While the feet are ignored, the face and other exposed body parts receive a lot of attention. Makeup, coloring, piercing, branding, tattooing... The most popular decoration method is makeup, at least for women.
The love of skin interpretation, body painting, and body art, our ancient ancestors developed these elements for tribal rituals long before the birth of modernism. While decorating, makeup also has a certain sexual innuendo. Fiery red lips and heavy eyeshadow will make you look younger, closer to the current aesthetic. Build a mirage of youth on the aging skin bag and transform the skin into a sacred stage - as long as the makeup technology is superb, everything will be fulfilled.
However, if it is too thick, the whole person will disappear behind the heavy makeup, so the face looks more like a mask, but it will damage the beauty, and it may also scare people. Is there anything you want to hide by having to paste your face like this? Why do you have to live with yourself so much, build a mask to confuse others?
The Secret of the Skin, by Yael Adler / Katja Spitzer, translated by Liu Li, Oriental Publishing House, February 2019
The ancient Greeks knew that beauty existed in the eyes of others, but this understanding sometimes led to psychological obstacles. Phoracophobia of body deformities
（dysmorphophobie)
It is a kind of fear of the deformity of the patient's own physical appearance, or can't help but make ugly assumptions about the self-appearance, and the patient will always feel that his face, nose, and whole body are very ugly. This is often difficult for those around them to understand, because this psychological disorder is common in those who are very attractive.
When people with deformity phobia look in the mirror, they will always stare at a small flaw or imaginary defect, completely forgetting other well-proportioned and beautiful parts. Patients are extremely concerned about their physical appearance, will not miss any opportunity to check themselves through the window, and urgently need the continuous affirmation of others. Their self-worth is severely disrupted, mostly due to childhood experiences, and symptoms begin to appear in adolescence. For a long time, advertising and the media have always tortured us with so-called aesthetic models, which is a 10,000-point crit for the more sensitive "deformed patients". Plastic surgery and dermatologists are the most sought after refuges for melancholy beauties, and distorted self-perception can even plunge them into endless plastic surgery and never compromise with their own in the mirror. Therefore, only psychotherapy is the only cure for "dysphoria".
Dose determines toxicity
How does Botox go from a deadly toxin to a beauty material?
Cosmetic addiction often comes from the fear of aging, and the consequences are sometimes grotesque and absurd.
A female manager of about 40 years old, slim, well-dressed, and successful in her career. One day, before noon, she came to the plastic surgery clinic. I asked about her medical history, the medications she took, the pre-existing illness, the menstrual cycle... All in all, asked everything you should know as a doctor.
But soon, I realized that there was always something strange, and there seemed to be something wrong with the lady. Why did she look so angry from the beginning to the end? Maybe I was too close to her to offend her? Or did my question hurt her?
I tried to concentrate and keep asking about her medical history. No, no children, no history of allergies. Towards the end of the conversation, I asked, "Have you ever been injected with Botox?" ”
"Yes! Of course! She replied almost furiously.
"What are the specific parts?"
She replied, "All! "The tone is quite reasonable.
Stills from the short film Super Venus.
Botulinum toxin – all over the face! I was relieved. Oh, it turns out that the female manager's hostile, empty-eyed expression has nothing to do with me, and she has no other expression... She just couldn't move her facial muscles, her face couldn't coordinate with her feelings and words, everything was paralyzed. Only the lips are constantly opening and closing, like a stranded fish on the shore, and their eyes are swirling in the eye sockets. Sick mask. Apparently, this lady was a victim of one of my "workaholic" counterparts.
It was interesting to observe such a completely numb face laughing, its mouth wide open, first a giggle in its throat, then a hearty laugh, and the body was still shaking with excitement. At this moment, the only discordant parts are the flattened, stiff and rigid face, no smile lines, no wrinkles in the nose, no happy bulging of the face, and eyebrows that have lost the ability to fly... I still prefer those heartfelt, uninhibited laughs, the patients' real and natural expressions make me feel happy, and sometimes the laughter can bring subtle resonance to the doctor and the patient. Unfortunately, I am now faced with a strange, even creepy sense of distance.
