Monday, April 27, 2009

Is plastic surgery an art form?

It’s no secret that I am into art; I collect art, I make art, and it colors my approach to plastic surgery. So in a sense I consider plastic surgery an art form as much as a technical tour de force, but a new exhibit at a gallery in New York makes the point literally. Apexart, in the TriBeCa district, has a new show curated by a plastic surgeon featuring “before and after” images and surgery videos. The patients are the medium, the operating room the studio. I haven’t seen the show, but I understand that it covers a range of procedures from pediatric reconstructive cases to facelifts.

The concept is interesting, but I suppose it was just a matter of time. Superficially, it seems perfectly legitimate to consider plastic surgery an art form, and I will be the first to defend the idea. But it also begs the question of what art really is. Plastic surgeons have long debated whether what we do is more science or craft; I am of the opinion that it is both. The downside to a show like this is not that it sensationalizes plastic surgery, but that it may oversimplify the question of art’s importance in a broader sense.

I am reminded of the recent case of a private college whose endowment fund evaporated with the economic collapse last year. They were forced to consider selling the one thing that had retained its value over the years: their art collection. Art isn’t merely a luxury, and its value isn’t arbitrary; according to Denis Dutton, author of The Art Instinct, making art is in our genes. And just take a look around to confirm that self-adornment and self-enhancement are impulses just as ingrained. It’s not a question of whether these are natural and normal pursuits but where to draw the line between good and bad taste.

I have a suggestion for the bad taste side: Another new art show, this one at the Weisman Art Museum in Minnesota, features a petunia plant. Named “Edunia,” the plant has a copy of one of the artist’s genes spliced in, making it technically part human (he calls it a “planimal”). In this case, using biomedical technology to create a living “work of art” just seems meaningless to me. Sure, the idea is provocative, which is the probably the whole point, but so what?

So I’ll stick with figure drawing and working toward bringing out people’s natural beauty with plastic surgery. Oh and I am definitely all about the new technology too, but I think of it as a tool and not the statement in and of itself.

Friday, April 17, 2009

Happy 50th Barbie

Much has been made of the symbolism of the iconic Barbie doll, who I’m told turned 50 last month. (No plastic surgery needed because she is plastic; her ludicrously long legs and other features setting an unrealistic standard of beauty; and even the jokes from her celebrated dumping of Ken because he was anatomically incomplete to “divorcee Barbie” costing more because she comes with most of Ken’s stuff.) But some take seriously the question of what Barbie says about a society that creates such a preposterously proportioned plaything. Do girls, and women, really aspire to be like Barbie?

At least one person has, a plastic surgery “addict” named Cindy Jackson who was born the same year as Barbie and who has made it her goal in life to become a sort of human Barbie doll. The reported cost of this plastic surgery transformation is in the range of six figures. Has this made her happy? You will have to ask her.

Plastic surgeons have become more attuned over the years to the problems that can go with this sort of plastic surgery compulsion. Patients who have serial plastic surgery without ever being truly pleased with their appearance often have a condition called Body Dysmorphic Disorder, or BDD. Fortunately this is not common, and most people who show up in a plastic surgeon’s office have healthy motives. They just want their old body back after having kids, or a less tired look to match their true energy level. Plastic surgery to please someone else or to try and live up to perceived societal expectations is always a bad idea.

But the truth is that Barbie really is more likely to end up with a fancy sports car and a swanky Malibu home. Looks do matter. And there is a place for plastic surgery, somewhere between the extremes of trying to be the human Barbie doll and acceptance of whatever our genetics have in store for us, no matter how unattractive. (We could continue that line of reasoning to birth defects, which few would argue should not be repaired, but these are at the end of a continuum of conditions that include merely disproportionate noses or crooked teeth.) The psychological effects of plastic surgery have been studied quite a bit, and they are uniformly positive when it is done for the right reasons. Self-esteem is improved, along with a generally more favorable outlook, leading to better measures of functioning in daily life.

Ultimately, it isn’t all that complicated. Plastic surgery isn’t a substitute for the things you can do for yourself with diet and exercise, nor is it a cure-all for every disappointment in life. As a rule, people really don’t want to be Barbie, they just want a restored version of themselves. Oh and Barbie?-Your AARP card is in the mail.

Friday, April 10, 2009

Hydration theory all washed up?

There was a feature on the local TV news recently about some new anti-aging product – I don’t recall what it was, but there was some controversy about its effectiveness – and the anchor wrapped up by summarizing what we all take for granted about anti-aging behaviors: get enough sleep, exercise, and drink lots of water. That last piece of advice seems to be widely applied, judging from the number of people lugging water bottles around as though they are concerned about suddenly wandering out of damp Seattle and finding themselves in the Sahara. Does drinking lots of water really make us healthier, or are we just wet behind the ears?

Intuitive reasoning bears on this behavior. By making an effort to drink more water, we are flushing out the “toxins” that are so harmful, right? And our skin needs lots of water so that it will stay well-hydrated and youthful, so it seems like a no-brainer. But there is a disconnect here between intuition and clinical science. What, if anything, can be proven about this theory?

Some have suggested that dehydration is an inflammatory state, and we do know that inflammation is an important underlying process in premature aging. But even that conclusion is based on pretty scant data. And to take it a step further by recommending extra hydration (as opposed to adequate hydration) is a wholly unproven proposition. There just isn’t any research data to back it up, and I have looked. Further, the notion that we can convince out bodies to bypass all of the normal mechanisms that determine how much water to hold on to and put some of the excess into our skin, or flush out more toxins, is a theory that just doesn’t hold water. Our kidneys are smarter than that.

You may be saying, “Well, it makes sense anyway, and what can it hurt?” Other than having to schedule your day around proximity to lavatories, there actually is a potential downside. Even water can be harmful in excess, as tragically demonstrated by a woman who died trying to win a water-drinking contest from a local radio show last year. That is admittedly an extreme case, but it illustrates how it is a possible to throw a lot of things out of balance by not simply listening to your body and drinking when you are thirsty. Our bodies are pretty well fine-tuned to inform us when we need a drink. So drink enough water, just don’t go overboard.