But I Don't Want to Look Plastic

plas·tic sur·ger·y

[ˈplastik ˈsərj(ə)rē]


The process of reconstructing or repairing parts of the body, especially by the transfer of tissue, either in the treatment of injury or for cosmetic reasons.

It has nothing to do with actual plastics. Silicone sometimes…yes, but not actual plastics. I think most people do realize this. I am occasionally asked by patients why it is called plastic surgery and share this definition. The reason this is on the forefront of my mind today is because of something that a new consult said to someone in my office yesterday, ‘But I don’t want to look plastic.’

No one does. OK, maybe some people do. I am not interested in aligning myself with that clientele. I believe that those people moving through the world with a completely unnatural, surgical appearance are the victim of a surgeon or physician that didn’t know when to say when. This lady’s concern was looking too ‘done’. She had been to another physician for injections, nothing surgical. Good thing since he wasn’t a surgeon….although that is not always a deterrent for some physicians. I have had patients present to me to discuss mole removal and in discussing their history relate they had liposuction by a Dermatologist. And you’re coming to a Plastic Surgeon for a mole? This is a topic for another blog. Let me stay on point…

I loved the reply that Patty came up with when the patient stated her concerns about looking ‘plastic’.

Do I look plastic to you?


She went on to tell the lady what she had previously had injected. Those injections were done by me because I would beat her mercilessly if she came in here with evidence of someone else working on her. Not really beat her but it would break my heart. She knows that…my office is amazing and loyal and great. Doubt they would cheat on me. But I’m watching, ladies…

Two points are very relevant to me regarding this exchange. The first is my drive to use the proper tool for the job and the second is when to know that certain tools are not the right one for the job. In this lady’s case, and in the case of many other patients I see, the injections she had done were not the right fix for the job. That is my opinion and I think most know what you can say about opinions. Everybody has one, just like something else. And I believe most of you know what that other thing is that everybody has.

You could present yourself to 100 plastic surgeons and likely come up with 100 different plans. One of the many, many things I love about Plastic Surgery is the variety. There are more fillers on the market than I even realize. There are multiple ways to do every procedure that anyone could come up with. I love that Plastic Surgery allows you to address literally every area of the body. Last Thursday my surgical schedule was a lower blepharoplasty (eyelids) then augmentation mastopexy (implants and a breast lift) then a brachioplasty (arm lift) then liposuction then a laser with fat grafting. 5 different patients, 5 different things: one of the best surgical days ever. Plastic Surgery is the love child of art and science. Figure out what needs to be corrected to make someone happy then figure how to execute the correction. Sometimes it is surgical, sometimes it is not.

Some patients desire an aggressive approach. I am all about instant gratification. I could only ever have been a surgeon because the alternative-life as a medical doctor-would have driven me batty. Let’s change this medication and check back with me in 6 weeks. Aaargh! Dislike. Here’s an idea: let’s cut it out and see immediate results. Excellent!

Some patients are not interested in jumping in with both feet. I have mad respect for that. The beauty of fillers and injectables is that there is little if any down time. Many people have little bruising or swelling and are moving through the world the next day...no big deal. I wish that had been my recent reality: I injected fillers into my face 2 weeks ago to correct some things I didn’t like. I am still swollen beneath my eyes and on my cheek. Oh well, goes with the reality of being a female plastic surgeon and practicing what you preach.

What does not make a lot of sense to me is someone that desires an aggressive result but is not interested in taking the plunge. With risk comes reward is a mantra that I often repeat. Perhaps more relevant to this conversation is ‘with lack of aggression comes disappointment’, at least in some cases. It’s not that the physician that did the injections knew he couldn’t deliver the results she wanted. I seriously doubt that is the case. I believe that too many physicians don’t know how to shut up and listen. Let the patient really explain what they want. After talking to this patient, it was clear to me that the plan to inject fillers was not going to deliver what she wanted to see corrected. After I discussed with her the options that would result in the difference she wanted, she expressed that the recovery from those procedures was more than she could take on right now. Totally acceptable, but not a reason to default to another technique that will not get the job done.

So back to her comment about looking plastic…I know what she means. A lot of people pursue so much ‘correction’ that they lose their natural appearance. I believe that this can result from the propensity to apply the wrong fix for the job. Clearly I’ve circled back to my opinion. If someone, for example, has significant volume loss in their face that sometimes comes with age and with this volume loss comes skin laxity and wrinkles, it is my opinion that trying to correct that conservatively with fillers is an exercise in ‘looking plastic’. Either accept that a face lift is the answer or accept that an incomplete, but believable and more natural, correction can be achieved with a different approach.

Do not be afraid of what it takes to maintain your youth, or at least the appearance of youth. Age is but a number. My beloved husband always says that he will continue to get older but he will never grow up. I LOVE that…I don’t want to grow up either. But I also don’t want to necessarily look like I am getting older if I can help it. Many that know me know that I abide by less is always more. You can always put more in or pull it tighter but you can rarely back it up. I love that the ladies in my world embrace this philosophy as well.  

I leave you with this quote from one of Plastic Surgery’s greatest advocates:

‘I’ve had so much plastic surgery, when I die they will donate my body to Tupperware.’ –Joan Rivers

Don’t be a Tupperware donor. I, for sure, will help talk you down if you find yourself headed in that direction. But also do not be afraid to maintain, correct, enhance. Remember, less is more. I look forward to the opportunity to help you find your way through the magnificent world of Plastic Surgery. You can find your own Tupperware.

Here’s up to it!