1 00:00:02,600 --> 00:00:05,520 Speaker 1: Guess what, well, what's that mango? So, have you ever 2 00:00:05,600 --> 00:00:06,960 Speaker 1: heard of poker talks. 3 00:00:07,880 --> 00:00:11,680 Speaker 2: Poker talks, is that like dtox for playing poker? Or what? 4 00:00:11,840 --> 00:00:13,920 Speaker 2: I actually not heard of it. 5 00:00:13,920 --> 00:00:16,320 Speaker 1: It's actually botox for playing poker. 6 00:00:16,520 --> 00:00:18,000 Speaker 2: Oh, I get it. That's smart. Yeah. 7 00:00:18,520 --> 00:00:20,840 Speaker 1: It was invented by this New York City doctor. His 8 00:00:20,960 --> 00:00:24,239 Speaker 1: name is Jack Birdie, and he's also this poker player, 9 00:00:24,320 --> 00:00:26,720 Speaker 1: and he realized the biggest problem for poker players is 10 00:00:26,760 --> 00:00:30,200 Speaker 1: there tells like people who like fire their brows or 11 00:00:30,400 --> 00:00:33,040 Speaker 1: curl their lips as they're trying to bluff, and so 12 00:00:33,080 --> 00:00:35,640 Speaker 1: he basically came up with a few places to administer 13 00:00:35,720 --> 00:00:38,440 Speaker 1: botox so you don't show your hand as much. 14 00:00:39,560 --> 00:00:41,919 Speaker 2: Now, I'm guessing this is just for humans, or can 15 00:00:42,040 --> 00:00:44,080 Speaker 2: you know those dogs that play poker? Can they also 16 00:00:44,120 --> 00:00:44,839 Speaker 2: get this treatment? 17 00:00:45,960 --> 00:00:48,600 Speaker 1: I love the idea of like Sharpei or one of 18 00:00:48,640 --> 00:00:51,320 Speaker 1: those like super wrinkly dogs just getting all smoothed out. 19 00:00:51,360 --> 00:00:54,880 Speaker 1: Think of the bowtops. I feel like it'll take so 20 00:00:54,880 --> 00:00:57,920 Speaker 1: many years off the dog. But hearing about Poker Talks 21 00:00:57,960 --> 00:01:00,680 Speaker 1: treatments really made us wonder, like, what what's the history 22 00:01:00,720 --> 00:01:03,640 Speaker 1: of these cosmetic procedures? How long have people been getting 23 00:01:03,680 --> 00:01:06,120 Speaker 1: those jobs? And why was the Civil War such a 24 00:01:06,160 --> 00:01:08,800 Speaker 1: turning point for plastic surgery? So let's dive in. 25 00:01:30,040 --> 00:01:32,479 Speaker 2: Hey, their podcast listeners, Welcome to Part Time Genius. I'm 26 00:01:32,480 --> 00:01:34,600 Speaker 2: Will Pearson and as always I'm joined by my good 27 00:01:34,600 --> 00:01:36,800 Speaker 2: friend mangesh Hot Ticketer and on the other side of 28 00:01:36,800 --> 00:01:40,360 Speaker 2: the soundproof glass really feeling that burned because he's doing 29 00:01:40,400 --> 00:01:43,000 Speaker 2: his daily set of Facer sizes. I don't know if 30 00:01:43,040 --> 00:01:45,000 Speaker 2: you've noticed this man, he's been doing them all week. 31 00:01:45,600 --> 00:01:46,039 Speaker 1: I didn't. 32 00:01:46,440 --> 00:01:48,800 Speaker 2: Well, that is our friends and producer Tristan McNeil. 33 00:01:49,000 --> 00:01:49,200 Speaker 1: Now. 34 00:01:49,240 --> 00:01:53,760 Speaker 2: Tristan claims these exercises are a viable alternative to plastic surgery, 35 00:01:54,080 --> 00:01:56,880 Speaker 2: something about how like toning your face muscles can make 36 00:01:56,920 --> 00:01:59,520 Speaker 2: you look younger. So good luck to you, Tristan. You're 37 00:01:59,520 --> 00:02:01,520 Speaker 2: already pretty young looking. But you know, we'll see if 38 00:02:01,520 --> 00:02:04,520 Speaker 2: this makes a difference. And honestly, from here, it mostly 39 00:02:04,560 --> 00:02:07,160 Speaker 2: looks like he's just kind of smushing his cheeks and 40 00:02:07,200 --> 00:02:09,720 Speaker 2: making this little turtle face. It's kind of I wish 41 00:02:09,720 --> 00:02:11,360 Speaker 2: everybody could see this. It's a little weird. 42 00:02:11,880 --> 00:02:14,040 Speaker 1: Yeah, So he was trying to explain this to me earlier. 43 00:02:14,120 --> 00:02:17,000 Speaker 1: He's been doing this old nineties exercise routine that's supposed 44 00:02:17,000 --> 00:02:21,160 Speaker 1: to tighten facial muscles. And he said it's called cheek energizing, 45 00:02:21,280 --> 00:02:24,119 Speaker 1: and supposedly it's part of this whole facer size program 46 00:02:24,400 --> 00:02:28,080 Speaker 1: that this doctor named Carol Maggio developed like thirty years ago. 47 00:02:28,560 --> 00:02:32,480 Speaker 1: It all sounds and looks pretty bizarre, and I mostly 48 00:02:32,520 --> 00:02:35,480 Speaker 1: just impressed that Tristan was able to decode the written instructions. 49 00:02:35,800 --> 00:02:38,320 Speaker 1: So I actually look this up, and this is a 50 00:02:38,320 --> 00:02:42,000 Speaker 1: breakdown of the cheek energizer move he's been doing. Quote, 51 00:02:42,360 --> 00:02:46,239 Speaker 1: place an index finger lightly on the top of each cheek. Now, 52 00:02:46,360 --> 00:02:48,919 Speaker 1: smile with the middle of your upper lip while thinking 53 00:02:48,960 --> 00:02:52,680 Speaker 1: about the expression you pulling the top lip flat against 54 00:02:52,720 --> 00:02:55,800 Speaker 1: your teeth. Keep your upper and lower lips firmly pulling 55 00:02:55,840 --> 00:02:58,399 Speaker 1: away from each other, and feel your cheeks move under 56 00:02:58,440 --> 00:03:02,560 Speaker 1: your index fingers. Repeat this, smile and release. I mean, 57 00:03:02,720 --> 00:03:06,760 Speaker 1: none of this makes any sense to mew. 58 00:03:07,320 --> 00:03:08,359 Speaker 2: It feels weird. I don't know. 59 00:03:08,480 --> 00:03:10,000 Speaker 1: Yeah, I'll only smile in the middle of your lip. 60 00:03:10,040 --> 00:03:11,679 Speaker 2: Okay, Oh got bad. Bad. 61 00:03:12,240 --> 00:03:14,440 Speaker 1: What's strange is that if we wanted, we could actually, 62 00:03:14,480 --> 00:03:17,079 Speaker 1: like ask the inventor herself about how to do this. 63 00:03:17,160 --> 00:03:20,520 Speaker 1: At age seventy three, she actually promotes facer size on 64 00:03:20,760 --> 00:03:22,680 Speaker 1: Skype and you can do a Skype session with her 65 00:03:22,760 --> 00:03:24,800 Speaker 1: and she'll walk you through it face to face. 66 00:03:25,280 --> 00:03:27,560 Speaker 2: I am totally gonna do this manga. That just sounds 67 00:03:27,680 --> 00:03:29,440 Speaker 2: weird enough for me to want to do it, and 68 00:03:29,680 --> 00:03:31,800 Speaker 2: it does seem like it'ld be a pretty surreal experience. 69 00:03:31,840 --> 00:03:35,000 Speaker 2: But as proponents of plastic surgery will tell you, most 70 00:03:35,040 --> 00:03:38,440 Speaker 2: improvements from facial exercise just don't hold a candle to 71 00:03:38,520 --> 00:03:41,160 Speaker 2: the results you get from a shot of botox or 72 00:03:41,200 --> 00:03:43,760 Speaker 2: maybe a half hour under the knife. And when you 73 00:03:43,760 --> 00:03:46,480 Speaker 2: think about it, that relative ease and the immediacy of 74 00:03:46,480 --> 00:03:49,600 Speaker 2: the results, it's what makes cosmetic procedures so appealing in 75 00:03:49,680 --> 00:03:53,800 Speaker 2: the first place. For instance, in twenty seventeen alone, fifteen 76 00:03:53,840 --> 00:03:58,280 Speaker 2: point seven million minimally invasive cosmetic procedures were performed in 77 00:03:58,320 --> 00:04:01,760 Speaker 2: the US, So we're talking about things like botox injections, 78 00:04:01,840 --> 00:04:06,360 Speaker 2: chemical peels, laser hair removals. That's almost two hundred percent 79 00:04:06,440 --> 00:04:09,800 Speaker 2: increase since the year two thousand. Now. Obviously a big 80 00:04:09,840 --> 00:04:13,280 Speaker 2: reason for that growth is that cosmetic procedures have become easier, 81 00:04:13,800 --> 00:04:16,599 Speaker 2: less invasive, you know, than they were in the year's past. 82 00:04:16,720 --> 00:04:19,560 Speaker 2: But millions of people are lining up each year to 83 00:04:19,600 --> 00:04:22,359 Speaker 2: have parts of their bodies nipped and tucked and shaped 84 00:04:22,400 --> 00:04:24,640 Speaker 2: and plumped. But you know, whether or not that's a 85 00:04:24,680 --> 00:04:26,520 Speaker 2: good thing is still kind of up in the air 86 00:04:26,560 --> 00:04:28,920 Speaker 2: for many people. And so with that question of mine, 87 00:04:28,960 --> 00:04:31,120 Speaker 2: we foind it be interesting to look into the history 88 00:04:31,120 --> 00:04:34,760 Speaker 2: of plastic surgery, including how and why it got started 89 00:04:34,839 --> 00:04:37,240 Speaker 2: and many of the ways it's changed over the years, 90 00:04:37,520 --> 00:04:39,359 Speaker 2: And then a little bit later in the episode, I 91 00:04:39,360 --> 00:04:41,640 Speaker 2: think we'll check out some of the more recent trends 92 00:04:41,680 --> 00:04:44,200 Speaker 2: in the industry, as well as how a selfie stick 93 00:04:44,279 --> 00:04:47,159 Speaker 2: might make you think twice about getting a nose job. 94 00:04:48,000 --> 00:04:50,080 Speaker 1: That's right, But you know, before we get into any 95 00:04:50,120 --> 00:04:51,839 Speaker 1: of that, I thought we could start by breaking down 96 00:04:51,880 --> 00:04:54,080 Speaker 1: some of the terms we'll be using today, you know, 97 00:04:54,240 --> 00:04:56,160 Speaker 1: just so things don't get confusing a little bit later. 