Botox, like "tempo" paper towels ("DEPLO", the first German handkerchief paper brand born in 1929 and entering the Chinese mainland market in 2009), is just a product name, and its full name is B0 ulinumTOXIN. The name of its active ingredient makes people feel that it is harmful and toxic, so some astute colleagues have switched to the abbreviation Ofulinum, making it sound more scientific and cute, and is conducive to sales, so that cautious customers can overcome the psychological barrier to "toxin-injection". But in fact, "dose determines toxicity" is never wrong, including Botox.
Botulinum toxin is known to be a potent poison that is made up of botulinum toxin cells
(Costridium botulinum bacteria)
Produced by neurotoxins, its name is derived from the Latin botulus (meat sausage, German for Wurst). Long ago, spoiled sausages or contaminated canned meat products often led to the death of poisoning eaters, and yes, corrupt meat products contain botulinum toxin, which paralyzes people's respiratory muscles and lung function.
So why is this dangerous deadly toxin used for medical treatment? Just 1 gram is enough to kill millions of people; for one person, 70 micrograms taken orally will kill, and 0.1 micrograms are enough for muscle or intravenous injections. However, the actual dose in each Botulinum toxin ampoule is negligible, and about 50 to 70 vials are injected to be fatal. It may be more intuitive to refer to it: the treatment of wrinkle beauty or hyperhidrosis requires a dose of 1 to 2 vials.
Illustration of The Secret of the Skin, illustrated by Katja Spitzer
Since 1978, botulinum toxin has been used as a therapeutic agent for the treatment of strabismus, eyelid muscle spasms, torticollis, and spasmodic cerebral palsy in children caused by hypoxia at birth, in other words, for the treatment of severe cramps and hardening of muscle tissue. By injecting Botulinum toxin, the muscles can be softened, so that they are no longer tense, and can help the subsequent physiotherapy to be more effective. Botulinum toxin, as a "wrinkle killer", came from an accident. As early as the 1980s, an American doctor injected his patients with Botox to treat muscle spasms in the eyes, and soon after, he was surprised to notice the side effects that followed: not only did the muscle tissue relax, but even the wrinkles around the eyes miraculously disappeared. Why? The reason is that when the muscle tissue is no longer tense, the skin on it is no longer wrinkled. The above is the birth story of "Botox anti-wrinkle". Since 1989, the use of Botox worldwide has increased millions of times.
Botulinum toxin blocks the release of acetylcholine at the neuromuscular junction
(acetylcholine)
After a few days, the injection will take effect, usually for about 5 months, and will return to the "aging" mode after failure. Interestingly, during the treatment of facial muscle numbness, people will "quit" a certain amount of vicious, serious and terrible expressions, just like the power athletes have a type of biceps, if they do not regularly carry out formal training, they will quickly lose their appearance. After botulinum toxin injection, the facial muscles become weak, the skin in the corresponding area is relaxed, and the wrinkles are no longer locked together. However, when Botox fails, the anti-wrinkle effect will also disappear, and muscle tissue will take over the big picture.
The pros and cons of the "wrinkle killer"
"The right amount" is the most important, don't trust skin care products
To remove the vertical inter-brow lines, doctors inject botulinum toxin into five small dots between the patient's eyebrows in a ∨ shape, and over the next few days, the muscles between the eyebrows will gradually relax, spreading to a range of about 1 cm centered on each injection point. Now, it's almost impossible to stare and raise eyebrows. In this regard, Botox benefits husbands who have "tigresses", and even if the wives are furious, their facial expressions will always be friendly and relaxed.
The above phenomenon is based on the "shift" inside the forehead muscles, and the sites that have not been injected with botulinum toxin will be motivated by the sudden vacation of other parts and work harder than before. As a result, the eyebrow skin will be lifted upwards, and it can also play a role in "broadening the horizon" when it is played well, which is also the effect pursued by many women. However, once the force is too strong, it will cause the eyebrows to be raised excessively and become "surprised". The two raised eyebrows belong to the "Spock Logo", named after Captain Spock in Star Trek. Of course, for cosmetic patients, this "Vulcan effect."
