EXILIS – 6 months experience.

Tue, 15 May 2012 13:01:39 -0500

After 6 months of Exilis treatments I am as excited as the day our machine arrived at VISAGE.
At the beginning, I took great comfort in the fact that the majority of Exilis users are Plastic Surgeons, a specialty that goes for solid results rather than “possible” improvements. After first several treatments, I became much more enthusiastic and convinced that Exilis offers unprecedented non-invasive fat removal and skin tightening in virtually all possible areas of the body. In many cases the results surpassed my expectations.

The Exilis technology is based on two sources of energy: radiofrequency and ultrasound. However, in the US, the FDA has approved only radiofrequency for all Exilis treatments.

We have experimented with many possible settings, maximizing delivery of energy and adjusting duration of treatments. Many of us at VISAGE MedArt underwent several modified procedures that allowed us to adjust standard protocols. We have pushed each treatment to the limits of reasonable tolerance in order to maximize the results. Eventually, we developed our own protocols that, 6 months later, allow us to claim, in vast majority of patients, the results beyond what has been reported by other users around the world. We realize that these results would not be possible without the trusting involvement of our patients, their compliance with pre- and post- treatment requirements and amazing motivation.

Exilis still remains a novelty on the aesthetic market in the US and around the world. This truly non-invasive, no-downtime procedure is the only technique that allows combined fat removal and skin tightening in practically any area of the body. I believe that certain modifications of the procedure, may render even better results.

EXAMPLES

Below are the photographs made during different stages of the treatment process. All images are of our patients only. The majority of those have not reached the full results since the component of skin tightening peaks 3-5 months after the treatment.

In the first example the patient underwent fat reduction in the abdomen and flank area.

Surprisingly, after only 3 treatments she had a visible fat reduction in treated area.

The same patient had quite significant improvement in both treated areas at the end of treatment.

Lateral views following 4 treatments of the abdomen and flanks.

The next patient underwent a series of treatments targeting abdominal fat with slight extension to the flanks.

Lateral views before and after four treatments of the abdomen and part of the flanks.

Another example of similar results after combined treatments of abdomen and upper flanks.

Lateral views of before and after 4 treatments of the abdomen and flanks.

The next patient underwent treatments for fat reduction and skin tightening of the abdomen.

Before and after images following four treatments of the abdomen.

And another example of abdominal fat reduction with four treatments over 5 week period.

Before and after four treatments for abdominal fat reduction.

All above cases are expected to show further improvement since the results of skin tightening appear after at least 3 months following the treatment.

The next series of photographs are the examples of early improvements following skin tightening treatments without fat reduction. Although the optimal results are expected at least 3 months after the treatment these patients exhibited visible reduction of cellulite by the end of 5th treatment.

This patient underwent 5 sessions for skin tightening only. The target areas included upper lateral thighs and low buttocks.

Lateral views before and after treatments for skin tightening treatments. A significant reduction of cellulite is visible on both sides.

The next example of skin tightening without fat reduction shows again an early reduction of cellulite.

Before and after five treatments for skin tightening in lower buttocks and back of the thighs.

A similar early improvement of cellulite is seen in this next patient following four treatments for skin tightening.

Before and after four treatments of the posterior thighs and lower buttocks.

All patients above, not surprisingly, had significant reduction of cellulite even though the full results of skin tightening are still 1-2 months away. Interestingly, Exilis treatment is one the leading modalities used for treatment of cellulite in Europe. In the US, however, the Exilis treatment has not been certified by FDA specifically for cellulite treatment, therefore this indication is not being promoted by the manufacturer.

The next 2 examples show the results of skin tightening in the lower face and neck area.

Frontal view of before and 2 months after the last treatment.

The next patient had no significant changes after the first two treatments but after four sessions there are positive changes seen at the jawline and jowls area. Although the results are significant, we hope the final improvement should be more impressive 3 months after the last treatment.

Before and after four treatments for skin tightening in lower face and upper neck.

The lower face and neck treatments, in my opinion, could have better results if more energy was available. The Exilis hand-piece that is specifically designed for face treatments has limit on the delivered energy. The hand-piece for whole body treatment can deliver much higher energy but is much larger making it difficult, and sometimes impossible, to maneuver below and above the jawline.
Before Exilis addresses this issue we try, where possible, to use larger hand piece with adjusted positioning of patient's head and neck.

The next patient underwent total of five treatments for the reduction of breast tissue. Although this region could be more sensitive in some individuals, this patient had tolerated high energy very well.

Before, during and after five treatments of gynecomastia.

