More and more people are helping nature with syringes and scalpels and are beautified by the doctor. Cosmetic surgeon Felix Graf von Spiegel is one of them. A conversation about the shift in beauty ideals and the everydayness of Botox.
Last year, People magazine named Chrissy Teigen and Paul Rudd the most beautiful people in the world. In your practice you get the current trends, say, what do you have to look like in 2022 to be considered beautiful?
Felix Graf von Spiegel: The trends are very heterogeneous, there is no uniform ideal. And you have to distinguish between younger and older people. What they all have in common: They want to look better and fresher.
Fresh like Kim Kardashian?
People don’t come and say, I want to look like Kim Kardashian now. That’s an exaggeration. But what can already be seen: A female figure is trendy and desirable. A narrow waist, curvy shapes on the hips and a slightly larger bottom are perceived as beautiful.
It wasn’t that long ago that cosmetic surgery in Germany was more of a niche business, was either attributed to the luxury-spoilt high society or was considered lacking in style and quality – double D and ass antlers send salute. But those days are long gone. Who is coming to the Beautydoc today?
Cosmetic surgery has definitely arrived in the mainstream, at least in the metropolitan areas. The willingness to have something done is present in all social classes. It starts with the minimally invasive procedures. But many women also come to us after pregnancy for a “mommy makeover”. These women just want to look like they used to look like when they were young, sporty and unpregnant. Such makeovers are combined interventions in which several areas are corrected at the same time in one operation. This is very popular and great results are achieved.
Felix Graf von Spiegel has already carried out more than 8000 treatments in his Nymphenburg practice for plastic and aesthetic surgery in Munich.
In fact, more and more people are going to the doctor for more beauty. In 2020, more than 425,000 interventions were counted in Germany, and the trend is rising. Which aesthetic treatments are currently the most popular?
Definitely minimally invasive treatments like Botox. And also fillers to build volume in the lips and facial contours and so on. Surgical interventions on the body include breast augmentation and reduction as well as liposuction. Eyelid tightening is at the forefront of aesthetic facial surgery.
Is it the new normal that we all get injected young?
Botox is, I think, absolutely commonplace these days. One has the feeling that there is no longer anyone who has done nothing. Even if people don’t talk about it.
What do you think, will there be minimally invasive procedures such as Botox treatments in cosmetic salons or changing tires at Pitstop in the future – cheap and fast?
At least botox treatments not in cosmetic salons, because botox is a medicine and medicines may only be injected by doctors. But the trend is definitely there. In recent years, a few chains have emerged in which young doctors work, fresh out of university without specialist training. It doesn’t have to be bad, you can learn the basics quickly. But if you want to make a really good filler, you need experience and that comes at a price. The young women in particular often don’t have that much money and then just let such chains do it at bargain prices. Is that really a good idea? phew I would rather go to someone with more experience. After all, it’s all about the face.
There used to be more plastic optics, more giant breasts and inflatable lips, is that possible?
People today want to look like they used to look. Actually, time should be reversed. Patients don’t want to look different, they want to look naturally beautiful. In Germany it is still the case that you should not see aesthetic interventions, but you should look better. A balancing act.
So the giant breasts have had their day?
The giant breasts are rather out. There are certainly still a few who would like to have it, but the trend is also towards naturalness in aesthetic breast surgery. Smaller implants are more commonly used these days. In the meantime, this is often combined with an autologous fat transplant, which evens out the transitions. The result then looks very natural.
The USA is by far the country in the world with the most cosmetic surgeries per year. It’s not uncommon for people to go to the beauty doc early for the first time. Nose and breast surgeries are often part of everyday life in high school. Can such a development also be expected for Germany?
At the moment I don’t see it that way, at least in our practice. I also hope that it doesn’t go so far that people in this country already undergo breast augmentation with implants when they are still at school. Unless, of course, you have a breast deformity. Such a breast augmentation with an implant always involves follow-up interventions. It usually lasts 15 to 20 years, after which the implant should be changed. The breast changes over the years, the implant does not. Therefore, it can also happen that a breast lift is also performed when an implant is changed.
Aren’t implants now that last a lifetime?
Manufacturers give a lifetime guarantee on the integrity of their implants. But surgical experience shows otherwise. If we change implants after many years, they are often defective. But that’s not a big deal, because modern breast implants are filled with a cohesive gel that can’t move freely in the body. So it stays in place. In the event of an implant defect, most manufacturers will replace the implant free of charge. However, the operation is not accepted. This is misleading and the doctor should educate his patient about it. There are many reasons why an implant change must take place. The most common is capsular fibrosis, but also changes in the shape of the breasts due to pregnancy, breastfeeding, weight fluctuations or simply normal aging processes. A reputable doctor will never give his patient a lifetime guarantee of breast augmentation, but will advise them that follow-up procedures are the absolute rule.
Anyone who hangs around on Instagram sees stars and starlets presenting their freshly sprayed lips and Brazilian butt lifts as a matter of course. What influence does social media have on the current image of beauty?
Younger people are very oriented towards and influenced by social media. They perceive a body image as beautiful and normal, which is by no means normal but has been achieved through interventions, and then they want to look that way. This is sometimes a worrying development. I often don’t find that young women really look younger or better when they’re sprayed on so massively.
At the same time, body positivity is propagated, one’s own body should be accepted as it is. How does that fit together?
That doesn’t add up at all. They are far from body positivity. The pressure to optimize oneself physically is huge, especially through social media. You just have to look at how young people are all running to the gym. Almost all young men are fit and muscular. That might not have been the case 15 or 20 years ago. Looking at society like that, I think body positivity is wishful thinking. And especially not for young people who are still unsure about themselves and their bodies. But of course, if you look good, it’s good to talk about body positivity. As aesthetic surgeons, we are responsible for what we want to offer our patients and what not.
What has been the craziest wish that a patient has ever made of you?
The craziest was a patient who wanted elf ears. So pointy ears. She’d had an ear surgery before and it had gone awry. That’s why I let myself be carried away to operate on it. I built a scaffold for the ear using costal cartilage and it worked well. If she hadn’t tried this procedure elsewhere before, I would definitely have tried to talk her out of it.
When do you refuse surgery?
Every doctor attracts his audience. Patients tend not to come to me with completely absurd ideas. Most of them have understandable wishes. If the expectations are unrealistic, I refuse.