98 00:04:56,279 --> 00:04:59,279 Speaker 1: So in general, we refer to the term plastic surgery 99 00:04:59,440 --> 00:05:01,400 Speaker 1: for a few time diferent things at once. You know, 100 00:05:01,440 --> 00:05:04,320 Speaker 1: they're cosmetic surgeries, which are the ones meant to enhance 101 00:05:04,360 --> 00:05:08,320 Speaker 1: a person's overall appearance and aren't considered medically necessary, so 102 00:05:08,520 --> 00:05:12,719 Speaker 1: things like liposeuction or facelifts, as well as the less 103 00:05:12,720 --> 00:05:15,719 Speaker 1: invasive procedures you mentioned like chemical peels and botox. But 104 00:05:16,080 --> 00:05:19,120 Speaker 1: plastic surgery can also refer to reconstructive surgeries, and those 105 00:05:19,120 --> 00:05:21,680 Speaker 1: are the ones performed to restore the normal function or 106 00:05:21,680 --> 00:05:23,960 Speaker 1: appearance of a person's body, and for the most part, 107 00:05:24,160 --> 00:05:26,440 Speaker 1: these are considered medically necessary. 108 00:05:26,960 --> 00:05:28,840 Speaker 2: Yeah, I mean there are several of these types. When 109 00:05:28,880 --> 00:05:31,440 Speaker 2: you think about surgeries like you know, repairing a cleft 110 00:05:31,480 --> 00:05:35,600 Speaker 2: palate or the you know, unbelievable jobs that these surgeons 111 00:05:35,600 --> 00:05:38,400 Speaker 2: can do when they're reconstructing a burn victim's face or 112 00:05:38,440 --> 00:05:41,160 Speaker 2: their body, it's pretty remarkable how far this has come. 113 00:05:41,800 --> 00:05:44,120 Speaker 1: Yeah, and I did think it was worth mentioning because 114 00:05:44,200 --> 00:05:46,440 Speaker 1: there's still a ton of stigma surrounding the term, Like 115 00:05:46,720 --> 00:05:49,280 Speaker 1: lots of people only associate plastic surgery with the cosmetic 116 00:05:49,320 --> 00:05:52,160 Speaker 1: side of things like tummy talks and calf implants. 117 00:05:52,800 --> 00:05:54,919 Speaker 2: Yeah. Well, my guess is that the stigma has a 118 00:05:54,920 --> 00:05:57,680 Speaker 2: lot to do with the word plastic itself. I mean, 119 00:05:57,720 --> 00:06:01,200 Speaker 2: I think it makes people think about fakeness and artificiality 120 00:06:01,360 --> 00:06:04,680 Speaker 2: and all the other things we associate with plastic as 121 00:06:04,760 --> 00:06:07,760 Speaker 2: a substance, Like we wrap our view of plastic as 122 00:06:07,800 --> 00:06:11,560 Speaker 2: being cheap and disposable onto these surgeries that share this name, 123 00:06:11,880 --> 00:06:13,960 Speaker 2: which of course is pretty unfair when you really think 124 00:06:13,960 --> 00:06:14,360 Speaker 2: about it. 125 00:06:15,000 --> 00:06:17,560 Speaker 1: Yeah, I mean, especially when you consider that the name 126 00:06:17,600 --> 00:06:20,159 Speaker 1: doesn't have anything to do with plastic in the first place. 127 00:06:20,520 --> 00:06:22,640 Speaker 1: Like I read this week that the first time the 128 00:06:22,640 --> 00:06:26,080 Speaker 1: word plastic was actually used to describe a surgical technique 129 00:06:26,120 --> 00:06:29,960 Speaker 1: was in eighteen thirty seven, which is so long before 130 00:06:30,000 --> 00:06:31,760 Speaker 1: plastic the substance was even invented. 131 00:06:31,920 --> 00:06:33,839 Speaker 2: All right, So then what did the term actually mean 132 00:06:33,880 --> 00:06:35,599 Speaker 2: when it was used in eighteen thirty seven. 133 00:06:36,000 --> 00:06:39,440 Speaker 1: It actually came from the Greek word plasticos, which means 134 00:06:39,480 --> 00:06:42,400 Speaker 1: to mold or give form. So a plastic surgery was 135 00:06:42,440 --> 00:06:46,040 Speaker 1: basically a shaping surgery, and that was pretty fitting because 136 00:06:46,080 --> 00:06:48,680 Speaker 1: the earliest forms of plastic surgery were based much more 137 00:06:48,720 --> 00:06:51,880 Speaker 1: in reconstruction than they were in purely cosmetic changes. 138 00:06:52,480 --> 00:06:54,200 Speaker 2: You know, It's interesting. This is another one of those 139 00:06:54,200 --> 00:06:56,720 Speaker 2: things that when we started looking into the history, you 140 00:06:56,920 --> 00:06:59,720 Speaker 2: really don't think about how far back some of these 141 00:06:59,720 --> 00:07:02,880 Speaker 2: things go. And so actually, the earliest known example of 142 00:07:02,920 --> 00:07:05,520 Speaker 2: plastic surgery dates all the way back to the sixth 143 00:07:05,560 --> 00:07:09,560 Speaker 2: century BCE, and it was indeed a form of reconstruction. 144 00:07:09,640 --> 00:07:12,320 Speaker 2: This was a nose job. The technique was invented in 145 00:07:12,320 --> 00:07:15,640 Speaker 2: ancient India by a physician and a surgeon named Soushruta. 146 00:07:16,160 --> 00:07:18,120 Speaker 2: And this was at the time when you know, it 147 00:07:18,160 --> 00:07:20,800 Speaker 2: was common to punish an adulter or a thief with 148 00:07:20,840 --> 00:07:24,120 Speaker 2: some form of body mutilation, usually by cutting off the 149 00:07:24,160 --> 00:07:27,480 Speaker 2: nose or maybe an ear. And so this physician was 150 00:07:27,520 --> 00:07:29,480 Speaker 2: one of many in the region who felt that this 151 00:07:29,720 --> 00:07:32,760 Speaker 2: was a kind of public shaming and was just way 152 00:07:32,800 --> 00:07:35,680 Speaker 2: over the line of course, and you know, basically ensured 153 00:07:35,720 --> 00:07:38,120 Speaker 2: that the criminals would be shunned for the rest of 154 00:07:38,160 --> 00:07:41,400 Speaker 2: their lives. We wanted to do something to help solve 155 00:07:41,440 --> 00:07:43,800 Speaker 2: this problem, and so it began looking for a way 156 00:07:43,840 --> 00:07:47,200 Speaker 2: to help these people reintegrate into society by restoring their 157 00:07:47,200 --> 00:07:50,960 Speaker 2: appearance as much as he possibly could. And so what 158 00:07:51,000 --> 00:07:53,400 Speaker 2: he came up with was this technique where a flap 159 00:07:53,400 --> 00:07:56,600 Speaker 2: of skin was removed from a patient's cheek and then 160 00:07:56,720 --> 00:08:01,080 Speaker 2: molded and shaped into a new nose the nostrils by 161 00:08:01,080 --> 00:08:03,800 Speaker 2: inserting these two hollow reeds, and then you'd leave them 162 00:08:03,800 --> 00:08:06,600 Speaker 2: in place to make sure the nostrils didn't close up 163 00:08:06,640 --> 00:08:09,760 Speaker 2: as the new nose healed. I mean, it's unbelievable that 164 00:08:09,840 --> 00:08:11,960 Speaker 2: somebody could pull this off that long ago. 165 00:08:12,400 --> 00:08:14,960 Speaker 1: Yeah, and it almost sounds like fantastical that anything like 166 00:08:15,000 --> 00:08:16,320 Speaker 1: that could even work. 167 00:08:16,960 --> 00:08:18,840 Speaker 2: Yeah, it seems to have been the consensus at the 168 00:08:18,880 --> 00:08:22,160 Speaker 2: time too. But you know, once word of this method spread, 169 00:08:22,680 --> 00:08:26,040 Speaker 2: other Indian surgeons began trying it for themselves, and some 170 00:08:26,120 --> 00:08:28,360 Speaker 2: even put their own spin on the procedure by building 171 00:08:28,440 --> 00:08:31,280 Speaker 2: the replacement nose from a flap of the patient's forehead 172 00:08:31,320 --> 00:08:34,280 Speaker 2: skin rather than you know, maybe their cheek. And this 173 00:08:34,440 --> 00:08:37,920 Speaker 2: early form of rhinoplasty proved so successful that it was 174 00:08:37,960 --> 00:08:41,440 Speaker 2: eventually adapted throughout Europe, where it became known as the 175 00:08:41,520 --> 00:08:42,320 Speaker 2: Indian method. 