Beauty Insights w/ Dr. Steven Dayan

Summer Hardy (00:03):
Welcome to Park Avenue Plastic Surgery Class, the podcast where we explore controversies and breaking issues in plastic surgery. I'm your co-host, Summer Hardy, a clinical assistant at Bass Plastic Surgery in New York City. I'm excited to be here with Dr. Lawrence Bass, Park Avenue plastic surgeon, educator, and technology innovator. The title of today's episode is "Beauty Insights." I get the basic idea, Dr. Bass, but I'm not sure I understand the angle. What are we talking about today?

Dr. Lawrence Bass (00:33):
The topic is beauty. On a basic level, everything we do in aesthetic plastic surgery is about beauty. So we're all starting from the same place, but from there it gets a lot more complex. To discuss this, I brought my colleague Dr. Steven Dayan. Dr. Dayan is a facial plastic surgeon in Chicago who's an exceptionally prolific speaker and writer. He's a New York Times and USA today bestselling author. His book Subliminally Exposed Springs from his popular undergraduate course, the Science of Beauty. He's known for his dynamic keynote speeches and deep understanding of human behavior. In addition, he's an entrepreneur having founded and run a medical research company, a medical marketing company, a skincare training center, and a medical education company practically out of breath listing them all. His ventures have placed him at the forefront of aesthetic innovation and product development. He's the recipient of the AMA Foundation's Leadership Award showing recognition of his tireless work in advancing our understanding of this field of medicine. So he's ideally suited to comment and discuss our topic today. Dr. Dayan, welcome.

Dr. Steven Dayan (01:59):
Thank you so much. It's nice to be with you, Larry, and Summer, it's nice to meet you as well.

Summer Hardy (02:03):
Yeah, nice to meet you. Thank you for joining us. So let me start off by asking you, in this technologically modern world, does our appearance matter that much? And if so, why?

Dr. Steven Dayan (02:14):
Well, appearance always matters to some extent. That's how we consider how we present ourselves to the world and our self-esteem is wrapped up in how we appear. But some, we started out with something interesting. I thought when you opened the program and you asked about beauty, and that's really a nuanced question, what is beauty? And if I ask you or anyone to define what is beauty, it's awfully difficult for us all to agree on what is beauty. And I teach a college undergraduate course. I always start that year with the freshmen and sophomore and I'll say, how do you define beauty? I get such incredible range of answers from all the different students. It's a very difficult question to answer, and it may be different for us as aesthetic physicians and how we view beauty.

Dr. Lawrence Bass (02:56):
And I think it's one of those, just to extend that idea. We all like beauty, but we all have a different idea of what it is. Isn't that right?

Dr. Steven Dayan (03:07):
And Larry, I think that's a really good point because the common euphemism, beauty is in the eye of the beholder. Beauty is beyond skin deep. There's are really simplistic answers, and beauty has been debated since prehistoric times. And we have words from Plato to Confucius. Even the Bible talks about beauty and they all have different versions of beauty, but as scientists, we really need to have a definition of what beauty is if we're going to study it. Otherwise we can't really study it unless we're able to speak the same language. So I've spent a career studying beauty and doing research on the concepts of beauty. So it's really my passion to try to understand what is beauty and how we use it both as to preserve our species and for ourselves to get ahead.

Summer Hardy (03:52):
This is really interesting. Can you tell us more about how a sense of beauty makes us feel?

Dr. Steven Dayan (03:58):
I sure can, but I first like to say that I think that there's two components to beauty. There's a component that you don't think about. There's a component that's subconscious. It's below your brain, you're not considering it. It's evolutionary preserved. It's the same portions of your brain called the amygdala. It's a part of your brain that even reptiles have that have been around for hundreds of thousands and hundreds of millions of years. The most primitive parts of our brain can detect beauty. It can detect something raw and beauty. And that's something you think about once again, something you feel. And that beauty is the strongest form of communication that exists in nature. And it's whether it's a animal, whether it's a plant, and whether it's a human. We all can detect something that is beautiful. Beauty is defined mathematically to some extent by ratios, by sizes, maybe by specific formulas.

