This study utilized a qualitative comparative approach, analyzing mythological figures through the lens of contemporary plastic surgery concerns. Primary sources include classical texts (Ovid and Hesiod) [2,3], medieval iconography, and modern theoretical works addressing aesthetics and body image [4,5]. Additionally, relevant case studies from plastic surgery literature concerning body dysmorphia, post-partum reshaping, and aesthetic procedures targeting lower-body regions inform the analysis [6]. To contextualize these transformations, we categorize mythical figures according to their anatomical and symbolic disruptions and are comparatively examined alongside contemporary surgical interventions. Special attention is given to patient motivations, psychological distress associated with perceived bodily “monstrosity,” and the symbolic significance attributed to lower-body transformations.

In the myth of Melusina, beauty and deformity are not simply opposites but interdependent. Her dual-tailed form remains concealed until betrayal exposes it—a metaphor reflective of anxieties surrounding bodily exposure and the revelation inherent in surgical procedures (Fig. 1). Similarly, Scylla, transformed by an envious rival, is depicted with legs corrupted into ravenous dogs, representing a nightmarish loss of bodily control (Ovid, Metamorphoses XIII) (Fig. 2) [2]. Echidna, known as the mother of monsters, combines a woman’s torso with a serpentine lower half, symbolizing ancient anxieties regarding feminine excess and unchecked fecundity (Hesiod, Theogony) (Fig. 3) [3]. Finally, the Sirens, characterized in medieval iconography with bifurcated tails, embody seduction intertwined with physical aberration (Fig. 4) [1]. These myths collectively reinforce cultural anxieties concerning loss of bodily control, especially from the waist down, where reproductive, digestive, and excretory functions occur. Plastic surgeons, analogous to mythmakers, negotiate these anxieties by transforming or concealing perceived monstrosities while preserving upper-body beauty [5].

From an evolutionary perspective, attraction is often governed by symmetry, smoothness, and reproductive cues [7]. The grotesque—a disruption of these features—triggers discomfort [4]. Melusina’s concealed tail, Scylla’s canine extremities, and the divided forms of the Sirens represent disruptions in expected human morphology. Aesthetic surgery patients often seek corrections for bodily changes disrupting symmetry and proportion, particularly post-partum alterations or age-related changes to the lower body [8]. The desire to regain pre-maternal or youthful contours reflects an ingrained evolutionary preference for traits symbolizing fertility and vitality [9].

Patient narratives in aesthetic surgery commonly reflect these mythical transformations. Individuals undergoing post-partum abdominal contouring frequently describe feelings of alienation from their lower body, employing terminology reminiscent of mythological monstrosity. Similarly, gluteal and labial surgeries often originate from psychological distress linked to deviations from idealized symmetry [6]. Table 1 summarizes the correlations between mythological figures and contemporary surgical concerns.

The myths of Melusina, Scylla, Echidna, and the Sirens illustrate the deep-rooted cultural and evolutionary nature of bodily anxieties. In plastic surgery, these anxieties become particularly evident in interventions addressing the “monstrous” zones, regions most intensely contested in terms of aesthetic ideals [5]. From a psychoanalytic perspective, these myths externalize subconscious fears about bodily autonomy and transformation. Just as Melusina conceals her tail, many patients fear exposure of post-surgical scars or bodily modifications. Scylla’s monstrous lower half mirrors primal fears regarding uncontrolled bodily changes, paralleling patient distress concerning post-partum or age-related bodily transformations. These narratives underscore the plastic surgeon’s role as both healer and symbolic restorer of bodily control. Unlike mythological transformations, which are typically irreversible, surgical interventions provide the possibility of reshaping, reclaiming, and dissolving boundaries between beauty and monstrosity. Thus, modern aesthetic surgeons act not merely as practitioners of physical alteration but as agents facilitating narrative revision, enabling patients to rewrite their personal metamorphoses. In conclusion, plastic surgery engages deeply with enduring myths of bodily transformation, highlighting anxieties and desires persistent throughout history. The ongoing interplay between beauty and monstrosity in traditionally defined “non-beauty zones” remains central to aesthetic medicine. By confronting and reshaping these narratives, plastic surgery transcends mere physical modification—it actively participates in the reinterpretation of mythology itself.