CONCLUSION

With the above examples we are confident that Exilis is very effective treatment for fat removal and skin tightening. I also believe that our results in many cases are superior to others. There are, however, few remaining questions regarding the optimal treatments. Although nearly all our patients have visible improvements it is difficult to explain, at this time, why some have more dramatic improvements than the others.

There is some evidence that combining Exilis radiofrequency with other sources of energy may render more efficient fat removal and better results. Therefore, on selected patients, we combine Elixis treatment with a very low frequency mechanical energy from other sources. It is too early to draw any conclusions regarding these combined treatments and the results are still some time away.

Of all treated patients, so far we have 2 that had only minimal response despite several additional treatment sessions. Although the cause is still undetermined, we have observed certain common features in these patients. Working together with Exilis we hope to identify those patients who may not achieve optimal results with present protocols and parameters. It is of utmost importance to us to provide reliable treatments to all patients with long term benefits.

NEW TREATMENT at VISAGE MedArt

Thu, 1 Dec 2011 14:17:50 -0600

Over the last decade the aesthetic industry concentrated on many aspects of facial and body rejuvenation. None has received more attention than skin tightening and fat removal using the least invasive procedures with minimal downtime. Fat Reduction-Skin Tightening became the Holy Grail of Aesthetic Medicine but, until recently, most of those have not lived up to our expectations.
I have been searching for the same since 2009. I have followed closely the evolution of many new devices in Europe and here; I saw many prototypes and several interesting devices already in use; I have reviewed many human and animal studies and considered opinions of the pioneers of new technologies. Not surprisingly, I've also witnessed remarkably aggressive marketing of many devices in lengthy “infomercials” and TV shows promising, with doctor's stamp of approval, quick, painless and nearly impossible results .
Almost always these magic devices ended up, in the real world, very overpriced disappointments because of poor results or intolerable discomfort.
Many studies, quoted as support to promising claims, were found to have either design flaws, not reproducible results or were not confirmed by the independent researchers. Although the consumers had spent/wasted billions on questionable treatments their declining excitement was re-ignited when the “newest” and “revolutionary” technologies rolled in on well-greased wheels of marketing vehicles.
On a more positive side, there have been few winners that deliver positive, satisfying and predictable results. Two distinctive technologies have proved to be highly effective for skin tightnening: Radio Frequency and Ultrasound. Although these two sources of energy are not new, the methods of their application have changed dramatically rendering very good results.
Thermage and Peleve use Radiofrequency; the first may provide measurably good results if one is able to tolerate a significant level of discomfort; the latter has a very limited field of treatment.
Liposonix and Ulthera use Ultrasound with very good results. Both are far from being comfortable to the average patient and frequently require remedies for pain control. However, the Ulthera can treat only selected areas while Liposonix, although much more versatile , has not received, as yet, FDA approval.
Although, Exilis was designed to implement Radiofrequency and Ultrasound, the FDA has approved only Radiofrequency as the source of energy.
The treatment device delivers desired energy through one of two hand-pieces with precise controls of depth and density of waves. The deepest layers of the skin can be treated to reduce fat deposits. Improvements in tightness, wrinkles, skin tone, and texture can be achieved by targeting more superficial layers .
Real time monitoring of the skin temperature during treatment allows for optimal treatments and full safety.
Exilis® treatments offer something that had not been possible until now. A non-invasive, downtime-free treatment ranging from the small area of the eyelid to total body sculpting. It is a non-invasive alternative to those select patients who have considered liposuction but want to avoid an invasive procedure, downtime and sometimes prolonged recovery.
These examples are provided by BTL, the makers of Exilis®.

Before and after 4 Exilis treatments
And this is an example of a single Exilis treatment for neck tightening done at our office during evaluation process.

Before and After a single Exilis treatment
All our patients at VISAGE MedArt know that our only interest, from the very beginning, is to provide superior long term results rather than instant, short-lived, gratification. The long term results, whether it is Botox, fillers or laser procedures, motivates us while searching for new technologies. We are very proud to add EXILIS treatments to our list of services!

Areas of Exilis treatment :
− peri-orbital (around the eyes)
− peri-oral (around the mouth)
− lips
− chin
− jaw line
− neck
− décolleté
− breasts
− arms
− hands
− abdomen
− back
− “bra roll”
− “love handles”
− tights
− knees
− “cankles.”

Treatments: For optimal and long-lasting results a minimum of 4 sessions are recommended spaced every 7-10 days. For fat removal and skin tightening the time it takes to treat depends on the treatment area and varies from 15 to 45 minutes per session. 
VISAGE MedArt will offer Exilis treatments beginning December 2011.