(04:52):
But in my opinion, what beauty distills down to is the raw energy form saying, I'm healthy, I am well and I have good genes. It's how we communicate in nature. We communicate potential, we communicate virility, we communicate fertility, anything that is considered beauty throughout nature, but that is something very different and distinct from the conscious component of beauty, which that's the world we exist in aesthetic medicine. And the conscious component of beauty can be influenced by culture. It can be influenced by the adornments, by the jewelry, your hairstyle, the makeup you wear, the earrings you wear, the posture you have. And most importantly, the single most important factor that makes someone beautiful is confidence. There's nothing more attractive than confidence. So you have the conscious component of beauty, you have the subconscious component of beauty, one you don't know about. When you think, when you feel, when you bring those two together, you get attractiveness. And that's what I define as attractiveness. And that is what I do every single day. As an aesthetic physician, my goal is to make people more attractive. And I don't do that by giving them the perfect face or the perfect nose or the perfect skin color. I do it by making them feel good about themselves, by giving them confidence, and that makes them more attractive.

Summer Hardy (06:10):
This is really interesting. I've never thought of beauty or attractiveness in this sense. So what's the global effect on how we perform?

Dr. Steven Dayan (06:19):
Well, it's certainly effectively perform if we feel good about ourselves. And there's clinical trials to show that those who feel good about themselves perform better at work. They perform better in their social responsibilities, in their financial responsibilities, in their occupations and athletics. And I've done a lot of clinical trials to evaluate this. We did a study three years ago. We published in surgery, dermatological surgery showing that even blind people can detect beauty. How does a blind person detect beauty? I mean, that was really kind of strange. It's like were we really able to detect beauty? Even blind people, you can't have vision people with 20/400 vision, so they're physically blind, but they too can detect beauty as well as someone who can see. How does that happen? Because I believe that we detect beauty within our skin. Within our skin. We have neurons, we have neurogenic cells because our skin evolved the same time with our brain.

(07:14):
And our skin is how we communicate with each other also. And our skin can pick up on some of the subconscious components of beauty so that your skin has neuropeptides in it. It's got the same cells like dopamine, serotonin, and oxytocin. All those neuropeptides that are released from your hypothalamus and your pituitary gland also are created and released in your skin. You actually have receptors for them in your skin. I believe our skin allows us to communicate with each other. I believe it's another sense that we haven't yet defined. And I think we all kind of recognize it now because as we do these zoom meetings and as we spend more time on our screens, we start to realize something is missing. And what's missing is that human connection, the human interaction that we all love so much. That is where we sense beauty in each other.

Dr. Lawrence Bass (07:57):
It's interesting, we sense an interaction when we're doing a zoom, but it simulates an actual interaction. It doesn't replace an actual interaction, does it? And this takes us back to what's on the plastic surgery board certificate, Tagliacozzi who said we, and I'm paraphrasing, but "we operate not so much to heal the form, but to buoy the spirit."

Dr. Steven Dayan (08:24):
Amen. I love that. And Larry, I'm sure you know this as well as I do plastic surgery, started post World War I. And the goal of plastic surgery initially was to allow people to pass back into society, to merge back into society, not to be super beautiful, but yet to look normal or natural so they could be functional within society. That was the original goal, and that was really somewhat of a psychological goal as much as it was a form. And I think we may have gotten a little bit lost in the fifties, sixties and seventies when we started to veer off and to make people look super enlarged or go beyond what we find naturally beautiful. And I think that there's a role for making people look more naturally beautiful and improving and treating what's up here as much as what's down there.

Summer Hardy (09:09):
And then just to kind of continue the conversation, you briefly mentioned a little bit about this, but I'm wondering how our appearance affects how others perceive us.

Dr. Steven Dayan (09:21):
Some of these are great questions, and I've done over a dozen studies now where I look at first impressions. I first started publishing this in 2004, the interventions that I do, whether it's a plastic surgery procedure or it's a neurotoxin or it's a filler or it's makeup or it's skincare or it's hands, I've studied all of these various factors and does it influence the first impression you project? In other words, do other people think of you differently if you've had these interventions? And the answer to that question is yes. So unknowing observers looking at you will sense that you look more successful, that you look more youthful, that you're more attractive on various parameters. And I've done this in so many studies now, but there's something very unique. We've also shown that if you don't look natural, your correctness levels do not go up. So first you have to look natural because if someone knows you had something done, then they look at you like something's wrong, something's off. And that immediately makes you less attractive. And your first impressions are deep projected and usually are not treated as well by outside observers or those who don't know you.

Summer Hardy (10:31):
Okay. Now let me ask a loaded question,

Dr. Steven Dayan (10:34):
Please.

Summer Hardy (10:35):
Is all of this really just vanity, Dr. Dayan?

