. First of all, the breast they're trying to reconstruct will drop naturally - it's difficult to make judgments, because there's still swelling and movement in place for the next few days or weeks after the operation, but I get them to try and get above the patient's head; to look down between and see what the patient would see."

Art classes for plastic surgeons are nothing new, but Esson says he believes some simply "pander to their preconceptions".

"I try to impose the principles of visual awareness, not just preconceiving what they think is beautiful or not beautiful."

Some surgeons, he says, are fixated on notions of proportion - how far apart facial features should be, for example.

"Their colleagues can look at their patients and say, ‘oh such and such did that nose' because they do the same nose on every person. That's precisely what I try to avoid, these notions of proportion and beauty which have changed over the centuries. I try to get them to look at the individual character of the patient, and see what sort of nose would suit a particular face."

Ideals of beauty change with time, says Esson. "In the 50s, Marilyn Monroe would be held up as the ideal, but she certainly wouldn't be today. I get equally worried about the surgeons who look at classical figures from Greece or wherever and say ‘this is the ideal of beauty'. There are some I know who think Michelangelo's sculpture is the ideal - and, of course, all of Michelangelo's women look as though they're men with breasts stuck on. I think a contemporary writer on Michelangelo said the only breasts he [the sculptor] knew were breasts of marble."

Esson has always been fascinated by bodies - inside and out.

"As a young person, even before my art school, I was always very interested in anatomy and studied Leonardo and so on."

Originally trained as a glass artist and sculptor, the Edinburgh College of Art and Royal College of Art, London graduate was, in 1993, Edinburgh's Royal College of Surgeons first artist in residence, observing operations and running a weekly drawing class. He established his three-day courses - which attract participants from New Zealand - on his return to Australia.

"Things like skeletons and anatomical structures have always been fascinating for me, I don't know why, I still collect skulls and masks of skulls and skeletons from various cultures around the world - Mexican, New Guinean, Tibetan. I suppose, in a sense, I've had a fascination with a sense of mortality. Maybe it's being Scottish that does that?"

Esson's work has been described by one reviewer as "grotesque . . . an entire meat shop on the paper operating table", but he says it's natural for an artist to want to know the structure of things.

"The one thing I think a good artist shares with a good surgeon . . . is not skill and talent and everything else, but a sense of curiosity. And I think it's that sense that causes us to think about the insides of the body perhaps."

Esson says plastic surgeons have a "keen interest" in visual arts. "Many of them are the ones who go to galleries and museums and are, maybe, art collectors. It's not just the techniques, it's something beyond that - they're fascinated by the creative process."

Following his Edinburgh residency, Esson produced a body of work titled Delusions of Grandeur. "People said to me, ‘oh, you don't think much of the surgeons, do you?' But, in fact, on the whole, I have a great admiration of the medical profession."

Sunday Star Times