Having spent the majority of my life in big cities such as Atlanta, Miami and Paris, I was taken aback by the responses of women in smaller southern cities such as Birmingham, Montgomery or Mobile to the notion of facelift procedures. I have on occasion related an anecdote about women in the South; if one asks a woman on the street in Miami or Paris “who is your doctor?,” the usual reply will get you the name of her plastic surgeon. The same question posed to a woman in Birmingham will get you the name of her gynecologist. I have no particular problem with gynecologists but it does reflect a palpable difference regarding priorities in medical care. Likewise, there always exists a group of women who proudly notify their friends and family of their impending surgery and show their friends the results the moment the dressings are off. A more common scenario in the South is that most women are very private in their personal affairs and only confide in their families and closest friends. We are not talking about people of wealth as no one knows how or why celebrities and the wealthy choose their healthcare providers. Judging from what we see on cable TV, the Michael Jacksons’ of the world as well as many aging models and TV stars should reconsider their choices of doctors, especially those who are fighting the aging process in an attempt to remain on the ‘’A’’ list.
The best example is the Hollywood penchant to completely overdo lip augmentation. The reason this is an issue is because “normal” people who inquire about lip enhancement look at celebrities, think they probably get the best plastic surgery, and assume that the comical, overdone lips are necessary for lip enhancement. Two bad assumptions are at work here: the first is that celebrities get the best plastic surgeons and the second is that enhanced lips should be huge and comical in appearance. Good plastic surgeons can usually enhance lips in any of a number of ways achieving fullness, a very youthful pout and accentuation of youthful lip anatomy without the “bee-stung” comical lips that we see all too often. The choice to overdo any plastic surgical procedure is entirely up to the patient and not a part of plastic surgery itself. There is an unknown in this process, which is the individual talent and taste of the plastic surgeon involved. This is why it helps to see examples of the surgeons work in order to get some idea of how aggressive or exaggerated the work is. Surgeons will usually show pictures of work they consider exemplary so when viewing catalogs of photos it is good to evaluate each result carefully taking in to consideration your specific taste, even if the photos are of procedures you are not considering.
One of the most challenging operations for a plastic surgeon is rhinoplasty. This is why there are so many “challenged” noses out there in Hollywood. It is a bit of a cliché to use the Jackson family as an example of rhinoplasty gone wrong but I’ll do it anyway. I believe that at least one of the early iterations of Michael’s nose was an attractive change from his original ethnic nose into a slightly improved version. I would surmise that it was an operation or two later that his final scar laden, next to nothing nose emerged was left of his original proboscis. Without the wonders of his handy, at home, hyperbaric oxygen chamber Michael may certainly have lost his nose in its entirety. I suspect that the last twenty or so operations were not procedures chosen by his surgeon yet performed nonetheles. The legacy of the Jackson family nasal nightmare should probably not be left with the surgeon but with the patients who are too famous, have too much money and succumbed to too much bad advice or a lack of good judgment.
Breasts have long been the subject of Hollywood photographers and celebrity magazines. Ever since Janet Jackson’s infamous Super bowl wardrobe malfunction there seems a preoccupation with breasts, especially large ones. Many women seem to have attached their femininity to their cup size. The trend to larger breasts is exemplified by today’s Victoria Secret models that are not as anorectic as the models of the 80’s and 90’s. In the real world outside of Hollywood women who consult for breast augmentation also want larger, fuller breasts but they also want “plausible deniability.” That requires breasts large enough to be sexy but not quite so large that they could not conceivably be nature’s gift.
Plastic surgery and the “beauty business” as it is now called did not arise from the devil as a temptation to vanity but rather as a consequence of the very normal desire of human beings to appear physically attractive to each other. The process of aging tends to extinguish some of the physical attractiveness of youth. Aging gracefully is the excuse given not to intervene with plastic surgery but our “grace” does not preclude spending billions of dollars on products for our hair, skin and nails. Recently, plastic surgeons have become facile and more creative with the surgical interventions we recommend to treat the aging face. Our operations tend to be less one-size-fits-all and are uniformly less invasive. Surgeons now are utilizing more of our scientific educational background to apply the latest in biology to scientifically improve our results and to stay abreast the latest research and findings.
Those of us in facial and body enhancement business are as different as our patients. The best we can do individually is to provide up to date, non-biased information including our training and certifications to the table and provide honest, accurate photographs of our work so that patients may get an idea of our preferences and our aesthetic sensibilities. The more factual information out there, the better chance the patient can find the right surgeon for the right problem.