Culture and Diversity in Aesthetics w/ Dr. Steven Dayan

1
00:00:01,080 --> 00:00:03,630
Welcome to Park Avenue
Plastic Surgery Class,

2
00:00:03,690 --> 00:00:07,350
the podcast where we explore controversies
and breaking issues in plastic

3
00:00:07,350 --> 00:00:10,170
surgery. I'm your co-host, Summer Hardy,

4
00:00:10,230 --> 00:00:13,380
a clinical assistant at Bass
Plastic Surgery in New York City.

5
00:00:13,710 --> 00:00:17,580
I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

6
00:00:17,610 --> 00:00:19,650
educator and technology innovator.

7
00:00:20,100 --> 00:00:24,060
The title of today's episode is
Culture and Diversity in Aesthetics.

8
00:00:24,810 --> 00:00:27,390
This seems like a very
timely topic, Dr. Bass,

9
00:00:27,450 --> 00:00:29,820
what is the scope of what
you're hoping to discuss today?

10
00:00:31,650 --> 00:00:35,760
The desire for beauty is
universal and not new.

11
00:00:36,780 --> 00:00:41,550
How beauty is defined in
popular culture is somewhat to

12
00:00:41,550 --> 00:00:45,840
very different in different cultures
in different parts of the world.

13
00:00:46,440 --> 00:00:50,610
From there, how that beauty is
supported by beauty industries,

14
00:00:50,940 --> 00:00:55,740
including medical beauty services,
is part of our discussion today.

15
00:00:56,490 --> 00:00:58,890
I've asked my colleague, Dr. Steve Dayan,

16
00:00:58,890 --> 00:01:03,120
to join us again on the podcast
to discuss this topic in detail.

17
00:01:04,380 --> 00:01:08,610
Dr. Dayan is a facial
plastic surgeon in Chicago.

18
00:01:09,840 --> 00:01:14,730
He is a New York Times and USA

19
00:01:14,760 --> 00:01:16,710
today bestselling author,

20
00:01:17,070 --> 00:01:21,750
and he's been an exceptionally
prolific speaker and writer. His book,

21
00:01:21,750 --> 00:01:26,400
Subliminally Exposed springs from
his popular undergraduate course,

22
00:01:26,880 --> 00:01:28,320
the Science of Beauty.

23
00:01:29,100 --> 00:01:33,540
He's known for his dynamic keynote
speeches and deep understanding of human

24
00:01:33,540 --> 00:01:35,670
behavior. In addition,

25
00:01:35,670 --> 00:01:40,380
he's an entrepreneur having
founded and run a medical

26
00:01:40,380 --> 00:01:43,740
research company, a
medical marketing company,

27
00:01:44,340 --> 00:01:48,630
a skincare training center, and
a medical education company.

28
00:01:49,260 --> 00:01:53,910
His ventures placed him at the
forefront of aesthetic innovation and

29
00:01:53,910 --> 00:01:55,020
product development.

30
00:01:55,650 --> 00:02:00,510
He's the recipient of the AMA
Foundation's Leadership Award showing

31
00:02:00,510 --> 00:02:04,830
recognition of his tireless
work in advancing our

32
00:02:04,830 --> 00:02:08,340
understanding of this field
in medicine. Dr. Dayan,

33
00:02:08,400 --> 00:02:10,260
welcome back to the podcast.

34
00:02:11,070 --> 00:02:13,380
Thank you so much, Dr.
Bass. It's nice to be here.

35
00:02:13,380 --> 00:02:14,790
Summer's nice to be here as well.

36
00:02:15,060 --> 00:02:17,850
I enjoyed it so much last time that I
thought I'd come back for another serving.

37
00:02:18,930 --> 00:02:20,550
Welcome back to the podcast.

38
00:02:21,030 --> 00:02:24,960
So can we start by hearing about the
history of culture representation in

39
00:02:24,960 --> 00:02:25,950
aesthetic medicine?

40
00:02:26,670 --> 00:02:28,890
Every culture has a
desire to be beautiful.

41
00:02:28,890 --> 00:02:30,960
That's nothing new and that's
been going on for millennium,

42
00:02:31,290 --> 00:02:34,050
but since the even
before recorded history.

43
00:02:34,410 --> 00:02:37,920
So that's nothing new and
that's part of our DNA.

44
00:02:38,700 --> 00:02:43,590
Now there are different styles and there's
different things that happen within

45
00:02:43,590 --> 00:02:47,880
our culture over time that vary
slightly, but it always goes back,

46
00:02:47,880 --> 00:02:49,410
in my opinion, to the primal

47
00:02:50,910 --> 00:02:53,940
necessities to survive.

48
00:02:54,570 --> 00:02:58,200
And that means to find someone that's
beautiful so that we can ultimately mate

49
00:02:58,200 --> 00:03:02,230
and have the perfect offspring. I think
that we're for that subconsciously.

50
00:03:04,030 --> 00:03:06,910
That makes sense. So
you kind of mentioned,

51
00:03:06,970 --> 00:03:11,830
but exactly what kinds of distinctions
are you considering and are you

52
00:03:11,830 --> 00:03:12,663
talking about?

53
00:03:15,370 --> 00:03:17,740
Well, all cultures desire beautiful,

54
00:03:17,740 --> 00:03:22,630
but how they manifest that is
different. So I'll give you an example.