Aesthetic Medicine and beauty

Sat, 12 Nov 2011 09:32:03 -0600

We all would like to be young and look young. We eagerly seek new options, miracles and fountains of youth believing that the newest and, how often, the most expensive is that elusive IT. Women, more than men, have a wonderful need to look beautiful, desirable and attractive with the least signs of passing time. This healthy desire is not new; it has been present for as long as human history records are kept , with notable exception of the Middle ages.

With development of mass communication and media, the internal drive for self-beauty is becoming less spontaneous and more “designed” and “ready to use” by duplicating prevailing trends. Many has lost the perception of beauty in classical understanding and simply follow the trend-setters' vision of marketable beauty.

So, is there a definition of beauty anymore?

There are many definitions of beauty because the perception of it seems to be so subjective. In general understanding, the beauty is that which brings about immediate and self-sustained admiration. This admiration was for centuries a result of spontaneous and instant impression induced by particular set of lines, curves, surfaces and shapes. But more recently, a new and powerful factor begun to play a role in our perception of beauty: the conformity with our expectations and desires coming from our acquired taste.

The issue of human beauty, however, is much deeper; it touches upon the qualities of our character and our soul. Even before the Greek Golden Age, beauty was always associated with important qualities such as moderation, honesty and certain conventions, all complementing each other. Greek philosophers defined this for us as : “Harmony is the most beautiful thing”.

Since conformity implies the set of rules is there a prescribed standard of beauty?

Immanuel Kant defined “beautiful” as ”...that which, apart from a concept, pleases universally.” The extent of that vision was only fully realized recently with the ability of contemporary media to beauty universal. The explosion of mass media was the trigger for culture-dependent phenomenon of manufactured standard of beauty with its universality originating from the Western model.

Human beauty in recent history

The last century technological revolution and advances in communication totally modified not only our perception of beauty but also the extent of its definition.
Take the example of nudity before the invention of photography and cinema. The nudity and looking at it was a strictly personal and intimate matter. For centuries, the only nudes seen in public were in the works of painters and sculptors.

In the XXth century the visual representation of nudity became progressively more acceptable, easily accessible and eventually became a part of everyday life. Not coincidentally, it came along the process of emancipation of women beginning with a new taste of Art Nouveau and culminating in the Second Wave of feminism and final women's liberation in 1960's.

Once the human body gained universal acceptance by exposure to contemplation and admiration, its representation was progressively applied to our daily habits and practice in many forms of new lifestyles such as diets, outdoor sports, personal beautification and, near the end of the 20th century, new plastic surgery. These new forms became the most convincing tools in achieving our aesthetic objectives and desires.

Plastic Surgery

Plastic Surgery became a logical step in pursue of personal beautification and physical individuality. If one lived in remote seclusion there would never be a need for plastic surgery. In reality, however, we pay great deal of attention to our reflection in a mirror as well as, or even more, in the scrutiny of others. The absence of these two key elements would eliminate a pursuit of any representation of self-image. Their presence in reality have determined rapid evolution of self-adjustments, in particular that of plastic surgery.

By far, the largest mirror in contemporary society is held by and directed by media which amplifies new standards and new criteria which are defined by the avant-garde environment of entertainment and fashion industry.

The modern plastic surgery owes its explosion to the dissemination by the media of these new standards of representation of the body. Plastic Surgery has become a powerful promoter of individuality which our society has embraced in the last few decades through new type of self–care and a strong will to improve oneself both spiritually and physically.

We are living in the era of “personal development” where the Aesthetic Medicine, and particularly Plastic Surgery, keep high position along with personal coaching and many other “well-being” strategies.

Is a harmonious, effective social life and sexuality possible outside of beauty?

How fortunate we are that the world does not revolve around beauty alone! How many of us know that the long term personal happiness appears to be inversely proportional to the “attractiveness” of the subject?
The most dramatic and revealing sociological study compared many aspects of personal happiness of people recognized by the society as “beautiful” such as models, beauty pageant winners or media celebrities to those whose appearance was considered average. The result were truly shocking, but not unexpected, and showed that the rates of depression, divorce, suicide, childlessness, and end-of-life loneliness are much higher for the “beautiful" than for the “average” looking people.
Excessive beauty, quite often, becomes a burden for the human being. Yes, the presence of beauty opens doors initially but the price to be paid subsequently seems unusually high.

But there is another, universally negative factor that is too often attached to a “beautiful” person who has succeeded either professionally or personally. There will always be a sort of aura of non-credibility and non-recognition of their true worth and therefore, of their work and accomplishments. In fact, beauty effectively masks the objective reading of one's worth.

Greek philosophers always suggested moderation in all aspects of life in order to achieve perfect harmony. In view of the study cited above this idea has proven itself throughout the ages.

