1023: Plastic Surgery | Skeptical Sunday

0:03Welcome to Skeptical Sunday. I'm your host, Jordan Harbinger. Today, I'm here with Skeptical Sunday co-host Michael Regilio. On the Jordan Harbinger Show, we decode the stories, secrets, and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you. Our mission is to help you become a better informed, more critical thinker. During the week, we have long-form conversations with a variety of amazing folks from spies to CEOs, athletes, authors, thinkers, and performers. On Sundays, though, we do Skeptical Sunday, where a rotating guest co-host and I break down a topic you may have never thought about, debunk common misconceptions about that topic.

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1:10Today, the old expression, I see a lot of familiar faces here tonight, used to refer to recognizing friends in the room. Nowadays, we all see familiar faces everywhere we go for an entirely different reason. People seem to have the same nose, the same jawline, the same forehead, and the same cheekbones. These faces don't look familiar because we've met them before, but because people are having their faces changed by plastic surgery to adhere to ever-changing beauty standards. Procedures that were once incredibly rare are now commonplace. People want to look like the faces they see on Instagram, but the problem is the faces they see on Instagram are filtered and manipulated in the first place.

1:47Are we entering into an insecurity feedback loop? Are we glimpsing at the future of fashion in which we change our faces as often as we change our hairstyle? or is there hope to get off the plastic surgery train and back into the natural station? Today, comedian Michael Regilio takes a scalpel to the plastic surgery trend to see what's beneath the surface. Hello, Jordan. You're looking good. Is that a new nose? It is a new nose. I got one just in time for Yom Kippur. Lucky you. Perhaps one day people will walk into a plastic surgeon's office and ask for a harbinger. Wow, I certainly hope not. People should just be themselves, especially when they're as handsome as I am.

2:25I agree. And initially, that's what plastic surgery was trying to make people look like themselves. Since ancient times, doctors have tried to help people who suffer from accidents and disfigurements. An ancient Egyptian papyrus describes using wood splints to hold broken noses in place that needed resetting and reshaping. But the first real plastic surgery took place in India in the 6th century BCE. And it was an actual nose job, like a literal nose job. It was performed to give people a nose. Give people a nose? Was there a problem in India at the time with people's noses just kind of falling off?

3:06Kind of. Okay, you're gonna have to flesh that one out? Oh boy. Look, in India, there was a practice of removing people's noses. thieves would have their noses cut off so they could be easily identified as dishonest wherever they went. Wow, talk about f*** around and find out. And when women were accused of adultery, they also had their noses cut off. Oh, so it's literally f*** around and find out. Was it just the women? Because if I'm not mistaken, adultery, usually a two-person affair. Yeah, well, that punishment was just for women. But you'll also notice that I said accused, which is all it took to lose your schnoz if you were a woman.

3:48Jeez, that is harsh. How did you know then if somebody was a thief or just banged somebody else's husband? Or was it just like, well, she stole a dick, so the same punishment applies? Hmm, I guess I can follow that logic. But how could a new nose be created back then? Even today, giving someone a nose where there is no nose is not that easy. In writings called the Shushruta Samhita, an Indian doctor, Shushruta, known as the father of plastic surgery, detailed a technique for skin grafts. They would essentially remove skin from your cheek or forehead and build you a new nose while leaving a bit of the skin attached to the host spot on the cheek or forehead so that blood could continue to flow.

4:32after several weeks when the new nose or flapper skin where the nose once was had healed they would sever it from the cheek or forehead and voila a new nose like thing that's just gotta leave you with a messed up cheek or forehead i mean it's inventive but it's still really revolting somehow yeah well better than no nose but a messed up nose too well there aren't any photos we can refer to, but I agree. It must have looked weird. Regardless, it was a remarkable technique that was adapted and improved on for centuries. Then the technique traveled to Greece, which is where the word plastic in plastic surgery comes from.

5:12The Greek word plastikos just means moldable. When I was a kid, I thought it was called plastic surgery because people were trying to look like plastic Barbie dolls and or they were injecting plastic into your body. Back then, I think it was kind of only boobs people really got done for cosmetic reasons. I I mean, I could be wrong, but facelifts and boobs was mostly it, right? Yeah, well, I got news for you. They are still definitely trying to look like Barbie and Ken dolls nowadays. But in 47 BCE, a Roman author published an encyclopedia of surgery with the Indian cheek, skin, nose job now called the Indian method.

