Picture ©Lightworks-Gallery, V. Schrader
A small series of articles by Dr. med. Margrit Lettko (Medical Director of the Network Aesthetics) and Dirk Brandl (Speaker Network Aesthetics)
Have you already read the first three parts of this series of articles? If not, then follow this link to get to the very beginning, or the following links to get to part 2 or part 3.
What must a doctor who offers aesthetic medicine know about attractiveness?
In our practice of applying or accompanying aesthetic therapies, we cannot do anything with the three hypotheses described in the last article. They are in no way suitable for supporting the doctor in his work. We would therefore like to present our practical experience here.
In our experience, attractiveness is clearly associated with youthfulness. Youthfulness does not mean youth or even youth mania. Youthfulness means that all the processes that take place in the face during aging can be alleviated by therapeutic interventions: The skin loses hyaluronic acid and collagen, the fat compartments of the face sag downwards, which is called “sagging” or medically called ptosis. Finally, the volume also changes, we either lose fat or gain weight with age.
Topic youthfulness: This statement is trivial on the one hand, but on the other hand it is precisely what must interest us as doctors and you as a patient. It is not the wrinkle so emphatically emphasised by the patients that is so “disturbing”, but it is features that arise due to the altered bone structure, fat reduction in certain parts of the face and skin changes. There are the typical age characteristics, for example the loss of volume in the midface or, conversely, the increase in volume of the sagging cheeks.
This is where we begin. We try to give the face back the characteristics of youthfulness. No plastic surgeon approaches the average face during a facelift, but rather the outstanding features of youthfulness and thus vitality. Neither average, symmetry nor sexual dimorphism are attractive, but youthfulness, whereby the term youthfulness should not suggest that we recommend transforming older people into young people. What we want to do is to soften the signs of old age through aesthetic interventions, and therefore we try to reduce all age-related changes. Beauty and youth are closely correlated. A smooth face, which is very tightened by a facelift, does not necessarily become more attractive by the intervention, if other age characteristics are not compensated at the same time.
The main characteristics of the youthful face
If we want to use aesthetic therapies correctly, we need to know exactly which signs or attributes give us the impression of youthfulness.
The condition of the skin is important, but smooth skin isn’t the only important factor for being beautiful.
The “super beautiful” ones have big eyes (rather the eye opening degree), higher eyebrows, accentuated cheekbones, small nose, full lips (sign of youth, not childhood), graceful jaw and chin area. Not all signs of the baby schema increase attractiveness, e.g. the child’s chubby cheeks. Attractive faces need the cheek shadow.
There is also another ingredient: the so-called expressive signs. Friendly smile, wide pupils, high eyebrows, through which a message is conveyed: Here comes a friend / a friendly being. We read something into faces, even if this attribute is not actually present. People with a strong frown line, for example, or a deepened Merkel wrinkle, arouse feelings in us from which we cannot protect ourselves. Our assessments based on these feelings happen at lightning speed.
Perception psychologist Todorov assumes, on the basis of his investigations with 3D grid – mathematically coded faces, that these faces with random negative features are automatically compared with faces that carry this emotional expression within them. He speaks of “overgeneralization”. Todorov has also discovered that the perception of trustworthiness is closely linked to the perception of attractiveness. Renz writes: “Those who look happy make the string of trust within us ring, and those who are perceived as trustworthy are also perceived as attractive”.
The mix for attractiveness is therefore child, woman/man and friend, for both sexes. But beauty is more than the sum of its parts. The actual beauty is a product of our brain and therefore of our experiences.
The first 150 milliseconds that let us decide whether we consider a face attractive or unattractive would not be possible without shape perception. Perceptual psychology has already given us important clues in this respect in the 1930s. We are able to perceive something holistically (figure-background relationship), which we need for all coordinative and sensomotor skills. A mental picture emerges which is based on rough generalisations. Everything we perceive plays a role. If someone has a warm, soft voice, a different mental picture emerges than if someone has a squeaky voice. It is our creation, born out of our experiences.
Part V of the series deals with the social benefits enjoyed by the attractive. An overview of all the works discussed or cited can be found at the end of Part 6.