Influence of Aesthetic Medicine and Surgery in the Field of Global Health

Professor Meningaud - Maxillofacial Surgery at Paris Est Créteil

Anti-ageing medicine aims to detect and correct the early signs of diseases. It is focused on the prevention of illness, just as one can be more or less ill, one can also be more or less healthy (depending on VO2 max, endothelial function, etc.).

Anti-ageing medicine does not aim to prevent a specific disease but seeks to restore the parameters of a young and healthy individual. These parameters can be biological, physical, mechanical, cognitive, etc. As we age, many parameters degrade, such as hormone levels (testosterone, oestrogen, DHEA), an increase in body fat percentage, or the time a person can balance on one leg.

Anti-ageing medicine utilises nutrition, optimising sleep, physical activity, stress management, and hormone correctors. All these factors reflect on physical appearance. Don’t we often say “You look well” or “You don’t look well” to people who are not sick? This seems obvious and has been proven repeatedly. However, what is less obvious is the reverse: the influence of appearance on health. This is the focus of this article.

Introduction

Appearance may seem like a trivial concern. Many intellectuals, psychologists, organ specialists, religious figures, and educators consider physical concerns to be frivolous. As a specialist in facial surgery, I have witnessed how much my patients suffer from this, whether it is a face mutilated by an accident or simply affected by the passage of time. Aesthetic medicine and surgery offer ways to help better manage one’s physical appearance and health, without dogma. I remain convinced that the beauty of people comes from their diversity.

Appearance, particularly of our face, is closely correlated with our chronological age

We age according to our arteries, our mental performance, our hormonal balance, our chromosomes, and also our outward appearance. Our appearance, especially our face, is closely correlated with our chronological age. My team was able to verify this in a recent study(1).

Unconsciously, everyone can estimate a person’s age with quite good accuracy. If we also receive some minimal training on the objective criteria of facial ageing, accuracy increases exponentially. From this, we deduce that, at some point, an effective anti-ageing treatment must eventually favourably modify appearance. If this treatment is effective, it won’t just modify biological or physical parameters, it will also influence our outer appearance.

Aesthetic medicine and surgery positively influence health

Conversely, it has been widely shown that interventions on appearance can have a positive effect on health in very concrete areas: posture(1), chronic pain (neck and back)(2), smoking cessation(3), improvement of lifestyle habits (weight loss, diet, physical activity, with an impact on blood sugar levels)(4), respiratory function(5), and visual field(6). The benefits of aesthetic surgery and medicine for mental health are already established: anxiety(7, 8), quality of life(9), self-esteem(10), self-confidence, and sexuality(11). But we can also ask if a direct action on appearance, and consequently on the psyche, will influence the biological parameters of ageing. Is a direct action on our physical appearance a form of “cheating” or does it exercise a positive feedback mechanism, i.e. a reinforcing mechanism for general health? Several arguments support this positive feedback.

Indirect influence of aesthetic medicine and surgery interventions

First, it is a general rule that life consists of a set of systems that remain in balance for a long time. On a molecular level, this is reflected in biochemical equations allowing a slight reversal through negative feedback (braking mechanism) or positive feedback (reinforcement mechanism). The hypothesis of a positive feedback mechanism of appearance in biology seems consistent with the laws of nature.

Moreover, it has been demonstrated that improving psychological dimensions like anxiety, self-confidence, or self-esteem has an influence on stress hormone secretion(1). It has even been suggested that body postures can modify hormone secretion. A team at Columbia University published that a simple change in posture could increase testosterone levels and reduce cortisol levels in less than two minutes(2). In a group of volunteers, the team measured salivary testosterone and cortisol levels when they moved from a submissive posture (hunched over, arms and legs crossed, head down) to a more confident one (arms open, head up, back straight, etc.). Although these findings have been contested on methodological grounds, it’s plausible that medical or surgical procedures that restore lasting self-confidence could have an effect on the chronic production of these hormones, and thus on other biological processes involved in ageing.

Direct influence of aesthetic medicine and surgery interventions

Finally, we now know that many new aesthetic medicine and surgery techniques have a positive biological effect on the tissues where they are applied. For instance, a simple hyaluronic acid injection has a local tissue-inducing (regenerative) effect, leading to increased collagen synthesis. In surgery, lipofilling techniques (injecting the patient’s own fat) enhanced by platelet-rich plasma can sometimes have an astonishing tissue-inducing effect. Additionally, effects may extend beyond the treated area (e.g., paracrine effects).

Conclusion

Anti-ageing medicine and interventions on appearance influence each other. By addressing both, a synergy can be achieved, benefitting both health and appearance. The most important point is to do no harm—*primum non nocere*. This Hippocratic principle is timeless. To achieve the desired results, these medical procedures must be performed by competent and well-trained practitioners, and the indications must be reasonable.

The Anti-Ageing Programme, available on Amazon, Fnac, etc.

References

  1. La Padula S, Hersant B, SidAhmed M, Niddam J, Meningaud JP. Objective estimation of patient age through a new composite scale for facial aging assessment: The face – Objective assessment scale. J Craniomaxillofac Surg. 2016 Jul;44(7):775-82.
  2. Sá PO et al. The Effect of Reduction Mammaplasty on Body Posture: A Preliminary Study. Plast Surg Nurs. 2020;40(1):29-34.
  3. Chao JD et al. Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg. 2002;110(7):1644-1654.
  4. Van Slyke AC et al. Perioperative and Long-Term Smoking Behaviors in Cosmetic Surgery Patients. Plast Reconstr Surg. 2017;140(3):503-509.
  5. Narsete T et al. Large-volume liposuction and prevention of type 2 diabetes: a preliminary report. Aesthetic Plast Surg. 2012;36(2):438-442.
  6. Zoumalan RA et al. Subjective and objective improvement in breathing after rhinoplasty. Arch Facial Plast Surg. 2012;14(6):423-428.
  7. Hollander MHJ et al. Functional outcomes of upper eyelid blepharoplasty: A systematic review. J Plast Reconstr Aesthet Surg. 2019;72(2):294-309.
  8. Moss TP, Harris DL. Psychological change after aesthetic plastic surgery: a prospective controlled outcome study. Psychol Health Med. 2009;14(5):567-572.
  9. Meningaud JP et al. Depression, anxiety and quality of life: outcome 9 months after facial cosmetic surgery. J Craniomaxillofac Surg. 2003 Feb;31(1):46-50.
  10. Litner JA, Rotenberg BW, Dennis M, Adamson PA. Impact of cosmetic facial surgery on satisfaction with appearance and quality of life. Arch Facial Plast Surg. 2008;10(2):79-83.
  11. Kouris A et al. Patients’ self-esteem before and after chemical peeling procedure. J Cosmet Laser Ther. 2018;20(4):220-222.
  12. Bruck JC et al [Increased self-confidence and decreased sexual discomfort after subpectoral mammaplasty]. Handchir Mikrochir Plast Chir. 2011;43(2):112-118.
  13. Liu SY et al. Self-esteem change and diurnal cortisol secretion in older adulthood. Psychoneuroendocrinology.
  14. Carney DR et al. Power posing: brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychol Sci. 2010 Oct;21(10):1363-8. 2014;41:111-120.