Social media and influencers are presently defining the beauty criteria, posing new and complex challenges to plastic and reconstructive surgery. This was, therefore, the topic chosen for the latest debate promoted by the AO Foundation, on AO TV , having as guests Alberto Rocha Pereira , specialist in reconstructive and aesthetical plastic surgery and director of the Plastic Surgery services of Hospital da Luz Lisboa and Hospital da Luz Torres de Lisboa, and two other surgeons, Amir Elbarbary (Cairo University) and Ana Catalina Tobón (Bogotá). The three specialists, representing three different continents, agreed that there is a trend to the “ globalization of beauty standards ”, and described as totally different the consultations and the questions now posed by patients, very much influenced by national and international figures dominating the social media. Where must the surgeon draw his “red line”? During the debate, Alberto Rocha Pereira explained: “In consultations, many patients approach us with photos, when we, doctors, learn and are trained to start a consultation by a real complaint about something that is not right or disturbs the patient. Presently, people bring along a photo of how they would like to be, without referring a complaint , meaning that they have no specific feature they would wish to change through surgery or treatment. They simply wish to look like the image in the photo. This is definitely not the best way to start a consultation.” “In aesthetical surgery, there is no clinical indication to change anything in the face of an individual. The person is perfectly healthy, but expresses the wish to perfect or modify a specific feature he dislikes. This should be the starting point to see if we can technically perform such modification.” “On the computer, it is always easy, in surgery, it is not. It is practically impossible to replicate surgically on the human face, exactly what can be done on a photo with a computer program. Even resorting to the latest technological advances, that virtually allow to predict the impact of displacing a bone or the reaction of soft tissues. But the way the skin and soft tissues adapt to a particular procedure varies significantly from person to person and is very hard to predict.” “When I realize that expectations are not realistic, I immediately explain that to the patient. In aesthetical surgery – and the same applies to other areas of surgery –, there are two persons who must be in full agreement as to the treatment to perform: the patient and the surgeon. ” “Whenever I have a patient trying to push me to do something I feel that will not be a good option for him, or when I realize that I will not be able to surgically meet his expectations, that is where I stop. And, of course, I always suggest him to seek for a second opinion.” “I am worried that we are moving towards a sort of globalization of beauty standards. People will try more and more to look like their idols, replicating ideas of beauty increasingly shared by more and more people, in different points of the globe, even when unsuited or disproportionate. And it will become harder to restrain that trend, for there will always be surgeons willing to and easily accessible in different countries.” Alberto Rocha Pereira concluded, reminding that a surgeon should always seek to find out the real motive why the patient wishes to change his face: “It may lie in a psychological or emotional basis – and that, evidently, cannot be solved with surgery”. Watch and read the debate promoted by the AO Foundation