5:46In addition to nose jobs, Romans could have their ears repaired, scars removed, and freed slaves could remove their brands. Oh, wow. I hadn't thought about where the word brand comes from, but, well, nowadays we certainly think of brands differently. Oof. Yeah. In fact, I wonder if there were knockoff brands back then, too. Like, hey, this guy's brand says Gucci, but it's spelled with a C-H. Yeah, and they had New York or Staten Island accents back in ancient Rome. I do wonder what hurt more, though, getting the brand or removing the brand. Both of them sound just kind of horrific. Right. Well, either way, the Romans were actually quite good at treating the wounds, which kind of gets me to a side note I learned while researching this episode.

6:30The Romans observed the connection between hygiene and illness. They boiled their tools and washed wounds in like a mild acidic solution. I think that's amazing they had that sensibility at all, because wasn't germ theory just a thousand plus years away at that point? Exactly. And that's the point I'm getting at. Like a thousand years later, the barber was bleeding people with the same razor he just shaved a dude with, like leading to terrible infections and death. Yeah. Well, I guess that's where barbicide comes from. But I'm thinking just some dude's dirty face facial hair. And then it's like, it'll be fine if I cut open your wrists and neck with the same razor.

7:06I spat on it. It's fine. Right. Yeah. Well, set aside the entire mentality behind bleeding as a cure for anything to begin with. and insert Sweeney Todd joke here, by the way. But when studying history, I so often find examples of ancient peoples getting something exactly right, and then the world just forgets about it. And I'm guessing the one reason that we took a big medical step back is that in Europe, surgery stopped because the Catholic Church deemed it sinful to cut human flesh and thought of it as pagan. Well, the Catholic Church has a pretty crappy track record for an institution that claims the guy at the very top is infallible.

7:45Right. And hey, just ask Galileo. Okay. But orbiting back to the nose job, in 1163, Pope Alexander III banned surgery and the dissection of humans. I'm guessing you mean dead humans. That's actually a great point, because if you read about the horrors of the Crusades, the dissection of live humans seemed A-OK with the Catholic Church. This episode is getting gross already. Nice. The church's prohibitions aside, in Renaissance Italy, doctors secretly practiced surgery, and yet again, there was a great need for nose reconstruction due to the popular trend a young man for dueling with rapiers. Weird name aside, the rapier was a very slender, very, very sharp sword, and many a young man came home from a duel short, one nose.

8:34The famous astronomer Tycho Brahe's nose went the way of the rapier after a duel with his cousin over who was the best mathematician in the family. Oh my gosh. That's why is that so funny? It gives the whole got your nose game a new meaning. But that is the worst nerd fight ever. Imagine proving you're better at math, not by using math or anything like that. That would be silly. But by trying to stab someone or kill them and then just slicing off their nose instead. Right. Well, physics actually is indeed math, but your point stands. And in the 1400s, Sicilian physicians took the old Indian method and developed a new method for rebuilding a nose.

9:13A flap of skin came from the arm. It was called the Italian method. Again, the flap had to stay connected to the source, which unfortunately meant they tied the arm to your head for weeks while it healed. A person's arm was tied to their head for weeks while they grew a new nose. Can you imagine what that looked like? That's so insane. It's amazing it even worked, actually. Yeah, and guess what? Because the fact that the arm was the way it was, if it was jostled, it would tear off the new nose. I can imagine doing that in my sleep. You ever do that when you're moving around, you wake up, you hit yourself in the face or something?

9:48I'm having nightmares already. I'm just thinking it would have been easier to just maybe not have dueled with those swords and been known as the second best mathematician in the family. The fact of the matter is I am surprised by the sheer number of noses that have been cut off throughout history. I mean, you never hear about that anymore. Really? I mean, sure. Occasionally someone's distracted and their nose gets cut off. But I never imagined how many times in history an entire industry developed to deal with the whole people be getting their noses cut off dilemma. Nowadays, actually, most of the people who need a new nose built are people who've had so many nose jobs that there's just no nose there.

