David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

Time Magazine Covers Plastic Surgery (With Some Wrinkles Here and There)

Plastic Surgery Makes Time Magazine

Miles Aldridge for TIME

The latest TIME Magazine cover story is an extended article about plastic surgery: “Nip. Tuck. Or Else. Why you will be getting cosmetic procedures even if you don’t want them.”

I’ve now read this article three times and am left with the question of whether or not this is a positive or negative commentary on plastic surgery, more specifically aesthetic or cosmetic plastic surgery. Or the question of whether the information presented is good or bad. Further, is what is written factual or not.

In terms of whether or not this is positive, I am reminded of the advice someone gave me a long time ago: it doesn’t matter what they say about you as long as they spell your name right. And, from this perspective, certainly this article is positive.

But let’s look a little deeper.

There are several parts of the article regarding cosmetic or aesthetic plastic surgery that I agree with.
Certainly it is on the rise: our national statistics confirm this. And there has been a dramatic rise in the non-invasive, or minimally invasive procedures like fillers, Botox, CoolSculpting, etc. Cosmetic surgery is no long for the ultra-rich or privileged. Many more people are availing themselves of these options even though they don’t live on Park Avenue or shop on Rodeo Drive.

Recent studies, which were quoted in the TIME article, also affirm that people seeking aesthetic surgery are not depressed, schizophrenic, or suffering from low self-esteem. Stated otherwise, they are normal. Perhaps, most importantly, as it has become more common, it has become more accepted. No longer is there a real or perceived scourge on you if you have undergone plastic surgery.

Even feminists are seeing this as something that might truly be feminine. And that is truly a breakthrough!

Not sure I’m on board with this.
Some of the assertions of this article are certainly in the middle, sort of like no man’s land. The authors contends that having plastic surgery is like having your hair colored, or putting on makeup. I agree that it is normal for us to want to look our best; I use skin care products every morning, and brush my hair (although the latter is somewhat lost after I have had a surgical cap on for most of the day). Talk about hat hair! But yes, most of us try and look our best.

The author appears to be likening having Botox to relax wrinkle lines in your face to getting a very different hair style, then I would agree. The Botox will wear off in three to six months, and your hair will grow out (at least for most of us).

However, having a facelift, tummy tuck, or a breast lift with implants is totally different. Anyone who equates this to putting on makeup has never had one, has never seen the inside of an operating room, and is totally naïve to the point of absurdity or ignorance. Undertaking cosmetic surgery can be extremely beneficial as I see in the eyes and smiles of my patients every day. But this is an undertaking that requires extreme care, skill, and careful consideration. This ain’t no haircut!

There are some inaccuracies.
The meeting of the American Society of Aesthetic Plastic Surgeons (ASAPS) is not “plastic surgery’s biggest convention.” The largest convention of plastic surgeons is always the meeting of the American Society of Plastic Surgeons (ASPS). I go to them both, and know this for a fact.

The authors state that no one at these conventions uses the term “plastic surgery,” but prefers to to use words like “realization.” This is perhaps the absurd statement in the article. I have never, as in not ever, heard anyone – surgeon or vendor – use this term when they mean plastic surgery.

They also characterized aesthetic plastic surgery as “sexualizing, normalizing, or anti-aging.” Again, news to me. We have always referred to “Body Contouring” and “Facial Aesthetic” surgery. The later may also be referred as surgery of facial aging. But the term “sexualizing” is not one I have read until this article.

There are a few things I must take exception with.
The author tells the story of a podiatrist who shortens toes so that they can fit into shoes. Please, don’t do this. Talk to any orthopedic surgeon who has tried to correct the problems from such surgery and they will tell you: don’t do it. Ask anyone who has incisions or surgery on their feet if they would like to have more of this. Of course necessary surgery is another thing. But please, don’t do this. Have I already mentioned that?

The article mentioned a plastic surgery consultant in Manhattan whom you can go to and she will suggest what you need and which surgeon to chose. For $300 to $500 an hour! Man, if I could get paid that for consultations, I might never operate! Not really. But the point is: get your expert advice from a board-certified or board-eligible plastic surgeon.

The article describes how this same consultant may recommend operations for other areas of your face/body that you are not concerned with. This is a slippery slope and one that I take great care not to do (up-selling is not a good practice in plastic surgery). But the bottom line here is, get your advice about plastic surgery from a plastic surgeon. It probably won’t cost you $300 an hour.

It’s not about vanity for most patients. 
From my reading, there is an attitude towards plastic surgery that is inferred and that it is all about vanity. Clearly the author went back and forth on this. I feel that vanity has a very negative connotation, and this is not what I see in my patients. I see patients wanting to change something about their appearance that bothers them on a daily basis. Something that they have not been able to correct with lifestyle changes, or diet, or exercise. Or something that has changed due to child-bearing, or massive weight loss, or inherited predispostions.

This is not vanity. This is about wanting the outward appearance to match the inner self. And to equate aesthetic plastic surgery to pandering to vanities would be to equate Time Magazine to the supermarket checkout line tabloids. I mean, they’re both writing about plastic surgery. Right?

But, let’s really get to the bottom line.
In order to make a splash, and the cover of TIME Magazine, the author has chosen to be “edgy.” Why else would he mention the feminization of an Olympic Decathalon medalist. I said I wasn’t going to mention Caitlin Jenner (where’s my Wheaties box?).

For five years I served as the chairman of the ASPS Public Education Committee, and we always were trying to find the item of interest in a story, trying to find the hook as it were. Some work better than others.

As most of my patients will tell you, having cosmetic plastic surgery in not “edgy.” It’s really much more down to earth. It’s about doing something for yourself that makes sense and is in keeping with who you really are. It is about making an impact on your life on a day to day basis.

Sure, we all have patients who push the boundaries of what can be done, but this is the minority. It is much more common for me to see a woman who wants a better shape and size to her breasts but still wants to go to the pool with her kids and not attract attention to herself, than it is for someone to look like a “porn star.” The people I see and take care of are reasonable people with reasonable desires. I genuinely believe this is true for most plastic surgeons and their patients. And I’m sorry, but this ain’t edgy. It’s, like, normal.

Let’s come full circle (and if you are still reading, thank you!)
From the title to the last paragraph there is the assertion that, like it or not, you are going to have to have plastic surgery. More often than not it’s because your neighbor or friend has had plastic surgery. Nonsense! (I would use a stronger term beginning with “bull” but we’re trying to keep this article PG-13.)

Certainly I have patients referred by other patients who have been happy with their results. In fact I have a lot of patients referred by other patients. But this is not a competitive “keep up with the Jones’ ” type of thing. The motivation to have  surgery comes from a concern about a part of their appearance, not a competition with their BFF. And yes, I would be naïve to suggest that no one has a quasi-competitive motivation, but they are a distinct minority.

I guess my bottom line here is if you are considering cosmetic plastic surgery, good for you. Seek a board-certified or board-eligible plastic surgeon, and discuss what is important to you. Make a sensible decision, and feel good about it.

That’s all I got.

Dr. David B. Reath

David B. Reath, MD

Plastic Surgery
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