55
00:03:24,400 --> 00:03:26,830
In Africa, if you go to
the Mercy Tribes of Africa,

56
00:03:27,160 --> 00:03:30,400
they put a 14 centimeter
plate in their lips.

57
00:03:30,940 --> 00:03:33,730
If I showed you that, you'd be
like, oh, that's a little strange.

58
00:03:33,730 --> 00:03:36,250
Why would they put a 14 centimeter
plate? Their lip is expanded,

59
00:03:36,250 --> 00:03:38,440
it looks distorted to us. It
wouldn't look very natural.

60
00:03:39,490 --> 00:03:42,940
They think that's beautiful and
attractive. We don't. But in our culture,

61
00:03:42,940 --> 00:03:46,270
we may put collagen in someone's
lips and we think that's attractive,

62
00:03:46,270 --> 00:03:48,640
and they would say, why would
you do that? That's unattractive.

63
00:03:48,970 --> 00:03:51,850
So we both have different ways
of approaching the same concept.

64
00:03:52,090 --> 00:03:55,720
What we're both doing is
we're highlighting a secondary
sexual characteristic,

65
00:03:55,720 --> 00:03:58,810
which is the lips. Lips are
associated with fertility,

66
00:03:59,050 --> 00:04:01,660
lips are associated with
youthfulness. The bigger the lip,

67
00:04:01,660 --> 00:04:02,680
the more prominent the lip,

68
00:04:02,920 --> 00:04:06,340
the more attractive someone is. So we
both see it as a beautifying feature.

69
00:04:06,670 --> 00:04:10,480
We both recognize it as a secondary sexual
characteristic trait that's directive

70
00:04:10,480 --> 00:04:13,300
in nature for females more so than men.

71
00:04:13,300 --> 00:04:16,420
And we both have different ways of
highlighting that within our cultures.

72
00:04:17,200 --> 00:04:19,180
So that's kind of what the
difference between the cultures.

73
00:04:19,750 --> 00:04:20,680
I'll give you another example.

74
00:04:21,790 --> 00:04:26,140
If you look at bodies, if you go to Brazil

75
00:04:27,640 --> 00:04:29,710
or even certain parts
of Sub-Saharan Africa,

76
00:04:30,040 --> 00:04:34,960
a large behind or a large buttocks
is really attractive and that also

77
00:04:34,960 --> 00:04:36,070
associated with fertility.

78
00:04:36,250 --> 00:04:40,450
We may find that a little bit too curvy
and unattractive to us because that

79
00:04:40,450 --> 00:04:41,680
seems inappropriate in the us.

80
00:04:41,860 --> 00:04:45,910
But you go to Cameroon and
there's cultures and there's
tribes there that place

81
00:04:45,910 --> 00:04:50,080
pillows into their clothing to highlight
their butt to make it look bigger

82
00:04:50,320 --> 00:04:53,890
because that in theory attracts a man
because they look more fertile and they're

83
00:04:54,130 --> 00:04:54,940
both doing the same thing.

84
00:04:54,940 --> 00:04:56,980
We're highlighting the secondary
sexual characteristics,

85
00:04:57,550 --> 00:05:01,210
but we just may do it differently here
in Western society than they do in some

86
00:05:01,210 --> 00:05:04,720
of those other African societies
or South American societies.

87
00:05:05,960 --> 00:05:10,390
So do you think it's
all about fertility and

88
00:05:10,390 --> 00:05:14,560
attracting a mate or is it a sense of

89
00:05:15,040 --> 00:05:19,750
self appreciation or how

90
00:05:19,750 --> 00:05:23,740
you are representing yourself
to the outside world? I mean,

91
00:05:23,740 --> 00:05:28,540
is there more than one reason
just mating that we style

92
00:05:28,540 --> 00:05:32,590
ourselves or does it
always come down to that?

93
00:05:33,850 --> 00:05:37,120
So great question Larry. I am a
reductiveness. So I think yes,

94
00:05:37,120 --> 00:05:40,750
it comes down ultimately to
our inherent desire to mate,

95
00:05:40,960 --> 00:05:43,600
just like we have a desire
to eat food and breathe air,

96
00:05:43,810 --> 00:05:48,010
there's certain things that we can't help
that are ingrained within us that are

97
00:05:48,010 --> 00:05:52,330
subconscious, that are based on our
survival, and two things in particular,

98
00:05:52,330 --> 00:05:57,040
fear and procreation or
finding the ultimate mate to

99
00:05:57,200 --> 00:05:59,780
have an offspring with. So everything
I think comes down to that. Now,

100
00:05:59,780 --> 00:06:00,613
having said that,

101
00:06:01,850 --> 00:06:04,910
we get self-esteem when we
feel pretty about ourselves.

102
00:06:04,910 --> 00:06:09,350
We get self-esteem or handsome or we
get self-esteem when others give us

103
00:06:09,350 --> 00:06:14,000
positive feedback. So we feel good
about ourselves and we seek self-esteem,

104
00:06:14,000 --> 00:06:18,050
we seek feeling confidence just
like we seek any other type of

105
00:06:18,050 --> 00:06:23,000
drug or anything else that
increases our mood, our appetite.

106
00:06:23,000 --> 00:06:24,170
So I think yes,

107
00:06:24,170 --> 00:06:28,010
we want self-esteem and then we represent
it with the way we address the way we

108
00:06:28,010 --> 00:06:29,750
present ourselves to the external world.

109
00:06:30,020 --> 00:06:33,740
But ultimately I think the reason why
we do that is because we're pre-wired to

110
00:06:33,740 --> 00:06:34,700
try to find a mate.

