With the rise of ‘selfies’ and photo sharing on social media, plastic surgeon Jeffrey Spiegel has seen an increase in requests for procedures like rhinoplasty, chin implants, and acne scar reduction. “People are more aware of their appearance and often dissatisfied with their own looks,” said Spiegel, who has his own practice in Brookline. But despite so much self-critical emphasis, Speigel, also chief of facial plastic and reconstructive surgery at Boston University Medical Center, believes that people are actually more concerned about image enhancement than actual physical beauty or handsomeness. “The shape of the nose, the position of the eyebrow, the curve of the cheek – all of these convey messages, whether it’s strength or youth; I look at what features need to be adjusted to convey the message that you want,” said Spiegel. He spoke with Globe correspondent Cindy Atoji Keene about the role of plastic surgery for his patients.
“I recently returned from Milan, where I was invited to conduct a master class in rhinoplasty. The seminar covered such topics as post-surgery nasal problems; ethical considerations in plastic surgery; structure and contour of the nose, and more. I addressed ‘Feminization of the Nose,’ based on my experience doing facial feminization surgery for transgender individuals. The traditional way of approaching plastic surgery is to break down aesthetics into numbers and ratios, such as the projection of the nose within a certain width to its length. But a more evolutionary way to look at the face is to look closely at the details and how they complete a harmonious picture. One example is the eyes: The shadow and depth of the eye can send a lot of gender cues. Reducing the bone around the eye and subtly adjusting the corner of the eye can make a person appear more feminine. When I meet with a patient, I have a long conversation with them and ask them what type of image they are trying to project. Surgeries are a delicate process that must be tailored to the individual patient to meet their expectations. And now I try to take a more holistic approach as well, considering all dimensions of wellness, putting a big emphasis on exercise, diet, and proper skincare. Cosmetic surgery is certainly a blending of art and science. The ‘science’ of plastic surgery are the ‘rules,’ such as how tissue behaves; how the body responds to interventions, and other physiological components. The ‘art’ component is subjective, like an artist painting a portrait. I think of myself as an airline pilot – I don’t have room for mistakes. I can’t say I have a safe landing 95 percent of the time; I have to land perfectly every single time. And if you ask me, have I had any ‘work’ done on my face? Like everyone else, yes, I’ve had Botox and things like that as I need to.”