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Going Miles for Smiles

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The post Going Miles for Smiles appeared first on Cosmetic Surgeon Brisbane Dr Raymond Goh | Plastic Surgeon | Specialising in Cosmetic, Reconstructive and Hand Surgery Brisbane.

Browsing through a furniture store on a spare sunday afternoon, I spotted in the distant corner of the store a beautiful console unit (table with drawers that’s usually placed behind a sofa). Instantly, a broad beam of light from heaven shone upon it, and I took steps toward having a closer look. It was beautiful. Retro-styled, simple, elegant, and made of luscious and distinctive wood. And yes, it was ON SALE! So I bought it. (Talk about impulse!)

However, upon bringing it home, settling it behind the sofa, and taking a step back to soak in this new delight, my excitement quickly turned into bewilderment. The more I looked at the console from all angles, the more I slowly surrendered to the fact that I had made the wrong decision in acquiring it. On it’s own it was beautiful. A timeless classic. However, within the setting of the living room occupied with existing furniture, it just did not “fit”. Too dark. Too obvious. Too wrong. It didn’t belong there.

The same issue can arise in cosmetic plastic surgery. We may see a nose, an eye, a breast, or a body that captures our eye and our imagination. Perhaps in a magazine or featured on our favourite TV celebrity or pop star. We enjoy marvelling at that particular physical attribute. If we are unhappy with our own physical appearance, it can be particularly easy to desire what we consider to be ideal or perfect.

The ideal, however, may not be perfect for YOU. In fact, it could make you look un-balanced, out of place, not right. We have to base our desired outcome from plastic surgery on a number of factors. Our ethnicity is one of them. A caucasian-type nose will not look right on an asian, and it will definitely be out of place on a negroid person. We have to confine our desires to within the range that is still considered normal for our ethnicity.

The other critical factor to consider is facial balance. Just like my recently acquired console that looked out of place amongst the existing furniture, displeasure with facial and body appearance often comes as a result of imbalance. Based upon this philosophy then, pleasing aesthetics can often be attained even when the individual parts are in themselves not perfect, but are ideally proportioned.

The next time you look at a beautiful person’s face or body, try to ignore the individual parts that might seem beautiful on their own, and instead have a look at their overall proportions and balance. A few factors that you may like to ponder include the balance between the upper, middle, and lower thirds of the face, eye width vs nose width, nose projection vs chin projection, and breast, waist, and hip proportions. More often than not, a beautiful face or body is likely to be evenly and pleasingly balanced.

Coming back to the console that I bought. I allowed it a week to see if my eyes could adjust to it. Alas, it was not meant to be. So back to the store it was returned. On this occasion, I was fortunate to be able to reverse my decision. In surgery however, this liberty may not always be granted to us. We may not have the freedom to change our minds after a procedure has been performed, as surgery often cannot be easily or completely reversed.

To avoid making the wrong decision with cosmetic plastic surgery, a thorough assessment of the patient as a whole is required prior to surgery. One needs to consider not only the individual physical trait that the patient is unhappy with, but it needs to be compared with the rest of the patient’s face or body. Careful thought is then given to devising a surgical approach that will achieve a result that balances both beautification of the area of the patient’s concern and improving overall harmony.

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Recently, during a regular operating morning, the song playing over the speakers sang out “Don’t HATE Me ‘Cos I’m Beautiful…”.

My anaesthetist commented joyously: “Oh, they’re playing MY song again…”!

It is commonly granted that beautiful/attractive people have an edge when it comes to getting what they want, and the service that they receive. This is blatantly obvious in the hospitality and retail industries – where upgrades or extra freebies are liberally offered to those who are deemed more aesthetically pleasing – but is observed in every aspect and setting of society. Sadly, not everyone is treated equally, even though we should be, as human beings of equal worth. Sub-conciously, people are discriminated in how they’re treated based solely on their appearance. Judgement is placed on first impression, often even before a single word is spoken. In so many industrialised nations, young people are undergoing cosmetic procedures to improve their face and body in order to improve their chances at scoring top jobs.