111
00:06:35,450 --> 00:06:39,710
Traditionally the beauty industry
in the US has been dominated

112
00:06:39,860 --> 00:06:44,720
by certain kinds of ethnic looks that draw

113
00:06:44,720 --> 00:06:48,860
from America's Eurocentric heritage

114
00:06:51,350 --> 00:06:55,490
and certain parts of the
body that are getting styled.

115
00:06:56,630 --> 00:07:01,520
Are we still in that vein or
are we doing that the same

116
00:07:01,520 --> 00:07:02,353
way,

117
00:07:02,690 --> 00:07:07,520
or are we doing it a little more
broadly or a little more variably at

118
00:07:07,520 --> 00:07:11,030
this point in time, but
still the same things?

119
00:07:11,030 --> 00:07:15,980
Or are we just broadening
out in every way what we're

120
00:07:15,980 --> 00:07:16,550
chasing,

121
00:07:16,550 --> 00:07:21,500
what beauty features we're modifying
and what acceptable standards for

122
00:07:21,500 --> 00:07:24,080
their modification may be?

123
00:07:25,190 --> 00:07:25,340
Well,

124
00:07:25,340 --> 00:07:29,840
this is where the cultural appropriation
or the diversity and a culture really

125
00:07:30,050 --> 00:07:33,680
has impact and influence. If
you look at the US population,

126
00:07:33,680 --> 00:07:37,850
which today is very multicultural, but
if you look at it in 1950s, it wasn't,

127
00:07:37,850 --> 00:07:40,310
it was highly Caucasian at that time.

128
00:07:40,310 --> 00:07:42,710
What was attractive was
someone like a Twiggy.

129
00:07:42,710 --> 00:07:45,020
I'm not sure if many people who
are listening know what Twiggy is,

130
00:07:45,020 --> 00:07:49,790
but she was a cultural beauty
icon in the 1950s. Big eyes,

131
00:07:49,790 --> 00:07:54,740
very small nose and chin, and she was
very infantile looking. Today, however,

132
00:07:54,770 --> 00:07:59,120
beauty is somewhat with a
heavier eyebrow, a wider nose,

133
00:07:59,120 --> 00:08:02,810
bigger lips, stronger
jawline, that's more feminine,

134
00:08:02,810 --> 00:08:03,680
that's more attractive today.

135
00:08:03,680 --> 00:08:07,670
But that's also based on the fact that
we have a culture that's comprised of

136
00:08:07,880 --> 00:08:11,120
many races and many ethnicities
and many backgrounds.

137
00:08:11,390 --> 00:08:13,310
So as more and more
people come into the US,

138
00:08:13,730 --> 00:08:18,290
we shift what becomes more attractive
to the average. And this goes for all of

139
00:08:18,290 --> 00:08:19,123
us too.

140
00:08:19,160 --> 00:08:24,080
If you live in a small community of just
a group of people that look like you

141
00:08:24,080 --> 00:08:26,090
and you don't extend outside
that group very much,

142
00:08:26,270 --> 00:08:28,010
then you find attractive
what's in your community.

143
00:08:28,220 --> 00:08:32,360
But if you live in a society that's
very multicultural and very diverse,

144
00:08:32,540 --> 00:08:36,110
then what you find attractive tends
to move over a little bit to something

145
00:08:36,110 --> 00:08:39,080
that's the average of all the
people within your reference range.

146
00:08:39,560 --> 00:08:42,560
And you can see that in our advertising.
You can see that in our marketing.

147
00:08:42,560 --> 00:08:43,730
You see that in our social media.

148
00:08:44,000 --> 00:08:48,680
So the US has moved now to a more
multicultural beauty that we all find

149
00:08:48,680 --> 00:08:53,570
attractive somewhere in between what it
was in the 1950s to what it is like now

150
00:08:53,570 --> 00:08:57,720
in maybe a South African country,
which may be all just one ethnicity.

151
00:08:58,620 --> 00:09:00,150
So it varies distinctly,

152
00:09:00,150 --> 00:09:04,680
but it's all based on our reference
range as a society and as an individual.

153
00:09:04,860 --> 00:09:06,750
And it goes beyond beauty if
you really think about it.

154
00:09:06,760 --> 00:09:10,050
It goes to the same thing with
ideas, thoughts, politics, religion.

155
00:09:10,050 --> 00:09:14,820
The more you expose yourself to more
cultures, more ideas, more thoughts,

156
00:09:14,820 --> 00:09:15,653
more disciplines,

157
00:09:15,750 --> 00:09:20,070
the more your reference range changes
to go towards the middle of that.

158
00:09:22,950 --> 00:09:27,750
Okay, that makes a lot of sense actually.
You've kind of touched on it a bit,

159
00:09:27,750 --> 00:09:28,583
but

160
00:09:30,210 --> 00:09:34,230
how do these diverse beauty standards
really translate into differences in the

161
00:09:34,230 --> 00:09:36,840
care that's sought and the
care that's then delivered?

162
00:09:37,560 --> 00:09:39,450
It changes a lot. And that's
a great question, Summer,

163
00:09:39,450 --> 00:09:43,650
because if you're a physician and you
live in a small town and you're just used

164
00:09:43,650 --> 00:09:46,680
to one type of look,
then that's all you do.

