SAN DIEGO — With the rise of plastic surgery-related TV and reality shows, state-of-the-art medical technology and evolving concepts of self image, the practice of plastic surgery has increasingly become commonplace. The Noticias de La Jolla Village recently snagged a chance to sit down with Dr. Stuart Kincaid, one of San Diego’s most popular and award-winning plastic surgeons, to ask him some up-close and personal questions about the ever-changing medical practice that can change both lives and appearances. — Claire Harlin
Noticias de la aldea de La Jolla:You have a very impressive background. You’ve received your medical background from Duke, and you’ve received fellowships from Stanford, Harvard and the University of California, San Francisco. What made you want to get into this profession in the first place? Stuart Kincaid: I’ve enjoyed my work over the years and the privilege to work with my patients. I try to share each of their concerns and improve whatever physical feature it is so they can become more self-actualized, better people and more confident, because as you well know, the more self-actualized we are, the more positive; it’s a more fun way to live our lives. The word “plastic” comes from the Greek word “plastics,” meaning “to shape or to mold,” and I would like to think that to shape or to mold the body and those features that, through aging or birthing or trauma, brings the self image and body image into better balance, in better harmony. LJVN: You mentioned your mother may have played a role in you becoming a plastic surgeon? SK: I think every mother in America would like for one of her children to have been a doctor and I happen to fall in that period of life. In a small town in the Midwest, I had two older sisters who were destined to become schoolteachers, and I guess my mother had it set in her mind that I was going to become the physician in the family. And i was the first of many generations, so yes, i did hear a lot about that as a young boy. Plus, i was diagnosed with kind of an unusual disease, Rocky Mountain Spotted Fever, in 1958 as a boy of 8, and i was taken to a big referral hospital, a children’s hospital at the University of Cincinnati, and I vividly remember that experience. I was in for over a month, and I guess the rest was destiny. LJVN: Is that contracted from ticks? SK: Yes, we had a collie dog and that was pretty prevalent in the Ohio Valley and also, as fortune would have it, they came out with antibiotics just about that time as a cure for the disease, so I guess I’m lucky to be here today, based on medical research and antibiotics. LJVN: So you got your first dose of the medical field by personal experience? SK: Yes. LJVN: You’ve been practicing for more than 25 years. What have been most significant changes you’ve seen in your field in medical advances and also the attitude toward cosmetic surgery? SK: Well, good new and bad news. The good news is that i think it has become more readily available and I think it has become more available specifically to mainstream America. In its inception, specifically back in the 1950s and 1960s, it was really in the hands of the rich and famous; we’ve often heard of that term. It was also in the hands of the entertainers. But as time went by, there were more trained surgeons who went out in America, and not just in the East and West Coasts, and it then became readily available to mainstream America. For instance, the American Society of Plastic Surgeons (ASPS) says the average household income of people seeking out plastic surgery today is $50,000 to $100,000. It’s not just for the millionaires and the billionaires, and they are subject to the same forces, the stresses of life, the traumas of birthing children, living longer; theres a lot of positive demographics that are driving the field of plastic surgery. I guess the challenge I meet today, is, along with more people embracing plastic surgery, it’s becoming increasingly difficult to meet people’s expectations. Through talk shows and the Internet and neighbors, i think many people have been led to believe they can achieve perfection and they can achieve it instantly with no down side, no complications, no risks, which obviously is not true. LJVN: Can you estimate what percentage of your clients is female versus male? SK: Mine pretty much mirrors the nation as a whole. It’s probably 85-90 percent female and 10-15 percent male, and i might add that the male sector is growing proportionately faster than females because females typically and historically have embraced plastic surgery more than men. But approximately 50 percent of marriages have ended in divorce, and we as a nation are fighting and struggling with that very issue. Now are going to be faced with retiring at a later age, we are very competitive, and now that we are in a global marketplace, psychologists have done studies to prove that people who are youthful in appearance are generally more productive and achieve more in life … Also, when people go through a broken