Valery said, "health is the silence of the organs",
and the world health organization that "health is not
only the absence of illness but a state of complete mental
and social well being". On the other hand, beauty,
which Plato placed behind health and before fortune, has
not been well defined.
cosmetic surgeon by definition must create or conserve beauty.
Surgical techniques abound in the textbooks of Europe north,
south and Central America but, in my opinion, artistic teaching
on beauty or human beauty is not taught enough.
cosmetic surgeon often finds it difficult to define beauty,
he is not alone. Ask different people and the answers vary
considerably, and in the main are not satisfactory. This
is why I thought it would be useful to approach the subject
from a psychological point of view, and attempt to understand
what it is, that enters the mind of a person, cosmetic surgeon
or not, when she percieves, or does not perceive the feeling
of beauty. It is important to understand this feeling within
us in order to guide us during our operations.
is beauty? What do the books say? The dictionaries? The
Right from the start we are told that beauty is about proportion,
equilibrium, symmetry. I therefore want to explain beauty
objectively and describe the different canons of Egyptian,
Greek and Roman. Apparently the centimeter is not the sole
judge, little by little the subjective has entered into
Beauty is an ensemble of shapes and proportions, which bring
us pleasure and which we admire, but the concept varies
according to different cultures.
Beauty is a balance between shape and volume.
is a balance between volume and shape.
lady and a man are going to the beach.
look at each other and pass.
accentuate the positive, decrease the negative but... don't
maintain the change obtained in shape!
Beauty stimulates an aesthetic feeling within us, pleasing
to the eye, a sense of admiration. Some say beauty is a
Beauty is a combination of qualities such as form, proportion,
colour in a human face (or other object) which delights
These last four words are important, beauty does not exist
itself, it exists in the eye of the beholder. If something
pleases someone, it is beautiful to him. If this same thing
does not please another, it is not beautiful to him. It
is not that which is beautiful that pleases him, it is that
which pleases him that is beautiful.
David Hume (1711-1776) the Scottish philosopher said, more
than two hundred years ago, "beauty is essentially
a private and personnel experience. Beauty is in the eye
and mind of the beholder". He also said, "beauty
is not a quality of the thing itself, but that which exists
in the mind of those who contemplate it". Everyone
experiences beauty individually.
Eric Newton: "beauty is something which gives pleasure,
but that which gives pleasure to one person does not necessarily
give pleasure to someone else".
Some philosophers conclude, "that which is beautiful
is good, that which is good is beautiful". What the
poetess Sapphie said a long time ago was "that which
is beautiful is good and he who is good will soon become
Our past feelings are partly responsible for how we feel
today. Our parents, love, former loves, women and friends.
They remind us of past experiences, and beauty is not represented
by the detail but by the whole collection being greater
than the sum of its parts. Equally today's emotions will
be responsible for tomorrow's emotions. The happy and unhappy
times of our past life leave permanent impressions guiding
our preferences. The faces we have loved during our youth,
warm and comforting, continue to live on in our mind.
Beauty is not only a question of the face, voice, body or
a graceful physique. People are beautiful because of their
character, personality, their ability to bring joy, their
capacity to love. We see emerging the notion of charm.
When we like a face we like the spirit that animates it
and it is not enough to say that someone is physically attractive,
a person can be attractive in many ways.
Beauty and charm are often confused. Cleopatra, George Sand,
Louise de la Valliere and Theodora were famous for their
beauty, in fact they were not very beautiful but possessed
great charm. Beauty is more an illusion than a reality.
Beauty is not for the eye but for the mind.
The beauty of the personality eclipses the beauty of the
face. We have seen many ways to define beauty and that it
is often associated with charm. Charm differs from beauty
in that it lasts forever, whereas beauty fades. The English
say "Charm lasts! Beauty blast! ". Finally we
see that it is not only the eye that judges whether someone
or something is beautiful, it is above all the mind and
that which we term the heart or inner beauty.