Dr. Steven Dayan (10:39):
Well, Summer, I don't think I would say it's all vanity. I think it's human nature to want to feel beautiful is human. You brush your hair every day. Why do we brush our hair? We brush our hair for a reason. We don't have to brush our hair, but there's a component to it that's aesthetic. We put on two socks every day. Why do we wear two socks that are the same color or the same? We have some sort of semblance that we want to look appropriate or we have vanity and in that component of how we dress ourselves. So to want to look groomed or to look good is natural. It makes us feel good about ourselves as well. So I don't think I would call it vanity. Of course, anything can go to an extreme and then it can be vanity or narcissistic in nature, and that's when it becomes pathological and not healthy.

Dr. Lawrence Bass (11:28):
And you said earlier that these things are really primal. And in my view, appearance, self-care is part of hygiene, which is part of self preservation, which is a floor need of every being, every creature to protect itself, to maintain itself in the best possible state. And this is merely an of that.

Dr. Steven Dayan (11:54):
I so agree with you. And I think if we distill things down back to our primal minds, to our primal brains, the deepest, darkest corridors of our brain, we better understand what our behaviors are every single day. So if you look at this as from a biological perspective, and I'm not talking from religious, spiritually or social perspective, from a biological perspective, we have one purpose on earth. And that purpose on earth is to procreate and to find someone who we can meet with to produce a better offspring, something who's going to outlive us, who's going to have a better genetic variability than us. That's our only purpose from a biological standpoint. Now, if that's the case, we are created, we are designed, we are developed. Whether you believe it was mother nature or supernatural being, we're designed to find that other mate. So how do we do that?

(12:42):
It's by beauty. We were able to sense beauty in others are that have good genes and ones that we're particularly attracted to, including the fact that it may be specific. What you find, Summer, and what I find attractive are two different things because it may be genetically encoded in you to find a certain thing beautiful, but you are designed to find the perfect person for you that has that genetic code that unlocks yours and creates a better offspring. You're also genetically encoded to know when there's danger around you to run, to not get into a corridor where there might be a lion. So you can sense danger, you can sense risk, you can also sense beauty the same way. And we see this all subconsciously. We don't think about it, we feel it. Does that make sense?

Summer Hardy (13:27):
Yeah, yeah, it does. This is all a new perspective that I've never heard of or even considered. So it's really interesting to hear.

Dr. Steven Dayan (13:35):
Let me give you another tip, Summer. So when you meet someone for the first time and you look in their eyes, their pupils dilate if they find you attractive. Do you know their pupils are dilating? Not really, but subconsciously you do your primitive brain, your subconscious brain picks up on that person. The pupils are dilated slightly. They're like, "oh my gosh, this person is really engaging. I like talking to them," but you didn't realize it, that their pupils are dilating. There's so many ways in which we communicate with each other that we don't even realize that we do. Subconsciously, if you smile, the person next to you smiles, it's mirror neurons. We have positive feedback between each other. The way you flip your hair may be a way to signal to the opposite sex or the same sex if you're interested in the same sex that you're interested in that person.

(14:16):
These are all things that we do and that we sense. And I wrote a paper a few years ago on the epigenetics of beauty. In other words, let's say your great grandparents were friends with another group of great grandparents. You meet your partner now and you don't realize that way back when hundreds of years ago, your grandparents came from the same little village in the same small little town you thought you never met each other. But it might be that your families have interacted with each other and there's epigenic codes and changes within your genes that predispose you to preferentially like someone else. So it's really quite fascinating how detailed mother nature is to make sure we find our perfect mates.

Summer Hardy (14:58):
Yeah, that's also a very interesting concept to think about. The epigenetics of beauty, kind of going back to modern life, do you think is there too much or too little in modern life, or put another way, are we spending too much time, money and thought on beauty? How do we really balance our desire for beauty?

Dr. Steven Dayan (15:19):
Well, I don't think it's possible to say there's too much because we all want to be and live beautiful. I think to Dr. Bass's point, it's personal hygiene. It's self-preservation. So I don't think that's going to change. I think if we can look a little bit more into your question, which is a great question is are we too obsessed with these different beauty standards? And I think that social media is probably that medium that can get dangerous. And I think we're learning more and more every single day and week about the detriments of spending too much time on social media, the anxiety that's related to too much time on social media, especially with young girls. When you look at the CDC report, I think it was 2021 or '22, '21 showing that 57% of young teenage females are socially lonely and depressed or have anxiety disorders, 30% consider suicide and 13% have attempted it. We have a real issue, and I don't think that's all beauty, but that's staring into a screen and looking at standards that may not exist, that may be falsified. And I think we have to be careful with that. I think as physicians, we have a grave responsibility to not put something out there that's not real or authentic. And sometimes I think that we could do a better job as a group than we do. And there's this need to show more, get more likes, get more fans, and I think that could become a self-defeating prophecy.

