Posted Thu, Oct 22, 2009

As a physician, a cosmetic surgeon, and as a male I have pondered weighty questions that I suspect a Tevye might have asked, such as: why do some actresses wish to appear unattractive.
Picking on the movie stars again! For those of you who have read Freakonomics the question why do crack dealers live with their mothers may not seem so strange. So I ask the question: why do so many middle aged movie stars want to appear grotesque. Goldie Hawn did the ultimate portrayal of over-filled lip procedures in First Wives Club but since then many stars have out-parodied the parody. Large lips; fixed, seemingly-paralyzed eyes; taut, pulled faces are pictured daily in our yellow-journals.
Admittedly I have 2 prejudices: being a man and a cosmetic surgeon. Yet both biases also give me insight. So I think that these divas whose entire lives have been consumed by attention from the press and the public to their beauty, now find themselves virtually ignored in middle age or old age. I will paraphrase James Harris in I’m OK, You’re OK: “Please say something nice about me, but if you can’t please say something bad about me. In any case just don’t ignore me.” For someone with a career in the spotlight, being ignored must be devastating. An obvious solution is to make oneself look grotesque to get attention. And attention is what Westerners like to give in press and media. Find a cosmetic surgeon who also enjoys this notoriety and who enjoys profiting from its creation, put him together with the aging diva, and it is no wonder that our impression is that California is the grotesque cosmetic surgery capital of the United States.
Feeling secure in my opinions, I expressed these views to my female relatives in Sweden and they could not disagree more. They each believe poor cosmetic surgical results are the fault of a bad cosmetic surgeon or more commonly an accidental poor outcome. They believe an actress goes to a surgeon who did a wonderful job on her friend and, with bad-luck, had a poor outcome on this person. In my view, they ignore the fact that all of the movie star’s friends look grotesque and that is precisely why they went to that cosmetic surgeon.
My conclusion is that these are people seeking attention at any cost. I think the blame for such a lack of aesthetic appreciation does not lie with the physician, but rather with the patient who seeks such obviously inferior care. This is not to excuse a cosmetic surgeon who performs these procedures. At the least he is guilty of poor judgment and probably also of poor ethics and obvious avarice. The interesting result is a group of self righteous patients and surgeons who dignify themselves as more insightful, indeed perspicacious, than people like me. They defend themselves with comments such as “who are you to judge beauty”, or “beauty is in the eye of the beholder”. Nonsense. There is enough recording of aesthetic values and perceptions for thousands of years to dismiss such self effacing arrogance. The fact is there are generally accepted criteria for “normal” and even for “attractive” that can be applied to this discussion. Can there be argument against the observation that health and youth constitute the optimal human appearance? Can there be an argument against my opinion that “nature” evokes what is attractive in form and color and that one needs only to look outside the window to appreciate what I am talking about? So I will hold steadfast to my opinion that these aging and yet to be recognized beauties would rather be recognized for being unattractive than not to garner attention at all.
Interestingly, last year I asked my readers to let me know whether they agreed with my views or that of my Swedish relatives who hold the doctor solely accountable. Six physicians answered the survey. Two agreed with me, two disagreed, and two were equivocal. Five readers responded and all agreed with me. This gives me illumination that I had not thought about. Perhaps you should trust your own judgment instead of the “experts”.

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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