176 00:08:43,440 --> 00:08:45,680 Speaker 1: So I had actually heard about this Indian method just 177 00:08:45,679 --> 00:08:48,560 Speaker 1: because it's one of those things I feel is compulsory 178 00:08:48,640 --> 00:08:51,520 Speaker 1: if you're Indian, like for an Indian pride, Like you know, 179 00:08:51,640 --> 00:08:53,720 Speaker 1: India also came up with the concept of zero as 180 00:08:53,760 --> 00:08:57,120 Speaker 1: a number and invented shampoo. Like these are just things 181 00:08:57,160 --> 00:09:00,640 Speaker 1: we know, and you are welcome. But so apparently we 182 00:09:00,640 --> 00:09:02,840 Speaker 1: weren't the only invaders there. There was also something called 183 00:09:02,880 --> 00:09:05,760 Speaker 1: the Italian method, and this was emitted by a surgeon 184 00:09:05,840 --> 00:09:09,360 Speaker 1: named Antonio Branca. This was in early fourteen hundreds, and 185 00:09:09,400 --> 00:09:11,600 Speaker 1: the big difference was that Bronca used a flap of 186 00:09:11,640 --> 00:09:14,920 Speaker 1: skin from the upper arm to build his patient's new noses, 187 00:09:15,040 --> 00:09:17,160 Speaker 1: and this was considered an improvement for the most part 188 00:09:17,200 --> 00:09:19,720 Speaker 1: because it left a lot less scarring than the Indian 189 00:09:19,760 --> 00:09:22,520 Speaker 1: method did. The only downside was that, and this is 190 00:09:23,040 --> 00:09:25,080 Speaker 1: a little strange to think about, in order for the 191 00:09:25,080 --> 00:09:27,840 Speaker 1: skin to fully attach itself, patients actually had to hold 192 00:09:27,880 --> 00:09:31,360 Speaker 1: their arms against their nose for like twenty straight days. 193 00:09:32,280 --> 00:09:34,640 Speaker 1: Obviously seems super uncomfortable. 194 00:09:34,840 --> 00:09:37,680 Speaker 2: It does sound miserable, but I guess in these cases, 195 00:09:37,720 --> 00:09:40,760 Speaker 2: you know, considering the results or the payoff, I guess 196 00:09:40,760 --> 00:09:43,319 Speaker 2: it was considered worth it. But yeah, let's get back 197 00:09:43,320 --> 00:09:46,520 Speaker 2: to Shushruta for a minute. Because after his breakthrough, this 198 00:09:46,600 --> 00:09:50,400 Speaker 2: plastic surgery continued to develop throughout Europe. So, for example, 199 00:09:50,480 --> 00:09:52,680 Speaker 2: ancient Rome got in on the act sometime during the 200 00:09:52,720 --> 00:09:57,360 Speaker 2: early first century, so surgeons of the era pioneered bleferoplasty, 201 00:09:57,480 --> 00:10:00,000 Speaker 2: which is the adjustment of the eyelids in order to 202 00:10:00,120 --> 00:10:03,920 Speaker 2: correct drooping or squinting eyes. And around the same time, 203 00:10:04,000 --> 00:10:08,199 Speaker 2: the Greek physician Galen performed the very first purely cosmetic 204 00:10:08,280 --> 00:10:10,559 Speaker 2: plastic surgery, so it was kind of like a nose 205 00:10:10,640 --> 00:10:11,720 Speaker 2: job for the wealthy. 206 00:10:13,080 --> 00:10:15,560 Speaker 1: It's kind of cool that those jobs were like first 207 00:10:15,679 --> 00:10:20,000 Speaker 1: both for reconstructive and cosmetic purposes. It's kind of stunning, 208 00:10:20,080 --> 00:10:23,440 Speaker 1: but you know, not everyone was happy about those breakthroughs 209 00:10:23,440 --> 00:10:26,720 Speaker 1: and body modification. As Christianity began to take hold in 210 00:10:26,760 --> 00:10:29,319 Speaker 1: Europe during the Middle Ages, plenty of religious leaders viewed 211 00:10:29,360 --> 00:10:33,960 Speaker 1: plastic surgery as sinful or almost borderline blasphemous, and this 212 00:10:34,040 --> 00:10:36,400 Speaker 1: belief gained more traction in the twelfth century when the 213 00:10:36,440 --> 00:10:39,000 Speaker 1: Pope I think it's Pope Innocent the third at the time, 214 00:10:39,160 --> 00:10:42,560 Speaker 1: he formally spoke out against it, and pretty soon after 215 00:10:42,640 --> 00:10:45,320 Speaker 1: it became a crime to surgically alter the human body. 216 00:10:46,280 --> 00:10:48,839 Speaker 2: So you see this kind of thing happen throughout history, 217 00:10:48,840 --> 00:10:51,959 Speaker 2: but in this case, like what changed that perception? What 218 00:10:52,280 --> 00:10:55,360 Speaker 2: made the church eventually back down from this. 219 00:10:55,360 --> 00:10:57,440 Speaker 1: This is going to sound strange, but a lot of 220 00:10:57,480 --> 00:10:59,760 Speaker 1: the shift was due to syphilis. 221 00:11:00,080 --> 00:11:01,880 Speaker 2: Really, you know that there were a lot of things 222 00:11:01,920 --> 00:11:03,760 Speaker 2: I was guessing about. Is not what I expected you 223 00:11:03,800 --> 00:11:04,520 Speaker 2: to say, though. 224 00:11:05,040 --> 00:11:08,120 Speaker 1: I know. So there was a really bad outbreak of 225 00:11:08,160 --> 00:11:11,080 Speaker 1: this disease in Europe during the late sixteenth century, and 226 00:11:11,280 --> 00:11:14,360 Speaker 1: one of the symptoms of advanced syphilis happens to be 227 00:11:14,920 --> 00:11:17,880 Speaker 1: soft tissue decay, which is usually centered in the nose. 228 00:11:17,920 --> 00:11:20,400 Speaker 1: I had no idea about this. But now there were 229 00:11:20,400 --> 00:11:24,200 Speaker 1: all these like upper crust lords and ladies with these big, 230 00:11:24,320 --> 00:11:28,559 Speaker 1: gaping holes in their faces, and suddenly this like quote 231 00:11:28,600 --> 00:11:31,760 Speaker 1: sin of like crafting a false nose, it started to 232 00:11:31,840 --> 00:11:34,280 Speaker 1: seem a whole lot better, you know than the alternative 233 00:11:34,280 --> 00:11:36,079 Speaker 1: of having, you know, a hole in your face. 234 00:11:36,360 --> 00:11:38,560 Speaker 2: Yeah, I mean that makes sense. And yeah, of course, 235 00:11:38,559 --> 00:11:41,920 Speaker 2: plastic surgeries development didn't end in Europe, and the techniques 236 00:11:41,920 --> 00:11:44,720 Speaker 2: eventually made their way here to the United States, with 237 00:11:44,840 --> 00:11:48,960 Speaker 2: one of the earliest practitioners being doctor John Metdouer. You know, 238 00:11:49,000 --> 00:11:51,880 Speaker 2: he and his sons ran this successful practice in Virginia 239 00:11:52,040 --> 00:11:56,120 Speaker 2: and they were specializing and repairing genital birth effects and 240 00:11:56,160 --> 00:11:59,679 Speaker 2: then later on in reconstructive surgery, and his legacy is 241 00:11:59,720 --> 00:12:03,599 Speaker 2: actually really impressive. So Metour is credited with performing the 242 00:12:03,679 --> 00:12:06,760 Speaker 2: first hard cleft palette repair on the Americas in eighteen 243 00:12:06,840 --> 00:12:10,439 Speaker 2: twenty seven, and notably, he completed the procedure by transplanting 244 00:12:10,480 --> 00:12:13,480 Speaker 2: pieces of bone rather than just skin or muscle as 245 00:12:13,520 --> 00:12:16,400 Speaker 2: previous surgeons had done. And so this new technique was 246 00:12:16,440 --> 00:12:19,920 Speaker 2: this huge leap forward for reconstructive surgery, and it's actually 247 00:12:19,920 --> 00:12:23,120 Speaker 2: the main reason why doctor Metour is often called America's 248 00:12:23,120 --> 00:12:24,360 Speaker 2: first plastic surgeon. 