Will this attitude change? Will the eyes of our society return to seeing people for who they are as an entire being – physically, mentally, emotionally? Perhaps not. We are human, after all.

Which brings up the discussion: do beautiful/attractive people get viewed upon or treated negatively by their peers because of their perceived beauty? Do they get ostracised – socially, professionally, or even subconsciously – because people assume that they have gotten to where they are and have gained their achievements primarily through their attractive physical traits? Do they have to endure jealousy, envy, and “discrimination” on a daily basis? I must admit that it is indeed a first world issue to feel sorrow for those afflicted with been too beautiful, although I have occasionally come across attractive people who genuinely wished they did not receive so much attention or that people would see them beyond the outer label and more at their inner merits.

So there we have it. Too beautiful, and people hate you. Not beautiful enough, and people don’t treat you right. Either way, we can’t always win. What’s important, I think, is how you feel about yourself. Inner confidence and security will always radiate and make a lasting impression.

The post It Hurts To Be Beautiful appeared first on Cosmetic Surgeon Brisbane Dr Raymond Goh | Plastic Surgeon | Specialising in Cosmetic, Reconstructive and Hand Surgery Brisbane.

I always ask my patients if they smoke, and how much.

For the best outcome from surgery, I strongly advise that patients who smoke cease their habit for at least two weeks prior to and two weeks after surgery – or at least significantly reduce the amount they smoke. The ingredients in cigarette smoke constricts blood vessels and reduces the ability of wounds to heal. Although I do not enforce smoking cessation as a mandatory condition for surgery to proceed, especially if surgery is more urgently necessary such as in the case of cancer or trauma related conditions, I do advise patients that they are at a much higher risk of having an adverse outcome if they continue to smoke.

Let me give you three clinical scenarios.

Skin grafts. When a skin graft procedure is performed to cover an open wound, it begins life as a clinically “dead” piece of skin. It needs to be “resuscitated” back to life (and rather quickly!) through the blood and nutrients derived from the area upon which it has been placed. After a few days of struggle, the skin graft establishes it’s own circulation. Such is the wonder of human healing. In smokers, the blood vessels are narrowed and blood flow is sluggish. Skin grafts in such circumstances can struggle to pick up sufficient blood and nutrients to keep it alive.

Breast reductions and lifts. As part of a breast reduction or lift procedure, the nipple is frequently elevated to a higher, more normal, position on the breast. The nipple is kept viable by maintaining and protecting tissues that connect the nipple to its blood supply. Although nipple loss – partial or complete – is a possible risk to all patients undertaking breast procedures, smokers are at a much higher risk, based on the same reasoning of compromised blood supply. To hit home the point, I sometimes exclaim to patients that their nipples could “die and fall off”! This is of course a rather uncommon but devastating worst case scenario.

General wound healing. Not too long ago, I performed surgery on a patient who sustained a traumatic injury to his hand. The wound was thoroughly cleaned and repaired. Instructions were given for the patient to stop (or at least greatly reduce) smoking. Under such circumstances, and with the appropriate wound care and infection control measures, I would expect the wound to heal up without any problems. When the patient turned up for his follow up review, he smelled like an ashtray. So much so that I had told him that I was endangering my own life by passive smoking through his breath! Not surprisingly, his wound remained unhealed for many weeks, as if someone had pushed the pause button on his body’s healing remote control.

Smoking is highly addictive. I know that. And I appreciate how hard it is for patents to stop smoking, especially in a short given time. I state the facts though, of what can likely happen if they continue to smoke during their period of surgery. Wounds can be slow to heal and can more easily develop an infection. Abdominoplasty closures can break apart and take months to heal with an big gaping wound. Facelift cheek skin can turn black and slough off. Skin grafts can die, dry up, and shrivel away. Nipples can fall off.

On a brighter note, many of my patients who stopped smoking prior to their elective surgery have continued to stay off the cigarette. Perhaps their surgery and determination to get a good result gave them a strong enough reason to quit the habit. Perhaps, together with their post surgical state of higher confidence and self esteem, they are also hoping to give away negative habits. Or perhaps the health hazards of smoking has finally hit home. Whatever the reason, they are leading a healthier life, and saving money to boot!

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