10:28at all anymore. Yeah, Michael Jackson comes to mind. I'm trying to think, like, if you've, look, email me if you've had your nose cut off and you didn't pay to have it cut off for aesthetic reasons. Like, how does it, I want to just know how it happened. That's all. Yeah, I mean, it's crazy, but we'll get into the whole Michael Jackson thing in a bit, but I'm not actually done with historical no noses yet because we've got to get to the next historical great nose snatcher syphilis. I did not know. So syphilis took people's noses as well? Well, not syphilis, but the treatment for syphilis that existed until the invention of penicillin in 1920.

11:05I see. Before that, syphilis was treated with that good old timey medicine, mercury. Like mercury, mercury, liquid metal mercury, the stuff that makes you go crazy? Yeah. Wow. Yeah, that stuff. It could actually stop syphilis, but it often made the nose collapse in a condition called saddle nose. And And again, doctors were challenged to find ways to rebuild people's noses. So I googled this. And by the way, it still exists. If you do like a ton of blow or you have leprosy, which apparently is still a thing. I really thought that was like we kind of got rid of that around the time of Jesus. But OK, you can have saddle nose.

11:41Your nose will collapse in on itself. And it does look a little bit strange. Oh, my God. Artie Lang. Look up Artie Lang. I just thought of that. I think he lost his nose to cocaine. He was one of Howard Stern's sidekicks back in the day. Let me Google that. Oh, yeah. There you go. That is, oh my God, that's really something. Don't Google this man and don't look at his nose. That is, oh my gosh. If you're doing cocaine, Google him because you'll stop immediately. Wow. Wow, that's really something. Yeah. So surely some people must have just opted for a fake nose over tying your arm to your head for weeks on end.

12:15You nailed it. In fact, in the late 19th century, many syphilis victims had prosthetic noses. Interestingly enough, they would hang them off their eyeglasses. And if you had 20-20 vision, you are shit out of luck. So that's funny, though, because the eyeglasses with the fake nose and the fake eyebrows that you get at Spirit Halloween or whatever actually have historical precedent. And I would never have guessed that. Hey, man, deep history. Additionally, because syphilis also caused extreme sensitivity to light, the glasses had to be darkened. And that's where sunglasses come from. Wow. For real, sunglasses are the result of syphilis.

12:51Yep. So next time I feel all cool in a pair of shades, I'll just thank a noseless brothel hound from 1904. Yeah, if you can find one. I mean, I got a guy. I always have a guy. Look, I'm going to skip the litany of questions that just popped into my head for the sake of moving things along. Okay. Until this point, plastic surgery was a necessity. But around the time sunglasses were being invented, plastic surgery for aesthetic purposes was also being developed. In 1895, Vincenzo Czerny, an Eastern European surgeon, inadvertently performed the first boob job by injecting a woman's own fat into her breast to compensate for a tumor he had removed.

13:32This, actually, by the way, is the technique used today in one of the most dangerous procedures around, the Brazilian butt lift. Only the fat isn't injected into your breast. Yeah, it's into butts, obviously. I kind of gathered that by the name. Wow. Right. Techniques that are common today were first being experimented with ages ago. In 1899, Austrian surgeon Robert Guernsey was the first to try fillers. He used Vaseline and paraffin and injected them into face wrinkles, breasts, and even penises for augmentation. Wow. Ouch. Really? At the risk of being crude, I've certainly heard of men using Vaseline on their penis.

14:09Never heard of it inside the penis. How did that go? And does that even work? Asking for a friend, obviously. Yeah, it worked great. People were totally thrilled with the results until serious complications kicked in and many people died. Oh, so it didn't go that great. Well, it depends on how you feel about dying. Yeah, on most days. Most days I'm against it, especially if I'm just trading. Well, anyway, fine. Yeah, me too, on most days. Turning back to injecting Vaseline, the initial success of the procedure opened a market for untrained hucksters. People would claim to be doctors and shoot people's faces, boobs, and penises up with Vaseline.

