The Archives of Facial Plastic Surgery recently published an opinion piece by Monte O. Harris, MD, titled "Cultivating a Global Aesthetic Consciousness." Harris makes a point of arguing that physicians apply a "world view" to the use of plastic surgery — to embrace diversity in a way that would change the very language we use to describe symptoms and even how one refers to people of color. Harris equates a "modern" approach to plastic surgery as one that rejects the veiled racism in the language of "white" and "non-white."

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Just as Pablo Picasso found inspiration for modern forms of artistic expression outside of the classical European aesthetic canons (Picasso incorporated the ceremonial masks of the African Dogon tribe into his groundbreaking cubist work, Les Demoiselles d'Avignon [1907-1909], we have a unique opportunity to adopt a "modern" approach to facial plastic surgery through redefining surgical logic to be more anatomically sophisticated and culturally sensitive.

The idea of a modern approach to facial plastic surgery has at its core the central precept of embracing individuality. For many surgeons, achieving consistent results in patients outside of the white mainstream has proven to be unpredictable and challenging. In my opinion, technical expertise is not the most significant hurdle to overcome in achieving favorable aesthetic outcomes in patients of diverse cultural backgrounds. Techniques can indeed be taught. Cultivating a global aesthetic consciousness for beauty aligned with technical competency is a more nuanced endeavor for today's aesthetic surgeon. Surgical success ultimately relies on an ability to precisely identify anatomic variables and reconcile these anatomic realities with the patient's aesthetic expectations and their sense of ethnic identity. Among the most challenging aspects is the surgeon's ability to "culturally connect" with the patient and in turn establish a foundation for the creation of a shared aesthetic vision.

Society has placed a premium on our ability to connect with each other—by any means necessary, eg, through Internet blogs, Facebook, and Twitter. This desire to connect should translate to our relationship with prospective cosmetic surgery patients, particularly with those who have traditionally rejected facial cosmetic surgery, seeing it as a means of conforming to mainstream European ideals of beauty. The consultation is an opportunity for both surgeon and patient to share and learn from each other. The biggest complaint that I receive from patients of African descent who have visited other surgeons for consultation is a lack of confidence with the surgeon's ability to internalize their desired cosmetic goals with cultural sensitivity. Exploring ancestry and culture is an ideal means to set the stage whereby surgeons can learn from their prospective patients. This educational platform supports an atmosphere for the "sharing of knowledge," whereby the surgeon and patient may co-create a shared aesthetic vision. Once the aesthetic vision is defined, it is up to the surgeon to formulate a plan in which the collective vision can be shaped into an anatomical reality.

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