Are women increasingly becoming victims of physical complexes that they did not have 50 years ago? 
The social pressure on women seems to reflect the power of media in creation of new standards.
Our society seems to glorify youthfulness as never before; this new standard forced itself upon us through media, contemporary music and cinematography. Over the last few years it even became a model for competitiveness on the job market.

Not to conclude the absolute we must admit some objectivity. Looking from a different angle on the evolution of aesthetics , the new trends are a reflection of the process we slowly begun to accept and incorporate into our new concept of self-care. The process has its strong roots in natural and deep human need for “normality”, for harmony, for moderation. But this universal standard of “normality” has been extended in recent decades and once it has been achieved there is a desire to project the idea into individual originality and, perhaps more often than not, into ambition of reaching a degree of uniqueness.

This trend is reflected clearly in patient approach to aesthetic changes. The initial requests frequently originate from aspiration for “normality”: not to have large breasts or too many wrinkles, to correct protruding ears, wide ankles or uneven bite. And once this has been accomplished, any further requests could bring aesthetic “alterations” from one level to another with more subtle and more refined changes aimed for perceived excellence such as brightening of teeth, modifying expressions, reshaping of buttocks or hips, improving contour of nose, or rejuvenation of ears or toes.

These two steps, from normality to originality, in order to be optimal and aesthetically pleasing, must be integrated with thorough understanding of the individuality and objective technical possibilities of Aesthetic Medicine in 21st century.

How to assess which wrinkles or curve is beautiful or not, important or immaterial in aesthetic sense?

This is very important question, a question that many patients expect to be answered during the initial consultation. The answer to this seemingly easy question depends not only on the technical possibilities but in essence on doctor's artistic abilities and understanding of visual perception, light interplay and dynamics of the perceived abnormality.

It may come as a great surprise to many that the educational process in any medical specialty or post-graduate aesthetic training does not include even the most basic review of the aesthetic ideals, the concept of “Beauty”, “Beauty” in the context of Art, the philosophy of “Beauty", etc.

None of medical residencies, postgraduate fellowships, training courses or certifications provide or require any knowledge of the art form. You learn a set of rules for each technique that is applied to every patient. For example, you learn to inject lips but not to assess the need for this injection. You learn how to lift eyebrow but not to predict at which level of elevation the effect will be opposite to intended. You learn many techniques of breast enhancement but not the aesthetic reasons to reject the idea. It is as designing a vehicle with the breaks and accelerator pedals but no steering wheel. Simply, what is missing from the aesthetic training is....the Aesthetics, the concepts of art and beauty.
But come to think of it the descriptions of beauty do not come from aesthetic practitioners, but from philosophers, poets and artists.

All the medical and surgical disciplines use a stepwise approach beginning with initial inspection, palpation, auscultation etc., in order to collect all the signs necessary for making diagnosis. This science of signs, the semiology, is the essence of medical abilities to diagnose in order to treat.
But in Aesthetic Medicine there is no semiology. It is like giving antibiotic to everyone for all illnesses. Do you have falling breasts? We’ll bring them back up! Small breasts bother you? No problem, we’ll enlarge them! Sagging skin? We’ll tighten it! Wrinkles? No problem. We will erase them! There is no semiological research in the sense of asking questions: “what are the ideal breasts for a given woman?", "what are ideal buttocks?", “ideal legs”? what is ideal nose?”, “which lines and folds need not to be corrected?", “what are ideal lips for a given face?”

The “ideal”, for clarification, is not the subjective concept of “the most beautiful”! It is the sum of many anatomical, cultural and artistic components that may gives rise to admiration. 

If Aesthetic Medicine does not feel concerned about the definition of beauty, what is really the purpose of their vocation?

In any cosmetic procedure, artistry is paramount. There is a large degree of medicine, science and technology involved in the Aesthetic Medicine, and this is what we as doctors are taught and must learn. Knowledge, experience and continuous learning are extremely important, but we must not confuse these with the term “skill”. Without the artistic skill, without the passion and, above all, without understanding of art form the beauty is void and the end results are left to the gamble of chance.

In Art, the knowledge of art and experience with looking at it, without the artistic skill may produce, at the best, a very knowledgeable and experienced art critic rather than artist. In Aesthetic Medicine, it is immaterial whether one has skills or not. There is no artistic scrutiny at any level or at any stage. Edgar Degas, a famous French painter explains this very simply: “ Painting is easy when you don’t know how, but very difficult when you do”. Almost anyone with minimal training could remove tattoo using the newest and most sophisticated lasers. But very few indeed, would have a skills to create one.

“True art conceals its own creation” is my favorite phrase and I feel this is so apt in today’s field of Aesthetic Medicine and Surgery. It’s all about the process of creating something that appears perfectly natural, and as such, simply appears as though it has always existed.

