I'm having my wings done

It's the stuff of science fantasy, but a respected American surgeon says that, within five years, he will be able to graft wings and tails on to human beings. Johann Hari on the bizarre world of radical plastic surgery

The TV sketch show Smack the Pony recently featured a hilarious scene in which a woman turned up at a plastic surgeon's clinic bearing a picture of a wolf. "I want to look like this, please," she explained, and people chuckled in living rooms across Britain. Across the Atlantic, however, there is a respected plastic surgeon who really is working on plastic-surgery techniques which could make us resemble animals in ways we can't even imagine today.

Dr Joe Rosen is not a quack. He works at the acclaimed Dartmouth Medical Centre, and has been a scientific advisor to Nasa. He is fond of making statements such as: "Human wings will be here. Mark my words." He believes in all seriousness that within five years he will be able to graft wings on to a human being's body. This is possible because our brains adapt to create neural maps for new body parts. When we have a limb amputated, our neural map of that limb gradually fades away; and if we gain a body part, our neural map expands accordingly.

"If I were to give you wings, you would develop, literally, a winged brain. Our bodies change our brains, and our brains are infinitely mouldable," Rosen has said.

Surgical techniques already in existence can be used to stretch torso fat and rejig rib bones to create a wing. Although no human would be able to fly, they would resemble angels and have full sensation in their new hanging, boned flaps of flesh. Rosen has designed blueprints. This is the new world of radical plastic surgery, where Rosen is Moses. He would not be content to settle merely for wings either. He has been working on cochlear implants to enhance human hearing (a procedure which the US military has shown interest in, raising as it does the prospect of super-human soldiers), and even tails.

In a conference speech last year, Rosen asked: "Why do we only value the average? Why are plastic surgeons dedicated only to restoring our current notions of the conventional, as opposed to letting people explore, if they want, the possibilities?" He says it is only our "Judaeo-Christian conservatism" that is holding us back.

If the medical-ethics board allowed it, Rosen insists he would carry out these procedures. And, as the case of Severino Antinori, the Italian doctor hell-bent on cloning a human, shows, once the technology and the will to experiment exist, it is very hard for even the most overwhelming ethical qualms to block these actions. Sooner or later, Rosen's plans will be put into action: just like the mouse with an ear on his back, one day soon a winged human will force us to re-examine the fundamentals of human life.

So it's time that we started to ask serious questions about the people who will be the guinea pigs in the radical plastic-surgery revolution. Put bluntly, who the hell would want wings or a tail? We can perhaps find answers by looking at people today who have already changed their bodies in radical and seemingly unnatural ways. Jim Rose, the head of a gross-out travelling circus or "freak show", has considerable experience of people who drastically alter their bodies. A former colleague of his known as Enigma now has horns. Seriously.

Enigma's horns are implanted deep into his skull. They are made of coral, which is recognised by the body as similar to bone. Each year he has progressively larger coral implants because it is taking time for his skin to stretch. He only gave up on his dream of having jewelled eyebrows embedded into his face when doctors told him forcefully that having transdermal implants near hair follicles was extremely dangerous.

So Rose's friends and colleagues such as Enigma are exactly the kind of people who will be first in the queue for Rosen's new operations. He says that, "Rosen is talking their language. I've worked with people with split tongues because they want to be like lizards, people who want to look like cats. I've lived with these people on the road for years, and believe me, they're very interested in operations that could give them tails or wings."

He has interesting insights on the psychology of people drawn to this kind of procedure. "If there's one thing that the outrageously altered have in common, it's an incredible need for attention. Most of them in their past have felt overlooked, usually by a parent. That gives them a mindset that's like, 'I will not be ignored.' Because of their desperate need for attention, they're usually happier after they've been altered [for example, by being covered with tattoos]." But the attention they receive "almost always causes this unbearable kind of egocentricity. I'd like to buy those guys for what they're worth and sell them for what they think they're worth - I could retire on that."

This raises the obvious concern that people longing for these procedures are ill. Some social scientists argue that we are seeing in the west a "global pandemic" of Body Dysmorphic Disorder (BDD), a condition which causes victims to feel their bodies are imperfect and must be corrected, often with surgery. The best-known manifestations of BDD are eating disorders such as anorexia and bulimia and, notoriously, individuals who have healthy limbs removed because they view them as ugly or extraneous.

But BDD expert Katherine Phillips of Brown University, Rhode Island, says the disease could take the form of trying to acquire extra body parts. However, it is unlikely to enhance their lives. She is conducting research into individuals with BDD who manage to persuade surgeons to give them the operations they want. "For most of them it doesn't help at all, it makes no difference. About 7% do get better, but for a small number, they get drastically worse and become very angry. They can attack their surgeons or kill themselves."

There are complex ethical questions about whether cosmetic surgeons should do what an apparently sane patient requests, no matter how abnormal it might seem. A recent case in New York City highlighted this. A female patient sued her plastic surgeon for malpractice because the doctors failed to take on board that she had a severe obsession with her body image. She claims that her mental state made her unfit to consent to more than 100 operations, including lyposuction, a tummy tuck and a nose job.

If problems like this arise even with normal cosmetic surgery cases, what will happen with the radical kind proposed by Rosen? Could any doctor operate to give somebody a tail or wings without being open to the accusation that they, too, were taking advantage of unstable or irresponsible patients?

Many plastic surgeons strongly disapprove of Rosen. Distinguished US plastic surgeon Dr John Hugill, for example, says that Rosen "is way too far out, totally beyond mainstream medicine or mainstream cosmetic surgery. No plastic surgeon I know would do anything of this sort, and nor should he. He should be ashamed."

This forces us, however, to confront what has become mainstream in plastic surgery. Surgical techniques have developed so quickly that we have begun to think it normal that 2 million people slice their flesh open each year in Europe and America simply to improve its appearance. Fifty years ago, facelifts - which, after all, involve dragging the flesh on your face back behind your ears - were seen as monstrous. Yet today we don't even bat a botoxed eyelid at the once-beautiful face of Cher, now drained of all expression in the desperate quest for a wrinkle-free face. If Cher and Michael Jackson have the right to disfigure themselves and yet still nudge their way into the mainstream, should Enigma and his horns be given the same rights?