Facial Rejuvenation to Facial Transplant: The Spectrum

November 27, 2011

I often speak about why I like to help people with their appearance. Most of what I discuss is related to understanding the impact our appearances have on how the world views and relates to us. When I cover these topics, I explain we are biologically driven to evaluate each other based on the 3 Ds of Aging:

    1. Deterioration of the Facial Skin
    2. Deflation of the Face
    3. Decent of the Face

It’s true that typically when we first meet one another we evaluate each other’s skin tone and tend to appreciate clear, beautiful, and even skin. We then evaluate each other’s eyes and mouth regions. This happens quickly and on a subconscious basis. We aren’t being shallow; it’s just how our brains work.

Our subconscious then tells our conscious mind how we feel about that person based on what we see in those areas. If the skin is irregular, we may see the person as older or sick. If the eyelids are heavy or baggy, we may form the opinion that the individual is old, tired, sick, sleepy or even hung-over from too much alcohol the night before.

What does your mind see in the photo on the left of my patient when he first came to see me? Does your opinion change when you view the picture on the right which shows him after I performed lower eyelid rejuvenation surgery?

This patient was a teacher and his students often thought he was sick, fatigued or drinking too much based on the non-verbal cues from his lower eyelid fullness. These comments ceased after this area was improved with surgery. Now his students can relate to him without the eyelid fullness shaping their opinions.

Before and After Treatment

Before and After Treatment

Let’s look at another example in the picture of the woman below. What opinion does your mind form of this woman when viewing the photo on the left? Does she appear happy or stern, approachable or not?

What does your mind see in the photo on the right? You can clearly see she now appears more open and approachable as well as more pleasant. The only thing that changed for this patient was the heaviness around her eyes. These two photos are before (left) and after (right) my Botox Browlift procedure, which made a big impact on the way other people related to her.

When we look at the mouth area and see loss of volume in the lines around the nose to the corners of the mouth, and also from the corners of the mouth to the jawline and jowling in the jawline, we often assess that the person is older, sick and less vibrant in appearance.

Check out the additional before and after photo below. Stop and consider how your mind interprets my patient’s photo on the right and then on the left. By restoring the volume of youth to her lower face, she found that others viewed her as years younger and more vibrant.



Examining the Impact of the Central Face

I enjoy the fact that I can help my patients with all three of the D’s of aging with outpatient procedures that have quick recoveries. When I assist patients in these ways, the reward is twofold: the world relates to them better, and I experience great professional satisfaction and joy from helping my patients.

With this as a background, I’d like to share a story about a recent medical meeting I attended. At this meeting, a doctor who helped perform the first facial transplant in the United States, Dr. Daniel Alam, spoke about his experiences in this surgery.

He began by reinforcing what I have been saying for years about how we relate to each other as people. We evaluate each other’s key areas for nonverbal communication: the eyes and mouth region.

When either of these areas is made more attractive, the entire face appears more attractive. In this way, these areas hold special power in how our subconscious brains communicate with each other.

Dr. Alam continued to say that our personal identities revolve around these central parts of the face. He referred to research, which showed we look at each other’s eyes and mouths as we communicate with one another.

This research paper by Caroline Blais et al, entitled “Culture Shapes How We Look at Faces,” discussed cultural differences in how we evaluate each other, and showed that the central areas of the face absolutely dominate non-verbal communication.


To illustrate this research, the doctor showed in his presentation how we can take a photo of our current President,

cut out this central portion of the face,

and place it on another person.

After doing this, our brain will still tell us that this is President Barak Obama.

In actuality, this photo is of actor Brad Pitt with President Obama’s central face superimposed.




The doctor then discussed that in certain medical cases, the central face can become distorted. He showed photos of one of the first facial transplant patients in the United States. This patient, Connie Culp, suffered a gunshot wound to the face in a devastating case of domestic violence. Ms. Culp’s husband shot her in the face and then tried to shoot himself. Both survived but Ms. Culp was left with a massive injury to her central face. Her subsequent surgeries left her with a distorted face.

Dr. Alam then discussed how our identity is defined by these central facial areas, and how, in cases like Ms. Culp’s, her injury made it difficult for her to be accepted by others. In our society, people may have trouble being friends with Ms. Culp based on her appearance.

Although we would like to believe we relate to others based on what they say and do, the nonverbal language that influences our subconscious mind, does indeed influence the way we interpret each other.

We yearn as social human beings to relate and interact with one another, and Ms. Culp’s injury made it difficult for her to build new relationships and friendships. In fact, Ms. Culp shared that in the deformed state, children would often run away from her and call her a monster.

Children don’t have the mental sophistication to allow them to overpower their initial subconscious impressions. But what they see, we subconsciously see in the same way.

Fortunately, Ms. Culp lives in this age of incredible medical advances. She underwent one of the first facial transplants in the world. Now, she has a much easier time living life day-to-day, interacting with others, and she is experiencing more acceptance from people around her. These days, children don’t run away or call her names. The people she encounters relate to her in a more positive way.

The sophistication of these procedures will continue to advance and give hope to others with serious facial injuries like Ms. Culp.

What I found so intriguing about this procedure is why it was performed in the first place. The surgeon performed the procedure in order to help this person relate better to others in the world. This is the same reason I love doing what I do. Helping my patients restore, reveal and reclaim their natural beauty, helps them relate better to others in the world as well. It’s powerful for our patients, professionally fulfilling for us as doctors, and it’s all along the same spectrum.

When I meet new patients for the first time, I assess their situations through this lens. I consider what I can do to help them recapture their natural beauty and improve the way others relate to them. My ultimate goal is to achieve enhanced appearances for patients and, in turn, facilitate enhanced relationships to create better lives.

For more information on eyelid surgery Florida, facial rejuvenation, or services available for cosmetic surgery Tampa, including blepharoplasty and Botox, Contact Our Office.