“Perhaps you’ve never thought of it this way, but beauty is power,” Dr. Rome said, with the calm certainty of a man who knows he speaks the truth. “And with enough power, one can achieve anything.”1 In the recently released historical thriller, The Beauty Doctor, the above-quoted Dr Franklin Rome practices beauty surgery in New York City in the year 1907, when the world of medicine was still a bit like the Wild West. Though the fictitious Dr Rome turns out not to be all that he claims, his observation about the power of beauty has to a large degree been substantiated by subsequent science. As aesthetic surgeons, the fact that attractiveness has benefits in terms of helping people achieve their goals and lead happier lives should make us feel pretty good about what we do. But how and why is physical beauty so important? Are beautiful people happier? It is a well-known fact, based on quite a few studies conducted by economists and psychologists, that good-looking people are materially wealthier. According to University of Texas labor economist Daniel Hamermesh, this is one of the main reasons they are happier than their plainer counterparts. Hamermesh was among the first scholars to investigate the effect of appearance on earnings potential. Among his findings is that a good-looking man is likely to earn up to 13% more money than his not-as-attractive counterpart over the course of his career. Beautiful women also tend to be paid more than those who are less attractive, though the percentage difference is not as great. But consider, too, that a good-looking woman (who may or may not be economically successful in her own right) is more likely to pair up with a wealthy spouse.2 In a study of nearly 300 Dutch advertising agencies, it was found that those companies with the best-looking executives enjoyed higher revenues, at least in part because attractive managers were more successful in their interactions with clients.3 In my own experience, many patients have told me that at least one of the reasons they want to have aesthetic surgery is to enable them to earn more money. A number of women working in the restaurant business who have come in for breast augmentations shared with me their observation that servers and bartenders with larger breasts generally receive more generous tips, as do younger and better-looking employees regardless of gender. Recently, a real estate agent consulted with me for a facelift, saying that she felt her younger colleagues had a distinct advantage, especially in the high-end marketplace. In addition to economic advantage, Hamermesh maintains that women derive personal joy from beauty due to their belief in its inherent value.2 Perhaps this harks back to earlier times when feminine beauty was thought to be a reflection of moral goodness. Or maybe it is simply that attractive women profoundly enjoy being regarded more favorably in almost every aspect of their lives. In a study from Harvard University, it was found that women who were made more attractive by wearing makeup were regarded by others not as simply better looking but also more competent, likeable, and trustworthy.3 This admiration of attractiveness apparently is not limited to our species. It has been found that even chickens show preference for the same type of attractive faces as humans do, suggesting that such responses may be built into the nervous system rather than due to cultural influences.4 Other research seems to confirm that the brain “rewards” us for looking at attractive faces. Certain reward regions of the brain are involved in our experiences of pleasure. Participants in a study conducted through the Department of Psychology at the University of Oslo (Norway) showed increased brain activity in these pleasure centers when looking at images of attractive faces compared to faces prerated as less attractive. An additional finding was that these higher levels of activity within the brain’s reward system resulted in behavioral change, such as choosing to look at the attractive faces longer and rating them even more favorably.5 A Finnish study found that both male and female nonincumbent parliamentary candidates who were more attractive than their competitors enjoyed an average of 20% more votes. The study suggested that one of the reasons for this advantage was that voters enjoyed watching good-looking candidates more than those who were not as attractive.3 But there is more to beauty than winning popularity and economic success. It is not a new theory that, historically speaking, seeking out an attractive mate is an evolutionary necessity. Physical attractiveness is often interpreted as a marker of good health, and especially in earlier times such assessment of a potential mating partner was essential to survival of the species. We appear to be programmed to recognize and prefer certain characteristics indicative of a genetically healthy mate. A large multicultural study attempted to identify the characteristics men consider to constitute “beauty.” The results showed these qualities to include clear and smooth skin; long and lustrous hair; symmetrical features; absence of open sores, pustules, or lesions; relatively large breasts; and low waist-to-hip ratio. Taken together, these naturally desired attributes not only are indicative of health and but also suggest a particular fitness for child bearing.6,7 Attractiveness, therefore, can be viewed as a primordial imperative. While for some it may seem an uncomfortable truth, in a very real sense beauty is power. Its importance in our lives is an indisputable scientific fact and applies to both women and men. Perhaps it is time to admit it. I found it somewhat amusing when I recently saw an article in which the actress Jane Fonda said she was not proud of having undergone plastic surgery. “I did have plastic surgery. I’m not proud of the fact that I’ve had it. But I grew up so defined by my looks. I was taught to think that if I wanted to be loved, I had to be thin and pretty. That leads to a lot of trouble.” She continued, “I’m older now, and I have to be more self-conscious. When you’re young, you can get away with more. I always thought that being self-conscious was a negative. But now I feel differently.”8 I don’t profess to fully comprehend the logic of Ms. Fonda’s thinking, but I am reasonably sure that plastic surgery has done a great deal to extend her career as an actress. And, in fairness, she has been quoted as giving some credit to plastic surgery for the longevity she has enjoyed in her profession. My point is that there is no reason to be ashamed or to apologize for certain basic human impulses as well as the practicalities of life that drive us to want to look as attractive as we possibly can. Let’s “tell it like it is”—that attractiveness is an asset in life and one that now, thanks to modern-day plastic surgery, is more accessible than ever before. Don’t get me wrong. It is not that I believe attractiveness is dependent solely on physical attributes, nor do I deny that we often focus so much on superficial beauty that we fail to appreciate the exceptional power of inner beauty. I also acknowledge that for some people the desire for “perfection,” physical or otherwise, can become an unhealthy and dangerous obsession. Good examples of this are eating disorders such as anorexia and bulimia, and body dysmorphic disorder (BDD) that drives some plastic surgery patients to undergo procedure after procedure, never being satisfied with the results. Beauty is valued in part because it is a relatively scarce commodity. Attractiveness, on the other hand, does not depend on having flawless features, an hour-glass figure, or a perfect masculine physique. It has a strong psychological component, being intrinsically tied to factors such as attitude, intelligence, and social skills, and it can be purposefully cultivated through behavior. For example, a warm smile makes a person attractive. Dressing in a flattering style, communicating well, being a good listener, caring for oneself and others—these all are factors that make a person attractive.9 I can think of many, many examples of individuals who are not by any means beautiful but who I consider very attractive because of their ready smile, positive energy, intellect, and curiosity. In the same manner, a person who possesses physical beauty but exudes negativity or is chronically unpleasant to others is not generally regarded as an attractive person. Ultimately, both beauty and attractiveness are dependent on the feelings they inspire in oneself and others. That is why, as plastic surgeons, perhaps the greatest gift we can give our patients is to promote that inner confidence that helps make an individual attractive to others—the confidence that allows a person to feel comfortable in his or her skin and to fully enjoy the challenge and rewards of daily life. Without it, even the most beautiful among us are likely never to attain true happiness. The author declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. The author received no financial support for the research, authorship, and publication of this article.
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Foad Nahai (2018) studied this question.