14:50It's almost funny to hear that because that still definitely happens today. I heard of a woman going to some fly-by-night clinic somewhere recently for a butt lift, and they injected her with, I want to say, cement or bathroom caulk or something, and of course it didn't go well. She got a horrible infection and or whatever and died. Oh, I'm aware of that story. And that somewhere is, of course, Florida. Sorry, Florida. Yeah. So look, both the cement in the butt and the old Vaseline in the penis shows that there was and is an enormous market for plastic surgery for strictly cosmetic purposes. And as painful as surgery today can be, it's nothing compared to what early patients went through.

15:34A 1910 article in a woman's magazine entitled Getting Pretty Quick details an early facelift performed on a middle-aged woman. Most notably, she was dosed with cocaine and had the facelift performed on her while she was awake. Oh man, for a minute I was like, dosed with cocaine? Tell me, oh, surgery while awake. So am I crazy for thinking a facelift being performed on you while you're just coked out of your mind sounds way more painful? Oh, she was in excruciating pain for weeks, during which time the article says her face was, quote, as red as a carnation. But in the end, it worked. She thought she looked much younger and was happy with the result.

16:17I would just rather look my age, thanks. That sounds like absolute torture. Not nearly as torturous as the nightmare that was World War I. This is the period in which modern plastic surgery improved exponentially. It's so strange, but it does seem like war is almost always the thing that causes innovation like this.

17:01wounded, and 16 % of those battle wounds involved the face. Plastic surgery had to get good and get good quick to help these massively disfigured men. I've read a lot about World War I, I mean, a long time ago. And in addition to plastic surgery, didn't a lot of the injured men wear special face masks, kind of? Because they couldn't really fix your skin, right? Right. Yeah, they did. Anna Coleman Ladd was a sculptor who innovated these face masks. Anyone familiar with the show Boardwalk Empire and the character Richard Harrow has seen a depiction of this work? A cast of the face was made and a mask was custom made to cover the disfigured part of the face.

17:39They used real human hair for the head and mustaches, and then an artist would paint the mask to match the men's skin tone. I remember that guy. He was, wasn't he kind of like a crack shot assassin type character? Yeah. Oh dude, he was a badass. I love that character. That was a really good character. And I'd never seen anything like that in anywhere. I didn't know that existed. And I remember Googling it back then, like, did wounded people wear masks? And sure enough, here we are. Yeah, really, anyone interested should Google this, by the way. It's crazy to think that at one time you could run into somebody in everyday life in what looked kind of like a Guy Fawkes mask from V for Vendetta with real eyes and real teeth.

18:21Yeah. But the rest of the face could have just been blown to hell by World War One kind of crazy weaponry. Unbelievable. Yeah. Well, I mean, V for Vendetta or possibly Anonymous, who also uses those masks, depending on what flavor of pop culture you prefer. But face masks weren't the only innovation. Surgeon Harold Gillies was thrown into the horrors of the war and quickly developed cutting-edge techniques to repair some of these horrible injuries. He improved on the Indian and Italian methods to great success. You know what's better than having your face blown off in trench warfare, Michael? The fine products and services that support this show.

18:58We'll be right back. Thank you for listening to and supporting the show. Your support of our advertisers does keep us going. All the deals, discount codes, and ways to support the show, all in one place. It's jordanharbinger.com slash deals. You can also use the AI chatbot to surface the promo codes. Or if you're for the especially lazy, you can email me directly. Now, back to Skeptical Sunday. So the techniques developed thousands of years ago were so effective that they were still being used in the 1900s. That's really amazing. Yeah, they were so effective that they're still being used now in one form or another.

19:31Chalk another one up for the noseless. I mean, they really are the unsung heroes of history. I just had no idea how much we owed to the noseless and to syphilis and those who went and got it, however they might have gotten it. They sure took one for the team or lost one for the team. Either way, building on these ancient techniques, Harold Gillies propelled us into the modern age of plastic surgery, which is why he is considered the father of modern plastic surgery. These new techniques were quickly seen as having far more vanity-inspired uses, by the way. This is the plastic surgery that I'm familiar with today.