Dr. Lawrence Bass (16:44):
It's like everything in life, moderation in all things. There's not an exact dividing line between what's good and what's too much, but even though you can't always define the exact dividing line, you can usually tell whether you're in the good range or in the too much or too little range, that usually jumps out and is fairly extreme because there can be too much of a good thing.

Dr. Steven Dayan (17:15):
I agree with you that I feel like we can all self-censor ourselves like, okay, we're going outside the middle way as Buddha would say, or moderation as maimonide would talk about. But there's something called an aesthetic bias. And when I wrote a paper on this three years ago where when we start to see something over and over again, our norm starts to change and we start to go towards that as a new standard of what we find attractive. So if I show you pictures of big lips over and over and over again, you eventually think that big lips are more attractive. And I think we have to be careful. If we keep staring at something, then we start to find that more attractive. And I think if you're on social media all the time and you're looking at people that look distorted, you may eventually start to find that attractive.

(17:57):
And I'll tell you where I think I see this the most, and Larry, I'd be interested to see if you think the same thing, but you'll find some plastic surgeons and aesthetic physicians, and you look at their staff and they all look a little bit bizarre, and you walk into their office, you're like, "oh my gosh, everyone looks a little too overdone." I especially see this with companies that sell these products, I call it reps disease. The first time they start working for these companies, they come in, their lips are out to here, their face is frozen and they think they look good. You're like, ah, that doesn't look good. But you lose track because if everyone around you looks the same, you start to get this bias. So I think we have to be careful to check our biases. And that goes obviously not just aesthetically, I think in life in general, but we oftentimes don't check our biases and aesthetically we have to do that as well.

Dr. Lawrence Bass (18:41):
And media. I have had that experience and I agree with you a hundred percent. And I'll give you another lip example and an example of how media really is able to influence our normative standards. So I practice in New York City and there's lots of fashion magazines, particularly going back a few decades, and there are lots of models. And so many of the models had these pumped up lips, particularly in the outer corners, which is usually not the fullest part of the lip, and it's in so many fashion magazines that I would have patients coming in with little pictures torn out of the magazine saying, "I want lips like this." And that looked beautiful to them because it was in the fashion magazine, but it was demonstrably not natural.

Dr. Steven Dayan (19:35):
Yes, and I'll add to that because I've seen that as well. I think where we're having a big issue now is that people don't know what they look like anymore. And the reason why I say that is I'll have a patient come in and she'll show me a picture of herself on her phone. She's like, "Dr. Dayan, look at me. I want my nose small. It's too big." But I'm like, "wait, that phone picture of you is not a real picture because a phone, a selfie on a phone to distort your image by 30%, it takes a center part of your face and expands it." So then I'll show her a picture that I take with a standard photograph at five feet distance. I'm like, "look at your nose. It fits your face proportionally." "But Dr. Dayan," and then I give her a mirror, "but wait, I don't like this side of my nose."

(20:13):
But she's seeing an opposite side of her nose from what she's used to seeing in her camera. So when I'm trying to treat her, I have to figure out between her and I, we have to figure out what I'm treating. Am I treating the way she looks in a selfie, treating the way she looks in a standard photograph or the way she looks in a mirror? So we don't know what we look like sometimes because we're not really sure which version of ourselves we like best, and it's unique because it wasn't like this years ago, but now with the phones, it's a whole nother variable to add in.

Dr. Lawrence Bass (20:41):
That's a really interesting point, and I see this more and more in my practice, that people have symmetry confusion in their face because they're now looking so much more of the time in a camera, a selfie, a video picture, than the quick glances in the mirror. And if you take a symmetry in their face and eliminated, they don't look normal to themselves anymore because they're so used to it and they think you created an asymmetry, even if you've blunted the asymmetry, that there's huge confusion over this, and it induces an obligation on our part as practitioners to spend time counseling patients and to show them these things in advance so they understand where they're starting from and think about what their goals are. But in a world where we spend a growing amount of time interacting by video, maybe how we look on the video is more important, even though that's a distorted image. We actually did a podcast episode on that where we had photographic experts talk about how webcams and cell phone cams distort our appearance, and because it is such a universal experience now in modern life.