249 00:12:24,840 --> 00:12:27,440 Speaker 1: Yeah, so it really seems like the nineteenth century is 250 00:12:27,480 --> 00:12:30,440 Speaker 1: when modern plastic surgery really started to take off. And 251 00:12:30,640 --> 00:12:32,720 Speaker 1: I was reading about how much of a game changer 252 00:12:32,840 --> 00:12:36,320 Speaker 1: the Civil War was for battlefield medicine. I mean, you 253 00:12:36,320 --> 00:12:40,000 Speaker 1: think about things like amputation techniques or more reliable forms 254 00:12:40,000 --> 00:12:43,840 Speaker 1: of anesthesia, but facial reconstruction was another area that saw 255 00:12:43,920 --> 00:12:48,400 Speaker 1: these major advances during America's bloodiest war, and records actually 256 00:12:48,400 --> 00:12:51,920 Speaker 1: show that Union surgeons performed more than thirty successful plastic 257 00:12:51,960 --> 00:12:55,679 Speaker 1: surgeries on these odd disfigured soldiers during the war, and 258 00:12:55,800 --> 00:12:58,640 Speaker 1: they also pioneered new techniques that would later become standards 259 00:12:58,679 --> 00:13:01,320 Speaker 1: in the field, like taking photo to track the progress 260 00:13:01,320 --> 00:13:04,560 Speaker 1: of repairs and also using smaller sutures for incisions to 261 00:13:04,559 --> 00:13:07,200 Speaker 1: help minimize the scarring. Yeah. 262 00:13:07,240 --> 00:13:10,240 Speaker 2: You know, it's interesting how these advancements happened during war, 263 00:13:10,320 --> 00:13:12,679 Speaker 2: because it actually wasn't just the Civil War where these 264 00:13:12,760 --> 00:13:16,280 Speaker 2: kinds of breakthroughs happen, like both world wars actually also 265 00:13:16,440 --> 00:13:18,880 Speaker 2: brought major innovations the plastic surgery as well. 266 00:13:19,720 --> 00:13:21,560 Speaker 1: Yeah, I mean, that's definitely a good point, and we 267 00:13:21,600 --> 00:13:24,000 Speaker 1: should spotlight a few of those advances before we talk 268 00:13:24,000 --> 00:13:26,720 Speaker 1: about the state of plastic surgery today. But before we 269 00:13:26,760 --> 00:13:43,960 Speaker 1: go any further, why don't we take a quick break. 270 00:13:44,760 --> 00:13:46,640 Speaker 1: You're listening to Part Time Genius and we're talking about 271 00:13:46,679 --> 00:13:50,440 Speaker 1: the long, surprising history of plastic surgery. Okay, well, so 272 00:13:50,520 --> 00:13:52,720 Speaker 1: we're up to the twentieth century now in our timeline, 273 00:13:52,760 --> 00:13:55,080 Speaker 1: and we were just about to get into World War One. 274 00:13:55,480 --> 00:13:57,320 Speaker 2: Yeah, that's right. You know, as we were saying, earlier 275 00:13:57,520 --> 00:14:01,160 Speaker 2: wars have certainly led to these turning points and you know, 276 00:14:01,240 --> 00:14:05,400 Speaker 2: reconstruction of various kinds and facial reconstruction specifically. And there 277 00:14:05,400 --> 00:14:07,439 Speaker 2: were a couple of reasons for this. I mean, if 278 00:14:07,440 --> 00:14:10,040 Speaker 2: you think about what was advanced in terms of warfare 279 00:14:10,080 --> 00:14:12,640 Speaker 2: at that time, you had machine guns and aerial bombers 280 00:14:12,640 --> 00:14:15,280 Speaker 2: that were being used in combat and really for the 281 00:14:15,320 --> 00:14:19,160 Speaker 2: first time during World War One. And the result of this, obvious, 282 00:14:19,240 --> 00:14:21,920 Speaker 2: you know, tragic result of this is that more soldiers 283 00:14:21,960 --> 00:14:25,280 Speaker 2: suffered facial wounds due to bullets and shrapnel than in 284 00:14:25,400 --> 00:14:28,040 Speaker 2: any of the wars before them. And you know, it's 285 00:14:28,080 --> 00:14:31,680 Speaker 2: obviously awful, but the wounds were often more extensive than 286 00:14:31,760 --> 00:14:34,760 Speaker 2: surgeons were used to treating. So the good news here 287 00:14:34,800 --> 00:14:37,440 Speaker 2: is though, that anesthesia and the treatment of infections had 288 00:14:37,480 --> 00:14:41,360 Speaker 2: definitely improved drastically by this time, so you had serious 289 00:14:41,400 --> 00:14:43,960 Speaker 2: injuries that would have been fatal in the past that 290 00:14:44,440 --> 00:14:47,440 Speaker 2: were now considered survivable, and that included a lot of 291 00:14:47,520 --> 00:14:50,120 Speaker 2: major facial disfigurements as a result of this. 292 00:14:51,120 --> 00:14:53,800 Speaker 1: Yeah, we mentioned earlier that there were some like thirty 293 00:14:53,840 --> 00:14:57,040 Speaker 1: odd plastic surgeries during the Civil War, and that actually 294 00:14:57,080 --> 00:14:59,200 Speaker 1: doesn't sound like that many at first, but when you 295 00:14:59,240 --> 00:15:01,520 Speaker 1: consider how many soldier died just because there was no 296 00:15:01,560 --> 00:15:04,120 Speaker 1: way to stave off infection, it starts to make sense 297 00:15:04,160 --> 00:15:05,440 Speaker 1: why the number was so low. 298 00:15:06,040 --> 00:15:08,560 Speaker 2: Yeah, And so with World War One, surgeons suddenly found 299 00:15:08,560 --> 00:15:11,360 Speaker 2: themselves with a lot of chances to develop and refine 300 00:15:11,440 --> 00:15:14,960 Speaker 2: new ways to deal with disfigurements. And one member of 301 00:15:15,000 --> 00:15:18,400 Speaker 2: the medical community was especially helpful in this regard. His 302 00:15:18,520 --> 00:15:21,760 Speaker 2: name was doctor Harold Gillies, and he was actually a nose, 303 00:15:21,840 --> 00:15:24,720 Speaker 2: ear and throat specialists. He was from New Zealand and 304 00:15:24,760 --> 00:15:27,080 Speaker 2: so he had joined the Royal Army Medical Corps at 305 00:15:27,120 --> 00:15:29,680 Speaker 2: the start of the war, and so during his time 306 00:15:29,760 --> 00:15:32,680 Speaker 2: on the Western Front, Gillies learned as much as he 307 00:15:32,760 --> 00:15:36,160 Speaker 2: could about reconstructive surgery, and this was mostly by observing 308 00:15:36,240 --> 00:15:38,800 Speaker 2: the dentists and the doctors that he was stationed with. 309 00:15:39,520 --> 00:15:41,880 Speaker 2: So then when he returns to England, he was actually 310 00:15:41,880 --> 00:15:44,280 Speaker 2: given the chance to apply what he'd learned to the 311 00:15:44,320 --> 00:15:47,760 Speaker 2: newly opened Queen's Hospital in London. There were more than 312 00:15:47,840 --> 00:15:51,120 Speaker 2: a thousand beds there and these were reserved for patients 313 00:15:51,160 --> 00:15:53,480 Speaker 2: in need of these facial reconstructions, so it was a 314 00:15:53,520 --> 00:15:54,160 Speaker 2: ton of people. 315 00:15:54,800 --> 00:15:56,600 Speaker 1: Yeah, I mean it's almost hard to imagine that many 316 00:15:56,640 --> 00:15:59,480 Speaker 1: people needing surgeries like that all at once. It's really 317 00:16:00,000 --> 00:16:01,680 Speaker 1: it's really staggering when you think about it. 318 00:16:02,080 --> 00:16:04,480 Speaker 2: Yeah, no, it really is. Actually, there was such a 319 00:16:04,520 --> 00:16:07,600 Speaker 2: demand for these services that patients often had to queue 320 00:16:07,680 --> 00:16:11,560 Speaker 2: up outside the hospital. So even with a thousand beds there, 321 00:16:11,960 --> 00:16:14,000 Speaker 2: it just gives you a sense of how many people 322 00:16:14,040 --> 00:16:16,480 Speaker 2: were affected by this. And there was this set of 323 00:16:16,520 --> 00:16:21,400 Speaker 2: blue benches reserved exclusively for patients with facial disfigurements, and 324 00:16:21,440 --> 00:16:24,000 Speaker 2: apparently the bright blue color was a way to warn 325 00:16:24,000 --> 00:16:26,320 Speaker 2: the locals that they might want to look away when 326 00:16:26,400 --> 00:16:29,760 Speaker 2: walking past the benches, and so it's just tragic to 327 00:16:29,840 --> 00:16:32,479 Speaker 2: think about that, and you know, it might seem insensitive 328 00:16:32,520 --> 00:16:34,360 Speaker 2: at first, but it was really as much for the 329 00:16:34,440 --> 00:16:37,000 Speaker 2: patients as it was for the public, and you know, 330 00:16:37,040 --> 00:16:40,040 Speaker 2: if anything, the soldiers probably appreciated the break from people 331 00:16:40,160 --> 00:16:41,760 Speaker 2: staring at them all the time, I guess. 