I am off to Hawaii in a couple of days for the annual scientific meeting of the Northwest Society of Plastic Surgeons. I know you feel sorry for me, but you have to give credit to the society for including the state of Hawaii as a member, giving us an excuse to go there from chillier parts of the Northwest in February. As it turns out, I will be working, and I am just now putting the finishing touches on two talks I will be delivering. The first has the high-falutin’ title “Integrating the Future of Plastic Surgery.” If you are a regular reader here you will know that I am interested in trends, new technologies and techniques, and how we can best bring these to our patients for their benefit.
What I am going to talk about is an approach to problem-solving called integrative thinking, defined as the ability to reconcile opposing concepts by creating a solution that has elements of both but is something new and unique. I look at it as involving both sides of the brain, uniting the rational, verbal, linear left with the artistic, holistic, creative right. Einstein described it well: “Invention is not the product of logical thought, even though the final product is tied to a logical structure.”
So what does this have to do with plastic surgery? Plastic surgeons are after all inherently creative people, the word “plastic” implying a flexible approach. No two cases are alike, and so plastic surgery is often more improvisation than cookbook recipe. But as techniques have evolved, certain standard approaches have become the norm, and once this “source code’ is out, any surgeon can learn how to do it. Plastic surgeons now compete with a variety of doctors from other specialties moving into plastic surgery for economic reasons. A related phenomenon is similar to outsourcing; just as your tech support person is likely to be in India, thousands of Americans travel overseas for discount plastic surgery. All of this is based on left-brain thinking and it has been tremendously successful. But because it is based on standards that can be taught and copied, it becomes difficult to contain, and some plastic surgeons feel that we are losing ownership of our own specialty.
I believe the key to continuing success in plastic surgery is innovation. Patients want (and deserve) less invasive procedures delivering more natural results with faster recovery. Creating the innovations that fulfill these goals requires tapping into the artistic right brain, and as Einstein said, tying it to a logical structure. Besides, it’s fun.
Wednesday, February 17, 2010
Wednesday, February 10, 2010
Is your avatar having more fun than you?
No, this isn’t about the movie Avatar but it isn’t about the original meaning either (in Hinduism avatars are incarnations of deities.) In modern times, computer games have brought a broader definition to the term, for an assumed identity with whatever characteristics are selected. In other words a sort of alter ego, a double identity.
What does this have to do with plastic surgery? I got to thinking about it reading the book Connected by Nicholas Christakis and James Fowler, about the way social networks impact our lives in unexpected ways. In the book they note that our appearance affects the way people treat us, a topic I have covered here before. Whether we like it or not, attractive people tend to earn more for the same work, attract more friends, and have opportunities presented to them that similarly qualified but less good-looking people do. What’s interesting is the research finding that avatars in online games tend to take on personality characteristics and behaviors matching their appearance, rather than the player’s real-life persona, and other players in the games react to the avatar's appearance in predictable ways too. If like me you don’t play online games, you may still have noticed this sort of thing at Halloween costume parties.
I think there is an element of this phenomenon in plastic surgery. Young people born with a large or crooked nose, for example, who have a rhinoplasty before going off to college often blossom from wallflowers into happy, socially active adults. Women often feel more confident after breast implants, and men after some lipo. Sure, it may be noble to learn to live with one’s genetic inheritance, but keep in mind that appearance affects others’ behavior toward us as much as our own.
What I have observed over the years is that most patients aren’t trying to become a glamour icon and start behaving like celebrities, they are just looking for an improved version of themselves. Plastic surgery for them really does help them fulfill their dreams and improve their lives, and there are scientific studies to prove it. Of course it is possible to have a happy and fulfilling life without either having plastic surgery or winning the genetic lottery for natural good looks, but dismissing the whole notion as vanity doesn’t acknowledge how powerful even a minor transformation can be for some. In the meantime, I will keep working on my techniques to make people 10-feet tall, blue skinned and capable of riding flying dinosaurs. Come to think of it, avatars of Vishnu are often portrayed with blue skin …
What does this have to do with plastic surgery? I got to thinking about it reading the book Connected by Nicholas Christakis and James Fowler, about the way social networks impact our lives in unexpected ways. In the book they note that our appearance affects the way people treat us, a topic I have covered here before. Whether we like it or not, attractive people tend to earn more for the same work, attract more friends, and have opportunities presented to them that similarly qualified but less good-looking people do. What’s interesting is the research finding that avatars in online games tend to take on personality characteristics and behaviors matching their appearance, rather than the player’s real-life persona, and other players in the games react to the avatar's appearance in predictable ways too. If like me you don’t play online games, you may still have noticed this sort of thing at Halloween costume parties.