165
00:09:46,980 --> 00:09:51,720
That's what you may make that
scooped out nose or you may make a

166
00:09:51,720 --> 00:09:55,260
strong chin and that may not be something
that the people are coming to you if

167
00:09:55,260 --> 00:09:59,040
they're from a different ethnicity
want. Last year or two years ago now,

168
00:09:59,040 --> 00:10:02,130
I did a whole program on diversity
in aesthetics. I traveled the world.

169
00:10:02,130 --> 00:10:04,680
I went to five continents,
seven different countries,

170
00:10:04,890 --> 00:10:06,780
and we studied beauty in
all different cultures.

171
00:10:07,110 --> 00:10:10,800
And we went to Africa and we studied
beauty in Africa with doctors in Africa

172
00:10:10,800 --> 00:10:12,120
treating African patients.

173
00:10:12,930 --> 00:10:16,710
And then we compared and contrast that
to doctors in the US who are treating

174
00:10:16,710 --> 00:10:17,760
African-American patients,

175
00:10:17,760 --> 00:10:21,450
the patients who are culturally from
Africa or are black or dark-skinned in

176
00:10:21,450 --> 00:10:24,210
color. We did the same thing with Latin
America, the same thing with Asia.

177
00:10:24,510 --> 00:10:27,450
So we compared and contrast, it was
so unique to see the differences.

178
00:10:27,450 --> 00:10:30,210
So when we were in Africa and
we were treating patients there,

179
00:10:30,210 --> 00:10:31,080
the patients would come in,

180
00:10:31,500 --> 00:10:35,340
they wanted their temples
treated or their lips treated.

181
00:10:35,760 --> 00:10:37,800
And I was thinking to myself, really,

182
00:10:37,800 --> 00:10:39,930
that's not how it's done
here in the US so much,

183
00:10:40,260 --> 00:10:42,210
or that's not what we would
think they would want treated.

184
00:10:42,210 --> 00:10:46,260
Because if you look at them skeletally
and you look at them morphologically,

185
00:10:46,410 --> 00:10:50,100
they seem to have a small chin
compared to our Eurocentric standards,

186
00:10:50,400 --> 00:10:51,960
and you think they want their chin bigger,

187
00:10:52,200 --> 00:10:56,970
their lips are large by standards
that we have in our rating scales,

188
00:10:56,970 --> 00:10:59,190
which go up to five points.
And you look at their lips,

189
00:10:59,460 --> 00:11:02,580
there are four out of five you
would say they're already augmented,

190
00:11:02,580 --> 00:11:04,590
they're already large, they don't
need their lips bigger. But no,

191
00:11:04,590 --> 00:11:06,690
they wanted their lips bigger.
It wasn't so much bigger.

192
00:11:06,690 --> 00:11:07,620
They wanted them treated,

193
00:11:07,620 --> 00:11:10,620
they wanted them with a filler because
they thought it gave 'em better shape.

194
00:11:11,610 --> 00:11:13,740
But in the US you might
think that's not necessary.

195
00:11:14,010 --> 00:11:17,490
So you start to see that in these African
communities that was different than

196
00:11:17,490 --> 00:11:19,920
the US population, they
were treated differently.

197
00:11:20,640 --> 00:11:22,770
Now a US doctor has to understand this,

198
00:11:22,770 --> 00:11:25,140
if they're going to treat those patients
who are coming over from that country,

199
00:11:25,140 --> 00:11:27,720
and as they start to come to this country,

200
00:11:27,930 --> 00:11:32,790
some of those desires then start to
infiltrate and become part of our

201
00:11:32,790 --> 00:11:37,650
norms and customs. So last year I
did a paper I presented already.

202
00:11:37,650 --> 00:11:40,140
It has not published this, but it's
been accepted for publication in

203
00:11:41,970 --> 00:11:43,320
Facial Plastic Surgery & Aesthetic
Medicine. So it should be coming out soon.

204
00:11:44,220 --> 00:11:47,070
We did a study in African-American
patients and lips,

205
00:11:47,820 --> 00:11:50,910
and it is a very interesting study
because if you look at the clinical trials

206
00:11:50,910 --> 00:11:52,440
that were originally done on lips,

207
00:11:52,710 --> 00:11:54,880
there weren't African-American
patients in the lip studies,

208
00:11:55,300 --> 00:11:58,300
and these are the pivotal trials to get
approval for filling in their lips. The

209
00:11:58,300 --> 00:12:01,060
reason why is because for a
patient to get fill in their lips,

210
00:12:01,300 --> 00:12:04,420
they had to be deficient in their
lips. They had to emphasize one,

211
00:12:04,420 --> 00:12:09,310
two on a scale of five in order
to qualify to get lip fill.

212
00:12:09,970 --> 00:12:10,690
Well,

213
00:12:10,690 --> 00:12:14,350
African-American patients wouldn't
qualify for that because natively they had

214
00:12:14,350 --> 00:12:18,610
three, four, and five size lips. So a
study was done, the product gets approved,

215
00:12:18,610 --> 00:12:22,000
but it didn't include African-American
patients and the FDA and others thought

216
00:12:22,000 --> 00:12:25,390
that that wasn't appropriate.
So the scale got modified,

217
00:12:25,870 --> 00:12:28,930
but still there was no clinical trials
to look at these patients with larger

218
00:12:28,930 --> 00:12:32,440
lips and say, do they want their
lips augmented and are they happy?

