Cosmetic surgery is in its infancy.

Medicine itself is thousands of years old but cosmetic surgery only began in mid-twentieth century — perhaps fifty years ago. It is still evolving — so we need to continually ask what role it might play in people's lives.

We believe that cosmetic surgery has proven to be an effective and powerful tool for personal change.

Currently the traditional viewpoint is that cosmetic surgery treats vanity - and is thus for the vain and foolish. But I have come to realize, from my thirty years of experience, that my patients are neither vain nor foolish.. My view has come to be that cosmetic surgery supports people to have their face and/or body come into harmony with their true inner being — their youth and beauty.

We are convinced that our patients have an appropriate concern when their outer appearance doesn't match their inner being. We could say that our goal as cosmetic surgeons is to bring forth harmony and, therefore, what we are actually treating is disharmony between outer appearance and inner being.

There is a more pointed way of saying it. Cosmetic surgery treats symbolic misrepresentation… In other words, if your face says you are angry when you are not, we correct those symbols of anger, perhaps low brows or downturned corners of the mouth. Faces may say we are old when we are young, sad when we are happy, and unattractive when we are attractive. We remove the symbols of anger, age, sadness, unattractiveness or age. Thus cosmetic surgery treats symbolic misrepresentation.

Cosmetic surgery is a specialty of medicine. We are highly trained physicians. But it differs quite a bit. Medicine lives in the corrective arena of life, and asks the question, "What's wrong and how do we fix it?" Cosmetic surgery, rather, lives in the enhancement arena of life so we ask a different question "Would cosmetic surgery be useful to enhance my life?"

The Lie of the Mirror

We look in the mirror and think we are the reflection looking back. Worse than that, we know we are. After all, "Who else would be looking back at me except me?" we reason. "Yup. It's me all right."

But it's not so. The mirror lies. It can say we are old when we are not. It can say we are unattractive when we are attractive. And these are powerful lies. They can make our lives miserable.

Consider the possibility that the mirror neither shows who we are nor what we really look like. It merely shows a two-dimensional reflection of our face… usually in bad lighting… unsmiling… from 18" away… reversed… usually at our worst in the morning and again late at night. We can't even see ourselves blink. This reflection is a lie because it has nothing to do with our inner reality nor is it what other people see of us. The catch is that we really think it does.

Our minds help the mirror in its lie. Let's use aging as an example. We get so used to the daily image we don't notice the gradual changes of aging. Then, suddenly, one day we catch a glimpse of a passing face in a store window, wonder who that is… and shock to discover it is our own face. We rush home, look in the mirror… and see the sags and wrinkles for the first time.

It's hard to feel alive and excited when the face looking back in the mirror says that we are getting old. The wrinkles are instantly what is real. The mirror belies how young we are inside.

After conversations with thousands of patients, we have concluded that these mirror-changes somehow act as instructions to have our self-perception shift from youth to old. We begin, unconsciously, to act, feel and think as old as the mirror instructs. Then the mirror becomes our worst enemy, perhaps even shortening our lives as we unwittingly develop wrinkled attitudes and inner organic wrinkles to match the mirror's instructions.

Often we wonder, along with our patients, if we would truly become old if it were not for mirrors and the feedback we get from others. Without them, would we stay young, alive, and excited until the moment we die? We wonder if this is what the brilliant anthropologist, Ashley Montague, meant when he said, "Die young — as late as possible."

We suggest that the purpose of cosmetic surgery is to make changes that make the mirror tell something closer to the truth. After cosmetic surgery, our patients have a brighter, fresher look to their faces, they become sharper in their dress, and there's a spring to their step. They laugh more. Their outer appearance now matches their inner youth.

Cosmetic surgery helps people look more like themselves than they have in a long time. Or, as one of our patients told us, laughing, "Now I look more like me than I ever did."

Harvey W. Austin, MD
Box 1470
Berlin MD 21811
email: h.austin@mchsi.com