Behind the fantasy world of cosmetic surgery

With the rapid rise in aesthetic surgery technology, having a liposuction has become as common as having one’s hair cellophaned or rebonded. With every reconstructive discovery, physical perfection appears to be easier to obtain. But just how far can plastic surgery go in turning a sow’s ear into a gold purse? What are the growing trends in Philippine plastic surgery? What are the realities and risks that come with the price of beauty?

"Plastic surgery in itself is a very difficult field," explains Dr. Benjamin Herbosa, one of Manila’s more established plastic surgeons. "It is not an exact science and yet it is viewed by a lot of people as the cure-all for their perceived physical imperfections. I always explain to my patients what they can and cannot expect from aesthetic surgical intervention. Naturally, everyone comes to the doctor’s clinic wanting to have perfection. But achieving their so-called perfection may not be realistic given a number of reasons. If a person wants a nose-job (rhinoplasty), the patient may want to have the nose of Brad Pitt and yet what he has is an Oriental nose–flat with big nostrils. How can you tell him honestly that he can have Brad Pitt’s nose? These are unrealistic expectations.

"People who expect to get these results are not looking for a surgeon, they are looking for a god. Yes, doctors may use space-fillers or implants and certainly these materials can enhance the patient’s features but at the end of the day, the surgeon still has to work within the parameters of reality–the dimensions, texture and other qualities of the patient’s original features."

In the Philippines, rhinoplasty and breast augmentation are the most sought-after procedures. "Majority of my patients are married between the ages of 22 and 42 age group," says Dr. Herbosa. "Surprisingly, there is a surge of patients who are between 16 and 19 years of age. They may want to look like a model in a teen magazine or they want surgery because they may not want to be thought of as fat by their classmates. At that age group, there is already so much pressure to look good.

"Men are not excluded from the pressures of beauty. Many men between the ages of 24 and 50, for instance, are now demanding for liposuction. Older men come to the clinics seeking to have their eye bags repaired. Between the liposuction and the eye bags, more men come to have their eye bags removed, they are more conscious of their face than their tummies. In the past, 90 percent of cosmetic surgery patients were female and 10 percent were male. Now, the proportions have changed to 75 percent female patients and 25 percent males."

It is not uncommon to find clients who are emotionally depressed and feel that changing their looks would make the psychological pain go away. Patients of this disposition are advised to look into themselves and consider their demands very carefully. It is most likely that no amount of surgery will change the way they see themselves. Their needs would be best solved by another kind of doctor. Sadly, most patients in this situation still insist on undergoing surgery, believing it to be a "quick-fix" for their emotional troubles. Eventually, the patient will be depressed once again and will pronounce the surgery a failure for not having succeeded in attaining happiness for them.

Another predictable occurrence is that Asian women wanting to look Caucasian. "Vogue and Elle magazines have been with us for a very long time," explains Dr. Herbosa. "These publications are filled with women who are supposed to embody the ultimate beauty ideal. An overwhelming number of these women are Caucasian. Is it no wonder then that a lot of Asian women are conditioned to believe Caucasian features to be the ultimate form of beauty?"

"Generally speaking, women in their mid-forties begin to feel that their faces are beginning to sag. They start to complain about jowls, eye bags and the canopying of the upper eyelid and the deepening of the nasal-labial folds because of the effects of gravity. Usually, I would recommend a mini face-lift for these women so that the changes will be subtler than if they had a major lift."

Another reality that cosmetic surgeons have to deal with is the con-artist patient. "There are people who actually will submit themselves to aesthetic surgery with the full intention of suing the doctor after the procedure is performed. Like all cons, they wear two faces. They initially appear very friendly, cooperative and with full knowledge of what to expect from the procedure that they are about to take. After the surgery is performed, they automatically turn on their doctor with all sorts of reasons for demanding compensation. They prey on the doctor’s fear of losing his good reputation," says Dr. Herbosa.

"There are many doctors who are not part of an aesthetic medical board and they may, to some extent, do good work," explains Herbosa. "The only problem is that they are trained only for the first level of work which is the cosmetic procedure per se. They are not trained to handle complexities that may occur during or after the surgery. Once a complication surfaces, they end up referring their patients to certified aesthetic surgeons. Botched jobs are always more difficult to work on as compared with virgin cases. So the first doctor’s mistake becomes the certified surgeon’s burden."

The best patient is someone with a healthy emotional psyche who has no fixed beauty icon in mind. She knows what she wants to have done and is aware that surgery will improve her looks but will not necessarily transform her into a movie star or a model. She is a person who would have done her research and through referrals from reliable friends and other sources would have spoken to several competent surgeons (as opposed to people who "shop around" looking for the doctor who offers the lowest price!). From her canvassing she would have narrowed her choice to a surgeon whom she is comfortable with and whom she feels can best answer her aesthetic expectations.

"The practice of cosmetic surgery is prevalent. Those that practise it are a dime a dozen. There are many that are not even surgeons. Out of the many practitioners that are doctors, only about 60 have passed the Board of Plastic Reconstructive surgery. Of the 60, only 12 of us have been accepted in of the Board of Plastic Reconstructive and the Board of General Plastic surgery," Dr. Herbosa says.

The pursuit of beauty is a human desire so often filled with risks beyond what we are aware of. Plastic surgery is surgery. It is invasive and it should be taken seriously. It is not a trip to the beauty parlor for a hot oil. Given the proper guidelines, having realistic expectations and choosing the most compatible doctor, however, can lead you to a physically alluring and happier you–a you based on the best and brightest that reality has to offer.