“What’s the Point in Anti-ageing Treatments?”
A lady once asked me this question at a crowded demonstration evening after I had spoken for an hour on anti-ageing treatments to a group of interested clients. I must admit it threw me, but it got me thinking too. The question does need to be answered, and answered well.
Some Personal Reflections on the True Value of Aesthetics
My oldest patient is in her nineties. Why does she want to remove lines from her face? I have a young man who is 19, but wants regular anti-ageing treatments to remove early signs of ageing. I have even been asked by 15-year olds for Botox. I have a patient in her late eighties who became very upset when I suggested there were going to be diminishing returns from her treatments.
Our procedures are expensive, so there does seem to be a question to be answered. What value do these people get from one of our treatments? It must be something profoundly worth having, or it would not be worth the cost. It cannot be something frivolous or superficial; it surely must be something deeper and more meaningful.
When you ask people why they have treatments, they will say things like “I do it for myself.” They may also suggest, in an embarrassed way that it is vanity that drives them. I am not sure that these answers tell a full story.
Sometimes reading between the lines you can get more of an insight. Using the analogy of appetite, if you asked people why they ate sweet things they would tell you it’s because they like the taste, or because they enjoy it. These are not objective scientific answers. In fact, they simply pose more questions. Why do we like sweet things so much? We understand that there are deeper instincts at work when we remember that sweet things also contain the highest and most easily accessible forms of energy. We most likely eat sweet things because we have an instinct that compels us to seek out energy, the driving force for all life. We understand that the instinct may feel like having a weakness for chocolate, but it is rooted in an ancient survival instinct that, unfortunately, is no longer helpful in our calorie-saturated world.
There is something equally profound driving the demand for anti-ageing treatments. In answering this essay’s initial question, you may have had sexual attraction as an explanation, and yes, I agree this is part of the all-encompassing answer I am going to suggest. We must however also explain why my 92 year old married patient thinks it’s worth spending her limited pension on treating her frown lines; she most certainly does not believe she will be more sexually attractive afterwards!
Her answer is that without her treatment, she says she looks like ‘a mean old woman.’ This may be more helpful, but you may still ask, so what? I believe the answer is to do with the opportunities that other individuals afford you depending on your looks. In other words, society treats you differently if you appear to be a mean old woman compared to a friendly old woman. This is the underlying reason we have evolved the instinct to be concerned about our appearance, the same instinct that drives you to dress appropriately for work, to have regular haircuts and showers; it affects your access to power in society.
The opportunities your appearance facilitates may be small, but are hugely meaningful. One of my earliest treatment experiences illustrated this very well. I had a 45 year old lady with lines all over her upper face. She was awkward about requesting Botox as she had never considered herself “that sort of person”. Two weeks later she had a fabulous result. She said she felt totally different, her naturally good skin no longer hidden behind fine lines. She had already noticed people treating her differently at work, smiling more at her, using her name and generally taking more notice. She had never anticipated or sought this response on a conscious level; she just didn’t want to see her lines in the mirror, but she got so much more.
This case illustrates how opportunities open up for those with a ‘better’ appearance. It could be just that people are more likely to start a chat on the bus, to hold the door open for you, or to simply remember your name. These small changes can also add up to bigger opportunities, and the evidence that better looking people do better in job markets is compelling.
The perhaps sad but timeless truth is that our appearance affects our access to opportunity from other people. Nearly all opportunity is accessed via other people, and the way you appear to other people informs a myriad of often subconscious prejudices. A 19-year-old with a prematurely lined forehead is marginally less powerful than he would have been without it. He has slightly less opportunity from others who may invest more of their time in the next individual along. With his mild lines gone, the difference to his 90-year-old grandmother is not remotely fathomable, but to his fellow 19 year, he gains a degree of attractiveness relative to all the other 19-year olds competing for their slice of other people’s attention. At the heart of this is competition, and I would go so far as to include our instinct to look good as a survival instinct.
You may dislike this heartless view of society, and the idea that access to social power should be based on ‘superficial’ factors. I understand this feeling, but you may get some comfort if you agree with me that it is nature’s way and it permeates every corner of our lives. The signals of health, vitality and potency are read by all social animals. It is a product of the very same forces that create all aspects of humanity and much of nature. A society that did not judge on appearance would almost certainly be at some disadvantage compared to one that did not because, in nature, appearance correlates to other factors we need to recognise in each other in order to survive such as health. That is not to say that everyone who looks good is healthy and powerful, but it does serve as an instantly recognisable signal of advantageous attributes that aid survival.
In my opinion, our powerful innate drive to maintain the appearance is a survival instinct derived from the fact that looks affect people’s behaviour towards us, and directly impact on the opportunities other people give us. We are social animals that depend entirely upon the society we live in to survive. The aesthetics industry is, therefore, like nearly any other industry in what it is providing – the ability to do more. It strives to increase personal influence, but not through mechanical or computing power, by enhancing social capital, the most important source of power there is.
by Dr Tim Pearce, MBChB BSc (hons) MRCGP
Clinical Director, SkinViva Training