According to the American sociologist Frumkin, a woman is
deemed beautiful according to her "sexual aptitude".
Whether she is judged beautiful or not depends not only
on the symmetry of her proportions or shape but equally
by the potential sexual functions suggested by these attributes,
and the sensual emotion is transformed into an aesthetic
The preceding classic assertions allow us to conclude that
the notion of beauty differs according to the culture and
the individual and that it is not exclusively a question
of shape, form and symmetry. A person's personality, charm
and interior beauty powerfully contribute to elicit a pleasing
impression in the beholder. The eye is not the sole judge,
there is also the spirit and above all the heart. The mind
is influenced by old memories, which reside within us and
shape our judgment in the same way that today's experiences
will influence the future. This is seen in a phrase of Buddha
"Today is the son of yesterday and the father of tomorrow".
Beauty is like an iceberg: only one part of it is visible.
Lorenz, Nobel Prize winner for Medicine and Physiology in
1973, has contributed in a decisive way to the progress
of the biology of behavior. It is he who helped us understand
his work "Essays on animal and human behavior"
he proposed the following drawing, which explains the release
of an emotion in both human and animals to care for young.
In the left column one sees a child's head and the heads
of very young animals, a gerbil a Pekinese and a robin red
breast. In the column on the right we see an adults head
and the heads of the same animals as adults.
one asks which column is preferred the left is automatically
chosen. Konrad Lorenz concluded from this that beauty is
an emotion, an emotion associated with the desire to protect.
Only the left column evokes this emotion. This emotion is
associated with a desire to protect as much in humans as
in animals. It is, he says, the release of an innate behavior.
A relatively large head, a disproportionately large forehead,
large eyes placed underneath, prominent curved cheeks, short
thick limbs a firm elasticity, and awkward movements are
the essential defining characteristics of "sweet"
and "pretty" these present themselves according
to the law of the 'summation of excitations' of a small
child or 'bait', like a doll or a cuddly animal. Just like
the dolls made today. On the left are those that give the
impression of a "sweetie" (child, gerbil, Pekinese,
red breast), the adults to the right do not elicit this
caring reaction (man, hare, hunting dog, blackbird). The
conclusion is obvious: beneath the traits of an adult, the
face of a child must show through.
a human is attracted by a face it is because this face has
of Konrad Lorenz explaining the triggering of care with
the little ones in men:
heads whose proportion give the impression of a "sweety"
(child, gerbil, Pekinese, red breast). Right, the adults
don't trigger the reaction of caring the little ones (man,
hare, hunting dog, black bird).
is instinctively attracted by a child's face. The sight
of a child's face immediately provokes within us an emotion
and this emotion is automatically accompanied by a desire
to protect. This is found equally in man and beast. Konrad
Lorenz explains that adult animals, which are driven to
protect their offspring, are attracted by 'something'
which the offspring emanate, a physical trait, a sound,
a smell. It is the same with man. There are signals that
elicit protection, sympathy, tenderness. What are they
repeats Konrad Lorenz? In the small child the signals
are on its head. It is roundness, fullness, curves, the
rounded forehead, full cheeks, the little turned up nose,
all these infantile characteristics elicit a desire to
protect. An infants face is associated with purity, sincerity,
honesty and vulnerability.
adult we see on the right hand column does not elicit
these reactions. His face has changed, his head is flattened,
the forehead receding, the nose lengthened, cheeks hollowed.
He has lost all his childlike characteristics. He elicits
no emotion, no desire to protect. It is the same for the
adult animals and the contrast is startling on viewing
the two columns, in the man angles have replaced curves,
naso-labial angle, angles of the jaw, external angles
of the orbit, angles of the chin. Designers and painters
know this theory well and reveal it in their work aimed
at students. Cartoonists in order to touch the hearts
of their readers know that in an adult or child's face
they must exaggerate certain traits, make the head bigger
than normal, with a rounded forehead, full cheeks and
Lorenz's drawing Cartoonist in order to touch the heart
of their readers, exaggerate the traits of young children
or animals: making the head bigger than normal with a
round forehead, full cheeks and shortened limbs.
