Monday, April 9, 2018
Authors: Mr. B.J Mayou, MB ChB FRCS; Mr. O. Amar, MD Surg (Hons), Dr. A Mahto, MBBCh BSc MRCP (Derm), Dr. M Zamani, BA, MD; Dr. A Granite, BA, MD, CESR (Derm)
With celebrity and social media culture embedded in our everyday lives we are constantly bombarded with images of people with the "perfect features, bodies, hair and lives". Access to infinite filters and body changing apps is common place and many of these "perfect" images that are assaulting our social media feeds are often very far from reality... Posting and boasting can be a rose tinted moment in time of the individual, often a snapshot of the highlights of their lives. However, the impact these images can have on the self-confidence of others can be vast - causing feelings of insecurity and inadequacy. In extreme cases, it can prompt people to seek cosmetic and aesthetic surgery procedures, as they hope to reinvent themselves and solve their problems. Often in these instances, where the individual may be afflicted by body dysmorphia or other mental health conditions, cosmetic surgery will not fix these problems or deliver the perfection they are seeking; thus driving the individual to seek more and more procedures and sometimes even becoming an addiction.
Mr Bryan Mayou, Cadogan Clinic Founder comments,
'Our team delivers natural results that enhance and refine, which in turn can have huge positive effects on body confidence and self-esteem, however they are not a quick fix solution to deeper psychological problems. We understand that each individual is just that, an individual. They have different body frames, shapes, skin types, weight distribution and they age at different speeds. Individual body concerns and expectations of results dramatically differ, so it is therefore imperative that patients undergo a thorough consultation in order to determine the best solution or treatment combinations, and also to ascertain if they are even the right candidate for the procedure in order to manage their expectations in the realms of possibility'.
The team at the Cadogan Clinic only treat those with genuine and realistic concerns and urge the industry to put a greater focus on the suitability of each individual for treatment. This involves taking the time to counter unrealistic expectations and declining to treat patients who are too young, have already had too many procedures or where the procedure can be a risk to their health.
Consultant Plastic and Aesthetic Surgeon Mr Olivier Amar comments, ‘Plastic surgery is a very personal choice and the job of a surgeon is to ensure they fully understand whether the patient is genuinely concerned and affected by the areas they want treated or whether they are feeling pressure simply down the media or social and peer pressure. I consider myself a doctor first and a surgeon second and will always prioritise the needs and health of my patients above all else.’
Consultant Dermatologist Dr Anjali Mahto has seen a rise in young patients seeking unnecessary treatment. Figures also reflect this trend, indicating that the fastest growth of cosmetic dermatology is injectable treatments in Millennials. Dr Mahto comments,
'I am frequently finding that I am questioning patients more when they are in their 20s and wanting injectables. Sometimes I feel they are trying to combat self-esteem issues that no amount of lip filler will solve, others simply will not get a good aesthetic result as it will ruin the natural beauty or harmony of their face, and some are not at the stage in their life where they need treatment or enhancement.'
Aesthetic Doctor and Oculoplastic Surgeon Dr Maryam Zamani has seen an increase in her practice with patients striving for their idea of 'perfection' which can mean patients wanting to look like another individual. These patients are often bringing along photos or videos from social media with unrealistic eye shapes and smooth contours they would like to achieve. She has also witnessed a trend with patients wanting to emulate the lives of the people who appear to have the 'perfect life'. There is also a growing number of people who are expressing signs of low body confidence. Dr Zamani comments,
"In order to help these individuals we need to be able to identify them. This means a stringent review of medical history; asking directly about body confidence, depression, anxiety or eating disorders. It is vital to access information on past medical procedures- both surgical and non-surgical and also to garner an understanding of other emotional impacts that are influencing their decisions such as death, loss of job, the end of a relationship and bullying. Any of these indicators can signify a red flag and it is important to help the patient find appropriate care to improve self- esteem and body confidence. Only when they are in a good mental state should they embark on tweaks.'
Consultant Plastic and Aesthetic Surgeon Mr William Van Niekerk adds,
'Not only should the expectations and outcomes be fully discussed in the consultation but also the risks and complications associated with the procedure – surgery is serious and not something to be taken lightly. In recent times, surgical and aesthetic procedures have been desensitised as procedures have become more commonplace and accessible to a greater number of people. Consumers are better educated than ever before, costs have decreased and cosmetic surgery has become more socially accepted amongst men and women, making some people turn to it without fully exploring the enormity of the decision.'
The way in which cosmetic surgery procedures are promoted throughout social media is another cause for concern. Surgeons and clinics are increasingly using emoji's to illustrate pre and post-surgery results, eluding to the claim that people look better after a procedure. Promotion in this manner is preying on the confidence and emotions of individuals and is an irresponsible measure taken by the practice, an area that desperately needs industry regulation.
Mr Olivier Amar comments, ‘Posting images in this way is juvenile. Body image is a sensitive topic and this kind of narrative can be extremely damaging, often leading to bullying or self-criticism that could be avoided. Posting an image that may be relatable to a sensitive patient could lead to them taking extreme or dangerous measures. Doctors have a responsibility to the health of their patients and should do what is best for them; just because you can do it, doesn’t mean you should.’
Dr Alexis Granite, Consultant Dermatologist adds, ‘When doctors and surgeons post before and after photos, it is important to demonstrate realistic, subtle improvements that enhance an individual's features rather than showing the same “trendy” look that is increasingly seen within media and celebrity culture. Natural proportions should be maintained and the industry should be using descriptive words like refreshed and enhanced, rather than younger and better. Medical practitioners need to take more responsibility and consider the images they are portraying and the vulnerability of the audience they are targeting.”
Dr Anjali Mahto agrees, ‘Clinics need to take responsibility in promotion and advertising. A consultation for any cosmetic procedure should be mandatory and a “cooling-off period” should be instituted. Additionally, promotional offers such as 2-for-1 deals should be discouraged; there should never be a situation where a patient is coerced into having a treatment carried out.’
Mr Mayou concludes, 'The needs and safety of our patients are of primary importance at the Cadogan Clinic and we are dedicated to providing the very best treatment, care and patient experience, administered by our world-leading team. We remain Consultant led, which is of vital importance in maintaining the outstanding levels of care. It takes a long time for a specialist to train to become a Consultant, forcing maturity as well as knowledge and advanced skill. We are also governed by a Medical Advisory Committee who review the assessment and post-procedure protocols and a new Quality Board to ensure excellence across the clinic. More practices need to follow suit and start taking responsibility for the way in which they promote themselves to vulnerable and impressionable people.'