Dr. Steven Dayan (22:04):
Larry, I want to follow up on this. I published a paper two years ago. We did it with the University of Illinois medical students. We had them take photos of themselves with, we said, if you're on a dating app, pick your best picture. So they took photos of themselves with their selfie. Then they did a filter themselves as a selfie, a filtered selfie. Then they turned the camera around and they took a picture of themselves with a camera. Then we took a picture at five feet distance, and we rated and we had them rate themselves, which picture of yourself do you like best? And they all said they liked their selfie or their filtered selfie the best. Then we had these pictures shown to unknowing observers who had no idea who these people were, saw multiple pictures. They never saw the same picture twice. They just saw multiple pictures. They rated these photos and hands down and wasn't even close. The unknowing observer who didn't know these people, found the photo of them at five feet distance, the normal focal length to make a person look as natural as possible. They found that photo most attractive. So that was really interesting. We find ourselves more attractive if we take a picture of ourselves and we morph it and we make it selfie and filtered, but the average person looking at us doesn't think that's the most attractive version of ourselves.

Dr. Lawrence Bass (23:08):
But to your earlier point, that constant exposure to your selfie image has started to train people that that's the way they should look.

Dr. Steven Dayan (23:17):
And a filtered version of it nonetheless, which is even worse. That's not what you look like.

Dr. Lawrence Bass (23:22):
So they're calibrating their identity on this artificial image, not on their actual appearance. Of course. It's fascinating.

Dr. Steven Dayan (23:31):
It's fascinating. If you really want to get deep into the weeds on this, which we won't do here, but I'm happy to do it again. Another podcast is think about a generation from now when there's avatars or there's versions of ourselves that we can project to people, and maybe we're out of business as plastic surgeons, because you can just have a figmented version of yourself that you create, and that's how you present yourself to the world.

Dr. Lawrence Bass (23:53):
Right? Well, the equivalent job will be the person who photo retouches or reprograms your avatar to look the way you choose to optimize the appearance.

Dr. Steven Dayan (24:05):
Yes, my wife can always see me as a 28-year-old strapping young man.

Dr. Lawrence Bass (24:11):
Hope for the future.

Summer Hardy (24:13):
Okay, so Dr. Dayan, as we wrap up this episode of the podcast, what takeaways would you leave our listeners with?

Dr. Steven Dayan (24:20):
Well, that's a great question. Summer, I think if there was one thing that I'd like to lead the listeners with is that beauty is innate, but beauty is not the most important component of how you project yourself. It's being attractive and attractiveness is confidence. The more confident you are, the more attractive you are. And while self-esteem and appearance are related up to 70% correlation between the two, it's not everything. What gives you confidence may be different than what gives me confidence or gives someone else confidence. And confidence can be gained from the way you perform academically, from the way you are with your family, from the way you perform athletically. There's many things that give people confidence, and I would urge people to find what gives them confidence and not feel that it just has to be wrapped up in the way they look, because we always have a little bit of insecurities about the way we look. That's human nature. But if you think about that too much and compare yourself too much, you're never going to be a happy person. You're never going to be a confident person, and you're never going to be an attractive person. So attractiveness comes down to confidence. Be yourself. Be confident in yourself. Create and do activities and behaviors that help you have great confidence yourself, and then you'll be beautiful.

Summer Hardy (25:32):
And what are your takeaways, Dr. Bass?

Dr. Lawrence Bass (25:36):
Well, young or old, male or female, there's a universal desire to be beautiful, and that's really because beauty is an extension of hygiene and grooming. It's a basic part of self-care, and it's a universal part of creating an identity and self-image. But as Dr. Dayan said, and I couldn't agree more, the most beautiful attribute is confidence, because that speaks to everyone.

Dr. Steven Dayan (26:07):
Yes. The person walking across the room that you can't get your eyes off of is the person who walks across the room with confidence, not a narcissist. That's something different. That's insecurities. But the person who walks across the room with quiet confidence is the one we're all riveted to. That's attractive. That's beautiful.

Dr. Lawrence Bass (26:23):
Well, thank you Dr. Dayan for joining us today and sharing your thoughts about the world of beauty.

Dr. Steven Dayan (26:29):
Thank you so much. It was a pleasure to be here.

Summer Hardy (26:31):
Thank you, Dr. Dayan for joining us on the podcast and providing such a great discussion of our favorite subjects.

Dr. Steven Dayan (26:37):
Anytime.

Summer Hardy (26:38):
Thank you for listening to the Park Avenue Plastic Surgery Class podcast. Follow us on Apple Podcasts, write a review, and share the show with your friends. Be sure to join us next time to avoid missing all the great content that is coming your way. If you want to contact us with comments or questions, we'd love to hear from you, send us an email at podcast@drbass.net or DM us on Instagram @drbassnyc.