332 00:16:43,080 --> 00:16:46,320 Speaker 1: So what kind of breakthroughs was Gilly's making at that time. 333 00:16:47,520 --> 00:16:50,120 Speaker 2: Well, there's actually probably too many to go through here, 334 00:16:50,160 --> 00:16:52,120 Speaker 2: but one of the biggest was what he called the 335 00:16:52,200 --> 00:16:56,280 Speaker 2: tube pedicle or flat procedure, I guess. So basically, Gillies 336 00:16:56,280 --> 00:16:59,040 Speaker 2: would cut a strip of living skin and tissue and 337 00:16:59,040 --> 00:17:01,200 Speaker 2: then he would form it to this tube that was 338 00:17:01,240 --> 00:17:04,600 Speaker 2: still connected to the patient at one end. Then the 339 00:17:04,640 --> 00:17:08,000 Speaker 2: tube could be laid across the patient's wounded face until 340 00:17:08,040 --> 00:17:10,680 Speaker 2: the skin graft actually took root. 341 00:17:10,600 --> 00:17:13,280 Speaker 1: Which sounds pretty gruesome, but I'm guessing there was some 342 00:17:13,320 --> 00:17:14,679 Speaker 1: sort of upside to this approach. 343 00:17:14,960 --> 00:17:17,600 Speaker 2: Yeah, definitely, I mean a really big one. So before 344 00:17:17,640 --> 00:17:21,320 Speaker 2: Gillies came along, reconstructive surgeries had long struggled on how 345 00:17:21,359 --> 00:17:24,639 Speaker 2: to ward off infection in this open wound while they 346 00:17:24,640 --> 00:17:27,679 Speaker 2: were waiting for this skin graph to take So his 347 00:17:27,800 --> 00:17:31,080 Speaker 2: variation solved this problem because it ensured that blood continued 348 00:17:31,119 --> 00:17:34,320 Speaker 2: to flow through the grafted area, so then once the 349 00:17:34,400 --> 00:17:37,399 Speaker 2: graft had taken root, the surgeon could simply sever the 350 00:17:37,440 --> 00:17:40,600 Speaker 2: tube and sculpt the remaining tissue into the patient's new 351 00:17:40,720 --> 00:17:43,639 Speaker 2: nose and throat, and you know, it doesn't paint this 352 00:17:43,680 --> 00:17:46,800 Speaker 2: pretty picture, but the technique was so successful that the 353 00:17:46,800 --> 00:17:50,399 Speaker 2: work at Queen's Hospital continued long after the war had ended. 354 00:17:50,800 --> 00:17:54,200 Speaker 2: So in total, the hospital performed more than eleven thousand 355 00:17:54,280 --> 00:17:58,320 Speaker 2: operations on over five thousand patients before they finally closed 356 00:17:58,320 --> 00:18:01,920 Speaker 2: their doors in nineteen twenty five. And Gillies actually received 357 00:18:02,040 --> 00:18:05,040 Speaker 2: knighthood for his efforts. And when World War two began, 358 00:18:05,480 --> 00:18:07,960 Speaker 2: he kept working on this new set of soldiers that 359 00:18:08,040 --> 00:18:09,520 Speaker 2: were in the same kind of need. 360 00:18:10,640 --> 00:18:14,000 Speaker 1: That's a tremendous legacy. But you know, we've mostly dealt 361 00:18:14,000 --> 00:18:16,320 Speaker 1: with the reconstructive side of plastic surgery so far. So 362 00:18:16,520 --> 00:18:18,280 Speaker 1: what do you say we switched gears and focus on 363 00:18:18,280 --> 00:18:19,639 Speaker 1: the cosmetic side for a little bit. 364 00:18:20,400 --> 00:18:22,680 Speaker 2: Yeah, that definitely makes sense. Actually, I'll start us off 365 00:18:22,720 --> 00:18:25,520 Speaker 2: with something that I was surprised to learn this week. So, 366 00:18:26,080 --> 00:18:29,440 Speaker 2: even with nearly two million cosmetic surgeries performed in the 367 00:18:29,560 --> 00:18:33,480 Speaker 2: US each year, the plastic surgery industry overall has actually 368 00:18:33,600 --> 00:18:36,639 Speaker 2: shrunk by about twelve percent since the year two thousand. 369 00:18:37,680 --> 00:18:40,159 Speaker 1: That's strange. I wouldn't have guessed that. I mean, I 370 00:18:40,160 --> 00:18:44,200 Speaker 1: guess breast augmentations and liposection. Just I mean, maybe they're 371 00:18:44,200 --> 00:18:45,960 Speaker 1: not as appealing as they used to be, is that right? 372 00:18:46,520 --> 00:18:48,760 Speaker 2: Yeah, I mean that those are still the top two 373 00:18:48,840 --> 00:18:52,360 Speaker 2: cosmetic surgeries in the States, with roughly three hundred thousand 374 00:18:52,480 --> 00:18:55,480 Speaker 2: each per year, But on the whole, there are fewer 375 00:18:55,520 --> 00:18:58,119 Speaker 2: people undergoing the ninth than there were about, you know, 376 00:18:58,160 --> 00:19:01,160 Speaker 2: twenty years or so ago. But the most interesting part 377 00:19:01,200 --> 00:19:04,160 Speaker 2: to me, at least, was that while cosmetic surgeries are down, 378 00:19:04,359 --> 00:19:09,200 Speaker 2: the number of minimally invasive cosmetic procedures like injection or 379 00:19:09,280 --> 00:19:12,920 Speaker 2: laser hair removal, those numbers are only going up each year. 380 00:19:13,320 --> 00:19:16,080 Speaker 2: So in fact, the American Society of Plastic Surgeons reports 381 00:19:16,080 --> 00:19:19,040 Speaker 2: that the number of these procedures has grown nearly two 382 00:19:19,200 --> 00:19:22,560 Speaker 2: hundred percent since two thousand, So that's the same period 383 00:19:22,600 --> 00:19:25,200 Speaker 2: that you know, these cosmetic surgeries have been declining. 384 00:19:25,800 --> 00:19:28,040 Speaker 1: Sure, and I'm sure poker tox is one of the 385 00:19:28,040 --> 00:19:30,720 Speaker 1: biggest reasons for all of exactly. Yeah, you know, I 386 00:19:31,080 --> 00:19:33,520 Speaker 1: do wonder what's behind that downward shift, Like, is it 387 00:19:33,720 --> 00:19:36,639 Speaker 1: just that the minimally invasive stuff requires less downtime than 388 00:19:36,680 --> 00:19:38,560 Speaker 1: the flow on surgeries or what's going on here? 389 00:19:38,760 --> 00:19:40,679 Speaker 2: Yeah, I mean I think that's part of it, you know, 390 00:19:40,720 --> 00:19:43,520 Speaker 2: plus the fact that these procedures are cheaper, they're faster, 391 00:19:43,760 --> 00:19:46,640 Speaker 2: of course, you know, less invasive, like you mentioned. And 392 00:19:46,680 --> 00:19:48,439 Speaker 2: I think it also doesn't hurt that there isn't as 393 00:19:48,520 --> 00:19:52,040 Speaker 2: much stigma around something like microdermabrasion as there might be 394 00:19:52,080 --> 00:19:54,320 Speaker 2: in getting a tummy tuck or a nose job or 395 00:19:54,359 --> 00:19:55,040 Speaker 2: something like that. 396 00:19:55,840 --> 00:19:57,520 Speaker 1: So I guess it kind of comes back to the 397 00:19:57,560 --> 00:20:00,960 Speaker 1: idea that plastic surgery might still carry a connotation of phoniness, 398 00:20:01,040 --> 00:20:03,760 Speaker 1: like and I guess these similar types of procedures are 399 00:20:03,960 --> 00:20:06,160 Speaker 1: kind of a way of sidestepping that stigma while still 400 00:20:06,160 --> 00:20:07,160 Speaker 1: altering your appearance. 401 00:20:07,720 --> 00:20:10,160 Speaker 2: Yeah, and you know, actually, just in looking this up, 402 00:20:10,160 --> 00:20:12,960 Speaker 2: I think that desire for a more natural look is 403 00:20:12,960 --> 00:20:15,680 Speaker 2: something that came up a lot. And there's a really 404 00:20:15,720 --> 00:20:18,760 Speaker 2: good article about this and Allure this past month, which 405 00:20:18,800 --> 00:20:20,920 Speaker 2: is a sentence I never really thought i'd be saying, 406 00:20:20,960 --> 00:20:23,600 Speaker 2: but I did want to share a quote from it 407 00:20:23,640 --> 00:20:26,560 Speaker 2: really quickly. The author is Caitlin Clark, and here's what 408 00:20:26,600 --> 00:20:31,840 Speaker 2: she writes. Disproportionate breast enhancement, overfilled lips, and exaggerated cosmetic 409 00:20:31,840 --> 00:20:36,240 Speaker 2: procedures in general are all trends on their way out. Now, 410 00:20:36,280 --> 00:20:40,040 Speaker 2: a successful plastic surgery or cosmetic procedure should no longer 411 00:20:40,080 --> 00:20:44,040 Speaker 2: be obvious. Patients are increasingly wanting to maintain their general 412 00:20:44,080 --> 00:20:48,000 Speaker 2: facial structure, inherited family traits, and just generally wanting to 413 00:20:48,040 --> 00:20:51,600 Speaker 2: look like themselves, but with a few refined tweaks. 