Drawings

When asked "How often do the results of surgery look exactly like a drawing? " The answer is  "Never."

No result is just like a drawing. The result is not the same as a drawing. There is always some difference.

So if that is true, and the results are never just like the drawings that are chosen then the question is

"Why do drawings?"

The following are some of  the reasons we do drawings.

1. Drawings are of great benefit to both patient and surgeon.

2. They are a form of communication better than words.

3. Drawings are done on various views of the of the subject’s face.

4. The photographs can be digital or film or both.

5. With drawings the surgeon and his assistants can see the  improvements in appearance that may be possible.

6. Many drawings can be done searching for what looks best.

7. With the many possibilities placed before them, one can choose what looks best.

8. The patient's choice is most important.

9. The drawings can be taken home and shown to trusted family and friends for helpful advice and criticism.

10. If someone is very critical of the proposed change in appearance, it is good for the person who is considering it to hear the objections before the surgery rather than after.

11. The surgeon can express his thoughts of desirable appearances, shapes, forms, contours and beauty etc. through the drawings much more precisely than with words.

12. The drawings of the proposed changes overwhelm the descriptive words with clarity.

13. The words for example may be every synonym of beautiful, glamorous, attractive, sophisticated, exciting, absolutely wonderful, gemlike in quality, cute, flirtatious, irresistible, gorgeous, etc. for what the surgeon intends to do.

14. Descriptive words are more like opinions and can be vague and subjective. Drawings are more objective and exact. And  if you don’t see it in the drawings, it isn’t there.

15. It is much, much easier to draw something beautiful and to change it than to do it with a scalpel.

16. Design can be done better with drawing than during the operation.

17. The design tells us what we want to achieve in the final appearance and may require more time and study than the surgery requires.

18. Anything can be drawn.

19. For example if the face of the young beautiful model or celebrity were chosen as an ideal, then that face or any part of the features can easily be placed on our subjects face.

20. This is especially easy with digital drawing. And who knows, whether it is the eyes, cheeks, nose, chin or lips those features of hers may be the best and the ones chosen.

21. We must be careful in choosing features of celebrities.

22. We are dealing with looks here, and with actors such as a personality or famous actor or singer, their fame and the love we have for them may be due to a lot more than their looks.

23. It is safer to stick with unknown models who are gracing the pages of magazines advertising things that have to deal with looks such as cosmetics, fragrances or clothes.

24. Those models, who are not otherwise known,  are chosen for their looks.

25. And sometimes they are chosen from many photographs both of themselves and other models with just the right look that subtly makes us think that perhaps we could look that good if we could wear whatever it is they are wearing.

26. The advertisers spend millions on these ads every year.

27. They study and track the response to the ads as objectively as they can to know how well their advertising budget is being spent.

28. Many persons from the advertising agency from the photographers, to the advertising and magazine lay out artists and to the executives and aspiring executives all have their careers on the line as they make these judgments of what looks good and what does not.

29. Each of us can pick up one of these magazines such as Seventeen, Glamour, Allure, Vogue and many others from many different countries and in different languages.

30. We can look at all the ads from month to month and even years back as fashions change and study the figures and faces to see what is beautiful and what is not in our opinions.

31. What is the true, fundamental nature of beauty we hope to find.

32. For our goal is not to appeal to a fad.

33. If we to have the same hair style and clothes as were worn in the fifties, sixties or  seventies it could be very noticeable and wrong today.

34. And sometimes we seem to see that in a person who looks good in one particular hair style - say the bouffant with a lot of hair spray - and they know how to do it - so they keep it up decades after it has gone out of fashion.

35. That is not the face we want.

36. We would prefer that all the changes made, be toward great beauty that will be eternal.

37. Our opinions change as do our faces.

38. We can look at the ideals of beauty from all of the artwork of the world representing human forms and faces from ancient to modern times.

39. Ideas of what looks good and what does not change can be sought from all over the world and from all of the art of the past and the projected styles of science fiction predicted for the future.

40. The changes from Egyptian, to Greek, to Roman and on into medieval, renaissance and modern times are known and are available to us and can be studied.

