Question Summary:
Regarding fatwa no. 19138, isn’t otoplasty surgery a cosmetic surgery? Is cosmetic surgery permissible? Can one undergo surgery to rectify abnormal looking nose or chin?

Question Detail:

Alhamdulillah, I regularly browse through the online Q&A and use it as a source of obtaining information and guidance. My question relates to a previous fatwa (number 19138) that was issued. Normally, some explanation is provided before the verdict is provided, but not in this case. The query in question related to the permissibility of otoplasty (a surgical procedure) for the purposes of rendering the ears to what would be perceived as "normal".
My question is posed as a lay-man and not meant to question the validity of the previous answer but to obtain an understanding of the rationale used in arriving at the answer.
It could be viewed that the otoplasty is a "cosmetic surgical procedure" and one that changes the appearance of a person from that with which Allah has bestowed one. I understand the potential ridicule that one who is born with such a condition may endure and I sympathise with such persons.
Can the ruling be extended to other features of a person that are not considered "normal" such as a nose or a chin?

Answer :

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In the Name of Allāh, the Most Gracious, the Most Merciful.
As-salāmu ‘alaykum wa-rahmatullāhi wa-barakātuh.

In principal, if someone has a defect in his body and the defect can be rectified by means of surgery, it will be permissible for him to undergo the surgery with the condition that the surgery does not pose a high risk to his life. For example, the jurists have mentioned that if someone has six fingers, it will be permissible for him to have the extra finger surgically removed if the surgical procedure does not pose a high risk to his life (i.e. the probability of surviving is greater than the probability of perishing). Similarly, they have mentioned that if someone has a cyst and the cyst can be removed by means of a surgical procedure, it will be permissible for him to undergo the surgery if it does not pose a high risk to his life.
Such surgical procedures are permissible because they are considered to be treatments, and undergoing a treatment is permissible in the Shariah. On the other hand, if the surgery is such that it poses a high risk to one’s life, it will not be permissible to undergo such a surgery, as it will be tantamount to exposing oneself to destruction.
 
في الخانية: رجل له سلعة أو حجر فأراد أن يستخرجه ويخاف منه الموت قال أبو يوسف رحمه الله: إن كان فعله أحد فنجا فلا بأس بأن يفعل لأنه يكون معالجة ولا يكون تعريضا للهلاك. وفي الفتاوى: إذا أراد الرجل أن يقطع إصبعا زائدة أو شيئا آخر قال أبو نصر رحمه الله تعالى: إن كان الغالب على من قطع مثل ذلك الهلاك فإنه لا يفعل لأنه تعريض النفس للهلاك وإن كان الغالب هو النجاة فهو في سعة من ذلك ( فتاوى قاضيخان: 3/313 ، دار الكتب العلمية )
 
وفي الهندية: إذا أراد الرجل أن يقطع إصبعا زائدة أو شيئا آخر قال نصير رحمه الله تعالى إن كان الغالب على من قطع مثل ذلك الهلاك فإنه لا يفعل وإن كان الغالب هو النجاة فهو في سعة من ذلك ... من له سلعة زائدة يريد قطعها إن كان الغالب الهلاك فلا يفعل وإلا فلا بأس به كذا في خزانة المفتين ( الفتاوى الهندية: 5/440 ، دار الكتب العلمية )
 
The above is in regards to undergoing a surgery in order to rectify a defect in one’s body. As for cosmetic surgery – i.e. surgical alteration of face or body for enhancing one’s look and beauty – it is not permissible. It is mentioned in a hadith that the Allah Ta’ala has cursed women who alter their teeth by filing them and making a gap between them for cosmetic purpose; and the hadith describes such women as those who change the creation of Allah (See: Bukhari: 2/725, 878 Qadeemi Kutub Khana)
 
عن عبد الله قال لعن الله الواشمات والموتشمات والمتنمصات والمتفلجات للحسن المغيرات خلق الله ... ( صحيح البخاري: 2/725، 878 ، قديمي كتب خانه )
 
( قوله: المتلفجات ) جمع متفلجة بالفاء والجيم من التفلج وهو برد الأسنان الثنايا والرباعيات مأخوذ من الفلج بفتح الفاء واللام وهي فرجة بين الثنايا والرباعيات ( عمدة القاري: 19/325 ، دار الكتب العلمية )
 
Scholars have explained that filing the teeth and making a gap between them for cosmetic purpose is not permissible as it is tantamount to changing the creation of Allah and a means of deceiving others (as older women used to do this in order to appear young).
 
وقد تفعله الكبيرة توهم أنها صغيرة ، لأن الصغيرة غالبا تكون مفلجة جديدة السن ، ويذهب ذلك في الكبر ... فورد النهي عن ذلك لما فيه من تغيير الخلقة الأصلية ( فتح الباري: 13/455 ، دار الكتب العلمية )
 
وفي حاشية البخاري للشيخ المحدّث أحمد علي السهارنفوري: ( قوله: المتفلجات) بالفاء والجيم ، جمع متفلجة ، وهي التي تفرق بين ثناياها بالمبرد إظهارا للصغر وهي عجوز ، لأن هذه الفرجة اللطيفة تكون للصغار غالبا ، وذلك حرام للحسن أي لأجل التحسين لما فيه من التزوير ( حاشية صحيح البخاري: 2/ 725 ، رقم الحاشية: 5 ، قديمي كتب خانه )
 
From the above, it becomes clear that undergoing cosmetic surgery is also not permissible as it is tantamount to changing the creation of Allah and as it is a means of deceiving others (as many people undergo cosmetic surgery in order to appear younger).
Note, however, that the hadith mentioned above does not prohibit undergoing a surgery in order to treat an illness or to rectify a defect in one’s body. In fact, the scholars have mentioned that if a woman files her teeth and makes a gap between them in order to treat an illness or to rectify a defect in her teeth, it will be permissible for her to do so and it will not fall under the prohibition mentioned in the hadith.
 
( قوله: المتفلجات) ... وذلك حرام للحسن أي لأجل التحسين لما فيه من التزوير فلو احتاجت إليه لعلاج أو عيب في السن فلا ( حاشية صحيح البخاري للشيخ المحدّث أحمد علي السهارنفوري: 2/ 725 ، رقم الحاشية: 5 ، قديمي كتب خانه )
 
( قوله: للحسن ) يتعلق بالمتفلجات أي لأجل الحسن قيد به لأن الحرام منه هو المفعول لطلب الحسن أما إذا احتيج إليه لعلاج أو عيب في السن ونحوه فلا بأس به ( عمدة القاري: 19/325 ، دار الكتب العلمية )
 
( قوله : والمتفلجات للحسن ) يفهم منه أن المذمومة من فعلت ذلك لأجل الحسن فلو احتاجت إلى ذلك لمداواة مثلا جاز ( فتح الباري: 13/455 ، دار الكتب العلمية )
 
In fatwa no. 19138, the questioner had asked about undergoing the otoplasty surgery in order to rectify his abnormally protruding ear.
Abnormally protruding ear is a defect; and therefore rectifying it with surgery will not fall under cosmetic surgery.
In regards to your last question, if someone genuinely thinks that he has a defect in his nose or chin, he should consult a competent Muslim medical professional in person who can then advise him whether or not it is in fact a defect. If it is decreed that it is a defect, it will be permissible for him to rectify the defect with surgery with the condition that the surgical procedure will not pose a high risk to his life.
 
And Allāh knows best.
Ml. Faizal Riza
Melbourne, Australia
Concurred by:
Muftī Abrar Mirza
Chicago, IL (USA)
Under the Supervision of Muftī Ebrahim Desai (South Africa)