219
00:12:32,440 --> 00:12:36,940
So we did a clinical trial two years
ago now we took patients who are

220
00:12:36,940 --> 00:12:39,940
African-American who desired
having their lips treated,

221
00:12:40,000 --> 00:12:44,650
and then we measured them on a scale and
they mostly came in at 3.4 to 3.5 and

222
00:12:44,650 --> 00:12:48,130
what size lips they wanted, and they
want lips that were size four on a scale,

223
00:12:48,130 --> 00:12:50,320
on a five point scale, four to 4.5.

224
00:12:50,890 --> 00:12:54,220
And we were able to get them pretty
close to what they wanted and they were

225
00:12:54,220 --> 00:12:55,053
happy with it.

226
00:12:55,540 --> 00:12:59,290
And we were able to show that these
patients desire their lips treated,

227
00:12:59,560 --> 00:13:01,060
they want their lips a little bit bigger,

228
00:13:01,210 --> 00:13:06,130
and that us as physicians are
underestimating undervaluing
that those patients

229
00:13:06,130 --> 00:13:07,810
may need those treatments
and want those treatments.

230
00:13:07,810 --> 00:13:11,230
So it's very interesting way to look at
it from the patient's perspective and

231
00:13:11,230 --> 00:13:16,030
what they desire and how it differentiates
from what the Eurocentric version of

232
00:13:16,120 --> 00:13:18,940
lips are and what we
were taught in school.

233
00:13:20,770 --> 00:13:25,330
So I'm curious to look
back at this issue of how

234
00:13:25,360 --> 00:13:28,990
different cultural groups
influence each other. I mean,

235
00:13:28,990 --> 00:13:31,720
I'm in New York City and
if you get on the subway,

236
00:13:32,140 --> 00:13:36,790
you're going to be in the subway
car with a lot of different cultural

237
00:13:36,790 --> 00:13:41,520
groups and seeing how people

238
00:13:41,520 --> 00:13:45,880
look not only from the cultural
group you're accustomed to,

239
00:13:45,880 --> 00:13:50,830
but from many others influences
your perception of what's
normal or beautiful or

240
00:13:50,830 --> 00:13:55,690
desirable, but not only
in-person exposure,

241
00:13:55,690 --> 00:13:59,170
but we're heavily exposed by media.

242
00:13:59,170 --> 00:14:03,850
And we've talked about the impact of
media on self-image the last time you were

243
00:14:03,850 --> 00:14:04,870
on the podcast,

244
00:14:05,140 --> 00:14:09,970
but how does media expose us
and how is that influencing our

245
00:14:09,970 --> 00:14:14,530
perception of what's beautiful
maybe drawing from other

246
00:14:14,530 --> 00:14:15,430
cultures?

247
00:14:17,020 --> 00:14:18,700
This is a great question. This is,

248
00:14:18,700 --> 00:14:23,080
I think one of the most beautiful things
about America is that we are a melting

249
00:14:23,080 --> 00:14:26,980
pod or a salad, if you want to call it
that, of many cultures that come in here.

250
00:14:27,280 --> 00:14:29,410
And if you're in New York,
you're driving on the subway,

251
00:14:29,440 --> 00:14:33,430
you're going to see a whole smorgasbord
of different types of people from

252
00:14:33,430 --> 00:14:34,263
different cultures.

253
00:14:34,570 --> 00:14:38,920
And isn't that great that you look
across the train and you're like,

254
00:14:38,980 --> 00:14:42,070
I want to look like, I think that's
really pretty. And it may be a tattoo,

255
00:14:42,100 --> 00:14:43,030
it may be a piercing,

256
00:14:43,150 --> 00:14:46,900
maybe a hairstyle or maybe the way their
lips are done or the way their eyebrows

257
00:14:46,900 --> 00:14:50,830
are done. But gee, I think that's great.
It's just like I love Italian food.

258
00:14:50,860 --> 00:14:53,300
I love Middle Eastern
food, I love Indian food,

259
00:14:53,840 --> 00:14:57,830
and I take from that and I develop
certain spices and I certain tastes for

260
00:14:57,830 --> 00:15:01,160
certain spices after tasting it. The same
thing with beauty and the same thing.

261
00:15:01,160 --> 00:15:04,490
When we all come together, we tend
to find other things more attractive.

262
00:15:04,490 --> 00:15:08,180
At first, they're unique and at
first we're scared. We fear them.

263
00:15:08,450 --> 00:15:10,250
We don't like them because
we're not familiar with it.

264
00:15:10,250 --> 00:15:11,450
But the more you see something,

265
00:15:11,660 --> 00:15:13,790
the more you become attracted
to it no matter what it is.

266
00:15:14,390 --> 00:15:17,100
And the more you see a certain type
of look, you become more attracted it,

267
00:15:17,100 --> 00:15:20,540
and eventually you start to adopt
some of those desires or needs or

268
00:15:20,540 --> 00:15:21,373
characteristics.

269
00:15:21,590 --> 00:15:25,010
So that's what I think is happening
with beauty and media is just a way to

270
00:15:25,010 --> 00:15:26,960
amplify that, especially
with social media today,

271
00:15:26,960 --> 00:15:31,430
because you're seeing all different types
of cultures come across your feeds and

272
00:15:31,430 --> 00:15:32,930
you're going to find it
attractive and it's great.

273
00:15:33,350 --> 00:15:36,260
It's not just what's going on in the
US but you have what's going on in

274
00:15:36,260 --> 00:15:38,030
different culture in different countries.