41. What we are searching for is the answer to the question of what is beauty?

42. And is there for the human face or the part we are working with a characteristic that is essential?

43. And is a characteristic without which the maximum or some part of the sought after beauty is lacking?

44. For example in comparing the ancient to the modern - the size of the muscles of men progressively increases through Egyptian, Greek, Roman and renaissance periods.

45. The body builders of today, with steroids or without, frequently surpass all of the ancient statues of Hercules from the Greeks, Romans, renaissance and modern times no matter how muscular and ideal they had seemed then.

46. The beautiful faces seen gracing the magazine ads seem much more strikingly beautiful than were done in ancient art and that is even though the Egyptians obviously wore a lot of eye makeup, wigs and jewelry.

47. The female faces and forms we have today with very small waists and breasts of any size chosen seem to surpass everything of the past.

48. Only the cartoons and science fiction type drawings of exaggerations of muscularity and male and female sexuality are able to surpass the actual shapes of the bodies of our times.

49. With all of the knowledge including diet, exercise, nutrition and cosmetic dentistry and surgery of our times, there are many opportunities for everyone to have improvements in face and body.

50. And so there are still  many sound reasons for everyone not being perfectly chiseled and physically beautiful with all that can be done. But there are many things more important such as character, morality, knowledge and wisdom.

51. And there are limitations of course. Perfection is a matter of opinion and opinions vary.

52. But it is amazing as we draw the more perfect faces and then create them with surgery, how few limitations there are.

53. The drawings chosen serve as a goal. A destination. The decisions of how the face should look have already been made. There is no need to ask or try different looks on the table to see which is better. The surgeon knows already where to go and the only question then is how best to get there - to achieve the chosen result.

54. As some scientists have said - if it can be imagined, it can be done.

55. And as Einstein said "Imagination is more important than knowledge." This fits the importance of drawings.

56. And it is from imagination - imagine how this face could be - that we choose our goal. It is interesting to ask how we know what looks best when we see  it. Or how much of our knowing comes from culture and experience and how much is born in us.

57. If we look at a set of drawings that represent alternatives of how our face can be improved, and if we know, that the drawings - since anything can be drawn - are not good enough, then in a sense, our imagination of possible improvements in those drawings leads us to improve them.

58. As we study our history,  the atoms and molecules of the human genome and explore the universe at ever increasing speed, it seems to be true that our intuition tells us what beauty is and is not. And some of that intuition may be genetic.

59. And certainly in the experience of cosmetic surgery the imagination of what beauty is and choosing the goal that truly is most beautiful is of equal to or sometimes even greater importance than the actual doing of the surgery that is to create it.

60. With the famous Sistine chapel ceiling of Michelangelo, the concept was as important as the doing.

61. As with the last supper by da Vinci, the concept stays and is forever beautiful as the actual painting crumbles.

62. And these artists did not get up there eighty feet high on a wooden scaffold with a broad brush and start painting the face of God. They planned it first.

63. Without planning,  it could only have been a disaster.

64. Some of the sketches and drawings Michelangelo made in the planning still exist.

65. A beautiful building is credited to the architect such as a Frank Lloyd Wright building or an I M Pei, or Frank Gehry building. They made the plans. They did the drawings.

66. They imagined the concept and chose the concept from what their imagination had conceived. And did not do the fundamental putting together of building the buildings.

67. And so my contention is that in most of the great works of art we most admire, the beauty is more in the imagining, the conceptualizing, the planning, and design than in the actual work of creating what was designed. .

68. And it is the planner, the one who imagines what could be, and who makes plans and records them for others to see who is given credit for the work of art. And not the artisans who put or help put the concept to canvas.

69. Therefore, for the maximum beauty of the result we need all the input of all the artists and architects of the world and all the opinions of all the critics ( in drawings please - words are almost worthless) from which to choose so that we arrive at the correct concept of what is truly most beautiful.

70. And beautiful to whom.

71. Let me tell you. Not just to one but to everyone.

72. The patient’s choice is of higher priority than the doctor’s or anyone else. The patient is who is going to see the result everyday for the rest of her/his life is most important. And s/he has the final say of what it should be, how it should look, and what is the final choice.

73. But there is a judge that we want to please even more than the patient. And that judge of this beauty contest is the human genome. We are of a species. If we were grasshoppers or ants we might make entirely different choices of what looks good and what does not. But we are of this species. And we want it to look good to everyone.

