Dr. Shenker tells us the truth about natural, beautiful results
Being an aesthetic physician and surgeon comes with responsibilities that I take seriously.
As a physician and as a surgeon, I embrace the long list of responsibilities and duties I have to my patients. I have to actively listen. I have to examine my patient carefully and with a deep attention to detail. I have to make an accurate diagnosis. I have to formulate an effective treatment plan which I have to execute with speed, skill and compassion. I have to be respectful of the needs and worries of each patient. If I find myself consulting with a patient who has a problem that I cannot fix, I am responsible for finding a colleague who can help. And the list goes on. These responsibilities don’t apply only to me, but to all physicians.
Recently, I was reminded of yet another of my responsibilities as a physician. This responsibility, however, relates solely to my work in the world of aesthetics.
It’s easy to notice when aesthetic results haven’t been done with expertise, skill, or thoughtful care.
My wife and I recently spent some time on vacation in Western Canada. While on an excursion outside of the hotel, my wife, who has a great eye for such things, pointed out a woman on our excursion who caught her eye. My wife, looking horrified, asked me, what is going on with this woman’s face? So, without staring, I did my best to have a good look.
What I saw was a well-dressed, healthy looking woman I guessed to be in her early to mid-forties. Sadly, she had every sign of poorly executed facial aesthetic treatments that one can imagine. Her upper and lower lips were not only huge, but also oddly distorted. Her cheeks ballooned out of proportion. Her chin was grotesquely widened and overprojected with either filler or a chin implant. Her jawline and jowls were over filled, yet somehow still saggy and lax. There appeared to be some oddly positioned mid-cheek dimples and some unnatural pulling of her facial soft tissues from what I suspect were poorly placed barbed threads. And her forehead was rendered totally expressionless by one neurotoxin or another.
While her face was a mess, I could see that underneath the mayhem caused by a “cosmetic” doctor or nurse, there was actually a beautiful face. But instead of a careful and subtle enhancement of her natural beauty, it had been obliterated. In its place was a face that was a caricature of the “overdone” face.
I want to be clear that I am not commenting on a difference between my ideal aesthetic and this woman’s. I understand that what some people think is beautiful may not be so to others. Some people like full lips and high cheekbones, and some don’t. What I am talking about in this case is the wanton use of powerful cosmetic products, devices and procedures, to temporarily or permanently destroy normal anatomy, facial harmony, and any sense of balance or proportion. I am commenting on those practitioners of cosmetic medicine who fail to understand that too much of a good thing is a bad thing.
They fail to understand that most of the time, more is not better.
Plastic surgeons and injectors have an important role in honouring each patient’s well being, aesthetic goals, and unique beauty.
As plastic surgeons, we do facial cosmetic procedures, either surgical, like eyelid or face or brow procedures, or non-surgical, like neurotoxins (Botox®, Dysport® and Xeomin®) and filler and laser work. When we do all of these procedures, it is our responsibility to vigilantly safeguard a person’s balance, harmony, symmetry and natural beauty. We need to avoid at all costs distorting, disfiguring and destroying the face a person brings to us on their first visit.
Not all results are temporary, and each treatment and procedure should be treated with incredible care.
Some will argue that these facial treatments are temporary, so the natural underlying facial features will come back in time. But that is not always the case. Some facial filler materials are permanent. Sometimes lips are filled with dermal grafts that are difficult, if not impossible to remove. Facial implants may need to be surgically removed. And all of this does not even take into account the fact that there is risk involved each and every time one of these “non-invasive” procedures is done. Multiply that risk by the many times the procedures are done in overdone patients, and add in the risks of the procedures intended to correct the problems, and all of a sudden the risk profile looks a lot different.
The oath we make to protect our patients in every aspect as practitioners is imperative.
As physicians,when we finished medical school, we all swore an oath, in the great historical tradition of centuries of physicians who came before us. That oath commanded us to “First, do no harm.” It is incumbent upon all physicians and surgeons who work in the aesthetic field to remember that oath extends to aesthetic procedures as well.
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