Body dysmorphia and Cosmetic Surgery

“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.”

― Leonardo da Vinci

Dr. Steven Harris and Dr. Neetu Johnson estimated in Aesthetic Medicine November 2017, the percentage of dysmorphic medical practitioners in the field, to be in the range of 16%, versus 8-15% prevalence in their patients.

Body dismorphic disorder (BDD), is a mental health issue, whereas someone is overly preoccupied with a perceived flaw in appearance. When one just focuses on details, rather than the whole, the aesthetic perspective is skewed. It happens with patients, and more importantly, it seems to happens a lot with doctors. And a lot of good things can be lost this way.

Those who do not see, to paraphrase Leonardo da Vinci, would be akin to people looking at things through the barrel of a straw. Losing sight of the forest for a tree. For patients “who do not see”, one of the dangers, is that of eternal dissatisfaction. Looking for perfection they will continuously feel that something is amiss and will remain unsatisfied.

“If the only tool you have is a hammer, you tend to see every problem like a nail”

― Abraham Maslow

Whether by the lack of expertise, or an over-reliance of a familiar procedure, some doctors seem to approach different problems with a set of solutions they perform all the time. A good surgeon will have a variety of techniques to best approach the anatomical intricacies that come up with every individual. The knowledge of these various techniques is even more critical when they are addressing revision plastic surgeries, as some tissues may have been damaged, unrecognizable, or might not exist at all anymore.

A good surgeon is able to think holistically, and save on unnecessary procedures at the time of the surgery, or after, by making the best out of each incision, and by addressing and fixing several issues at once. A professional might specialize in one type of surgeries and might be only willing to fix a specific part of the body, however, is always well versed in the specific knowledge that comes with the plastic surgery of the other organs. Such a professional differs from the surgeon who might solely focus on a vague issue to correct a perceived flaw with a singular familiar approach. A quick fix to a complex issue.

There is the risk when losing sight of the big picture, of overdoing things and pushing things out of balance. A particular example could illustrate this matter: the making of higher bridges in Asian noses to resemble Caucasian profiles. The result is oftentimes unnatural or plain weird. The change is obvious, and not in a good way: Asian skulls are wider than those of Europeans. A high bridge nose sitting on such a face does not come as logical. On a Caucasian face, as the skull is usually narrower, the nose is usually narrower, the bridge can be higher and the eyes can sit closer to one beautifully. The change in the general facial harmony can be upsetting, as it is the whole gestalt of the face that makes it meaningful. The different elements of the face are, in fact, greater than their sum.

Then, there are those who intuitively feel that something is off balance, without being able to pinpoint the area that needs improvement, as they do not have the exerted eye nor the experience of professionals. The risk here is to find a problem where there are none and to go after a corrective surgery after the wrong mark. It will fail to bring any satisfactory results, and possibly worst, even render the function of some of the organs more difficult pre-operatively.

A good plastic surgeon, from training and experience, has acquired an eye for beauty, and knows these things. For this reason, a perceived flaw must be approached alongside with the other traits of the face. If the perceived flaw is not disturbing any function, or distracting the eye from facial pleasing features, it might as well be subtly toned down. At times, a tad bit of imbalance, a slight defect can be the signature that makes you stand out. Think of Mona Lisa, famous for her twisted smile, not for her perfect symmetry. The little flaws give a dynamism perfection would lack.

When going for any beauty enhancement, patient and practitioner should aim at a genuine rendition (rather look old than look odd). You should be looking as good as you can for your age, as your face too, has a story to tell.

Albeit the human brain is incredibly good at unconsciously perceiving proportions in a face or in a body, it can be difficult for a patient who feels that something is “not quite right”, to be sure of exactly what. Good practitioners are good listeners. They also have on the top of very good skills and many techniques, a lot of experience in the field of plastic surgery. Be sure to tap into their expertise.

“Your flaws are perfect for the heart that’s meant to love you.”

― Trent Shelton

In the matter of beauty, balance and harmony are key. They work in concert with other perceived elements making us like and even feel attracted to someone. Alongside with good looks, authenticity and vulnerability are two very underrated elements of attraction.

Visible flaws are there to offer this sense of vulnerability and authenticity. They make you a certified human.