I was at a dinner party recently with several of my former medical school classmates where we were chatting about the various fields of medicine we entered. At the table there was an emergency medicine physician, a cardiothoracic surgeon, a radiologist, a pediatrician, two family physicians, and myself. As we traded stories about our lives and our practices, one of the spouses who (was not in medicine) commented how it seemed that all the doctors at the table gave back to society by caring for the medical problems of people in need. He then quipped, “except for Dave who just shoots up botox in the society ladies.” This got a little chuckle around the table, and heads turned to me to see what my response would be. But, having been a plastic surgeon for a long time, this was not the first time I have heard such jibes from my peers. And because I liked the guy who made the comment and placed it into the context of an attempt at humor after a few glasses of wine, I decided to let it go.
But what my friend and many others may undervalue is the good that aesthetic services can provide an individual beyond just the act of smoothing out a few lines or wrinkles to make one look a little younger. I have said that my field is not about making one look better, but rather making one feel better about oneself. It is a subtle distinction, but one that makes the difference between conceptualizing cosmetic services as procedures which are image driven, shallow, and trivial versus treatments which enhance self-esteem and wellness.
Here is an example. Many times, I see an individual who comes in because he or she would like to appear more youthful or refreshed in anticipation of some upcoming life transition. Often, a new job or job interview prompts this person to seek a “fresh start” or a “boost”. And in most situations, after treatment, most patients will inform me that the changes aided them, whether in helping them land a job or some other benefit during the period of change. I have always contended that our treatments have a positive impact by making patients feel better about themselves more than the fact that they look better. It makes sense–the projection of greater self-confidence and positive energy will have more of an impact to those around an individual than a few less lines or wrinkles. And if these enhancements in self-attitude can translate into real advantages in life, work, or love, then it is hard to refute that these services provide some real value to the health and wellness of people.
I realize it is easy to poke fun at my field as saturated popular culture is with images and ideas pertaining to plastic surgery and cosmetic treatments. But I contend that I provide meaningful therapeutic benefit to my patients. I may not be bypassing clogged coronary arteries or re-setting broken bones, but I know that I too am providing my patients with services that can make them feel better and live better.




I have just finished your blog read. I find it refreshing that you have considered the philosophical concept behind beauty. I am at the other end of the aesthetics field, a beginner. As I try to find my way, I have had comments from others about why I may be pursuing this art.
I have been a Nurse Practitioner for 13 years helping the under-served, various ethnic groups, people with no knowledge of health or nutrition, woman’s health,chronic pain conditions and psychological conditions. I was well loved by my patients and peers. I loved teaching wellness and was delighted with the results of my patients.
People needed emotional support to take time for themselves. Possibly due to religious beliefs, cultural pressures, and economics, people believe they are being selfish or self absorbed if they are not constantly doing for others. Women especially have trouble giving their selves permission to be well. I have encountered this with may women. I worked hard to inspire them to exercise and eat well and take time for themselves. And when they did, their lives changed and the pebble was thrown in the water. I loved doing this, but am done.
Before I was in the Medical world I taught massage and massaged about 8000 people. Again, helping people give to themselves. When I became trained in a variety of aesthetic procedures I knew that I again was helping people come to terms with giving themselves permission to feel good about themselves. All that seek aesthetic care are not just the very wealthy. I knew a woman who saved her money 8 years to get scar removal and tummy tuck after a childbearing nightmare abdomen. Adolescents who had terrible acne scaring cry when they look at improvements. People suffer with their looks and perception of looks. They can change their perceptions perhaps, but not usually. I like helping them give themselves permission to look good.
The overly obsessive about they way they look, may take that inner journey once the beauty obstacle is removed, to proceed with a deeper look at personal value.
I realize that I have gone on and on, but have (apart from my friend Dr Hansen at OHSU Portland)found little warmth from the aesthetic field. There is a coldness I have come across in several offices, from front desk to providers. They perhaps want so much to appear aloof, professional and appeal to some fantasy wealthy client, but as this field grows the less affluent women will be seeking out these services and will come to the warm and welcoming providers given the chance. I appreciate your blog, esp. your last entry. This is a very hard field to get into. Understanding how people feel about themselves is absolutely related to high level wellness. It should be part of the business plan. Thank You for your time.