( Vulcanization effect)
"It's not a disaster, just two more stitches on the upper brow can quickly return to its original shape."
Captain Spock in Star Trek.
In addition, the "anger effect" of botulinum toxin is also used by psychiatry to treat depression, the principle of which is to cut off the link between the wrinkles between the eyebrows that look breathless and angry. After erasing the ability to get angry from the eyebrows, the brain thinks, "Great, nothing to be angry about, I can continue to be happy!" "Through self-observation, we can also find this effect, such as after laughing, even if it is not related to ourselves, we will be full of vitality." Emotions create expressions, and vice versa.
All muscles that develop spasms or are overactive can be treated by Botox. For example, neurologists use it for headaches and migraines. Excessive muscle tension can compress the nerves, causing headaches, so when the muscles in the corresponding areas relax, the pain will gradually disappear. Dentists use Botox to shrink the oversized jaw masseter muscles to treat bruxism
( zahneknirschen)
and beautify the overly angular, wide jaw.
Urological overactive bladder, orthopedic "tennis elbow" (joint injury caused by elbow overuse), gynecological vaginismus are all treated with Botox. In addition, botulinum toxin is used to treat muscle spasms after stroke, and gastroenterology is used to treat fissures, i.e. painful ruptures of skin in the area.
This small secret weapon can not only be used in muscular areas, but also help those suffering from hyperhidrosis, armpits, palms, feet, a few simple stabs can easily solve the problem. The sweat glands in the dermis are similar to muscles, activated by acetylcholine and blocked by Botox. After two days of injection, the sweat glands stop wicking and can last for months. Botox injection therapy is quick and simple, and the body can generally easily accept it, the only thing that is not easy to accept is its price.
The beauty industry worldwide is far more profitable than billions a year, and they will never tire of developing new selling points. Spending huge sums of money on advertising, exposing those wrinkles that were originally ordinary, so that all kinds of ugly wrinkles always haunt our minds, and we have to have Botox to "cure the disease": the "irritation stripes" between the eyebrows, the "crow's feet" between the eyes, the "nose back stripes" on the nose, the "heads up stripes" on the forehead, the "puppet stripes (lip stripes)" on the mouth, the cobblestone chin (too many shallow sockets on the chin)," the "bare gum smile", the "clothes folds" of the upper lip, and finally a "turkey neck". To eliminate the above "botulinum toxin" needed, most of the products on the market are actually not legal, but people can use the indications outside the use
(off label use)
The excuse to receive injections.
The most troublesome thing is the mouth. In order to plump the shape of the lips and eliminate wrinkles on the upper lip, the edges of the lips that receive Botox sometimes become weak, and there are disturbances in speaking, smiling, kissing, drinking water, and even eating. Of course, as long as you can make the skin smooth and flat, everything is at all costs... This is not the end, the mouth function returned to normal for several months, during which there was no way to go out of the ocean.
A responsible doctor should be cautious when injecting botulinum toxin into the face of a patient, using small doses, and injecting them in a punctate manner; rather than coarse branches and large leaves, which can paralyze people at any time. You know, it's the facial expressions that make us look energetic, young, and vibrant, and most importantly, likable and "readable." When we face others, we usually don't pay attention to our own expressions, so there will be friendly and cordial conversations, but there will be a face full of indifference, even cold.
Poster of the movie "Plastic Surgery Diary" with the theme of "plastic surgery"
Of course, if you can inject Botox with no more and no less, accurately and in place, the effect is often amazing - the patient is happy and the risk is minimal. As doctors, we are happy to help patients solve their problems and let them sleep well at night without worrying about any side effects. However, it is worrying that the micro-adjustment of improving the appearance and pleasing people often points to distorted ideas about youth and beauty. Attend a medical aesthetic conference to find out what the participating doctors have done to their eyes. Some colleagues also inject themselves in front of the bathroom mirror at home, and it is precisely such a group of twisted, sunken, paralyzed faces that get together to discuss "beauty".
In my opinion, the attitude of thinking that wrinkles make people look old or ugly is very problematic, and 60-year-olds certainly can't look the same as 20-year-olds, and there's no need to toss. After flattening your face with Botox, what next is to trim your old neck, chest and shoulders, as well as your sagging, wrinkled arms? Although human beings have managed to achieve flight, in any case, rejuvenation is only a fantasy.