Since the early 1990’s the medical field of cosmetics has been rapidly expanding. It is an exciting and creative part of medicine encompassing an ever increasing number of techniques, procedures, products and technologies. The umbrella of cosmetics now covers a wide variety of options, from the minimally invasive to quite aggressive.
I have witnessed this expansion and rise in popularity since my beginnings in 2007. I have seen in this short time products and techniques come and I have seen products just as quickly disappear from the market. I have seen the “bandwagon” approach of many, jumping onto the latest fad, only to drop this for the next very "latest" ”amazing” thing.   I have quickly become more guarded over new products and technologies and their convincing claims. And I remain very cautious and often skeptical about the “latest” and “revolutionary” machines of beauty and miraculous methods .

The most important aspect of Aesthetic Medicine is a simple awareness that although lasers, Botox, Juvederm, implants and scalpel may bring about the most amazing and artistically pleasing results, these are just raw, passive, and obedient tools without built-in recipes for beauty or guarantees for aesthetic magic. These may come only through skills and knowledge of those who use them with artistic responsibility regardless of individual or prevailing tastes.

“Art has got nothing to do with taste” said Max Ernst.

(inspired by thoughts of one giant of modern Plastic Surgery from Casablanca)

The ideal beauty of human body art

Thu, 3 Nov 2011 10:06:22 -0500

Venus of Villendorf Venus of Dolni Vestonice Venus of Lespugue

The above figurines were created at the time of European Ice Age approximately 25,000 years ago.
Coming from many different areas, these examples may suggest a fascination with certain attributes of femininity rather than simple expression of uniform beauty. All are characterized by the absence of face and feet making them more symbolic rather than personal. Some show elaborate patterns on the head representing either hairstyle or head cover.
The figurines certainly do not conform very much to our present sense of an ideal body. It is believed that the images represent a homage to fertility and ability to survive under harsh conditions.
The accumulation of fat may be seen as a means of storing energy when expected external sources were beyond the reach.

ANCIENT EGYPT

This is a relief carved 3,500 years ago on the ivory chest of king Tut. We see a unique and refined fashion, delicate and fastidious an even, slim female body.
Women were shaved entirely, sometimes even their heads. And to emphasize this, their pleated skirts were worn wide open in front.
In Ancient Egypt, beauty was closely linked with completeness. A beautiful face was considered to be one with fine features, large, expressive eyes and black hair. The neck had to be long and graceful, the body very slim with fine wrists and ankles and long, delicate neck.

Garden promenade of Tut-anch-Amun an his wife Anch-es-Amun.

Queen Nefertiti, who was the most influential woman of Ancient Egypt for more than a decade has been regarded as the symbol of female beauty and power. Her famous limestone bust represents Egyptian perception of ideal feminine beauty with well defined facial structuresa and perfect symmetry.

 

Nefertiti bust with perfect facial symmetry.

ANCIENT GREECE

This well known drawing by Leonardo da Vinci, about 1500, relates to the only architectural treatise at all, to survive from Antiquity, by Vitruvus Pollio. Although it is unillustrated, it profoundly influenced art throughout history, especially in the period Renaissance.
Vitruvius, in the I century B.C., describes the classical ideal of beauty as derived from symmetry and a modular relationship, where the smaller part compares to the larger as this to the whole: this is called "The Golden Section" or the "Golden Mean".

Vitruvian Man

Architecture in Greece was seen as an imitation of nature with anthropomorphic - human – proportions. Vitruvius distinguished the three column types as Doric, Ionic and Corinthian, the proportions deriving respectively from a man (Doric), a young girl (Ionic) and a matron (Corinthian).
Art, science and nature were considered as completely homogenous, as a unit.
The Ancient World was dominated by a striving for physical and mental harmony. Well-formed, balanced proportions expressed aesthetic completeness and were regarded as the most important criteria for beauty. There were heated debates as to what constituted beauty. Female beauty was regarded as very important combining two key characteristics: charm and slim figure. "Whiter than ivory" was Homer's idea of the perfect woman's complexion. Those who wished to be beautiful had to radiate youthfulness. 

This “standard” of beauty lead through the centuries and remains the core of our contemporary culture.
 No other goddess of the Ancient World could match the beauty of Aphrodite (Roman: Venus): the goddess of fertility, beauty and love. Aphrodite, alias Venus, who "arose from the sea," is the embodiment of beauty and love. Socrates postulated, that the main task of the artist was to give a standard idealized contour of the human body in exact proportions to gain Balance and Harmony. We can still admire this in the statue of the "Venus de Milo", one of the most famous works of art in history...