275
00:15:38,360 --> 00:15:42,170
So you see what they're doing in Japan
or Korea or wherever that may be that

276
00:15:42,170 --> 00:15:45,230
you're following and you might
say, Hey, I want to do that here.

277
00:15:45,800 --> 00:15:50,360
I think it unifies us
all as we move forward

278
00:15:50,360 --> 00:15:51,890
into what we find beautiful.

279
00:15:55,970 --> 00:15:59,180
This has been a really interesting
discussion. I'm wondering though,

280
00:15:59,180 --> 00:16:03,770
is aesthetic medicine and surgery doing
a better job today of adjusting for the

281
00:16:03,770 --> 00:16:07,490
cultural and diversity in
the patient population?

282
00:16:08,840 --> 00:16:12,890
So I think that medicine
today is definitely doing
a better job because it has

283
00:16:12,890 --> 00:16:15,050
to. It's got to meet the
demand of our patients.

284
00:16:15,290 --> 00:16:16,520
When I was coming through training,

285
00:16:16,520 --> 00:16:20,480
we were given the canons of beauty
and the mathematical five formula,

286
00:16:20,480 --> 00:16:24,230
which has proven itself over and over
again to not necessarily work for all

287
00:16:24,230 --> 00:16:26,600
cultures the same, and
it's very Eurocentric,

288
00:16:27,020 --> 00:16:29,750
and that probably was a
bias training. Now today,

289
00:16:29,750 --> 00:16:34,490
we look at people very differently
and we look at them as what's

290
00:16:34,490 --> 00:16:37,610
beautiful within their own
culture. I think that's important,

291
00:16:37,610 --> 00:16:40,010
but we're also looking at the way
people feel about themselves too.

292
00:16:40,010 --> 00:16:42,200
We're looking at the psychosocial
aspect of it as well.

293
00:16:42,620 --> 00:16:45,770
I think as our students come
through today and as we train,

294
00:16:46,070 --> 00:16:50,180
that's part of the curriculum is making
sure everyone's more sensitive to these

295
00:16:50,180 --> 00:16:52,610
other cultural desires. So yes,

296
00:16:52,610 --> 00:16:54,680
I think we're doing a much better
job say than we were in the past.

297
00:16:54,680 --> 00:16:58,370
I think our clinical trials are making
sure to have a diverse population in

298
00:16:58,370 --> 00:16:59,000
them,

299
00:16:59,000 --> 00:17:02,330
and we're making sure our studies and
our designs and our questions and our

300
00:17:02,330 --> 00:17:06,050
patient reported outcomes are all
asking questions that are necessarily

301
00:17:06,410 --> 00:17:11,120
capturing the needs and desires of
different genders and different cultures.

302
00:17:12,170 --> 00:17:14,750
And then just to play
devil's advocate a bit,

303
00:17:16,280 --> 00:17:20,360
are all of these kind of
more like stereotypes and
the care should just strive

304
00:17:20,570 --> 00:17:24,620
to provide custom options to each
individual patient based on the individual

305
00:17:24,620 --> 00:17:27,020
preferences instead? I know
you've talked about it a bit,

306
00:17:27,410 --> 00:17:29,450
but I just wanted to throw that out there.

307
00:17:30,290 --> 00:17:33,350
So of course, I think we should
treat people as individuals,

308
00:17:33,590 --> 00:17:36,260
and I think when we get to cookie
cutter treatments, we get in trouble.

309
00:17:36,320 --> 00:17:40,310
And I don't think aesthetics struggles
when we go to cookie cutter treatments.

310
00:17:40,310 --> 00:17:43,220
And I think that's where aesthetics
falls apart and everyone tries to make us

311
00:17:43,220 --> 00:17:43,850
cookie cutters,

312
00:17:43,850 --> 00:17:46,220
but it just doesn't work in aesthetics
because we're dealing with people's

313
00:17:46,220 --> 00:17:50,820
emotions and we're dealing with cultures
and societies and expectations that are

314
00:17:50,820 --> 00:17:54,330
very different than someone who's has
gallstones and needs their gallbladder

315
00:17:54,330 --> 00:17:58,020
taken out. It's not that simple.
And when we try to simplify it,

316
00:17:58,020 --> 00:18:01,200
I think we get into trouble. So yes, I
think everyone should be individualized.

317
00:18:01,200 --> 00:18:04,620
I had a patient come to me recently
who wanted a hump put on her nose.

318
00:18:04,620 --> 00:18:06,960
She was Italian. She goes, I
want a hump on my nose. I'm like,

319
00:18:06,960 --> 00:18:07,980
do you want to a hump on your nose?

320
00:18:08,340 --> 00:18:10,800
She wanted a hump on her nose because
she thought that was elegant and

321
00:18:10,800 --> 00:18:13,530
attractive and fit
within her culture. Now,

322
00:18:13,530 --> 00:18:15,900
I wasn't going to give her something that
I thought was inappropriate that would

323
00:18:15,900 --> 00:18:18,630
make her look strange, but to give her
a little bit of convexity to her nose,

324
00:18:18,630 --> 00:18:21,240
okay, I can do that. But I thought
that was an unusual request,

325
00:18:21,240 --> 00:18:22,500
but that was her desire.

326
00:18:23,040 --> 00:18:26,580
So I think that we have to be sensitive
to what the desires is of that person

327
00:18:26,790 --> 00:18:28,350
that's culturally appropriate for them.