I think there is an element of this phenomenon in plastic surgery. Young people born with a large or crooked nose, for example, who have a rhinoplasty before going off to college often blossom from wallflowers into happy, socially active adults. Women often feel more confident after breast implants, and men after some lipo. Sure, it may be noble to learn to live with one’s genetic inheritance, but keep in mind that appearance affects others’ behavior toward us as much as our own.
What I have observed over the years is that most patients aren’t trying to become a glamour icon and start behaving like celebrities, they are just looking for an improved version of themselves. Plastic surgery for them really does help them fulfill their dreams and improve their lives, and there are scientific studies to prove it. Of course it is possible to have a happy and fulfilling life without either having plastic surgery or winning the genetic lottery for natural good looks, but dismissing the whole notion as vanity doesn’t acknowledge how powerful even a minor transformation can be for some. In the meantime, I will keep working on my techniques to make people 10-feet tall, blue skinned and capable of riding flying dinosaurs. Come to think of it, avatars of Vishnu are often portrayed with blue skin …
Tuesday, February 2, 2010
Breast implants in athletic women
Women athletes arguably have more obstacles to overcome than their male counterparts, title 9 and lack of career options in professional sports notwithstanding. Lower natural levels of muscle-building hormones such as testosterone means even harder work to develop strength, and the lean build that is beautiful in so many ways becomes less feminine at the same time. There are several versions of attractive female figures, but for many athletes the desire to have at least a few womanly curves is natural. The choice to have breast implants is both personal and justifiable, yet opinions of the many seem to be given credence.
That is probably part of the reason why there has been so much media coverage of the decision of Australian hurdler Jana Rawlingson to have her breast implants removed. Apparently she has decent odds of medaling in the next summer Olympics but felt that the implants might get in the way. Frankly that is a little bit hard to imagine unless they were large to begin with, which is not a typical choice for an athlete in the first place. I wish her luck but if she does well it will be because of her dedication and training, not because she had her implants out.
The question of implants in athletes deserves serious attention from plastic surgeons who breast augmentation, though, because there are unique issues that need to be addressed. Ordinarily, with low body fat and small breasts, submuscular placement of the implants gives a more natural look. However, with a lot of muscle development that just isn’t a good choice for a number of reasons, some obvious and others not. I have been using an in-between option called subfascial implant placement (fascia pronounced like fashion) in cases like these. This provides support for the implants and more natural curves. Combined with small, usually low-profile implants, this results in more real-looking and proportionate breasts. Whether these breasts are truly more aerodynamic is another question.
That is probably part of the reason why there has been so much media coverage of the decision of Australian hurdler Jana Rawlingson to have her breast implants removed. Apparently she has decent odds of medaling in the next summer Olympics but felt that the implants might get in the way. Frankly that is a little bit hard to imagine unless they were large to begin with, which is not a typical choice for an athlete in the first place. I wish her luck but if she does well it will be because of her dedication and training, not because she had her implants out.
The question of implants in athletes deserves serious attention from plastic surgeons who breast augmentation, though, because there are unique issues that need to be addressed. Ordinarily, with low body fat and small breasts, submuscular placement of the implants gives a more natural look. However, with a lot of muscle development that just isn’t a good choice for a number of reasons, some obvious and others not. I have been using an in-between option called subfascial implant placement (fascia pronounced like fashion) in cases like these. This provides support for the implants and more natural curves. Combined with small, usually low-profile implants, this results in more real-looking and proportionate breasts. Whether these breasts are truly more aerodynamic is another question.
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