Children are curves and roundness.
Above: The male has changed the curves of childhood for
Below: The female still has the curves ofchilhood.
see that women maintain their curves whereas men loose them.
We understand therefore that a good aesthetic surgeon should
in his interventions optimize the traits that, as in a baby
or child, provoke the reaction of attraction, of tenderness
and of protection.
roundness = tenderness.
and this is fundamental towards giving the impression of
beauty, in the adult face one must find, one must recognize
the traits of a child. However the traits are not the sole
source of the protective reflex, there are also the expressions.
These at least have the advantage of being accessible to
everyone. Some adults know how useful expressions are in
order to please or to move someone. The emotions provoked
by the childlike features of Brigitte Bardot were increased
by her famous spoilt child 'pout'. Also well known are the
childlike expressions used, and some say abused, by Marylin
Monroe or Audrey Hepburn. It has been said that Marylin
Monroe made herself up badly to give the impression of a
little girl who does not know how to apply her make up,
and also that after a long session at the hairdressers she
would ruffle up her hair to obtain a certain disorder which
reminded one of a little girl who has just finished playing.
Also, if women do not have a childlike demeanor and wish
to dominate men, men will not feel a protective desire and
will be reminded more of their mother than of their wife.
Women, who are more concerned about beauty than are men,
may show these childlike expressions consciously or unconsciously.
They can appear knowingly or unknowingly shy, fragile, weak,
innocent, naive, ignorant, temperamental, sulky, admiring,
curious, etc. Some women highlight apparent weaknesses
in order to provoke this protective emotion. Has it not
been said that it is the apparent weakness of women
that is their strength? All this with the aim of striking
straight to the heart of men. Napoleon I would have said
"Women's two weapons are make up (the significance
of this will be discussed later) and tears, as in a helpless
little girl". Marylin Monroe was using the same sentence
as Napoleon and was adding: ďMen are lucky as we can not
use such two weapons at the same time. One therefore understands
how a child's features on an adult can move one, freckles,
rosy cheeks, glowing complexion, long eyelashes, blond curls,
full cheeks (given in aesthetic surgery by lipofilling)
, well defined and full lips. For men, the side parting
as sported by many of the great seducers (Clark Gable, Gary
Cooper), a 'floppy mop' (Leonardo Di Caprio), shaving everyday,
can only be explained by a desire to resemble a child. It
is not necessary to have all these signals, only one is
needed to please.
individual can always have childlike expressions. As for
traits if one does not have these one can sometimes acquire
them thanks to cosmetic surgery. Beauty is not entirely
a natural phenomenon, it has for a long time and especially
in our time been a cultural phenomenon. Humans seek to improve
themselves and for women for whom beauty is more important
than for men (man is attracted above all by force and power)
improve their beauty and charm by make up and what we call
accessories: glasses; false eyelashes, ear rings; hairstyles;
highlights; tattoo around the lips, eyelids, eyebrows (the
word "tattoo" should not be used when talking
to women rather: semi-permanent implantation of natural
pigments!); hats; necklaces; and the invisible accessory
- perfume. Coco Chanel said ďa woman without parfum has
no futureĒ. Some of the more modern accessories have been
studied by beauty professionals in order to hide faults:
thick arms on modern glasses hide "crows feet",
a high situated bridge may accentuate the length of a too
short nose. Placed lower down it reduces the length of a
long nose. All these stratagems are explained discreetly
and at length in women's magazines and an old proverb summarises
this perfectly "beauty is made for 30% by nature and
70% by nurture by adornment". The disadvantage of these
accessories is that without them one may no longer seem
as young or as beautiful.
desire to make oneself more beautiful is not a trap that
women set for men, it is a wish to please to be better accepted
by society and the family. It is agreed that life is harder
for a woman than for a man, although great improvements
have been made in the last few decades. In addition make
up gives confidence, a little like the war paint of the
North American Indians. Do we not say "change the appearance
and you change the being" and "if one prepares,
it is for the parade! ". Itís importance is extreme.
