After 45, It’s A Good Idea To Get Botox: Dr. Mirza

Hear the words “plastic surgery,” and duck pouts, frozen foreheads and Barbie-esque figures indigenous to Hollywood will spring into your mind. But the cosmetic circles are promoting an ‘au naturel’ trend amongst influencers and models that may have already hit your Insta-feed without you realizing at first glance. Despite becoming a de rigueur in the fashion savvy world, cosmetic surgery has come under scrutiny especially when celebs become beyond recognizable – perhaps rightfully so.

HTV caught up with Dr. Fahad Mirza, a plastic/reconstructive and cosmetic surgeon to get an expert opinion on the ins and outs of all things ‘synthetically’ beautiful. Dr. Mirza is a Consultant Plastic Surgeon at Ziauddin Medical University Hospital. He also performs non-surgical and surgical aesthetic surgeries. But that’s not all; the doc has got a few more tricks up his sleeves as he is an occasional actor and model as well. Dr. Mirza who devotes 99% of his time to medicine, believes that beauty is an absolute physical reality.

Beauty Is In the Phi of the Beholder

“Scientific evidence shows that our perception of physical beauty is hard-wired into our being and based on how closely the features of one’s face reflect phi in their proportions. ‘The Golden Ratio’ or ‘Divine Proportion’ (1.618) appears extensively in the human face and thus seem most appealing.”

He emphasizes that studies have proved that beauty cannot be pigeonholed into races or physical attributes. “Irrespective of who you are, a human brain takes only one-tenth of a second to decide whether the face you are looking at is beautiful or not. It’s all about symmetry and proportions. As the saying goes beauty is not race-specific, it is specie-specific.”

Taking the liberty of saying it bluntly – yours is a sensitive profession which has come under scrutiny time and again. Proponents would say that ‘you help people feel a little better about themselves,’ while opponents would argue that it promotes superficial standards of beauty. Your take on it.

“Growing old is not an option but looking old is. If something helps you take off 5 to 10 years from your appearance then why not? Furthermore, I am not the one who is encouraging these practices; it is the society’s unwavering standards which discourage or bully anything not conforming to its ideals. There is no harm in it if it helps ward off someone’s complexes.”

Botox & Fillers: What You Need To Know

As you grow older, your skin tends to become thinner and weaker, right? What happens is how several strings of threads interlace to form a fabric; in similar fashion collagen and elastin interweave our skin. The loss of these two with age weakens the skin, and it hangs loosely. But your facial muscles stay robust. Consequently, you will have noticeable lines on your forehead due to a muscle pull. Botox weakens those muscles and restores the missing balance. The injected muscles can no longer contract, which causes the wrinkles/lines to relax and soften. It is also anti-aging because with time these lines will be etched in your skin and become permanent like those in your palms. “After reaching 45, it’s a good idea to get Botox because of its anti-aging traits; it’s called Baby Botox which has minimal muscle damage to the skin and retains movement. These targeted injections deliver the more natural, tailored look Botox is often coveted for.”

A common misconception was that a thinner face looks younger whereas, in reality, a youthful face is a fuller face. As you age, you look tired when you lose the foundation of your face i.e., the deep fat. “Suddenly you will start seeing shadows and valleys on your face; you can notice where the lower lid ends and the cheek begins. This happens due to volume loss. Fillers that are made up of Hyaluronic Acid replace this loss by adding subtle volumes and give a fresher appearance. How long will they last depends on several factors but it may vary from six months or a year to 18 months.”

He further specifies that fillers have serious side effects – if injected intravascular, blindness or deadness can occur. It is also advised to sit upright for at least four hours after Botox injections. Lying down, running or jumping is forbidden. A single dose of antibiotics is recommended after implants.

Nip & Tuck

At what age do you think a procedure is appropriate?

“It’s set in stone that I never take patients below the age of 18, especially for aesthetic procedures. I do not take patients less than 21 years of age requesting facial changes because their features are still developing.” He deems 30 years or above an age bracket for an ideal patient – independent, well-informed people looking for self-improvement.

What is the ratio between men and women opting for such treatments – celebs and non-entities?

For rejuvenation purposes, women are more inclined towards these procedures. Almost 9 out of 10 patients are female. Men consult mostly for hair thinning which can be successfully treated. Surprisingly, men from our media industry don’t shy away from these treatments. “Male celebrities do like to opt for fillers to augment their chin, nose or jawline, for looks are a prerequisite in their line of work. The percentage is close to 60% females to 40% males in the world of glitz and glamour,” he quips.

Think Less Kardashian, More Meghan Markle

Facial expressions play a pivotal rule in performing arts while we see a plethora of fine actors who are straight-faced ­– in the desire to “age gracefully” or “remove wrinkles or frown lines” they have gone under the needle. How do you view this artistic dilemma? Even a star like Nicole Kidman after quitting Botox joked about it. She said, “Now I don’t use it anymore – I can move my forehead again.”

Botox in point of fact paralyzes the muscles so if you are taking the one-size-fits-all approach then get ready to embrace a frozen look. You will turn wrinkleless but expressionless as well. “Better practitioners including myself; customize the dose to the patient, their strength of movement and gender. That’s why we recommend Baby Botox which gives the best of both worlds – a face with no wrinkles but with little compromise on expressions.”

With all these advancements and awareness, why do we see a job gone drastically nasty every once in a while locally or internationally?

“The key is to observe the beautiful normal.” He expresses that you cannot invent a new face; you can just beautify the existing natural features. A trained, qualified doctor also needs to have an artistic eye to perform these non-surgical beautification procedures as its more like facial sculpting.

Better than Photoshop

Let’s talk about John Mayer…After his vocal chords were damaged by growth, the singer credited two things for his ability to sing again: surgery and Botox injections. Experts are finding more than one ways to use the toxin. Are these non-cosmetic uses acknowledged in Pakistan?

It’s not a little-known secret that Botox with its power to temporarily paralyze muscles helps more than smoothing wrinkles. Experts now rely on it for treating effects of chronic migraines, depression, Cerebral Palsy to name a few. However, it’s a dangerous drug and can even cause death. If injected in bloodstream it may paralyze breathing muscles therefore only controlled dosages under qualified supervision are suggested. The world is adapting to its non-cosmetic uses gradually.

Vanity Insanity

Is there any ethical dilemma involved and have you ever refused patients due to such reasons?

“I cannot refuse treatment to a patient outright, but yes, it’s imperative to find out patients’ motivations. I am here to drive them towards self-improvement. At times people unrealistically expect these treatments to save their marriages or attract good suitors. What’s crucial is to identify that red flag patient who isn’t striving for physical improvement but has a deeper psychological issue, and by doing a procedure on him, I won’t be serving him but confounding or further aggravating his problem. In such instances, I refuse a lot of patients but courteously.”

Your message to millennials who are chasing unrealistic and unhealthy beauty ideals.

“It won’t be right if I preach what I don’t practice because it’s a part of my daily grind as well. I belong to an industry where looking good is of the essence.”  He suggests millennials to join a gym, drink lots of water for healthy skin, use sunblock religiously and invest in night creams. “It is an obligation to preserve and protect what you are blessed with. The appeal of cosmetic procedures lies with the fact that it should be preventive rather than overly corrective. Get it fixed if it is bothersome but do not get ahead of yourselves.”

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