414 00:20:52,040 --> 00:20:54,840 Speaker 1: Which definitely tracks with these so called tweak mins I 415 00:20:54,840 --> 00:20:58,240 Speaker 1: read about last week. So there's this new skin tightening 416 00:20:58,240 --> 00:21:00,840 Speaker 1: treatment that's supposed to take off this year, face tight, 417 00:21:01,400 --> 00:21:05,040 Speaker 1: and it actually uses this radio frequency energy to tighten 418 00:21:05,080 --> 00:21:07,720 Speaker 1: and sculpt the skin around your neck and jalline. It's 419 00:21:07,840 --> 00:21:10,639 Speaker 1: totally non surgical, and the effects supposedly last up to 420 00:21:10,720 --> 00:21:13,639 Speaker 1: five years, which is kind of amazing. And even on 421 00:21:13,680 --> 00:21:16,720 Speaker 1: the surgical side, it seems like smaller, less obvious treatments 422 00:21:16,720 --> 00:21:18,960 Speaker 1: are how most people want to go these days. For instance, 423 00:21:19,040 --> 00:21:22,080 Speaker 1: there's this one procedure that's becoming really popular right now, 424 00:21:22,400 --> 00:21:25,200 Speaker 1: and it addresses something so obscure that you probably forgot 425 00:21:25,200 --> 00:21:26,240 Speaker 1: it's even a body part. 426 00:21:27,080 --> 00:21:30,280 Speaker 2: I'm gonna guess that we're talking about the uvula here 427 00:21:30,320 --> 00:21:32,280 Speaker 2: at the back of your throat, because I've actually heard 428 00:21:32,320 --> 00:21:35,159 Speaker 2: they can go in and sort of like shave it 429 00:21:35,240 --> 00:21:37,000 Speaker 2: down if it's bothering you. Did you know this? 430 00:21:37,560 --> 00:21:39,720 Speaker 1: I didn't realize that, but I guess it's good to know. 431 00:21:40,600 --> 00:21:43,320 Speaker 1: But you know, the surgery I'm talking about is actually 432 00:21:43,359 --> 00:21:46,800 Speaker 1: for the filterum, which is that little indented space between 433 00:21:46,800 --> 00:21:49,680 Speaker 1: your nose and your lip, and it's sometimes also called 434 00:21:49,960 --> 00:21:50,960 Speaker 1: Cupid's bow too. 435 00:21:51,960 --> 00:21:54,760 Speaker 2: All right, So what exactly are people doing to their filterums? 436 00:21:56,119 --> 00:22:00,400 Speaker 1: Apparently the filterum elongates over time, so a lot one 437 00:22:00,560 --> 00:22:02,719 Speaker 1: is a pretty clear sign of age for some people. 438 00:22:02,800 --> 00:22:05,239 Speaker 1: But now there's this quick little surgery where you make 439 00:22:05,280 --> 00:22:07,520 Speaker 1: a tiny incision it goes right under the nose, and 440 00:22:07,560 --> 00:22:09,600 Speaker 1: then lift up the lip a little so the filter 441 00:22:09,800 --> 00:22:12,440 Speaker 1: looks smaller. And while that might still sound like a 442 00:22:12,480 --> 00:22:15,520 Speaker 1: lot of trouble over something so small and so unnoticeable, 443 00:22:15,760 --> 00:22:18,600 Speaker 1: the procedure tends to be easier and safer than getting 444 00:22:18,640 --> 00:22:21,080 Speaker 1: lip injections or I guess using a bunch of weird 445 00:22:21,080 --> 00:22:22,439 Speaker 1: fillers to plump up your lips. 446 00:22:23,080 --> 00:22:25,160 Speaker 2: Yeah, I mean, I can imagine how this new method 447 00:22:25,280 --> 00:22:28,840 Speaker 2: might provide a more natural looking result. And from everything 448 00:22:28,880 --> 00:22:31,240 Speaker 2: I've been reading this week, it does seem like the 449 00:22:31,280 --> 00:22:35,719 Speaker 2: average cosmetic surgery patient is more interested in this direction nowadays, 450 00:22:35,720 --> 00:22:38,680 Speaker 2: Like not this complete overhaul, but kind of a subtle 451 00:22:38,920 --> 00:22:41,399 Speaker 2: I kept seeing the word plussing of what's already there. 452 00:22:42,240 --> 00:22:45,520 Speaker 1: Yeah, it's an interesting shift from the way we used 453 00:22:45,520 --> 00:22:47,520 Speaker 1: to be with these like over the top changes that 454 00:22:47,560 --> 00:22:49,840 Speaker 1: gave cosmetic surgery such a bad rap in the first place. 455 00:22:49,880 --> 00:22:52,879 Speaker 1: But you know, there's still a lot of potential pitfalls 456 00:22:52,880 --> 00:22:55,359 Speaker 1: with these procedures, not to mention the lingering question of 457 00:22:55,400 --> 00:22:57,959 Speaker 1: whether all this focus on physical appearance and beauty is 458 00:22:58,000 --> 00:22:58,879 Speaker 1: actually good for us. 459 00:23:00,080 --> 00:23:01,800 Speaker 2: We can spend a little bit of time mulling that 460 00:23:01,880 --> 00:23:03,760 Speaker 2: one over. But before we get to that, let's take 461 00:23:03,760 --> 00:23:21,800 Speaker 2: one more quick break, all right, Mago. So before the break, 462 00:23:21,840 --> 00:23:25,080 Speaker 2: you were saying there are still some drawbacks to cosmetic surgery, 463 00:23:25,080 --> 00:23:27,800 Speaker 2: even with all the advancements and the greater focus on 464 00:23:27,840 --> 00:23:30,600 Speaker 2: a more natural look that we see these days. So 465 00:23:30,840 --> 00:23:32,400 Speaker 2: do you have an example of what kind of stuff 466 00:23:32,440 --> 00:23:33,680 Speaker 2: you're actually referring to? 467 00:23:34,640 --> 00:23:36,600 Speaker 1: Yeah, So, why don't we go back to nose jobs 468 00:23:36,640 --> 00:23:38,600 Speaker 1: for a second. We live in such an age of 469 00:23:38,600 --> 00:23:41,600 Speaker 1: wonder is that it's now possible to actually reshape your 470 00:23:41,600 --> 00:23:45,760 Speaker 1: nose without the need for any surgery at all. Instead, 471 00:23:45,800 --> 00:23:49,919 Speaker 1: there are these non surgical nose jobs that I guess 472 00:23:50,000 --> 00:23:53,560 Speaker 1: you inject this acid based filler into your nose, and 473 00:23:53,640 --> 00:23:56,640 Speaker 1: the filler then lodges into the imperfections in a person's nose, 474 00:23:56,880 --> 00:23:59,359 Speaker 1: kind of filling in the gaps and smoothing everything into 475 00:23:59,400 --> 00:24:01,720 Speaker 1: this more dreamline shape. 476 00:24:02,040 --> 00:24:04,280 Speaker 2: I mean, it's interesting because it kind of goes back 477 00:24:04,320 --> 00:24:07,000 Speaker 2: to some of the reconstructive nose jobs we talked about 478 00:24:07,160 --> 00:24:09,879 Speaker 2: earlier in the episode, you know, where you're actually trying 479 00:24:09,920 --> 00:24:12,520 Speaker 2: to build up the nose rather than shave it down 480 00:24:12,680 --> 00:24:15,080 Speaker 2: like we're used to seeing. But in this case, like, 481 00:24:15,080 --> 00:24:19,240 Speaker 2: what's the concern? Is the filler unsafe? No, it's not that. 482 00:24:19,320 --> 00:24:20,920 Speaker 1: And if I were going to sum up the worry, 483 00:24:20,960 --> 00:24:23,720 Speaker 1: I think I'd say that the procedure makes it too 484 00:24:23,760 --> 00:24:25,720 Speaker 1: easy to change the shape of your nose, and the 485 00:24:25,760 --> 00:24:29,200 Speaker 1: whole thing takes something like fifteen minutes of results are 486 00:24:29,320 --> 00:24:32,480 Speaker 1: visible right away. But you know what, while that sounds 487 00:24:32,480 --> 00:24:34,359 Speaker 1: like it might be a win across the board, there's 488 00:24:34,440 --> 00:24:37,280 Speaker 1: evidence that the ease of access is actually resulting in 489 00:24:37,320 --> 00:24:39,840 Speaker 1: way more people getting nose jobs than they would otherwise. 