Nevertheless, I am happy to inject botulinum toxin into patients, and as long as it is done properly, the results can be satisfactory. The best effect is that people around you can't see that you have been injected with Botox, but when you are on vacation to recuperate yourself.
If you are planning to receive botulinum toxin treatment, then be careful not to inject too much, the "more the merrier" rule does not apply to botulinum toxin! The volume of the effective molecules of Botox is too large for the skin barrier membrane, so please do not trust the advertisements of various botulinum toxin skin care, bottles and cans containing miracle ointment do not exist, if there is only talk...
A "reservoir" in the cell
Hyaluronic acid, is it really that magical?
The door opened, and it was first a mouth that came in, then its owner, a lady.
I could no longer take my gaze off her, and my red-intestinal mouth was abruptly pestle in her face, as if some discordant foreign object was hanging there.
Yes, the beautiful plump rose red lips are sexy, but the lady in front of me now reminds me of a friend, or more precisely, a cartoon character full of femininity. Okay, but why would she want to turn her mouth into a giant vulva? And her every move is also very strange.
Sometimes I ask myself, why do people get so caught up in this way that they lose their most basic judgments about normality and beauty? Is this really what they want? Or is something wrong?
In addition to botulinum toxin injections, there are other ways to achieve physical beauty, which are more or less painful, but none of these matter, namely: injections under wrinkles and hyaluronic acid gel oligoplasty (
Volume build-up with hyalurosaure gel)
。
A large number of plastic surgery failures in the beauty industry have made hyaluronic acid infamous. Hyaluronic acid, along with Botox, has long been widely used in the medical field. Whether it is joint pain, wounds, gingival nipple atrophy, dry eyes, scars, or deformities or post-accident physical defects, hyaluronic acid is a very reliable and good helper, and usually does not have a rejection reaction with the human body, and problems are easy to correct. For sunken scars, hyaluronic acid can be regarded as a fast-acting, effective filler that will bounce the scar back to the normal skin height.
Hyaluronic acid is a hot darling of medical beauty, which not only fades shadows, plumps the skin, makes the tissues supple and juicy, but also tightens the skin, softens the contours, and makes the lips plump and sexy. Good-looking lip curvature, just the right upper and lower lip ratio, slightly raised corners of the mouth, and then make a beautiful lip bead for the upper lip, as perfect as a work of art, an outstanding sculpture. Despite this, the overall perfect lips will still not be in harmony with the face, at least everyone will be suspicious after seeing it. There are some "artist" doctors who especially like to fill in the patients on their own initiative, and finally build a hovercraft for the faces of the people.
Hyaluronic acid is a substance that is native to the human body and is part of a natural tissue filler. The viscous basic substance of the fibrous in human tissues is called the "extracellular matrix", and if you are interested in touching and feeling it, you may wish to gently press the eyeball: plump and round and full of elasticity. The extracellular matrix is distributed throughout the body and is mainly concentrated in the skin, joint lubricant, eyes, discs and cartilage.
Hyaluronic acid in the extracellular matrix is equivalent to a reservoir, and theoretically, 1 gram of hyaluronic acid can condense 6 liters of water, making our skin look supple and elastic. Unfortunately, over time, the hyaluronic acid water level in the body drops significantly. Although the complete emptying of the reservoir is very slow, when a person is 70 years old, at most 20% of the amount is left, and sometimes there is nothing, and the person becomes dry and crumbling. The molecule of hyaluronic acid is quite large, and when applied to the skin, it can only go deep into the stratum corneum at most, and it is impossible to go deeper. However, after applying, it can at least lock in water to the skin, so that the skin can absorb water and expand, but it can only last for a few hours.
With age, the loss of hyaluronic acid will increase, if you really want to send some back to the dermis layer, then you can only achieve it by needle pricking through the epidermis and basement membrane. As for the expensive hyaluronic acid ampoules that are applied to the skin and claim to be anti-aging, they are all fake big empty. As usual, the daily chemical industry is still profitable, not only will your wallet be injured, but your skin will not become young.
