Before I get to Fillers Part 3, I want to go over something that I think is important to think about.  It’s not a right or wrong thing.  It’s a matter of perspective and how we automatically settle the score on NEED and WANT.

In my practice here in the West Village, I meet a lot of great people with different backgrounds: artists, musicians, students, models, fashion designers, lawyers, techies, bankers, investors, entrepreneurs.  I like to find out what each person’s concerns are, make an evaluation, identify problems that have good options for treatment and then offer these options.  Most people embrace the modern options of looking better: Botox, fillers, cosmetic and reconstructive surgery. However, some people have an interesting response: I don’t think I NEED that!

I came to the United States as a five year old boy.  South Korea in 1970 was about as poor as the poorest third world country due to the devastating Korean War.  There was a desperate NEED on my parents part to find a better place to live.  In December of 1970, our family flew from Seoul to Honolulu and then Los Angeles and left Korea forever.  As a five year old, I recall feeling like it was an adventure, not knowing how difficult life was for my father and mother.  I remember watching television and wanting the latest cool jeans or other fancy things, but I never got them.  Back then, life was about NEED not WANT.  What I did get was a nurturing family with plenty of good food and freedom to play and learn.  I never faced starvation.  I didn’t have to worry about my education.  My parents had stable jobs and adequate pay.  But I lived in the NEED mode without knowing it for a long, long time.  Through college.  Through medical school.  It’s not that I didn’t enjoy myself. I had plenty of time to play sports, hang out with friends, do road trips.  But for anything extra, like buying really fashionable clothing or traveling to beautiful places, it was much more difficult: even with some money to buy nice things and travel the globe, I didn’t need them.  So I didn’t.

My understanding of NEED and WANT was evolving in my mid 20’s but it definitely changed with one experience I had as a second year surgery resident.  I was 27 years old.  It was a Saturday morning and I was on the Trauma Surgery service.   Our team was called to the Emergency Room for a severe burn victim.   A woman.  She was a mother and a wife, working overtime on the weekend at an insurance office, who got doused with gasoline and set on fire by a crazy man demanding some kind of payment on a claim.  The paramedics arrived and brought her into the trauma room.  I was assigned to assess the woman’s injuries.  We listened to the verbal report from the paramedic: 100 percent third degree burns, airway intact, no pain medications given.   I confirmed that she had a 100 percent third degree burn.  The paramedics did not give her any morphine because the burns were that extensive.  100 percent third degree means that all the sensory nerves of the body were burned.  We all knew she had a mortal injury.  With modern medicine, we could have kept her alive for a week or two but she would have suffered more than anyone could ever imagine before dying.

I asked her, “Are you in any pain?”  She said, “No.”  I explained to her that we could try and do everything possible, but the chances of her surviving was very unlikely.

“Just tell my son and my husband I love them.”

“Do you want us to do everything?” I asked.  “No,” she said.

It was a strange, existential moment for me.  My knees were shaking as I talked with her, asking her how she wanted to die.   Before, I was thinking that I had plenty of time to get to the next level of my career, find love and marriage, buy a house and have a family.  All in one real but surreal moment, any thought of having a guaranteed future evaporated.

I don’t know why that experience out of all the other tragic ones I’ve seen as a medical student and doctor forced me to see my life in a different way.  If I’m not living the way I WANT, I’m not living, I thought.  And what does it mean to be living?  At that moment, I started to convert my way of thinking from NEED to WANT.  It wasn’t easy.  I stopped thinking about living with expectations about what my future was supposed to be and started working on living in the moment.  How do I WANT to live?  How much time do I really have?

If this all seems very obvious to you, then I’m pretty sure you grew up in a much healthier environment than I did.  But it is extremely hard to change old habits.  I still plan for a future, but I don’t do it at the expense of not living the present.

How does this relate to anything about cosmetic surgery?  Maybe not that much or not at all.  Or maybe it’s about living in the moment. Either way, be sure of the choices you are making. Hopefully, the past and future postings of this blog will help you make good ones.