490 00:24:40,359 --> 00:24:42,720 Speaker 1: But what's concerning is that people are changing the shape 491 00:24:42,720 --> 00:24:45,440 Speaker 1: of their nose or other parts of their bodies based 492 00:24:45,520 --> 00:24:47,320 Speaker 1: on false evidence. And I'm actually going to tell you 493 00:24:47,400 --> 00:24:51,040 Speaker 1: what this is. According to a recent report from the 494 00:24:51,080 --> 00:24:55,320 Speaker 1: American Academy of Facial Plastic and Reconstructive Surgery, about fifty 495 00:24:55,359 --> 00:24:57,640 Speaker 1: five percent of the people who visit a plastic surgeon 496 00:24:57,960 --> 00:25:01,080 Speaker 1: do so because they want to improve the their selfies. 497 00:25:02,119 --> 00:25:05,600 Speaker 2: Yeah, that's a little disconcerting. But I mean, on the 498 00:25:05,600 --> 00:25:08,159 Speaker 2: other hand, is wanting to look better in selfies that 499 00:25:08,280 --> 00:25:10,240 Speaker 2: much different than wanting to look good in a bathing 500 00:25:10,320 --> 00:25:12,520 Speaker 2: suit or in a wedding photo, or you know, like 501 00:25:12,560 --> 00:25:14,520 Speaker 2: whatever other goal people might have. 502 00:25:15,400 --> 00:25:17,639 Speaker 1: No, I mean, it isn't. But the red flag in 503 00:25:17,640 --> 00:25:20,800 Speaker 1: this case is that selfies aren't actually an accurate representation 504 00:25:20,880 --> 00:25:23,240 Speaker 1: of the person who took them. In fact, there was 505 00:25:23,280 --> 00:25:25,680 Speaker 1: this study just last year that found that selfies taken 506 00:25:25,720 --> 00:25:29,280 Speaker 1: too close can make your nose appear about thirty percent 507 00:25:29,400 --> 00:25:32,560 Speaker 1: larger than it really is. And that makes sense, right, Like, 508 00:25:32,800 --> 00:25:34,640 Speaker 1: if your nose sticks out of your face, it means 509 00:25:34,680 --> 00:25:36,960 Speaker 1: it's close to the camera and as a result, it's 510 00:25:37,040 --> 00:25:38,600 Speaker 1: much bigger compared to everything else. 511 00:25:39,760 --> 00:25:42,200 Speaker 2: I mean, that makes sense. But what about the plastic 512 00:25:42,240 --> 00:25:45,520 Speaker 2: surgeons themselves, Like, wouldn't they know that selfies aren't a 513 00:25:45,560 --> 00:25:48,359 Speaker 2: fair representation of their clients? That did they just go 514 00:25:48,400 --> 00:25:49,920 Speaker 2: ahead with the procedures anyway. 515 00:25:50,960 --> 00:25:52,359 Speaker 1: I mean, at the end of the day, it's not 516 00:25:52,400 --> 00:25:54,920 Speaker 1: really their call to make right. But some plastic surgeons 517 00:25:55,000 --> 00:25:57,720 Speaker 1: do try to talk their patients out of it whenever possible. 518 00:25:57,800 --> 00:26:00,159 Speaker 1: So you know, the study I mentioned was champion by 519 00:26:00,160 --> 00:26:05,160 Speaker 1: this facial plastic surgeon named Boris Pashkov. And you notice 520 00:26:05,160 --> 00:26:07,879 Speaker 1: how frequently his patients were showing him selfies to explain 521 00:26:07,920 --> 00:26:10,840 Speaker 1: why they wanted the surgery. So he started taking photos 522 00:26:10,880 --> 00:26:13,639 Speaker 1: of them from the proper portrait distance, which is actually 523 00:26:13,680 --> 00:26:15,920 Speaker 1: five feet away, just to give him a better sense 524 00:26:15,920 --> 00:26:19,280 Speaker 1: of what their face actually looks like. And as Bors 525 00:26:19,320 --> 00:26:22,040 Speaker 1: put it, quote, I want them to realize that when 526 00:26:22,080 --> 00:26:24,520 Speaker 1: they take a selfie, they're in essence looking into a 527 00:26:24,560 --> 00:26:26,080 Speaker 1: portable funhouse mirror. 528 00:26:27,680 --> 00:26:29,720 Speaker 2: You know, I do think the elephant in the room 529 00:26:29,800 --> 00:26:32,120 Speaker 2: that we really haven't touched on is that with any 530 00:26:32,160 --> 00:26:34,920 Speaker 2: of the drawbacks we've been talking about, it's women who 531 00:26:34,960 --> 00:26:38,040 Speaker 2: are disproportionately affected by them, because when you look at 532 00:26:38,040 --> 00:26:41,280 Speaker 2: the stats for plastic surgery, eighty five to ninety percent 533 00:26:41,359 --> 00:26:44,040 Speaker 2: of the patients are women, depending on you know, the 534 00:26:44,119 --> 00:26:46,000 Speaker 2: specific procedure, right. 535 00:26:45,880 --> 00:26:47,960 Speaker 1: And the thing is people probably aren't too surprised to 536 00:26:48,000 --> 00:26:50,199 Speaker 1: hear that, Like you always hear about how there's you know, 537 00:26:50,320 --> 00:26:53,320 Speaker 1: an enormous pressure on women to look like other women 538 00:26:53,359 --> 00:26:57,080 Speaker 1: do in movies or magazines or Instagram. And since those 539 00:26:57,080 --> 00:27:01,119 Speaker 1: images are all overproduced and filtered and deaf they photoshopped, 540 00:27:01,359 --> 00:27:02,919 Speaker 1: a lot of us end up devoting a lot of 541 00:27:02,960 --> 00:27:05,040 Speaker 1: time and energy chasing something unattainable. 542 00:27:05,720 --> 00:27:08,359 Speaker 2: Yeah, you're right, it's a legitimate source of pain. And 543 00:27:08,480 --> 00:27:10,480 Speaker 2: in fact, I was reading about this study in Scientific 544 00:27:10,520 --> 00:27:14,000 Speaker 2: American where the researchers found that women who believe they 545 00:27:14,040 --> 00:27:17,280 Speaker 2: can become more beautiful with effort have a higher risk 546 00:27:17,320 --> 00:27:21,240 Speaker 2: of developing appearance based anxiety, and so they're more likely 547 00:27:21,280 --> 00:27:24,040 Speaker 2: to show an interest in cosmetic surgery as a result 548 00:27:24,040 --> 00:27:24,280 Speaker 2: of this. 549 00:27:25,760 --> 00:27:27,639 Speaker 1: And so that wasn't the case for women who have 550 00:27:27,680 --> 00:27:29,320 Speaker 1: more fixed views on their beauty. 551 00:27:29,760 --> 00:27:31,960 Speaker 2: Yeah, no, that's right, and you know, as you might expect, 552 00:27:32,000 --> 00:27:34,439 Speaker 2: it wasn't the case for men either. But what I 553 00:27:34,480 --> 00:27:37,280 Speaker 2: did find interesting about this is is that believing we 554 00:27:37,359 --> 00:27:41,320 Speaker 2: can improve a trait really can help us achieve that goal. So, 555 00:27:41,440 --> 00:27:44,479 Speaker 2: just to take an example here, people who think that 556 00:27:44,600 --> 00:27:48,760 Speaker 2: intelligence or creativity are malleable, they tend to improve in 557 00:27:48,800 --> 00:27:52,000 Speaker 2: those areas. Over time compared to people who don't believe 558 00:27:52,040 --> 00:27:53,600 Speaker 2: those traits can be changed. 559 00:27:54,320 --> 00:27:56,879 Speaker 1: That's weird. So having an eye towards improvement is actually 560 00:27:56,880 --> 00:27:58,000 Speaker 1: a good thing for the most part. 561 00:27:58,520 --> 00:28:00,520 Speaker 2: I mean, that seems to be the case, But it 562 00:28:00,560 --> 00:28:03,760 Speaker 2: mostly comes down to how realistic your goal is. So 563 00:28:03,800 --> 00:28:05,960 Speaker 2: according to the co author of the study, your name 564 00:28:06,040 --> 00:28:09,680 Speaker 2: is Professor Melissa Berkeley, here's what she says. She says, 565 00:28:09,680 --> 00:28:14,240 Speaker 2: prior research has shown that malleable beliefs increase motivation, which 566 00:28:14,280 --> 00:28:16,480 Speaker 2: is good if we're talking about being motivated to stay 567 00:28:16,520 --> 00:28:19,600 Speaker 2: in school or improve somebody's math skills. But when the 568 00:28:19,600 --> 00:28:22,679 Speaker 2: domain is as unrealistic as the beauty standards we have 569 00:28:22,800 --> 00:28:27,199 Speaker 2: for women today, increasing motivation may lead to harmful behaviors. 570 00:28:28,200 --> 00:28:31,439 Speaker 1: So basically, if someone's going to alter their appearance, you know, 571 00:28:31,520 --> 00:28:34,320 Speaker 1: through a procedure or surgery, they should make sure they're 572 00:28:34,320 --> 00:28:35,919 Speaker 1: doing it for the right reasons, not not because of 573 00:28:35,920 --> 00:28:38,160 Speaker 1: how a selfie turned out or because of the way 574 00:28:38,200 --> 00:28:40,680 Speaker 1: a celebrity looks on screen, but because they want the 575 00:28:40,720 --> 00:28:43,280 Speaker 1: outside to better reflect how they feel inside. 