328
00:18:29,280 --> 00:18:34,020
That's interesting because
I think historically a lot
of patients sought plastic

329
00:18:34,020 --> 00:18:38,880
surgery to try to blunt certain ethnic

330
00:18:38,880 --> 00:18:43,470
identity so that they
wouldn't look stereotypically

331
00:18:43,770 --> 00:18:47,370
part of the ethnic group they
came from. And increasingly,

332
00:18:47,370 --> 00:18:51,480
patients come in and want to modify,

333
00:18:51,510 --> 00:18:53,160
harmonize, beautify,

334
00:18:53,760 --> 00:18:57,540
but retain or amplify
their ethnic identity.

335
00:18:57,810 --> 00:19:00,720
And it's great that they can
feel comfortable and proud,

336
00:19:01,080 --> 00:19:05,010
but either request is a fair request.

337
00:19:05,220 --> 00:19:09,600
It's really just important to understand
where the patient is hoping to go,

338
00:19:10,020 --> 00:19:15,000
so you don't make a misstep in taking
them in a direction different from what

339
00:19:15,000 --> 00:19:16,470
they're asking for.

340
00:19:17,520 --> 00:19:18,870
So I think this is a great point,

341
00:19:18,870 --> 00:19:22,560
and I want to emphasize this a little
bit more because if you look at patients

342
00:19:22,560 --> 00:19:23,760
in the fifties and sixties,

343
00:19:23,940 --> 00:19:27,420
when plastic surgery first came
into the US and became part

344
00:19:29,610 --> 00:19:34,590
of what we do to enhance our beauty,
everyone wanted to be American.

345
00:19:34,680 --> 00:19:37,200
They wanted to look American,
they wanted to blend in.

346
00:19:37,440 --> 00:19:39,960
They did not want to be different.
They were hiding their ethnicity.

347
00:19:39,960 --> 00:19:43,080
So you see a lot of these people coming
in and getting a little scooped out

348
00:19:43,080 --> 00:19:47,310
noses because that was the look
and that was the American look.

349
00:19:48,240 --> 00:19:50,940
So you see a lot of those
patients, they're now in
their seventies and eighties,

350
00:19:51,270 --> 00:19:53,070
but I'm sure you see them in
your office. I see them too.

351
00:19:53,070 --> 00:19:55,470
There's a little scooped out
noses that doesn't work so well.

352
00:19:55,470 --> 00:19:57,540
But that's what they wanted.
And sometimes they come in,

353
00:19:58,020 --> 00:19:59,190
now I see 'em with their grandkids,

354
00:19:59,190 --> 00:20:01,680
but I saw 'em with their kids.
Now I see 'em with their grandkids and the

355
00:20:01,680 --> 00:20:03,210
grandkid comes in and
says, I want a nice nose,

356
00:20:03,210 --> 00:20:06,300
but not like my mom's or my grandma's.
And the mom or grandma's like, wait,

357
00:20:06,300 --> 00:20:08,550
what's wrong with my nose?
They love their noses,

358
00:20:08,940 --> 00:20:11,100
but that's not what they
want say. So what I find,

359
00:20:11,100 --> 00:20:12,750
and tell me if you see
it differently, Larry,

360
00:20:12,780 --> 00:20:16,560
because this is a unique observation I
made, is that people who are first gener,

361
00:20:16,560 --> 00:20:18,570
people come over on the
boat, people who come in,

362
00:20:18,570 --> 00:20:21,210
they just move to this country.
They want to look American.

363
00:20:21,210 --> 00:20:22,290
They want the scooped out noses.

364
00:20:22,290 --> 00:20:25,770
They didn't want their identity
to be so noticeable on their face.

365
00:20:26,220 --> 00:20:29,370
The first and second generation that I
get, especially the second generation,

366
00:20:29,610 --> 00:20:33,570
is so proud of their ethnicity, is
that they don't want any loss of it.

367
00:20:33,840 --> 00:20:35,070
I want to maintain my ethnicity.

368
00:20:35,070 --> 00:20:36,900
I want to make sure people
know that I'm Syrian,

369
00:20:36,900 --> 00:20:39,150
or they want to make sure people
know that I'm Asian, Chinese,

370
00:20:39,150 --> 00:20:41,940
whatever it may be. They don't
want to lose that ethnicity.

371
00:20:41,940 --> 00:20:44,820
Whereas the people who come over
right away from the other countries,

372
00:20:44,970 --> 00:20:47,160
they want to look different. They
want to look more Americanized.

373
00:20:48,310 --> 00:20:52,120
Yeah, I think that's
something I've seen. And

374
00:20:53,770 --> 00:20:58,000
I think people are looking
for much more nuanced things.

375
00:20:58,000 --> 00:21:02,830
People who are here are not
trying to stamp a certain

376
00:21:02,830 --> 00:21:04,300
identity into their look.

377
00:21:04,300 --> 00:21:08,290
They're just trying to create
their own unique enhanced look.

378
00:21:08,920 --> 00:21:11,260
That's who they were to start with,

379
00:21:11,260 --> 00:21:14,050
but just more beautiful and balanced.

380
00:21:16,180 --> 00:21:17,530
Yes, I agree with that.

381
00:21:20,230 --> 00:21:22,780
Okay. So finally, to sum up,

382
00:21:22,810 --> 00:21:26,530
can you tell us what trends have been
affected by the increasingly more diverse

383
00:21:26,530 --> 00:21:27,760
view of human beauty?