The discovery of Venus of Milo made her into the immortal symbol of female beauty in his sculpture, created in around 100 BC.
Paradoxically, in contrast to the symmetry of bust of Nefertiti, Venus of Milo contains certain intended facial asymmetries. The only symmetrical part is her lower face. Her nose is deviated to the left, left ear stands higher than the right and the left eye is higher and closer to midline than the right. These features of Venus prove the genius of Greek art and unsurpassed understanding of visual perception. This is a gift and absolute requirement for those who create art, from ancient sculptor to contemporary Aesthetic Physician.

Venus de Milo

In Greek mythology, Helen is regarded as the most beautiful mortal woman of her time. The daughter of Zeus and Leda is said to have been so beautiful that every man wanted to own her - including Paris, who foolishly abducted her to Troy and thus started a 10-year war in which Troy was finally completely destroyed.

 
 

Helen of Troy

EARLY MIDDLE AGES

In the Middle Ages, which were dominated by the Christian faith, excessive care of the body or the application of make-up was regarded as sinful and heathen. Beautiful women were treated with mistrust, and regarded as dangerous temptresses because of the expulsion from Paradise caused by Eve. Feminine beauty was therefore linked with danger and sin. And yet there was an ideal of feminine beauty, dominated by a delicate, white skin. Regular blood letting ensured a pale complexion, and toxic white lead was even used to lighten the color of the skin.
In these genesis scenes of the "Grandval Bible" from the early Middle Ages, about 840 AD, we can see, how the consideration of physical characteristics, the proportions and harmony of the design, has become unimportant. The human being lived religiously, beyond earthly reality, in an eschatological world awaiting God. Particularly women were presented as plain, unattractive figures.

Adam and Eve, Grandval Bible, 840

LATE MIDDLE AGES-GOTHIC STYLE

Here we see the paradise scenes on a miniature from one of the most beautiful books ever made, called " Les trés riches heures du Duc de Berry", a prayer book of the French king's brother, originating from about 1400.
An enormous change in art has taken place. We see the so called "Beautiful " or "Soft Style", a luxurious, refined fashion again, with a slim silhouette.

Trés riches heures, Paradise (Praying Book of the Duke of Berry), 1440

RENAISSANCE

In the Renaissance, the cultures of antiquity and their ideals of beauty were rediscovered. Women's bodies were depicted very voluptuously. While the arms and legs were meant to be as graceful as possible, the tummy, bottom and waist were allowed to be well rounded. In everyday life, there was once again more emphasis on beauty. The porcelain complexion was increasingly regarded as the expression of a particular grace, and this was generally emphasized with make-up.
Birth of Venus, Sandro Botticelli,1486

The attention is drawn vehemently from religious to profane, worldly themes, for the first time in history except in the Hellenistic era of Ancient Rome. The ideals of Humanism are personified in the painting of Giorgione "Sleeping Venus", from 1505. It had an immense influence until modern times, including a special pose of a reclining nude.

Sleeping Venus Giorgione, Venice, 1505

LATE RENAISSANCE - MANIERISM

This famous painting is an example of the style of late Renaissance, called Mannerism. In Diamond Mine, from 1570, painter shows scenes of a diamond mine in the excessive manner of exaggerating certain physical features of human body, for example human limbs, far away from classical proportions of different body parts.

Maso da San Friano , Diamond Mine, 1570

BAROQUE
Here we have typical Baroque splendour depicted in "Wife of King Kandaules" in 1646 by Jacob Jordaens, contemporary of Rubens. And like Rubens, the stout, luxuriant and voluptuous bodies became proverbial.

The Wife of King Kandaules, Jacob Jordaens 1646

ROCOCO- LOUISE QUINZE

The late Baroque time, the Rococo, underwent dramatic change in taste and perception of beauty. The ideal woman became slim, with tight waist and graceful .
Here are charming examples from "Commedia dell'arte" by 0talented sculptor of XVIII century Franz Anton Bustelli.

F.A. Bustelli, porcelain figurines

EMPIRE

The Empire era represents return to ideal concept of Antiquity. Maya, the only nude painted by Goya, next to "Dressed Maya", with a flowing silhouette is similar, in many ways, to the Renaissance composition of Giorgiones Venus.

The Mayas, Francisco Goya 1798; Madrid, Prado

CLASSICISM

Classicism continues with deep fascination with classical Golden Greek beauty. Ingres shows us the most perfect bodies in his painting of two antique divinities, Jupiter and Thetis, with classical proportions of beautiful bodies .

Jupiter and Thetis, Jean Dominique Ingres, 1810

ROMANTICISM

Fifty years later in a new epoch of Romanticism, we see the same artist, Ingres, with a different sense of beauty: soft curves and magical fairyland was discovered in the art of the middle of 19th century.

