Episode 9-Part 3: Botox and Changing Perceptions of Aging
You don’t have to have Botox to look good at 50
We know that appearances are important. However, to the extent that when you are talking about looking good at 50, looking good in the eyes of the world, then you must have had Botox or other aesthetic treatments. If not, then you are boasting to the world about your superior genes? What is the problem with that?
Terence: I definitely think there are a lot of people with naturally good skin. I wouldn’t say superior, but they just have genetics that help. Certainly their lifestyle and diet also helps, that’s probably the more important thing. Things like sunscreen, not smoking, exercising, and I do see many patients that don’t age as much as someone else. I think that certainly plays a big part. Maybe the people who are upset are envious? I’m not sure, but I definitely don’t think it’s all that impossible to have good skin without having to do alot.
Dr. TWL: With the popularity of aesthetic treatments rising, especially when they are practiced by non specialists – non dermatologists, non plastic surgeons. It is creeping into the public perception that these are kind of normalized.
Do you think that society has normalized the idea that you must have aesthetic treatments in order to look good?
Zul: I guess with social media, aesthetic treatments have sort of become the cultural norm that you must have it in order for you to look good. Personally, I don’t think that’s the case. I think what’s paramount is a healthy lifestyle. Good genes are helpful, but a healthy lifestyle – eating well, exercising, not smoking, no late nights, sleeping well. That is paramount in helping a person to look as best as he or she possibly can.
Dr. TWL: Yeah and it’s very interesting, because we’ve already spoken about the lifestyle factors being evidence-based. The disruption of the circadian rhythm has been shown to accelerate aging in cell and animal models. Just by experience, if you are lacking sleep or you have to do night calls, you find yourself really fatigued, and your immune system is also down. So what you said Zul, is very important in terms of shaping our societal views of aging.
Is ageism an issue in the aesthetic medicine field?
Increasingly, we know that we ought to be a bit more sensitive about age and people growing older. Because, being discriminatory is not the way. When you see an individual who is showing the physical signs of age, we can clearly communicate that objectively in a medical way. But is it appropriate for us to convey that to the layperson, to the public, and does it lead to some form of ageism in terms of a discriminatory attitude?
Chris: I think there would be some ageism in society, based on looks. I mean everyone wants to look good, and we know that better looking people get promoted faster, they earn more money in the corporate world etc. So there is definitely some discrimination against people who don’t look as good – I’m not sure whether that’s ageism or not. But according to society, I suppose younger people in general tend to look better. But I guess that’s why people do go for these aesthetic treatments to look younger, to help with their personal and professional life.
There’s nothing wrong with wanting to look good
Dr. TWL: You know, there’s absolutely nothing wrong with that. In fact, a way to look at that issue is really in terms of how you put yourself together. Because for that same reason, we dress well. It’s a measure of conveying respect to the other party. Our hope is that you are really taking care of yourself. None of us here would be advocating an intervention where you’re just simply doing the aesthetic treatments and having a very unhealthy lifestyle – like heavy smoking, heavy alcohol consumption, and sedentary lifestyle. Because I feel as doctors, as medical professionals, the public actually innately holds us in a certain position – in terms of how they respect what we say.
More than appearances, be the best version of yourself
Maybe like 8-9 years ago, I would have been really convinced that you do have to look your part. Looking good would offer you certain advantages in life. But ultimately, it’s a matter of to whom you are trying to sell your attractiveness to. Because the same people who may be evaluating you based on your attractiveness, are maybe not the kind of people who would stick with you in the long run, do you know what I mean?
Maybe your employer is hiring you just because of your good looks, or thinks that you can get an edge over somebody else because of your better looks. I’m not sure if that’s going to be sustainable, because there’s always going to be someone who’s better in terms of that. Additionally, if you’re totally incompetent as well, no matter how pretty you are, I think it’s a real problem.
Terence: Yes, I agree. Our philosophy has always been we want you to have the best version of yourself, and it doesn’t necessarily have to be through some form of surgery. It’s definitely more important to be truly who you are. Additionally, like you say, it really depends on who you think your audience is. I think aesthetic treatments in cosmetic dermatology or surgery is not going to land you that job, it’s not going to get you that promotion, or get you that boyfriend. So make sure you do it for the reason you want to do it. You should not have inflated expectations of what these treatments do for you.
Do you have experience with body dysmorphic disorder?
Dr. TWL: I’m sure amongst the 3 of you, and I can say, personally speaking as well, that there has been patients we encounter who actually have a psychological problem. I think it’s probably pretty common in plastic surgery patients as well.
Zul: Yes I’ve encountered patients with body dysmorphic disorder. Patients who’ve had aesthetic treatments like fillers who then have it removed a few days later. Then go somewhere else and had fillers again, then have it removed because they’re not satisfied with what they have. There’s an element of depression in this, so we’ve got to really pick it up.
Dr. TWL: Yeah, it really is so saddening. I feel that we have to get to this point as doctors – where the public actually look up to traditionally as healers – sometimes have to make this kind of judgement simply because aesthetic medicine is actually fairly new.
The rise of social media and aesthetic medicine
I don’t know about you, but I personally feel that a lot of the narcissistic displays that we see on social media are on the rise. Without a doubt, it’s borne out by epidemiological studies ,that narcissism – not in terms of a pathological narcissism – but just narcissistic traits in general, are on the rise internationally. I think there could be some sort of correlation with the rise of aesthetic medicine. It’s a cycle – the beauty industry which is now also intertwined with medicine, provides an avenue for improving your appearance. It sells this idea to you that you can be better looking and will offer you these advantages simply because you look better. This can fuel narcissistic traits.
Chris: Yeah, so we do you have to be a little bit careful. As you say these patients or people in general just keep wanting to look better and better, but sometimes there’s a limit to how much you can do. So we do have to be careful and tell them look, I think you’ve had enough – sometimes we shouldn’t do anymore. But there are some unethical doctors out there who will just keep giving fillers even if the patient’s face is already very full, and they don’t really need anymore.
Also not just doctors, but in other countries, or even in Singapore, beauticians are still carrying out these treatments in their own houses or hotel rooms. These practitioners are not bound by any ethical obligation, but by commercial interests. They will just keep giving you as much as they can sell, so it is very dangerous. And it is true that social media is feeding this type of behavior in general.
Dr. TWL:Well at the end of the day, we still don’t know if Jlo was lying or not. But to be offended that cosmetic interventions like botox are being specifically denied by celebrities even if they are telling the truth, what’s the deal with that? Why should it be seen as them boasting about their superior genetics, or even crediting their skincare regimen? Now I feel that my underlying discomfort is that we are being pressured to look good and to feel like we are only going to be the best version of ourselves by the advertising that’s going on with cosmetic treatments.
Well that’s it for today’s podcast episode. Thank you Chris, Terence and Zul for coming on board with your expertise and personal thoughts on the practice of aesthetic medicine. You may follow them on Instagram @azatacaplasticsurgery, we hope you enjoyed this podcast and till the next episode!
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