A recent article in one of the UK’s daily newspapers has brought to light a continuing, but not often articulated problem of technically correct, but artistically incorrect administration of facial fillers. The rise of the “alien” face has been growing in Europe as well as here in the Middle East.  According to Dr Steven Harris, cosmetic surgeon in London, England; the problem lies in distorted beauty standards promoted on social media.  The problem is so prevalent that the warped appearance of patients after exaggerated amounts of filler material has become the new “normal”.  This problem is self-perpetuated and compounded by the thoughtless repetition of the deformity by demanding customers and obedient doctors. Exaggerated amounts of cheek, lip, and chin injections in the end cause physical and psychological harm.

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For decades, the sound plastic surgical approach to appearance modification was the “less is more” principle. Plastic surgical procedures used to be discrete improvements, just like society used to favor discrete and understated elegance and class.  Contemporary behavior in society has changed in the younger generations and often has been characterized as “in your face” display of wealth, emotions, and sexuality.  Plastic surgery procedures are no different.

 As practitioners in the field, we must be aware of societal values drift and cognitive averaging, but we also have to be mindful of key psychological problems that the patient may have such as Body Dysmorphic Disorder. The desired outcome of any esthetic intervention is a happy, satisfied, and prettier patient. By having careful and frank communication prior to our procedures, we can achieve a greater understanding of what we should or should not do to a particular patient.

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