Turkish Bath, Ingres, 1862

VICTORIAN ERA

A pale skin and ornamented hair was regarded as beautiful and elegant in the Victorian era. However, it was the body, rather than the face, that was the measure of all beauty. The slim, fragile female body with small hands and feet became the ideal of feminine beauty. Women were meant to be gentle and delicate. Tight corsets created a slim, wasp-like waistline. The Empress Elisabeth Eugenie Amalie von Wittelsbach, known as Sissi, was one of the most famous, beautiful women representing the ideal of feminine beauty of this era.

Sissi

IMPRESSIONISM

One generation later in the epoch of Impressionism, the new fashion saw a slim waist again, but the "fin de siécle" has something unique in addition: the "Cul de Paris", the "Parisian Bottom". The buttocks are emphasized for the first time since Antiquity. This characteristic feature was casually depicted in Toulouse-Lautrec's painting "Ball at Moulin Rouge" .

Bal at Moulin Rouge, Toulouse-Lautrec

ART NOUVEAU - JUGENSTILL

The new fashion called "Jugendstil" or "Art Nouveau" brought back a “freedom” of silhouette liberating the body contours from corset as we see in Hodler's painting "The Day II" from 1905.

EXPRESSIONISM – THE ROARING TWENTIES

In the 20th century, the ideals of beauty begun to change with increasing speed. A new concepts of feminine beauty would transform visual tastes almost every single decade. Although there have been many reasons for these changes, but the most critical has its root in development of mass media, particularly that of imagery.
In the 20s, the early cinema begun creating its stars. Louise Brooks and Gloria Swanson defined female beauty: small head, expressive eyes, a full mouth and short hair were the main features.
Louise Brooks Gloria Swanson

After the horror of the First World War ended in 1921, a dramatic change in the concept of beauty had occurred. Only practicability became important. In the era of "Bauhaus" and the "Roaring Twenties" the difference between the sexes vanishes for the first time in art history. Curves are no longer an ideal, as in the "Dancing in Baden-Baden", painting by Max Beckmann.

Dancing in Baden-Baden

LATE EXPRESSIOISM - CLASSICAL MODERN ERA

Reclining Female Nude" by Modigliani, represent a rapid twist in perception of female “beautiful”. Although the classic ideal body is reclaimed for the moment, the multitude of changes in art and taste allows no more universal ideal.

Reclining Female Nude, Amadeo Modigliani, 1917; Milan

30's
 
Hollywood's glamorous, unapproachable divas become the models of beauty in the 30s. The "divine" Greta Garbo combined beauty with mysterious sensuality, while Marlene Dietrich's appearance in a man's suit and tie was seen as an expression of bisexuality

Greta Garbo Marlene Dietrich

40's
 
Christian Dior's fashions defined the ideal of beauty in the 40s: the slim, elegant woman with a ladylike charm. From that point on, fashion became a key ingredient is establishing new standards of marketable beauty.

50's

Coco Chanel put an end to Dior's “outdated” image of women: She focused primarily on the natural look, reflected in loosely draped fabrics, simple accessories and restrained make-up. Grace Kelly became world-famous for her cool beauty, whilst Gina Lollobrigida and Sophia Loren represented the temperamental mystique of Mediterranean beauty.

Grace Kelly Gina Lolobrigida Sophia Loren

REBELIOUS 60's
The massive changes in society in the 60s were also manifested in a new perception of beauty. The British model Twiggy set a new standards of beauty with her bony figure and, as the first model icon, laid the foundations for the minimalist figure: in the eyes of society, slim became synonymous with beautiful. The lips had a matt finish, while in contrast the eyes were emphasized with eyeliner.
The revolution of 60's was completed when Mary Quant introduced her iconic MINI.

Twiggy Mary Quant:Mini!

CRAZY 70's

Narrow waists and splendidly voluminous hairstyles were the fashion in the 70s. Make-up was striking, yet kept in cool colors, and everyone wanted expressive eyes. Variations on this trend were the "gypsy look" and the "glitter look" à la Diana Ross.

Diana Ross

EXCESSIVE 80's

Cindy Crawford Naomi Campbell Linda Evangelista
The 80's became the era of the emancipated career woman. Beauty was styled down to the last detail and decorated with striking colors. With her powerful, feminine make-up, figure hardened by workouts and clear goals, the high-powered career woman overcame every obstacle. Supermodels like Cindy Crawford, Naomi Campbell and Linda Evangelista became unachievable ideals of beauty.

INDIVIDUAL 90's
In the 90s, individuality led to a much wider range of looks. Whether blond, brunette or black-haired - the ideal is beautiful individual faces which cannot be easily labeled in a single category. Kate Moss initiates the androgynous wave, with her girlish appearance.