relationship, for example, they want to put their best foot forward as they go into the next phase of their life and perhaps dating or relationships. That being said, whereas the male typically dated a younger woman in previous years, now I see it’s not uncommon to be the other way around, like the common term we hear today, a “cougar.” Not infrequently in my practice, I see it the other way around, with an older woman dating a younger man, so i guess it makes people more comfortable in society and social circles to close that gap, so to speak. LJVN: Not the emotional gap, but the physical? SK: Well, the appearance. I’ve had comments where the younger woman marries, the second time around, an older gentleman, and hears comments such as “Is that your father at the PTA meeting?” Not necessarily so. LJVN: Have you seen an increase in teens and younger people coming to you for cosmetic surgery? SK: That gets back to your previous question about the good news and the bad news. Some of its inappropriate or parents putting social pressure and stress and posing their desires on their children, who may not be of adult age. I occasionally will do reconstructive surgery on adolescents under 18, such as a young adolescent girl with very large breasts that may impact her performance in school or in physical educations classes, or a young boy who has prominent ears, whether he’s being teased or it’s affecting his social development. I consider that more reconstructive rather than cosmetic. I do honor the ethics committee of the ASPS, which says one must be 18 to give informed consent, and even in those situations I encourage both parents to be present and involved in the decision-making process. LJVN: Have you ever turned down a patient? SK: Yes, I have on a number of occasions. Generally I feel it’s a person whose desire didn’t come from within themselves. It could be a mate; it could be a neighbor; it could be in the workplace. They were, in my professional opinion, doing it for the wrong reasons, or even if the desire came from within them, they had, in the interview process, unrealistic expectations, something that I honestly didn’t feel like i could deliver on. I like to under-promise and over-deliver with every one of my patients. LJVN: Is there one particular request you see a lot of these days? SK: I can tell you that, statistically, for women the No. 1 request in recent years is the breast augmentation, but a close second is liposuction. In the male gender, liposuction is No. 1. Another phenomenon we should be aware of is the weight issue. The First Lady of the United States, that’s one of her dreams is to improve nutrition and the dynamics of American eating habits, and I agree with her on that issue. Two-thirds of Americans are overweight and one-third is obese and we are a nation that is overfed and under-exercised. LJVN: What’s the strangest request you’ve had so far? SK: Getting back to the extreme, unrealistic expectations, I do remember a number of years ago a young man, sad to say, in his 20s, wrote a lengthy letter to me about his emotional ups and downs over many years. He felt he was a human being locked in a spider body. He had a very round body and very long, thin upper and lower extremities, and sad to say, that man didn’t feel particularly good about himself. He’d never had a date or a relationship with a woman in his life, and he wasn’t particularly productive, and he had not had any psychiatric or psychological counseling prior to coming to my doorstep. In that situation, even though I felt empathy for him and wanted to help him — I did talk to him about some body contouring procedures — I thought in that particular case he needed emotional health practitioners first to address some of his issues prior to embarking on plastic surgery, per se. LJVN: What suggestions do you have for those who are experiencing the effects of age and gravity? SK: I’d say do it when its right for you. The desire should come from within you. People frequently quote age, but that’s just the beginning. First, what is the ethnicity of the patient? Caucasians have thinner, less-elastic skin, and therefore age more rapidly on average than, say, a patient of Mediterranean or Asian or certainly African-American ethnicity, where they have thicker, more-elastic skin. Secondly, we are in the sun belt area of the country where we are exposed to much more solar damage day in and day out, including year round, so we might age more rapidly than someone in the northern part of the country. We also all have different individual habits, such as smoking, or people have different medical problems. From 20 to 30 years ago, patients have gone from [waiting until] 60-65 to mid-40s to late 40s. Plastic surgery is more readily available and safer, with newer-generation medications and surgery rooms, and in general, the public is more aware and more accepting of it. Yesterday’s 60 is today’s 50, and plastic surgery is probably more important to a woman at the peak of her career than at retirement.