In Your Face by Dr Bryan Mendelson

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This may seem like an odd choice for my book review day, but for those of you fascinated by aesthetic plastic surgery (I’m sure I’m not the only one), this is a must-read. Dr Bryan Mendelson is a world-renowned aesthetic plastic surgeon and his 25+ years of pioneering research into facial anatomy and facial ageing has earned him a reputation as somewhat of a master of the natural facelift (if ever you need to know). He has penned this most interesting book with the help of Melbourne historian and author Vicki Steggall, who is not a plastic surgeon but has given this book a fabulous structure and narrative that makes it approachable and thoroughly interesting.

Dr Mendelson explains how our faces have emerged from expressionless fish (yes – that’s right) to the complex and significant windows of individuality and ego as well as our most powerful tool for communication. The book discusses the science of physiognomy and how we have become a society that makes judgement and places value on a person’s personality and character based on their appearance. Dr Mendelson explains why the face is so important to us and where our pursuit of beauty derives from as well as considering the differing viewpoints of those that believe in and accept aesthetic plastic surgery and the arguments against it. All the while, however, he is ultimately ‘for’ enhancing one’s appearance, but his reasons are so sound you wonder how anyone could begrudge a person’s desire for a little work here and there. Ultimately, he sees his role not just as a surgeon, but also a psychologist for people whose lives are affected by their appearance and his view is that our psychological wellbeing is inextricably linked with our face as a reflection of our true selves and how people respond to it.

The book revisits early and quite primitive methods of facial reconstruction from 6th century BC to 1920s France to today’s ground-breaking facelift methods, pinpointing both the cultural and dramatic events (such as war) which have prompted development, experimentation and research in this area.

Below is an illustration from the book that shows a patient recovering from a skin graft performed in order to reconstruct his nose. Noses were often lopped off in battle, or severed deliberately as a form of punishment or of defining and owning people. It was a cruel act of mutilation that is fortunately not as prevalent in the modern day. The ancient practise of rhinokopia (removing the tip of the nose) gave rise to a method of skin grafting that is seen as the beginning of reconstructive plastic surgery. Thank God we have moved past the old method in the pic, however. The patient had to wear a harness to keep a slice of the skin from the upper arm connected to the nose in order for blood flow to ensure the graft to successfully implant. This could take up to 21 days!! Imagine!!

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This book is not about the rich and famous or a tell-all depicting all the worst ‘jobs’ around, it is so much more – it’s historical information as well as the discussions on the intersection between aesthetic plastic surgery and psychological wellbeing are engaging and quite refreshing.

And if you are indeed thinking of going under the knife, you’ll be glad to read the chapter where Dr Mendelson finds the fascia (the fibrous support layer beneath the skin), which is the real reason we look old (not sun damage (although sun damage contributes)). And the last chapter of the book, which takes the reader on a step-by-step tour (almost) through a standard facelift is fascinating reading indeed!

In Your Face is published by Hardie Grant Books (2013)