Editorial Echoes Journal of Cosmetic Dermatology, 14, 1
Cosmetic procedures and the distortion of beauty Zoe Diana Draelos, MD
Beauty is hard to define. Even more perplexing is the definition of beauty can change from moment to moment. For example, you can admire your daughter reading quietly on the sofa, a vision of beautiful serenity enriching her mental horizons with the written word. Your son enters the room, yanks the book from her relaxed hands, throws it to the ground, and stomps on the book. She screams, punches him in the stomach, and scowls with anger. While justified in her response, is she still beautiful? Probably not. Her moment of beauty has been ruined by the aggressive behavior of another. Can she be beautiful again? Yes, almost instantaneously when her countenance clears. Beauty can also change based on the physical surroundings. For example, a woman dressed in a lovely evening gown ready to attend the ball in a stunning hall surrounded by handsome men wearing opulent jewels is beautiful. However, what is beautiful? Is it the woman? Is it her gown? Is it her jewels? Is it her surroundings? Probably, it is the combination of all of the above. A rather plain looking woman can be beautiful with the appropriate adornments. Yet, beauty can be modified beyond surroundings. Beauty can also be enhanced. A woman with high cheeks bones and a narrow curved jaw line has the facial architecture for beauty but skin dyspigmentation, thin lips, and small eyes and may pose appearance challenges. Cover her skin with an opaque facial foundation to camouflage the pigment irregularities, add lip liner with deep red lipstick to broaden the lips, and stroke black eyeliner around the eyes with black mascara to the eyelashes and this rather plain face can achieve the designation of beauty. This means that beauty can be achieved through the interplay of color and proportion on an attractive canvas. What are the options if an attractive canvas does not exist? What if the skin is wrinkled and the eyes are obstructed by inelastic eyelids and the narrow jaw line is thickened with redundant nasolabial fold skin? Can this woman be made beautiful? This is where the dermatologist swings into action with toxins and fillers to restructure the canvas into a form consistent with beauty. However, the physician can take this aging canvas and turn it into a grosteque work of art if not careful. This is the topic of discussion for this editorial. Do cosmetic procedures create beauty, enhance beauty, or distort beauty?
© 2015 Wiley Periodicals, Inc.
This is a controversial topic because defining beauty is very difficult. I would assert that cosmetic procedures do not create beauty because of the many factors previously mentioned. There is more to beauty than the wrinkle free face created by chemodenervation and the facial plumping of fillers. An immobile forehead with unusual wrinkling superior to the lateral eyebrow upon emoting is not beautiful, but simply different. Thick lips on an aging face look out of place. Flattened nasolabial folds are just flattened nasolabial folds even though the eye knows the folds should exist on a mature face. I do not believe that cosmetic procedures turn back aging and restore the face to a younger state and dermatologists should not approach facial rejuvenation procedures in this fashion. Rather, dermatologists should seek to enhance beauty. Every woman has some unique feature that makes her beautiful. This feature could be well-proportioned lips, long eyelashes, dramatic eyes, or a nice jawline. Focusing on the enhancement of this one feature could provide a focal point for the dermatologist and a realistic goal for the patient. It would minimize the excessive cosmetic manipulations that result in the distortion of beauty. I do believe that it is possible to inject too much botulinum toxin and too much filler. It is necessary to remind patients that a little is attractive and too much is grotesque. Even though there is a financial incentive to do more for the patient, the unusual appearance of the over injected patient will reflect poorly on the skills of the dermatologist. A good reputation over the lifetime of a dermatologist from tasteful injection techniques will be much more valuable than the immediate financial return from an extra 40 units of botulinum toxin. Finally, I think it is important to remind every woman “beauty is as beauty does.” There is more to beauty than a face. A pleasant expression, tasteful clothing, artistically applied cosmetics, and elegant behavior are all part of the equation. Society seems to be focusing on the teenage female face at present for its public representations of beauty. It is hard to believe that this experientially na€ıve face is beautiful. It is wrinkle free with evenly pigmented and textured skin, but without wisdom. Perhaps a society so desirous of extending lifespans should re-examine its perceptions that lead to the distortion of beauty.