74. We want everyone who ever sees the result think that it is as perfect as it can be, that it cannot be improved upon and that it looks completely normal.

75. We should consider all recorded history of what has been considered beautiful thousands of years ago, and extrapolate into the future and predict what will be considered still beautiful for the rest of our lives, for centuries to come and for thousands of years from now.

76. When they dig you up or see your photographs thousands of years from now, we want all the people of the future to be amazed at your beauty, at the beauty of what was done and not know or be able to tell that anything was ever done.

77. We want to aim for the most beautiful face the world has ever seen or ever will see. And I say face, because no matter what part or parts we are working on, we want the whole face to be beautiful, and so it must be fitting.

78. Let’s say we can make your face anything we want it to be. Then that is the question The big question is what do we want it to be? I would like to have that question answered as accurately as possible before we begin to do it. And you will want to know as well.

79. Drawings are a search for the answer. We are searching for beauty. The maximum beauty. The most beautiful it can be.

80. We are searching for what will fill all or our criteria of what looks best.

81. The question is "What do we want the face to be"

82. And the answer is in the drawings.

83. We keep searching until we are sure, certain that we have found the goal that cannot be beat. Cannot be improved. Cannot be bettered.

84. Another very good reason for drawings is so that the patient and the surgeon have agreed upon all the details of what  final appearance is desired. .

85. In the final meeting with the patient we together make a list of all the things we wish to accomplish. The average length of the list is about twenty things. Twenty items that are to be modified in such and such a way as shown on the chosen drawings.

86. Sometimes there are only a few things like six or eight. But sometimes the list is as many as fifty things long - and more.

87. We then go over the list a prioritize those things that are most important to be sure that the doctor knows the patients wishes regarding all those things.

88. Then we discuss with the patient all the pros and cons of each of the changes being made and the alternatives for each area, such as the lips, chin, cheeks, forehead, frown lines, ear lobes etc.

89. All of these areas have their own set of possibilities, alternatives, pros and cons, and common complications.

90. At times such a detailed discussion of so many facets is fatiguing, confusing and maybe really unnecessary.

91. Sort of like a taxi driver explaining every corner he is going to turn before you get in the cab. It does not actually change the trip.

92. Would we do drawings even if the subject were blind and could not appreciate them. Yes. Definitely. And the reason is that we need them as a map; as a guide. A compass that points the surgeon and takes us in the proper direction at all times .

93. The surgeon has enough to think about for the patient’s welfare in doing the procedure and in getting from here to there.

94. It greatly lifts a burden from the surgeon to know just what the plan is. The direction. The destination . The chosen goal.

95. And the result of the operation we want to be as close to perfection as anything a human has ever created. It will not be an accidental accomplishment done with the eyes closed.

96. We know that it is going to be as close to perfection as anything a human has ever created in advance because the drawings are the most perfect possible.

97. Or else the surgery should not begin. We need to know where we are going before we start.

98. Or else we could wind up getting no where by going in the wrong direction.

99. So that every movement the surgeon makes, every step he takes is in the right direction it is greatly to his advantage to have the map showing clearly the correct direction in front of him.

100. Instead of searching as he goes along, the surgeon who knows the destination has only to cover the ground from here to there.

101. He can run with only the goal in mind, to the destination, which is perfection.

102. The winner of a race is not necessarily the fastest. S/he must also be in the right direction; i.e. toward the finish line.

103. If the direction has not even been determined before we begin, all the time of the surgery could be spent trying to make the correct decisions about what is going to look best for this person for the rest of their lives.

104. And that is how cosmetic surgery has usually been done. It is almost surprising that it comes out ok most of the time.

105. We therefore keep improving the drawings until we are satisfied that they are truly beautiful. - and that they are so beautiful and close to perfect that no further work on them will make a significant improvement.

106. This can take many hours of study and comparing. It can take days - weeks and often years.

107. One of my favorite patients was 19 when she first came. We took her pictures and did some drawings.

108. She was interested in art and knew many artists.

109. She knew the art teachers she had in high school.

110. She knew other artists in the area .

111. And she knew the art teachers of and artists at her college.

112. She also had many trusted friends and relatives.

113. She came back to see me several times over the next few months bringing drawings and modifications of photocopies of drawings of both the front and side views.

