The term ‘saving face’ has  a variety of meanings,  most commonly perceived as an act of doing something that saves one’s self-esteem or dignity. But an increasing number of China’s politicians are redefining the age-old Eastern philosophy of “saving face.”

Reports from some of China’s largest cities, such as Beijing, indicate that there is a surge of government officials being treated annually at their Plastic Surgery hospitals. (China has numerous very large hospitals dedicated just to plastic surgery…the largest being over 1,000 beds!) Because officials have to go on television much more than before and to make many public appearances, they want to make sure they have strong and attractive facial features that portray ‘leadership’ and confidence.  The most popular procedures are eyelid lifts, Botox and injectable filler treatments, and facial bone reshaping.

Plastic surgery is now a multibillion-dollar-a-year industry in China and is growing at the rate of 20 percent annually. While this story and those statistics may be interesting, you may ask ‘what does that have to do with the price of Starbucks in America’?

While there may be significant cultural and political differences between these two countries, the unifying theme is that appearance counts…and often is very relevant for job promotion and career advancement. How much does physical appearance determine a person’s prospects of career advancement? Undoubtably the type of job sways how important appearance is. Fashion models are expected to be beautiful. Professional athletes  are expected to be fit. Corporate executives are expected to be well groomed and wear high-priced suits.

But what about common and everyday jobs where physical appearance does not seem to be important to how well the work is performed? The answer is… looks still  matter. Attractive people tend to make more money and move higher up the job ladder compared to unattractive people. Tall businessmen tend to enjoy more career success than short businessmen. People who are very over-weight or under-weight are at a disadvantage. Is this fair? No, but humans are visual animals, after all.

In Gordon Patzer’s very insightful book,  Looks: Why They Matter More Than You Ever Imagined (2008),  this bias in favor of physical appearance over competence is called ‘lookism’. He catalogues the evidence about how much influence physical attractiveness and body type have on a person’s prospects of success. Patzer claims that looks influence how well a person is treated at work, at school, at home, and many other spheres of life. Obviously, looks aren’t the only factor that determines success and status. Yet looks are far more important than most people suspect.

The recent and ongoing recession has brought forth a surge of patients interested in maintaining or improving their appearance, and they are often quite forthright about it. They openly admit they fear job competition and displacement from younger, less experienced candidates.   Professionals today want to project an image of good health and success, and good looks are a large part of the package.

The concept of ‘Lookism’ is universal and shared by people around the world. While extremes examples in plastic surgery are routinely, and even fervently, reported on here in the US, these are exactly that… extremes. Most people simply want to look and feel better…not morph into another person or personality. Today’s plastic surgery techniques offer a large range of treatments that really can help one ‘save face’.  From such minimally invasive techniques as Botox and injectable fillers  to limited ‘nips and tucks’ such as the Lifestyle Lift or Smartlipo, one can maintain and improve their appearance with minimal to no downtime.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Since the tragic passing of Michael Jackson, much has been said about his talent and unparalleled entertainment skills. Unfortunately, his plastic surgery experiences and the well chronicled morphing of his face will always be mentioned as part of his legacy. Few celebrities have been as identified with the adverse potential of plastic surgery as he has.

The exact number of surgeries and tissue manipulations that he had will never be known exactly. Those plastic surgeons and dermatologists associated with him, directly or indirectly, are beginning to surface with their comments and observations. More will undoubtably emerge  in the future.

What does the association of Michael Jackson and plastic surgery teach us? Was he a victim of numerous botched and  procedures or did he have body dysmorphic disorder and sought manipulations to try and escape both his race and gender? Undoubtably, both contributed to create this poor image for plastic surgery.

As a plastic surgeon, without knowing any of the details, I must criticize our own profession. While Michael Jackson, or any patient for that matter, may like to have a certain change, it is our responsibility to help guide them to the best decision and not serve as a vehicle to merely surgically accommodate them. Just because another plastic surgeon may be willing to do a procedure, or the fear that someone else will (so why not do it), is not a compelling enough motive to perform the surgery.

The possibilities of plastic surgery, as vast as they are, were on poor display in this most visible of all celebrities. While we often never know the true motivations of why some patients desire plastic surgery, we do know when we are bordering on the reasonable and potentially ill-advised operation. Sometimes we must protect patients from themselves even when it hurts to do so.