Have we not read Sharon Stone in women's press state: "I
have never considered myself as a great beauty, only a great
magician". Tyra Banks a well-known black beauty said
"I am not ugly but my beauty is a total creation".
have always had make-up and to improve a face, make-up must
be natural, and by increasing them, remind one of the qualities
of a young face. Lipstick must make one think of the more
intense red of a child's lips, who has a faster metabolism,
blusher must make one think of his rosy cheeks, and powder
- the pale and velvet skin of youth. This is what Desmond
Morris calls over stimulation. Very long false eyelashes
are only a reminder of the long lashes of a child. If make-up
can improve, badly applied it can also spoil the beauty
of a face. It can be friend or foe. Have we not read in
certain ethnology books that it was the witch who was asked
to make up ill people's faces so that they would not needlessly
shock those with whom they lived.
traits and expressions are therefore important in order
to evoke emotion with a desire to protect. There is also
the voice, this must be soft and pleasant, like that of
a child. A harsh voice, found among many smokers does not
make one think of a child. Clothes must also be pleasing
to the eye and to the heart and have a youthful cut. Does
not the mini skirt evoke the long legs of the adolescent?
The colours have to also evoke childhood, light colours,
blue, pink, have always been chosen by old ladies. Of course
black is to be avoided. In summary all the human senses
must be solicited, sight, hearing, smell (children have
no smell, hence the use of deodorants) and touch, the firmness
of the skin is important. Institutes of beauty have long
understood this and centred their advertising on this. Do
we not read in the feminine press: ladies perhaps you have
beautiful breasts, a beautiful stomach, and beautiful legs
but are they firm? Firmness, the elasticity of tissue is
a fundamental quality of children's skin and forms part
of its beauty. It can be very expensive to be beautiful,
jewels, the beauty accessories are easily available to those
with sufficient budget, and more difficult to those with
a modest budget. This fact explains why medicine and aesthetic
surgery are popular among those who are not well off, and
who cannot please by their natural gifts alone, or by the
artificial means of the well off. Only being able to please
by their bodies, if patients of modest means have acquired
or natural defects they will allow themselves to be operated
on more easily as it is their only way of continuing to
idea of the use of the child's image is well known. One
sometimes wants to sensitise the heart for more mercenary,
rather than noble reasons. It is well known that every time
one shows a child's face next to a product distribution
is favoured and profit increased. Whether it is a medicine
or other product the number of consumers, if they are sensitive,
will increase. One is of course looking for a path to the
heart but also, and above all, to the wallet. The strategy
of showing a child's face is used in public awareness campaigns
by caring organisations when trying to raise funds for a
country in difficulty or in the battle against poverty and
misery. It is also well known that a child who begs will
receive more handouts than an adult. The Walt Disney films
that so enchant their viewers use only small and vulnerable
animals; it is always the little mouse, little dog or little
deer that we see, never the adult. This is also the case
for toys, it is most often a little animal or a child's
head that is used for a doll. As Saint-Exupery said: "It
is the heart that is the final judge, not the eye".
is necessary to know that a physical defect can also release
a protective desire. Some celebrities or women in politics
voluntarily conserve a discreet squint that could easily
be corrected by surgery in order to elicit this famous protective
desire and by this strategy increase their powers of seduction
and attraction. They do not want to be operated on. It is
also well known that if one of the features on a face is
not perfect one is advised to enhance the other traits on
the same face in order to lessen the defect and to dazzle
the eye with the other traits. If, for example, the eyes
are beautiful and the nose ordinary, embellish the eyes
even more and the ordinary nose will be noticed less, advise
the beauticians who even if they do not know the theory
of Konrad Lorenz do know how to make a face more beautiful.
