Last month, I had the privilege of visiting the city of Nara. Nara was previously the ancient capital of Japan and today it has elements of sublime beauty, serenity and mystery in keeping with its regal past. Nara is dotted with temples and shrines along with beautiful parks where deer are free to roam. They are sacred to the city because in ancient folklore a visiting god rode into Nara on a white deer.
I was in Japan to attend the Asian Pacific Craniofacial Association (APCA) conference. Part of my work in the UK is to deal with facial and skull deformity and the conference attracted many experts from around the Pacific Rim. The meeting took place in a state-of-the-art centre. An incredible building, which reflected the fact that the co-existence of modernity with and an ancient historic past is a recurring theme in Japan.
I attended because I always love visiting the country of my birth and I find it fascinating how the approaches to surgical problems between countries and continents can be very different. One of the reasons for this is that diseases vary geographically but also cultural differences can influence management. During the APCA conference, there were some scientific papers and lectures on cosmetic surgery of the face. The essence of what is regarded as beautiful varies between cultures although I do believe that there are universal norms of an attractive human face too. One of the most active centres of plastic surgery in the World is Seoul in Korea. There were several papers from Korea on jaw and cheek surgery carried out to diminish the horizontal width of the face. The full and soft cheeks, which can sometimes be a symbol of youth in the West is not always desired in the East. A lot of cosmetic surgery of the nose in Europe centres on making the nose smaller. The statistics are different in Japan and Asia where augmentation of the nose to enhance projection is common. Differences in the racial anatomy of the upper eyelid in the Japanese have led to a great deal of cosmetic surgery to create a subtle skin fold crease. This is lacking in over 70% of far Eastern people but almost always present in European races. The presence of the crease is felt to enhance attractiveness in the Japanese female and also in some men.
Of course, there are many similarities in cosmetic issues between the East and West. Treatment for making parts of us smaller, larger or younger is international. The need to allay our cosmetic concerns and anxieties probably has similar psychological origins throughout the world. A few days in Japan truly refreshed and stimulated me to marvel at the diversity and parallels between us all.
Happy New Year!
Hiroshi Nishikawa, January 2017