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Fairly or not, superficially or not, human beings in most human cultures inhabit a hierarchy of attractiveness and youth. When people look good, the rest of the world looks at them as being healthier and more vibrant than otherwise. When people perceive that they look good they carry forth and project that feeling into the world. A perceptive colleague of ours once told us that cosmetic surgery is not an art form, it’s a way to make people happy. In general we view the craft of cosmetic surgery as a process of making people look better and increasing the part of their self confidence based on how they look.
Most but not all pts presenting for revitalizing surgery of the face are female so we will call them “she”. In fact the issues of aging with men are so close to that of women that we find very little difference. Because faces age in generally similar ways every plastic surgeon hears the same concerns and eventually becomes a minor expert in the psychology of aging and an observer of human self-perception. Most pts coming for consult will say that they look older than they feel. Women in particular seem to have a horror of looking like their mothers. Men and women express concerns about the workplace and staying competitive.
A sympathetic ear is necessary to help these pts. Cosmetic surgery of the aging face is an attempt to regain what has been lost, and there is a good deal of psychic pain in that loss. Some people have had good looks carry them along in life and a good deal of their personalities may be tied into the way that they look. Most people of facelift age have lived full lives, many have lost spouses or divorced and are unwilling to give up on potential future relationships if they perceive that their appearance stands in the way.
Though these concerns may seem trivial or shallow, one of the duties of a physician is to alleviate suffering, a condition which brings many pts into the office. We did not appreciate many of these issues until we ourselves became of facelift age and felt them more poignantly.
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