At the same time, a natural look is developing. Make-up is more restrained, hair is worn more natural. Where, in the 80s, many models were somewhat transcendentally beautiful and glamorous, the look of the "girl next door" is more popular now.
Heidi Klum, with her natural appearance and feminine proportions, attempted to take fashions in the 90s away from the extreme thinness that had predominated for years.

In our times, beauty is closely associated with naturalness and individuality. It is no longer important to pursue an ideal from someone else; now, women are striving to show off their own advantages. Today, women are regarded as beautiful if they are charming, healthy, fit and powerful.
Yet, with the advance of popular imagery, heavy marketing and deceptive visualization, one can not escape the oppressive trends in “creation” of modern, market-beauty.
A manipulation of still images rendering too “perfect” and “ideal” body resulted in emulation in real life . It produced a distorted physical and emotional model. “Thin” became new beautiful, desirable and even expected in fashion industry; soon it spilled over to the lives of many. Anorexia became a worldwide phenomenon; an illness intertwined with perception of style, escape from un-reality, a response to pressure from manufactured distortions of mass media and tragedy for many.
Sad world of anorexia

What could better explain that dead-end representation of beauty than the tragic example of Isabelle Caro, a famous French model and actress, the saddest victim of viral anorexia.

Isabella Caro at the beginning of modeling career.

Shortly after her successful entry into the fashion world, her subsequent steps were monitored in horror by many in and outside of fashion industry. The media, as if unaware of their complicity in this tragedy, led the way in competing for the most dramatic images of Isabella's rapid health decline. Her relentless weight loss and physical changes made her beautiful features unrecognizable.

Recognizing the roots of her incurable illness and extreme appearance motivated Isabella to bring her personal battle into the public forum as a warning for the society in general and young women in particular. With the help of famous photographer Toscani several dramatic and unforgetable images of Isabella Caro appeared as billboards in the major European cities.

The impact of these images surprised even their authors. Anti-anorexia campaign led to successful introduction of many restrictions imposed on the fashion industry. Isabella Caro died of extreme anorexia in January 2011. At the time of her death her weight was 53 lbs.

TODAY

Our times brought many other distinctive features reflecting ever changing lifestyles. The concept of beauty became, on a surface, a melange of frequently opposing ideas. Yet each new objective had some justification in the past. Each was reflection of the past accomplishments leading to further refinements. Each was born, like Aphrodite, from the foam of the solid wave moving forward.
Sandro Boticelli, The Birth of Venus, 1486

But how can we explain the avant-garde of today? Is it still a spontaneous creation and logical evolution of our understanding of beauty or contemplated provocation with well designed shock value crafted for the profit-first popular culture?
How did we come from visually admirable and priceless masterpiece of Boticelli: to the financially record breaking image made by great contemporary artist Lucian Freud?:

Lucian Freud, Benefits Supervisor Sleeping, 2008
The last 2-3 decades brought about a rapid development of Aesthetic Medicine and Plastic Surgery. This field begun to play a major role in our pursue of physical perfection, the same physical perfection that we, universally, intuitively understand as a classical beauty. It gives us a chance to look the best we can and emphasize our natural beauty without distorting it. Why then, all too frequently, do we see in the media and on the street the tendencies that are opposite to this intuitive desire for beauty and self-improvement?
In search of beauty we conform too often to the “trend setters”, to unrealistic outcomes based on preoccupation with fake images and media hypes. We fall into the trap of adoration and identification with celebrities, mostly those who have very little to offer aesthetically or artistically.

Are we making a step away from the natural beauty:

walking through distorted reality:

to settle for a caricature of natural?:

WHAT'S NEXT ?

New injectable and Merz

Fri, 19 Aug 2011 15:01:40 -0500

The Food and Drug Administration (FDA) has approved Xeomin for temporary improvement of moderate to severe glabellar lines. This alternative to Botox and Dysport has been used for many years in 14 European countries under the name Bocouture.
Xeomin is made by Merz, a company known for their filler Radiesse. Xeomin was already approved by FDA in 2010 for certain neurological conditions.

There have been many claims of superiority of many products used for wrinkle treatments. However, there is no significant difference in any of them from clinical and practical point of view.

The studies have shown that two major claims are of no importance. First, if given in comparable doses and similar concentration, all products diffuse at the same rate and at the same distance from the point of injection. Second, the presence or absence of proteins in product is immaterial since these are immediately neutralized after injection.

Merz expects also an approval for new hyaluronic acid filler(s) that have been used in Europe for few years. Once approved, the company will become the main competitor on the aesthetic market in the US.