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Would Shakespeare Have Gotten Botox?

Heather Furnas, MD, holding Shakespeare book reading Time's Nip. Tuck. Or else. over shoulder of Francisco Canales, MD

Heather Furnas, MD reading next to Francisco Canales, MD

Nip. Tuck. Or Else.That’s what a recent Time magazine cover story declared.

You will get a cosmetic procedure–perhaps a facelift or perhaps just a few units of Botox. It’s inevitable. (Even if you’re resistant.)

Cosmetic Procedures Doubled

OK, so the premise may be a little exaggerated, but Time magazine reporter Joel Stein made a convincing argument. In the year 2014 Americans doubled the number of cosmetic procedures that they had in the year 2000.

Shocking? Yes, but over a century ago wearing make-up was shocking. Ruby lips and peachy cheeks signified the prostitute’s art and was unfitting for respectable women.

When mothers and church-going women finally wore lipstick without sparking gossip, hair dye was a source of shame. To counter the image of a tawdry trollop, Clairol created reassuring ads with lines like, Does she or doesn’t she? Only her hairdresser knows for sure.

And now? Who cares if you dye your hair! Search YouTube for “hair dye tutorial,” and 187,000 results come up.

In Joel Stein’s words, “Acceptability eventually comes to nearly all forms of vanity.”

What Happened to Our Ethics?

If make-up, hair dye, and Botox have all crawled out from under the rock of shame, have we lost our code of ethics? Maybe. Or maybe we’ve just rewritten it. Maybe we’re always rewriting it.

In 1978 the first “test tube baby” was born to two loving parents and into a world of controversy. Critics claimed scientists were playing God and risked creating Frankenstein babies. Yet by 2012, 1.5% of all babies born in the US were conceived by IVF.

More recently, face transplants and genome tampering have ethicists’ pens scribbling. Are we creating designer babies? And if we accept that, where will we stop?

Medical innovations don’t see the light of day before scientific vetting. The FDA , university panels, and other oversight organizations confirm that an innovation is safe and benefitial to humanity before approving it.

After an innovation is released to the public, society as a whole judges it. Initially people were wary of Botox, a deadly neurotoxin. Who would dare ask for, much less pay for, such an injection? But when people furrows relax with minimal risk, they pushed Botox into a $2 billion industry.

In the past, the stereotypical patient was an insecure, depressed woman seeking male approval, but that stereotype went the way of dial phones. Now men are jumping on board, and even feminists are getting nips and tucks.

Cosmetic Procedures Demystified

Besides their demonstrated safety and benefits, cosmetic procedures are taking off for a third reason: They’re being demystified.

In the past, doctors were the keepers of the vault of information. To find out about surgery, patients had to consult with a plastic surgeon. Before-and-after photo albums were a major advance.

The Internet changed all that. There’s a lot of bad information out there, but there are websites that offer a true education. Now a patient can visit the doctor’s website, see videos, and follow the social media before a face-to-face meeting at the consultation .

Unfortunately, choosing a doctor isn’t always straightforward. Changes in medicine have prompted many doctors not trained in cosmetic specialties to open up cosmetic practices, so patients need to educate themselves now more than ever.

Peer-reviewed journals, universities, and specialty societies often provide articles, newsletters, and blogs for the lay public.

But the website that has taken center stage is RealSelf.com. People from around the world ask questions, post photos and videos, and write reviews about their experiences. Specialists answer those questions and post their own educational videos and before-and-after photos.

RealSelf.com is like a world cosmetic surgery convention driven by and for patients.

Vanity or Carpe Diem?

So what about the old standby argument that only vain, superficial people have cosmetic surgery, while those with strength of character accept their features as they are?

Historically people didn’t have easy access to mirrors or photographs. Once they had regular access to their images, women took an interest in makeup. Then hair dye. And now cosmetic procedures.

Our ancestors “accepted” themselves because there were no other options. That’s why an older Queen Elizabeth I made sure her courtiers showed the public her younger portraits. As a woman who kept peace in part by flirting with possible marriage alliances, she knew the power of image.

To Botox or Not To Botox?

We’re hard-wired to judge a face. We turn our heads toward youth and beauty. It’s in our DNA.

How harshly was a 40-year-old woman judged in William Shakespeare’s time? His second sonnet tells us:

When forty winters shall besiege thy brow

And dig deep trenches in thy beauty’s field,

Thy youth’s proud livery, so gazed on now,

Will be a totter’d* weed of small worth held.

*ragged

Confronted with such metaphors, who wouldn’t put a few drops of Botox into those deep trenches? Or rejuvenate the face by tightening the worthless, ragged weed?

Time magazine is wrong. Plenty of people won’t give a flea’s wings when their hair turns gray and their neck falls. They’re the one’s who will seize the “Or else” instead of the “Nip. Tuck.”

We’re no more reluctant to accept aging than Shakespeare’s countrymen were 400 years ago. The difference is we can finally do something about it.

And some of us will.

RESOURCES:

http://time.com/3926042/nip-tuck-or-else/

http://www.cnn.com/2014/02/17/health/record-ivf-use/

http://www.shakespeares-sonnets.com/sonnet/2

 

Dr. Heather Furnas

About Dr. Heather Furnas

Inspired by watching her plastic surgeon father operate in African bush hospitals, Dr. Heather Furnas followed in his footsteps, training at Stanford and serving on the Harvard clinical faculty. She and her husband, Dr. Paco Canales, practice together in Santa Rosa, California, where they raised their two children. (To learn more about their practice, visit www.enhanceyourimage.com.) She believes an informed patient is more likely to be a happy patient and is committed to providing that education. If you have any suggestions for topics you'd like to learn more about, she would love to hear from you!

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