Choosing a Cosmetic Surgeon
Posted Sun, Dec 12, 2010

“He who can swim can get pearls from the bottom of the sea; but he who cannot swim goes under. Hence only he should dive for pearls who is practiced in swimming.”
Translated from German: Abraham Joshua Heschel ‘s Maimonides
As one might guess I am reading Heschel’s Maimonides and I am surprised and pleased at how much I have learned about the Jewish people and about myself. The quotation above somehow contradicts the aphorism: It is better to be a jack-of-all-trades than a master of none. Which of the 2 do you desire in a cosmetic surgeon?
On a trip to Manhattan last week, walking on the Upper East Side, my wife commented that many of the women walking past us had “the same face”. Translation: their cosmetic enhancements looked alike. As we passed a variety of department stores I noticed that many of the display windows, the entire windows, were devoted to marketing a given cosmetic surgeon and his formulas for facial rejuvenation success.
On reviewing a book of facial rejuvenation this weekend I noted that the authors, each seemingly expert in his area of discourse, extolled the virtue of a technique with little mention of what led to the need for the technique or how to evaluate when that technique was suitable. Further, each author promoted his technique as safe and effective, ignoring decades of literature to the contrary.
These seemingly disparate experiences over the past 10 days have again led me to contemplate what differentiates cosmetic surgeons who usually produce excellent results from the majority of cosmetic practitioners and medi-spas. The answer may be that the majority of facilities have a goal of selling a technique or product, sort of one size fits all; and the more exceptional practitioners insist on evaluating the cause of the patient’s concerns. Notice I said patient and not consumer. It is just too much wishful thinking that I accept that a consumer understands the etiology of their concern or that a commercial operation in or out of a doctor-office cares.
I once lectured at an international dermatology forum where I joined 4 experts in demonstrating how to treat a patient for facial rejuvenation. It happened to my advantage that I sat last in the row. The session was ostensibly on the use of facial fillers and each expert in turn looked at a patient across the stage and described how he/she would use a facial-filler with the patient. When I was asked how I would treat the patient I requested to be allowed to examine the patient and describe my findings. The chair of the session dismissed my request saying that I already knew what I was going to do and further discussion was superfluous. The session ended with me refusing to participate.
In answer to my wife’s observation I find the cosmetic surgeons in Manhattan to be skillful and erudite and deservedly experts in their fields. What I think has happened is that the business of selling techniques and products has superceded interpersonal relations and the similarity of the faces of our passersby reflects patient acceptance of the predictable if not the mundane.
Stepford wives anyone?
Mirror mirror on the wall
Who’s the fairest of them all?
Why you my dear, and you and you and you.


Edward Lack
Edward Lack MD is a board certified dermatologist and a board certified dermatologic cosmetic surgeon. He is President and Medical Director of MetropolitanMD, a multispecialty cosmetic surgery center in Chicago,which is unique in having a double board certified cosmetic dermatologic surgeon, a double board certified facial plastic surgeon, and a double board certified cosmetic plastic surgeon. Dr. Lack is also the Past President of The American Academy of Cosmetic Surgery.

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