Facial Rejuvenation Surgery: A Luxury or a Treatment?
3 December 2019 onur
Since its inception, aesthetic surgery has brought with it some ethical and philosophical questions.
Is aesthetic surgery a luxury? Or a necessity?
Is it done for better health? Or for beauty?
Although there is not a life-threatening health issue, why does an individual undergo a surgical operation that takes 4 or 5 hours?
Why would a surgeon operate on an individual when there is no life-threatening health issue?
For some, undergoing plastic surgery is a craze, an extravagance, a kind of thoughtlessness and some sort of spoiled behavior. For others, facial rejuvenation surgery is an adventurous journey that only dissatisfied people who are not at peace with themselves and dreamers can embark on.
These are just prejudices.
People easily criticize things they don’t understand.
Moreover, similar prejudices preoccupy the individuals who are considering undergoing these surgeries, who are in the research process and will benefit most from them.
Let’s review facial rejuvenation surgeries as well as the conditions that lead people to these surgeries.
It may help us to answer one single question: “Is facial rejuvenation surgery a luxury or a treatment?”
Let’s take your attention away from facial rejuvenation surgeries for a moment.
Let’s consider a short stature.
People’s “height” varies. Some are 130 cm tall while some are 200 cm tall. Some breeds are taller while some are shorter. The average male is taller than the average female. The average height increases as the income level and protein consumption increase. Significant height differences can be observed even among members of the same family. In other words, the range that we consider the normal human height is quite wide.
In each society, there is a “normal height distribution” for a certain gender and a certain age. For instance, a 12-year-old boy is 150 cm tall “on average” and may have a height of 135-165 cm in the normal distribution. Normal distribution means that the value remains between the lower and upper limits of the normal. Most of the time, the normal distribution represents 90% of the population while 10% of the population is outside this normal distribution. Briefly, 90% of 12-year-old boys are between 135-165 cm, and the remaining 10% are not of normal height. A 5% group will be over 165 cm tall at age 12, while another 5% group will be under 135 cm at the same age.
Your child is within 5% of the shortest stature for his age and if you still haven’t taken him to a pediatrician, you are utterly and plainly ignorant – no offence intended. Your child’s short stature may be purely genetic, or there may be a genetic, acquired, hormonal or environmental pathology that restricts his growth. The child should be examined and followed up, and if there is a medical problem that negatively affects his growth, it should be treated. If there is no medical problem, you can say that this is how tall he will be and make peace with it. The point here is not whether a person is at peace with their own height or the height of their child. No family voluntarily accepts that their child is shorter than their peers. You only make peace with the negativities in life that you cannot change.
This example may seem irrelevant to you, but the “aging” process is also a “variable” process that can be impacted by genetic, environmental and hormonal pathologies, just like the “growth and development” process. Not everyone ages at the same pace, in the same way and at the same intensity.
Just as we are talking about the “normal growth distribution” in the society, we can also talk about the “normal aging distribution”. For instance, imagine that we rank 10,000 women aged exactly 50 in terms of their signs of aging. You can imagine this ranking as an imaginary beauty pageant. Each of these 10,000 women, all 50 years old, will exhibit a different level of facial aging. Some will look much younger than others. Some will look as if they are the mother of others.
Just as in the “normal growth distribution”, 90% of women will be within the normal range for their age category.5% will look abnormally younger and 5% will look abnormally older.
In real life, this distribution has a background.
- Genetic connective tissue problems,
- Cancer treatment at an early age,
- Metabolic problems that cause excessive weight gain and loss at an early age,
- Working in jobs that cause intense sun damage and require physical labor at an early age,
- Multiple pregnancies at an early age,
- The stress of living that causes intense psychological trauma at an early age, such as mothering a disabled child, or
- Completely genetic factors
may cause individuals to appear aged well beyond what is considered “normal” for their age.
Public opinion always focuses on and accepts the average, i.e. the “norm”, and excludes the 10% outside the normal. On one hand, people are advised they should be at peace with themselves, but few of those who give this advice prefer to marry a man 20 cm shorter or a woman 10 years older than themselves. Research shows that among individuals with similar professional qualifications, those who are more beautiful and taller are more easily selected and “recruited” for better jobs.
In summary, the society tells individuals aging beyond normal to “be at peace with themselves” but excludes them at the same time. It advises them to “go away, live at peace with themselves, accept their fate, not ask for more, not go to or appear at certain places too often”.
We plastic surgeons do not consider facial rejuvenation surgery as a “commodity” that anyone can buy. We see it as a treatment that brings individuals with beyond-normal facial aging into the normal range for their age category.
The purpose is to take an individual in the last 10% of their age category in terms of facial aging and move them to above-average levels, preferably into the top 25%. This is not a desire to rejuvenate but a desire to look healthier and more beautiful. We aim to make individuals happier and healthier and give them equal opportunities.
In a nutshell, from our perspective, facial rejuvenation surgeries are a form of treatment, not a luxury. That’s why we talk about our “patients” and not about our “clients”. Therefore, our patients are prepared and followed up with the same care and surgical discipline in facial rejuvenation surgeries as they are prepared for another surgery and followed up afterwards. The indications (necessity) of surgery are handled with equal diligence. Not everyone can have these surgeries. Those who know me will tell you: In my practice, although many patients come to me voluntarily and tell me they want to undergo surgery, I turn them away on the grounds that they are not eligible for these surgeries.
My “happiest” patients in facial rejuvenation surgeries are those individuals who, according to the signs of facial aging described above, are initially in the last 10-25% of their age group but ultimately look better than the average of their age group.
I advise my colleagues to be very careful with patients who are currently in the best-looking 10% of their age group. The expectations of this group can be surreal and it is too challenging to please the members of this group. Patients in this group either tend to compare themselves with another age group or desire to be in the 1-2% that looks best in their age group. Both of these are unrealistic expectations. Wondering why?
- No matter how successful your surgery was, you will continue to bear the physical characteristics of your age category on your face. For instance, a person who has facial rejuvenation surgery at the age of 55 does not go down from 55 to 40-years old, and it is unrealistic for them to compare the results of their surgery with the “norms” applicable to 40-year-olds.
- No matter how successful your surgery was, genetic factors will determine whether you can enter the top 1-2% of your age group that looks best. There are exceptional beauties of every age category and unfortunately the exceptional extremes of human beauty are determined by congenital/genetic factors.
Personal reasons including but not limited to “But I was beautiful when I was younger”, “But I perform on stage”, “But I’m famous”, “But I’m rich”, “But I’m a perfectionist” or “But my spouse/partner wants me to have it” can never alter medical facts.
The rule applies to any person and any profession.
If you set out with unrealistic expectations, you will inevitably be unhappy.
You can talk to a plastic surgeon who is heavily involved in facial aesthetics (especially the aging face) to get information about your facial aging status according to the norms of your age and what you can expect from surgery.
Take good care…
… of yourself and your beauty.