Expressing the feelings inside

Most people are surprised to learn that plastic surgery of the face dates back hundreds of years before biblical times. It makes us wonder, why did people – before anaesthesia or antisepsis – risk their lives to have this surgery? Today’s modern surgery has reduced those risks, but the question remains: why is it so popular today?

Plastic surgery’s earliest patients were men whose nose tip was missing, due to punishment, accident, duels or warfare. It was unsightly, but they could breathe – they weren’t choosing surgery to improve function. They wanted to restore the appearance of their nose. Why? Were they vain? Or was there something else that made them decide to undergo weeks of surgery – which is what it took – unimaginable pain and possible death from infection?

Just like most present-day patients, these men were not vain. In my 40 years’ experience with people seeking quality, subtle surgery, vanity is rarely the motivation. The answer is much deeper, because our appearance is not superficial: it’s the external manifestation of who we are.

Living with a face that doesn’t look like who we are inside leads to despondency and suffering. These men were driven to surgery through despair. As the “father of plastic surgery”, Gaspare Tagliacozzi, noted back in the 16th century, the true purpose of this surgery is to lift the spirits. It’s an observation that has stood the test of time.

So how does this relate to a middle-aged person at a plastic surgeon’s office today? These people are rarely motivated by some ideal of youth and beauty. They don’t want to look ridiculously young; quite the opposite. They just want to look less tired – the main effect of facial ageing – and more like the person they feel like inside. Most are vibrant people who don’t feel remotely tired.

Like the men above, they want to get on with their lives freed of being judged by their face. They choose surgery to lift their spirits and then move on without that burden. For some, it is like a return to life.

Facial ease is something we take for granted when younger, which is why the young so rarely understand. But after experiencing facial ageing, many re-evaluate their beliefs about plastic surgery and the importance of appearances.

Unfortunately, people can be dissuaded from taking action by superficial media coverage focusing on poor surgery and distorted results. The real story about the return of confidence that can be experienced after quality surgery is rarely talked about. That is why so many patients want their stories told, so they can share their experience with others.

Bryan Mendelson is the author of ‘In Your Face. The hidden history of plastic surgery and why looks matter.’