576 00:28:43,760 --> 00:28:46,360 Speaker 2: Yeah, and you know, cosmetic surgery can be empowering in 577 00:28:46,400 --> 00:28:49,000 Speaker 2: the same way as reconstructive surgery. I mean, you know, 578 00:28:49,080 --> 00:28:52,440 Speaker 2: namely as a way to reclaim or reassert your own identity. 579 00:28:52,920 --> 00:28:54,920 Speaker 2: And that doesn't mean that who you are should be 580 00:28:55,000 --> 00:28:58,480 Speaker 2: completely wrapped up and how you look, but being comfortable 581 00:28:58,480 --> 00:29:00,920 Speaker 2: in your own skin. It's you know, it's important, and 582 00:29:00,960 --> 00:29:03,840 Speaker 2: it's crucial for mental health too. And if you'd rather 583 00:29:03,920 --> 00:29:06,480 Speaker 2: just dabble in a lower key approach, you can always 584 00:29:06,560 --> 00:29:09,800 Speaker 2: try facer size. I mean, if it works for Tristan, 585 00:29:09,920 --> 00:29:11,120 Speaker 2: it can work for anybody. 586 00:29:11,520 --> 00:29:14,640 Speaker 1: I mean, he looks younger every single minute, like he's 587 00:29:14,920 --> 00:29:17,000 Speaker 1: Benjamin Buttoning right in front of our eyes. 588 00:29:18,520 --> 00:29:21,480 Speaker 2: All right, well, that's probably enough unsolicited beauty talk for 589 00:29:21,600 --> 00:29:24,080 Speaker 2: one day, but we still have plenty left to chat 590 00:29:24,080 --> 00:29:26,080 Speaker 2: about in today's fact off, so let's get to it. 591 00:29:34,200 --> 00:29:37,880 Speaker 1: According to Colors magazine, Iran is the nose job capital 592 00:29:37,920 --> 00:29:40,760 Speaker 1: of the world, and apparently the procedure is expensive enough 593 00:29:40,960 --> 00:29:43,400 Speaker 1: that it carries a bit of a status cloud with it, 594 00:29:43,480 --> 00:29:46,760 Speaker 1: So Colors puts it this way. People will wear their 595 00:29:46,800 --> 00:29:49,520 Speaker 1: post surgery bandages for months like a badge of honor. 596 00:29:49,920 --> 00:29:53,000 Speaker 1: Some even wear the bandages without undergoing the surgery. 597 00:29:53,400 --> 00:29:55,280 Speaker 2: All right, well, they are all sorts of people who 598 00:29:55,320 --> 00:29:58,760 Speaker 2: are obsessed with celebrities and get plastic surgery to look 599 00:29:58,840 --> 00:30:01,760 Speaker 2: like them. You see stories of them all over the Internet, 600 00:30:01,800 --> 00:30:03,880 Speaker 2: of course, and you know people paying to look more 601 00:30:03,960 --> 00:30:07,320 Speaker 2: like Justin Bieber or Kylie Jenner or Lindsay Lohan. But 602 00:30:07,440 --> 00:30:10,040 Speaker 2: you know, one of the most surprising cases is this 603 00:30:10,160 --> 00:30:14,360 Speaker 2: Chinese writer and superfan who has spent almost a quarter 604 00:30:14,480 --> 00:30:18,040 Speaker 2: of a million dollars to get ten surgeries to look 605 00:30:18,120 --> 00:30:23,560 Speaker 2: like guess who William Shakespeare. And apparently the only place 606 00:30:23,600 --> 00:30:27,160 Speaker 2: he refuses to spend is the haircut. For some reason, 607 00:30:27,200 --> 00:30:30,560 Speaker 2: he doesn't want the Bard's receding hairline, but he's been 608 00:30:30,600 --> 00:30:32,320 Speaker 2: willing to grow his hair out just to kind of 609 00:30:32,360 --> 00:30:33,440 Speaker 2: amplify the look. 610 00:30:34,880 --> 00:30:37,960 Speaker 1: That's great, you know. Weirdly enough, there's a surgery to 611 00:30:38,000 --> 00:30:41,400 Speaker 1: switch your left and right fingerprints by slicing them off 612 00:30:41,440 --> 00:30:44,560 Speaker 1: and grafting them on the other And I guess authorities 613 00:30:44,560 --> 00:30:46,400 Speaker 1: only found out about this in two thousand and nine 614 00:30:46,480 --> 00:30:48,600 Speaker 1: when this woman who'd been kicked out of Japan for 615 00:30:48,720 --> 00:30:51,760 Speaker 1: overstaying her visa re entered the country and then was 616 00:30:51,800 --> 00:30:54,480 Speaker 1: caught for a different crime. Her name was Lynn Wrong. 617 00:30:54,640 --> 00:30:57,560 Speaker 1: She paid fifteen thousand dollars for the surgery to mask 618 00:30:57,560 --> 00:31:02,080 Speaker 1: her fingerprints, and it's been dubbed Japan's first biometric fraud crime. 619 00:31:03,560 --> 00:31:05,880 Speaker 2: All right, well, did you know the inventor of botox, 620 00:31:05,920 --> 00:31:09,479 Speaker 2: who was this ophthalmologist named Alan Scott, never really cared 621 00:31:09,560 --> 00:31:12,720 Speaker 2: about wrinkles. So he had this patient who'd undergone three 622 00:31:12,760 --> 00:31:16,560 Speaker 2: surgeries for double vision, and this was his way of 623 00:31:16,800 --> 00:31:20,120 Speaker 2: using almost like this natural duct tape to patch up 624 00:31:20,160 --> 00:31:22,960 Speaker 2: the eye. So Scott says he isn't sure who was 625 00:31:23,000 --> 00:31:26,280 Speaker 2: more nervous about the experimental treatment, him giving it or 626 00:31:26,320 --> 00:31:29,920 Speaker 2: the patient receiving it. But once it was successful, Scott 627 00:31:30,040 --> 00:31:33,440 Speaker 2: sold the concept to allergant, who immediately realized the skin's 628 00:31:33,440 --> 00:31:34,600 Speaker 2: smoothing benefits. 629 00:31:36,480 --> 00:31:39,400 Speaker 1: So here's something I hadn't realized. Animal plastic surgeries are 630 00:31:39,440 --> 00:31:42,560 Speaker 1: actually a thing, and people have been getting Tommy tucks, 631 00:31:42,680 --> 00:31:46,160 Speaker 1: eyelid lifts, and laser nostril procedures for their dogs for 632 00:31:46,200 --> 00:31:49,040 Speaker 1: a while now. And the treatments aren't purely cosmetic. The 633 00:31:49,040 --> 00:31:52,680 Speaker 1: treatments actually prevent bacterial infections and help the dogs with 634 00:31:52,720 --> 00:31:57,200 Speaker 1: wrinkled noses breathe better. It tends to be a booming industry. Apparently, 635 00:31:57,240 --> 00:32:00,800 Speaker 1: in twenty eleven, people spent sixty two million dollars on 636 00:32:00,840 --> 00:32:03,800 Speaker 1: plastic surgery for their pets. But I'm actually gonna tell 637 00:32:03,840 --> 00:32:05,920 Speaker 1: you about one story where it made a huge difference, 638 00:32:05,960 --> 00:32:08,480 Speaker 1: and this was at the Vancouver Aquarium. There was this 639 00:32:08,560 --> 00:32:12,480 Speaker 1: one eyed yellow tail rockfish and the vets there noticed 640 00:32:12,600 --> 00:32:15,280 Speaker 1: it was getting bullied by the other fish in the tank, 641 00:32:15,360 --> 00:32:18,160 Speaker 1: like they'd steal its food, they'd attack it from that side. 642 00:32:18,480 --> 00:32:21,440 Speaker 1: And it was just low confidence, I guess. But the 643 00:32:21,520 --> 00:32:24,960 Speaker 1: doctor sewed this big, bright yellow prosthetic eye into the 644 00:32:25,000 --> 00:32:28,280 Speaker 1: socket and now the fish is fatter, he's doing well, 645 00:32:28,440 --> 00:32:30,240 Speaker 1: and he isn't getting bullied anymore. 646 00:32:30,600 --> 00:32:33,320 Speaker 2: Oh, that's a great story. Actually, I think that's good enough. 647 00:32:33,480 --> 00:32:35,640 Speaker 2: I think I'm gonna let you take the fact off today. Mango. 648 00:32:37,000 --> 00:32:38,960 Speaker 1: Well, I'm happy about it. Thank you. 649 00:32:39,480 --> 00:32:41,560 Speaker 2: Well, that is it for today's show. If you've got 650 00:32:41,600 --> 00:32:43,480 Speaker 2: facts for topics you want to share, you know, we 651 00:32:43,560 --> 00:32:45,680 Speaker 2: always love hearing from you at Part Time Genius and 652 00:32:45,720 --> 00:32:48,760 Speaker 2: HowStuffWorks dot com or find us on Facebook or Twitter 653 00:32:48,920 --> 00:32:51,120 Speaker 2: for from Gabe, Tristan, Mango and me. Thanks so much 654 00:32:51,120 --> 00:32:51,640 Speaker 2: for listening. 655 00:33:01,120 --> 00:33:04,360 Speaker 1: The struct to the bottle, but the sacri