A facial scar can detract from the beauty of a manís face.
To avoid the embarrassment that it can provoke in social
situations Passot said: "Give him the Legion of Honour
and he will be taken for a hero".
upper strait line seem shorter than the lower one, due to
the direction of the arrow outside.
the beautician who does not know the Muller-Lyer illusion
of two equal length lines with arrow points pointing in different
directions at each end knows how to give the illusion of making
the eyes look closer together by applying make-up to the internal
angle of the eye, or the opposite increasing the apparent
distance between the eyes by applying make-up to the external
angle. This is the same for making up cheekbones on an either
too long or too wide face. The rouge can be made closer or
be beautiful? It has been said that this is because of pride,
pretentiousness, a desire to be admired and to be situated
in a row above the others!
cult of beauty is in fact a culture. Humans are the only animals
who do not accept their fate and seek to improve it: to cultivate
beauty is to increase your quality of life, to want to make
it more beautiful. Progress of civilisation in all areas has
increased life expectancy, this does not seem to be enough,
it has to be and appear even more beautiful, and this is what
has made some say: if medicine has given years to life, it
is medicine and aesthetic surgery that has given life to years.
and fashion, it is still said, are external signs of our internal
need to express ourselves and to reinvent ourselves and we
have defined fashion as an attempt at a work of art on the
as everyone knows is not eternal, but equally beauty has no
age. One can be good looking at 20 but it is also possible
to be irresistible at any age, as Coco Chanel said. Madame
de Pompadour said: "The first requirement of a woman
is to please and as time passes this becomes more and more
difficult". This reminds me of a very old woman who came
to me one day to ask me to do a face-lift. In the face of
the lack of enthusiasm I showed to perform this intervention
due to her advanced age she said very calmly "when one
has ceased to please one must not displease". Presses
itself in some as a great desire to be loved. This desire
to be loved even more is the final message that the followers
of the beauty cult want to get across. Konrad Lorenz affirms
this: everyone loves children and wants to protect them, this
is innate. Can one blame someone for wanting to resemble them
to be loved more? His theory is without failings. We must
remember that the cosmetic surgeon must force himself to reproduce
juvenile characteristics in his work when this is possible
and desired in order to elicit emotion and admiration. We
have seen the links that exist between beauty and admiration
and the deep reverberations felt by the mind and the soul.
This is well summarised by Theodore Gautier: "to admire
is to love with the mind, to love is to admire with the heart".
Lorenz offers us, again in his book 'Essays on Animal and
Human Behaviour', a drawing in which he compares the changes
that have occurred in animals that have become domesticated
and he evokes a parallel with similar modifications in humans
over time and the idea that modern life imposes upon him a
sort of 'domestication'.
Lorenzís drawing wild animals and examples of domestic varieties
from which they are descended:
A "Corassin" and a violet Chinese fish,
b- A wild goose and a domestic goose,
c- A wild chicken and a domestic chicken,
d- A wolf and a hound dog.
of the extremities of the skeleton, stunted development of
locomotive organs in the domestic varieties.
drawing makes one think. Will today's beauty last much longer
if we are not careful?
Lorenz's theory is developed in detail. To elicit a protective
desire an adults face must carry child-like traits or expressions,
called beauty. The emotion of beauty is subjective, the personality
and the first qualities of the individual are at play. In
those who feel this emotion, the emotion is largely influenced
by emotions of their earlier life.
F. Fournier, M.D.
President of the French (National) Society of Aesthetic Surgery
Private Practice of Aesthetic Surgery, 55 Blvd de Strasbourg,
75010 Paris, France
Phone: +33 1 47 70 66 56, Fax: +33 1 42 67 56 86
Send for publication: June 16, 2001