Cosmetic Changes

As society embraces multiethnicity, more people opt for plastic surgery, while researchers study beauty from every angle — and skin tone





“Our goal is to probe the depths of what is aesthetically acceptable and beautiful for each group.”

James B. Lowe III, MD










OPEN ANY ISSUE OF VOGUE, and it’s apparent that the iconic American standard of beauty — the tanned, blue-eyed blonde —now shares the pages with beauties of every race.

“In the 50s, the only ethnic models in fashion magazines were the ones that looked Caucasian but with slightly different skin tones,” says James B. Lowe III, MD, assistant professor of plastic and reconstructive surgery at the School of Medicine. “Today, beauty transcends race and color and is truly dependent on the harmonious relationship of a person’s features.”

Lowe and his colleagues at the School of Medicine are among a handful of scientists worldwide studying how to preserve ethnicity in plastic surgery procedures. For the past three years, they have been researching aesthetic attractiveness among different ethnic groups.

“Caucasian beauty is well-defined in our culture, so we know what’s acceptable,” says Lowe, who also is a plastic surgeon at Barnes-Jewish Hospital in St. Louis. “But what’s attractive for Caucasians isn’t necessarily beautiful for everyone. We ought to know what’s acceptable to other ethnic groups.”

James B. Lowe III, MD, right, and colleagues perform cosmetic surgery, responding to the new century’s broader definition of physical beauty.

A recent study conducted by the American Academy of Facial Plastic and Reconstructive Surgery revealed that cosmetic and reconstructive surgery among minorities increased exponentially between 1999 and 2001 — quadrupling among Asian-Americans and African-Americans; tripling among Hispanics.

As the number of ethnic patients seeking plastic surgery continues to rise, understanding how to preserve ethnicity is critical to creating an attractive and natural look.

In Lowe’s study, researchers measured the position of facial features — lips, brow lines, cheekbones, noses — in African-Americans, Middle Easterners, Hispanics and Native Americans, along with a breakdown of Asian subcultures into Chinese, Japanese, Vietnamese and Hawaiian. They also analyzed ethnic models in fashion and other popular magazines to further define the aesthetic for major ethnic groups.

“We can’t make someone look ‘natural’ if we don’t know what ‘natural’ is for them,” says Lowe. “Japanese people don’t want to look Chinese, and Chinese people don’t want to look American. Our goal is to probe the depths of what is aesthetically acceptable and beautiful for each group.”

Study results help Lowe treat patients like Lucille Harris, a 59-year-old, African-American elementary school teacher who came to the medical center because she wanted to rejuvenate her face.

“I felt like I was 25 inside, but I looked 60 on the outside,” she says. “I wanted to look as good as I feel.”

Harris had been considering having a face-lift and a brow-lift for years, but was afraid of the pain and had concerns about the cost. In the early 1990s, Harris’ mother, then in her 70s, elected to have a face-lift at the School of Medicine. She was one of the first older African-American women in the region to have facial plastic surgery.

“My mother was my mentor, and she gave me the courage to go forward with it because she loved the results so much,” says Harris.

Skin tone and facial structure influence the aging process and affect the types of procedures that are most effective for a particular skin type.

African-American and Middle Eastern skin may scar and change color after surface procedures that penetrate the skin, such as laser resurfacing. Light skin shows signs of aging — fine lines and deep wrinkles — much earlier than Hispanic or African-American skin; therefore, procedures that minimize aging, such as face-lifts, brow-lifts, Botox injections and chemical peels, are common with this group.

Lowe says the majority of patients want to improve their appearance while preserving their ethnicity. Most of the time patients bring in a picture of a brother, sister or other person who is considered attractive in their culture.

“The goal,” says Lowe, “is to achieve a natural look that brings individual facial features into a harmonious balance while maintaining ethnic traits.”