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Cosmetic procedures and the distortion of beauty Zoe Diana Draelos, MD
Beauty is hard to define. Even more perplexing is the definition of beauty can change from moment to moment. For example, you can admire your daughter reading quietly on the sofa, a vision of beautiful serenity enriching her mental horizons with the written word. Your son enters the room, yanks the book from her relaxed hands, throws it to the ground, and stomps on the book. She screams, punches him in the stomach, and scowls with anger. While justified in her response, is she still beautiful? Probably not. Her moment of beauty has been ruined by the aggressive behavior of another. Can she be beautiful again? Yes, almost instantaneously when her countenance clears. Beauty can also change based on the physical surroundings. For example, a woman dressed in a lovely evening gown ready to attend the ball in a stunning hall surrounded by handsome men wearing opulent jewels is beautiful. However, what is beautiful? Is it the woman? Is it her gown? Is it her jewels? Is it her surroundings? Probably, it is the combination of all of the above. A rather plain looking woman can be beautiful with the appropriate adornments. Yet, beauty can be modified beyond surroundings. Beauty can also be enhanced. A woman with high cheeks bones and a narrow curved jaw line has the facial architecture for beauty but skin dyspigmentation, thin lips, and small eyes and may pose appearance challenges. Cover her skin with an opaque facial foundation to camouflage the pigment irregularities, add lip liner with deep red lipstick to broaden the lips, and stroke black eyeliner around the eyes with black mascara to the eyelashes and this rather plain face can achieve the designation of beauty. This means that beauty can be achieved through the interplay of color and proportion on an attractive canvas. What are the options if an attractive canvas does not exist? What if the skin is wrinkled and the eyes are obstructed by inelastic eyelids and the narrow jaw line is thickened with redundant nasolabial fold skin? Can this woman be made beautiful? This is where the dermatologist swings into action with toxins and fillers to restructure the canvas into a form consistent with beauty. However, the physician can take this aging canvas and turn it into a grosteque work of art if not careful. This is the topic of discussion for this editorial. Do cosmetic procedures create beauty, enhance beauty, or distort beauty?
© 2015 Wiley Periodicals, Inc.
This is a controversial topic because defining beauty is very difficult. I would assert that cosmetic procedures do not create beauty because of the many factors previously mentioned. There is more to beauty than the wrinkle free face created by chemodenervation and the facial plumping of fillers. An immobile forehead with unusual wrinkling superior to the lateral eyebrow upon emoting is not beautiful, but simply different. Thick lips on an aging face look out of place. Flattened nasolabial folds are just flattened nasolabial folds even though the eye knows the folds should exist on a mature face. I do not believe that cosmetic procedures turn back aging and restore the face to a younger state and dermatologists should not approach facial rejuvenation procedures in this fashion. Rather, dermatologists should seek to enhance beauty. Every woman has some unique feature that makes her beautiful. This feature could be well-proportioned lips, long eyelashes, dramatic eyes, or a nice jawline. Focusing on the enhancement of this one feature could provide a focal point for the dermatologist and a realistic goal for the patient. It would minimize the excessive cosmetic manipulations that result in the distortion of beauty. I do believe that it is possible to inject too much botulinum toxin and too much filler. It is necessary to remind patients that a little is attractive and too much is grotesque. Even though there is a financial incentive to do more for the patient, the unusual appearance of the over injected patient will reflect poorly on the skills of the dermatologist. A good reputation over the lifetime of a dermatologist from tasteful injection techniques will be much more valuable than the immediate financial return from an extra 40 units of botulinum toxin. Finally, I think it is important to remind every woman “beauty is as beauty does.” There is more to beauty than a face. A pleasant expression, tasteful clothing, artistically applied cosmetics, and elegant behavior are all part of the equation. Society seems to be focusing on the teenage female face at present for its public representations of beauty. It is hard to believe that this experientially na€ıve face is beautiful. It is wrinkle free with evenly pigmented and textured skin, but without wisdom. Perhaps a society so desirous of extending lifespans should re-examine its perceptions that lead to the distortion of beauty.
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