My experience with patients who push the limits of their own best interests is one that almost never turns out to either’s benefit. Saying no is incredibly difficult, particularly  when you know you can do the procedure and your ego and practice development may be positively served. But  the plastic surgery legacy of Michael Jackson illustrates that there are downsides to every human manipulation and that well executed but ill-conceived operations do not collectively make for good long-term outcome.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

One of the many wonderful things about plastic surgery is that there is rarely one way to approach or treat a problem. Plastic surgeons with different experiences, and sometimes different geographic locations and cultural backgrounds, may treat certain cosmetic and reconstructive concerns differently. For this reason, patients considering plastic surgery often get second opinions. In my Indianapolis plastic surgery practice, I find second opinions to be very valuable and encourage all of my patients to do so particularly when they have uncertainties or have difficult issues.

I have seen a lot of patients who come in for second opinions. Based on that experience, I can give a few words of insight on how a patient should seek and approach these additional consultations. I preface my thoughts without losing sight of the overall goal…to get the best information possible so you can make the most educated decision.

When calling a plastic surgeon’s office to schedule a consultation, I would not tell them that this is a second opinion. There certainly is nothing wrong with getting a second, third, or fourth opinion. That is your right and your time and money. But you want to approach each consultation as if it was a new one. Approach each plastic surgeon as if they were the first one you have been to. Do not prejudice someone’s thoughts and recommendations knowing that they are being measured and compared to what someone else said.  You want an unbiased opinion.

While in secondary consultations, do not engage in a discussion of what the other plastic surgeon said and ask what he or she thinks about their recommendations. This is particularly important when the recommendations are different. Personalities, ego, and professional jealousies can all enter into what is subsequently said. You are unlikely to separate out the facts from the emotion in this scenario. Ask specifically why those recommendations are best and what the downsides are. If you know other recommendations that may be different, ask about it and preface it that you have read or heard about these other options. Listen and take notes. You will need these to sit down and compare consultations later.

In cosmetic plastic surgery, the cost of the procedure is important. And that is definitely one factor in making a final decision. Never…and I repeat never…make a consultation with the reference that you are shopping around for the best price. Or mention your shopping mission during the consultation. This does not sit well with most plastic surgeons and casts a negative overtone to the whole consultation. This is not the time to begin price discussions. Get the plastic surgeons recommendations and get their price quote. After you have done all your consultations, the consideration of price can then be undertaken with all the other factors. Price bartering, unlike some retail industries, does not usually work well in plastic surgery. It is not that it is inappropriate, it is just that it is not that effective. If everything else is equal and plastic surgeons have different prices, then go with the lower price. If there is one plastic surgeon that you really like but their price is higher….there may be a good reason.

Make the best of additional opinions in plastic surgery by approaching each one as if it was the first. Ask the same questions and listen. The issue of cost should be but one of the final determinants in your decision.   

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

We live in an era of plastic surgery where much of the new procedures and offerings are based on technology. Whether it be new devices, implants, or drugs, plastic surgery (like everything else) is technology-driven. But with each new technology, comes the same old questions of when to use it, is it better than what we do now, and what is its eventual role for the problems that we are treating?

The answer to these questions, however, is not technology-driven….it is people driven. People use technology to solve problems….technology just makes it possible to solve some problems faster and easier….or to solve some problems that could not be previously solved. The best scalpel, laser, or suture in the universe can not replace the skill and experience of the one welding it. Technology can make plastic surgery outcomes more consistent and even make some outcomes possible that were not possible before…..but technology will never make the plastic surgeon who has chosen the wrong operation…or done it poorly….have great results.
Dr Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana
Indianapolis

Every plastic surgeon understands the importance of listening to patients, either before as well as after any operation. Plastic surgeons understand this better than any other medical specialty, short of psychiatry. (and we have to be part-time psychologists often!) But, quite frankly, listening takes time and extensive time is often not possible at each and every appointment. And just because you listened for a long time to a patient doesn’t always mean you are truly understanding their motivations for surgery or are developing meaningful rapport.

As I have gotten experience in practice, I have moved listening from the passive mode to the active one. Passive listening means you ask a question and let the patient speak until they run out of things to say. This often turns to rambling and provides unnecessary and meaningless information. Active listening is where you guide the patient by pointed questions….like prodding cattle. Interjecting and asking just enough questions to keep the patient on track…to a meaningful conclusion in a timely manner. Medical issues are best served by active listening, personal patient topics are best done by passive listening (particularly when you are doing a procedure when the patient is awake, in the office or in the operating room)
Dr Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana
Indianapolis