In the past, hyaluronic acid was a polysaccharide extracted from the cockscomb and injected into human tissues as an allogeneic body, often causing severe immune system allergic reactions, resulting in unsightly red and inflamed nodules, papules and hard cocoons. Now, hyaluronic acid is mostly synthesized by artificial biotechnology, produced through culture culture, and removes proteins that may trigger allergies, obtaining a final product that is affinity with the human body. In addition, hyaluronic acid macromolecules are joined together by special techniques to stay in tissues for longer periods of time. When the hyaluronic acid is exhausted, it needs to be "returned" to the needle, and until then it has been ideally used as a reservoir for the skin, adding elasticity and moisture to the skin.
By attracting healing cells and stimulating connective tissue regeneration, hyaluronic acid also promotes wound healing and blood clotting – and it is this ability that gives hyaluronic acid the effect of rejuvenating the skin. Proper injection of hyaluronic acid is at most a micro-plastic surgery, which can avoid bad cosmetic accidents, and if it does not go well, the worst case is only to inject some hyaluronidase at the corresponding site, and the hyaluronic acid gel will be decomposed after a few hours. In contrast, the efficacy and side effects of Botox often have to wait for it to dissipate after weeks or months.
Plastic surgery mania
How to avoid "beauty goes astray"?
An era in which beauty and "small fresh meat" are everything, invisibly spawned huge social pressure, movie stars sang for it, and various gossip magazines spared no effort to render how women over the age of 40 are leftover women. Once the first small lines appear on the faces of the actors, they will be erased as soon as they enter the camera, until the lady has completely become an old lady, and finally can appear in front of the camera with her true face. Now many women and actresses in TV shows can be mothers who can play roles in their own dramas at their own ages.
Nowadays, not only are public figures under pressure, but even the daily life of our ordinary people is gradually moving closer to the so-called "perfect" fashion trend. Misdirected, misguided! Once I saw a famous film actress on stage, and the dazzling spotlight illuminated all the hyaluronic acid stored in her face: the implanted apple muscle, the wrinkles pulling between the nose and lips, and all kinds of artificial protrusions. Another time, in an academic report on wrinkle removal, a well-known overseas dermatologist in front of the podium apparently injected a large amount of botulinum toxin on his forehead, and his forehead almost slid to the eye. To overcome this problem, he raised his eyebrows again and made himself look like a Neanderthal rather than a beauty doctor.
There are countless such examples, and it is difficult to explain. Why do people have to treat themselves this way? Or is there really some special force that drives hordes of people to beauty and plastic surgery hospitals to reinvent themselves?
Obviously, the answer is yes. Recently, a female patient asked me to inject hyaluronic acid into her lips to balance a small uneven area (almost invisible to me), and she was in a hurry to eliminate this "blemish". The lady, who had just moved to Berlin, also described to me in detail how shrewdly her past "divine doctor" had trimmed her lips: "Here, here, after he aimed the needle at this part, hey—" She exclaimed ecstatically: "Shoot the acid into it!" ”
As a doctor who is very interested in psychology, I can't help but think: for this female patient, a simple lip hyaluronic acid injection sounds more like a sex picture. Her "hey" and full commitment must have made me re-examine the doctor-patient relationship from a sexological point of view. In fact, in the field of aesthetic medicine, there are more or less masochistic situations: pain, pleasure, deferential dedication to the master of the hand-held syringe, the shaper, the artist who is about to create a new work, can help you eliminate an annoying flaw without any effort. But as a doctor, once he/she begins to promise perfection, he or she is no longer an angel in white, but plays God himself.
From a psychoanalytic point of view, the botulinum toxin mask and sausage mouth reflect not only the fear of aging, but furthermore, the fear of death.
From the first day we come into this world, after taking our first breath, each day is one step closer to death, as the adage goes: "Life is full of dangers, and life is always fatal." So now, we should learn to get along with ourselves, correctly position ourselves, and enjoy life, and all the stories of life are also written on our faces.
author
: Yar Adler ; Finishing: Walk Around;
edit
: Walk away, Qin Dansi; Proofreader: Zhai Yongjun