384
00:21:29,920 --> 00:21:30,430
Sure. Well,

385
00:21:30,430 --> 00:21:33,580
I think there's a lot of trends that
have come in the last few years that are

386
00:21:33,580 --> 00:21:36,700
based on the diversity of
culture. If you want to look at,

387
00:21:37,000 --> 00:21:40,900
I think lips being a little bit
larger and being a little bit fuller,

388
00:21:41,470 --> 00:21:43,240
I think that's part of the culture trend.

389
00:21:45,520 --> 00:21:48,490
I would say noses are definitely
different than they were a generation ago.

390
00:21:48,490 --> 00:21:49,720
A little bit of a larger nose,

391
00:21:49,720 --> 00:21:52,870
one that fits the face is more
acceptable today than it was in the past.

392
00:21:53,170 --> 00:21:54,880
I think we should do
a lot more brow lifts.

393
00:21:54,880 --> 00:21:58,390
I think we're doing less brow lifts today
because people don't want a hollowed

394
00:21:58,390 --> 00:22:00,970
out eye or large brows.
They want the heavier,

395
00:22:01,090 --> 00:22:05,140
thicker brow I think is more attractive
to say there was in the past a stronger

396
00:22:05,140 --> 00:22:09,160
jawline. That's something
that was not necessarily,

397
00:22:09,160 --> 00:22:11,650
was something that was not
sought after in the past.

398
00:22:11,650 --> 00:22:14,470
But now I have lots of women
who want that strong jawline,

399
00:22:14,770 --> 00:22:18,610
whereas they don't want
to have it be thinned out.

400
00:22:18,610 --> 00:22:22,180
So I think those are probably some of
the cultural changes that I've seen over

401
00:22:22,180 --> 00:22:26,320
the last five to 10 years with an
increasing multicultural society.

402
00:22:28,000 --> 00:22:30,040
And what are your takeaways, Dr. Bass?

403
00:22:31,090 --> 00:22:35,770
Well, just to summarize, as we said,
desire for beauty is universal.

404
00:22:36,010 --> 00:22:38,530
Dr. Dayan and I a hundred
percent agree on that.

405
00:22:39,100 --> 00:22:43,660
But the definition of beauty is highly
dependent on your cultural identity,

406
00:22:45,040 --> 00:22:48,400
along with your individual
life experience,

407
00:22:49,000 --> 00:22:52,090
what you've been exposed to
in the environment you're in,

408
00:22:53,680 --> 00:22:57,160
which is really something separate
from your cultural identity, per se.

409
00:22:58,120 --> 00:23:00,310
The fashion industry, the beauty industry,

410
00:23:00,310 --> 00:23:04,600
they're much more
culturally sophisticated and

411
00:23:04,600 --> 00:23:07,060
diverse than in times gone by.

412
00:23:08,080 --> 00:23:13,000
And we live in a much more interactive
world and a much more interactive

413
00:23:13,030 --> 00:23:15,070
national and international culture.

414
00:23:15,070 --> 00:23:19,930
One where media shows us a
much bigger slice of the world

415
00:23:20,260 --> 00:23:24,370
than previously, and a lot
of different points of view,

416
00:23:24,430 --> 00:23:26,830
different people's view
of what's beautiful.

417
00:23:27,280 --> 00:23:30,070
So that has a profound influence on us.

418
00:23:30,070 --> 00:23:34,990
How we individually view
beauty based on what we've

419
00:23:34,990 --> 00:23:39,370
been exposed to the
medical beauty industry.

420
00:23:39,460 --> 00:23:44,080
Plastic surgery and aesthetic
medicine embraces a lot

421
00:23:44,080 --> 00:23:48,770
more culturally diverse
and individually diverse

422
00:23:48,770 --> 00:23:51,590
images of beauty than
they have previously.

423
00:23:52,190 --> 00:23:56,270
And this has transformed
those medical fields

424
00:23:56,750 --> 00:24:01,520
into a service that's
responsive to individual

425
00:24:01,520 --> 00:24:04,790
views of beauty with a
customized plan of care.

426
00:24:06,890 --> 00:24:08,120
So Dr. Dayan,

427
00:24:08,120 --> 00:24:11,750
I'd like to thank you for joining us
again today and sharing your thought

428
00:24:11,750 --> 00:24:15,710
provoking insights on this topic.
I always love talking with you.

429
00:24:16,880 --> 00:24:18,200
Oh, thank you. It's a pleasure to be here.

430
00:24:19,520 --> 00:24:23,570
I'll also share my thank you for joining
us again on the podcast, Dr. Dayan.

431
00:24:23,570 --> 00:24:25,610
I really enjoyed our engaging discussion.

432
00:24:26,360 --> 00:24:30,440
Thank you for listening to the Park
Avenue Plastic Surgery Class Podcast.

433
00:24:30,500 --> 00:24:32,390
Follow us on Apple Podcasts,

434
00:24:32,450 --> 00:24:34,700
write a review and share
the show with your friends.

435
00:24:34,850 --> 00:24:38,360
Be sure to join us next time to avoid
missing all the great content that is

436
00:24:38,360 --> 00:24:41,930
coming your way. If you want to
contact us with comments or questions,

437
00:24:41,930 --> 00:24:43,130
we'd love to hear from you,

438
00:24:43,250 --> 00:24:47,900
send us an email at
podcast@drbass.net or DM us on

439
00:24:47,900 --> 00:24:49,640
Instagram @drbassnyc.