Q. What is beauty, and how can cosmetic surgery help me achieve it?

A. It may sound trite or commonplace, but beauty indeed is in the eyes of the beholder–that person or potential patient standing alone looking in the mirror and examining her face or body in a way no one else except her trusted surgeon would do with her. Plastic surgery is art work. It's the technical art of applied anatomy in an effort to sculpt people. It's not sculpture in the way we know it to apply to stone or metal. But it's an extremely delicate and technically skillful movement of human tissue in a way that from every possible angle of view is exciting, understated, and matches the usual expectation of what someone wishes to expose to those looking at her. Again, when done properly cosmetic surgery is indeed magical and can provide tremendous joy to the patient.

There are some general guidelines about beauty, and I'll share a few with you. For example, study the face of the well-known model Paulina Porizkova. In this highly photographed face, one sees a short, wide face rather than a long narrow face, high arched brows, widely placed eyes and a razor sharp jaw. The base of the nose is approximately one third the nasal length and the nose is ever so gently straight to minimally concave, leading to beautiful and aquiline tip definition. There's approximately a 105 degree angle between the nose and upper lip. The cheekbones are wide and full. The lips are pouty, and there's no redundant skin in the upper eyelids and no baggy or boggy fat in the lower eyelid. There's no laxity of the neck in this most beautiful face. Granted, many of the pictures we see are with makeup, and indeed makeup can enhance a good cosmetic surgical result by at least 25 percent. Nevertheless, the elements in Paulina's face, truly make up what Western culture seems to value as "beautiful."

In the fifties the beautiful female body was looked at as one which was full and more hourglass in shape–top heavy breasts, large wide hips and a narrow waist. Some of these features seem to be aesthetically pleasing today, but have been modified a bit. The breasts, for example, should look natural, untouched, feminine yet full. There should be a gentle slope from the top of the breast towards an upturned nipple with most of the volume in the lower two thirds. When the female lies back, the breasts should fall to the side and behave and feel like a normal breast, even though they may have been augmented or enhanced with conservative implants.

Most of this surgery is done today through the armpit so there are no visible scars on the female chest with or without clothing. With the advent of liposuction we've been able as well to take the body which is bottom-heavy and the thighs, hips, inner thighs, inner knees, as well as buttocks, and slim these areas down after the patient has made her best effort at diet and exercise. This produces a safe or aesthetically pleasing narrow, central torso. If one were to imagine a patient with small breasts and large hips looking in the mirror rather unhappy about her shape in or out of clothing and then undergo aesthetic body contouring wherein the breasts may have been enhanced and the hips, thighs, abdomen and buttocks liposuctioned with the newest techniques, we'd now find a female body in much more proportion for herself when buying clothing, in lingerie, in a bathing suit, or with no clothing on at all.

Remember in the end that aesthetic surgery of the face or body is a want and not a need, and that those who choose to go forward and make these improvements are trying to realistically match their psyche with their body image. But, as a final thought once again, beauty is only what you see to be beautiful, and in many cases plastic surgery is not the answer at all.