INDEPTH
Rethinking
Vanity
Vanity may not be such
a bad thing after all
By Michael Ehrlich, MD
D
r Ehrlich, I’m not afraid of the laser
blepharoplasty. I know I’ll look better afterward. I’m afraid by having
the procedure I am being vain. Isn’t
vanity wrong?”
Patients who undergo cosmetic surgery
are commonly portrayed as vain, wealthy,
sun-worshiping females who care more
about their appearance than any other
aspect of their lives. Despite data showing
otherwise, these ideas are perpetuated by
society on television, the Internet, and at
the office water cooler.
It’s common for my cosmetic surgery
patients to express concern that they will
look “overdone.” Daily. I have patients
bring in photos and state emphatically, “I
don’t want to look like THIS!” There has
been extensive discussion in the cosmetic
literature about how to prevent an overaggressive brow lift or excessive lower lid fat
removal. There are articles about dealing
with unhappy patients, case studies of
complications, and textbooks of various
approaches to cosmetic problems. There
are screening tools to rule out body dysmorphic disorder. There is, however, little
discussion about vanity and its possible
role in preventing patients from having
cosmetic procedures. This is a topic I discuss commonly with my patients.
VANITY VERSUS NARCISSISM
Vanity is commonly defined as the
excessive belief in one’s abilities or attractiveness. Unfortunately, vanity is often
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used interchangeably with narcissism,
which psychiatrists define as an unhealthy
self-absorption due to an abnormal sense
of self. We all have the facility to be vain,
but this does not make us narcissistic. The
social and evolutionary psychology literature are riddled with examples showing
we are hardwired from birth to respond
to beauty. Research shows us that babies
Rather than be afraid
of vanity, we can help
educate our patients
to embrace this natural,
long-standing, and
powerful feeling.
stare longer at beautiful faces, and isolated tribes rate faces as beautiful in the
same way as college co-eds. Throughout
human history, excluding perhaps the
last 75 years, human males have been
ingrained to respond to the looks of
18-year-old nubile females as they had the
greatest chance of being fertile partners.
We also find evidence throughout
ancient history of acts of human adornment beyond what is hardwired in order
to attract others. Whether through the
medium of fashion, makeup, or tattoos,
the historical purpose has been to find a
fertile mate. We observe the same efforts
of adornment in the animal kingdom. The
peacock devotes precious resources to create a beautiful tail. Why? To show that it
is a healthy potential mate to those around
it. In fact, in Western art, vanity was often
symbolized in the form of a peacock.
While cultural and technological
advances have changed some of our desires
for looking attractive, our instincts date
back to ancient times. Some patients are
afraid that their cosmetic treatments, from
filler to facelift, will make them feel vain.
It is therefore important to provide them
with the knowledge that feelings of vanity
are built-in, pervasive, and distinct from
personality disorders like narcissism. As a
physician, I consider it my duty to explain
and thereby diminish barriers which may
incorrectly prevent a patient from having
a procedure that they desire, for which
they are a good candidate, and which will
improve their quality of life. Rather than
be afraid of vanity, we can help educate
our patients to embrace this natural, longstanding, and powerful feeling. n
Michael Ehrlich, MD, is an oculofacial
surgeon in Danbury, Conn. He can be reached
at [email protected].
February 2013