Artistry in plastic surgery not just paint by numbers

I have been thinking more lately about the relationship of art and plastic surgery. Sometimes this happens when I am drawing a model, and noticing there is something not typical in the proportions. Often though what sets me onto this train of thought is an article or lecture by some plastic surgery expert who has developed an elaborate mathematical analysis of the approach to a particular operation. So what is wrong with this “cookie cutter” approach? Shouldn’t a standardized method give more consistent results? To be sure, there are many circumstances where numbers are important; for example matching the base diameter of a breast implant to the dimensions of the patient. In other situations, however, they can be misleading. The failure is not appreciating the importance of artistry, the beauty of individuality, and the patient’s vision.

One reason for this is that there is no such thing as an ideal set of proportions that works on every face or every body. Consider for example the actress Penelope Cruz: a mathematical analysis of her nose would likely show that it is too long, the angle from the nose to the lip is too acute, and so forth; but she is widely regarded (and I agree) to be one of the most beautiful women in Hollywood. Successful models are just as likely to have a distinguishing feature as they are classically proportioned beauty.

There have been some intriguing articles written where people are surveyed as to which celebrities have the best features; who has the nicest nose, the most luscious lips, etc.A computer program is then used to cut and paste all of these favorites into a composite face, which usually ends up looking either fairly bizarre or blandly generic. This is why these canons of beautiful proportion have been routinely debunked, but they reappear on a regular basis nonetheless.

 I call it “paint by numbers” surgery, like the kits they used to make that help you create a “masterpiece” by painting in the assigned color onto the designated spaces. They never quite look like the real deal either.

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