114. Over the next year I did the noses of some friends of hers from her high school or college.

115. She finally concluded after all this input and study, on a front view drawing done by a professional artist and portrait painter, and a profile drawing I had done for her.

116. Finally at age 21, approximately 2 years after I had first seen her, we did the nose.

117. And the result was as good as I had ever had or better.

118. It was an excellent beautiful result.

119. No ever found any flaw in it. Her face was beautiful. And the nose was fitting and flawless.

120. From this I learned the importance of drawings to the person.

121. She wanted precisely her choice of front and profile views - no more and no less than on the chosen drawings.

122. And I learned the importance of drawings to me as the surgeon in many ways that I will explain,

123. But basically from this experience I learned that if I were to achieve the beauty that had been so carefully put into these drawings, then the patient and I and all her friends and relatives would approve and like it.

124. Are we the only ones who do this?

125. We are certainly not alone in planning with drawings.

126. From Imhotep till now, all architecture is drawings. Plans.

127. Did other artists draw first? Yes.

128. Many drawings that Michelangelo made still exist. Planning the ceiling or a sculpture.

129. And some of his sketchings have holes in them where they were placed on the area to be painted, and the holes allowed dots to be traced onto the surface to be done.

130. Then the dots were filled in to reproduce the sketches - drawing plans - and the drawing was thus transferred to the surface, then to be painted in by the dots.

131. Several architectural plans for the Vatican were made over a period of thirty years and still exist, before the final plans of Michelangelo (at age 72) for the dome were accepted.

132. And the credit is given to the planner, the one who conceives, conceptualizes and communicates it, rather than the one who does it.

133. Surgeons not only have had drawings in the past but have used casts of the patients face and then modifications of the face in plaster and other materials.

134. We have tried the plaster casts and still do them occasionally, as well as the rubber alginate materials and acrylics.

135. But the casting procedures are very, very time consuming and do no look very life like unless color is added and that can require many , many hours,.

136. Even then, the face is usually up with the person lying on their back, and that very often obscures many of the things we hope to improve. Especially if they are over 30.

137. Nevertheless, the study of whatever medium is chosen, should continue until it is clear that the goal far out weighs the present appearance and it cannot be improved and is as close to perfect as possible.

138. Therefore, study the drawings for years if necessary or forever even, if that is required to be sure in ones heart and soul. 

139. Therefore, study the drawings for years if necessary or forever even, if that is required to be sure in ones heart and soul. 

140. Which is more important  words or the pictures?

     Try a questionnaire on friends or the general public asking:

     "To find out what can be done with cosmetic surgery, is it better to  

     1. See pictures that show what can be done - or

     2. Read a written description of what can be done? "

141. It will be found that the great majority who understand the question much prefer pictures of appearance over words describing appearance.

142. But if a third alternative is added  -  3. Both pictures and written description  -  then that will be the choice of the most. And so we have both.  The text is in the " Index of information" and the "Questions and Answers" in the columns on the right side above.

143. Also text is best to show the results of the procedure in the words of the patient's experiences which are shown in the Anesthesia Questionnaire and the Result's Questionnaire from the index in the left column on the front page.

144. While pictures are most important, a lot of words are there in the index of information. 

145. Without pictures, a cosmetic surgery site or explanation is like talking about art without showing it, without seeing it or in the case of music without hearing it.

146. Therefore, do drawings. Plan and design what is going to be the most beautiful result.

147. Then with the drawings showing what everyone agrees is the most ideal perfect appearance on that face, we can choose to proceed to try to achieve that result.

148. How close to the drawings can we usually come with the surgery results? is an excellent question.

149. There are two ways to answer it.

150. One way is to look at the before and after pictures of the patients we have who allow their pictures and drawings to be seen, to see for yourself how close to the drawings did the results of surgery come. We can show you dozens quickly and easily or you can look at most of the more than ten thousand patients we have done over the years.

151. The other way is to look at the results questionnaires of the patients who fill them out for us and tell us if we came close or not. Some of those results questionnaires are shown on the internet at http://wrmorganmd.com/rq0.htm.

152. There you will find that of several hundred results questionnaires 97% of patients said they are close to their chosen goal drawings. And 62% said they had exceeded or had better results than the drawings.