20:11Vanity projects. That's almost where I thought we would start, but of course, it's Skeptical Sunday, so we do a little deep dive. That's right. This is where things have arrived. One of the first things people ran to plastic surgeons for was to change their breasts. There was big money and big boobs. Not surprisingly, plastic surgeons looking to capitalize on this newfound knowledge classified small breasts as a disability called hypomastia. Disabled because of small breasts. How sad. A bunch of surgeries were tried to correct this devastating disability. Well, now you're being cheeky. Actually, I'm being booby, but it's actually a rather sad story.

20:48Women were injected with ivory, wood, bits of rubber, and even ox cartilage. That is horrifying. How did that work out, Michael? Not great. Meanwhile, Japanese doctors experimented with injecting liquid silicone into the legs of polio patients. So American doctors said, hey, why not boobs? Over 50 ,000 women had liquid silicone injected directly into their breasts. Okay. First of all, I got to wonder why someone's like, I want bigger boobs. And the doctor's like, let me pick this hard thing like wood or ivory. Yeah. I mean, the logic is just not there for me. Like, this was on an animal, so the body can tolerate it.

21:28That's kind of as far as I get with the ox cartilage and the ivory thing. Wood is mystifying. Bits of rubber, okay, you're getting there, but yeah, oof. Okay, and I can tell by the way you emphasized directly into their breasts that something about that was problematic. Correct. Over time, the silicone in direct contact with tissue caused chronic inflammation and caused granulomas to form, resulting in hardening and pendulous breasts. Granulomas are described as feeling like hard sand. I'm not sure it's a great look for two dudes to spend too much time discussing breasts, but you gotta tell me, what are pendulous breasts?

22:05Droopy. Droopy boobs. Ah. You know that joke song, do your boobs hang low? Do they wobble back and fro? Yeah, it's to and fro. And I'm embarrassed to admit it, but yeah, I'm obviously very familiar with that tune. Well, that song was about pendulous breasts. Sadly, the direct injection of silicon caused so many problems that often the only thing that could be done was to remove the breasts entirely. That is really unfortunate. Go to the plastic surgeon to get bigger breasts and end up with no breasts at all. Sad trombone. That's actually really tragic and scary. Yeah. And well, in 1961, the problem was at last solved.

22:41American plastic surgeons Thomas Cronin and Frank Gorel, along with Dow Chemical, developed the silicone breast implants. That is to say, silicone balloons, for lack of a better term. There must be a better term. Well, either way, the modern boob job was bored. Women were now able to ask men to not look at their cleavage, eyes up here, pal, and they quickly realized they weren't happy with their eyes either. Ah, enter Botox. Nailed it. In the 1970s, Botox was used to treat facial tics by literally numbing and deadening the nerves. In 1989, Dr. Richard Clark started using Botox to smooth lines of the forehead.

23:23And when told that one could reduce wrinkles by injecting a toxin directly into your face, the entire world said, toxin schmoxin, sign me up. And plastic surgery kind of officially began making plastic looking people. Plastic people seems like a bit of a dig. I don't see any harm in someone improving their looks, but there is a bit of privilege going on here as two dudes who either don't have a problem at all with their looks or, or in your case, clearly don't care at all about their looks. Pass judgment on those that elect to go under the knife. Yeah. Okay. All right. I agree completely. So full mea culpa on my part for being snarky, But we've actually entered a whole new phase, or more appropriately, a whole new craze.

24:07Plastic surgery has, in many cases, ceased to be about fixing little imperfections and turned into chasing perfection. I see. That's fair enough. I mean, you'd have to be blind to not see that plastic surgery rates are skyrocketing from when we were younger. That's right. Rates of plastic surgery increased by 20 % worldwide between 2015 and 2019. In the U.S., 18 million procedures are performed each year. In South Korea, 25 % of women between the ages of 19 and 29 have undergone plastic surgery. That is a crazy high number. And I'm trying not to be judgy, but between the ages of 19 and 29, those are the years that people are naturally most attractive.

24:51But I also understand the temptation to maximize that, right? And with numbers like that, it does seem like people are trying to adhere to a new beauty standard entirely. Right. Plastic surgery is actually not all that different from fashion. I mean, whereas women wanted thin hips and big breasts in the 80s and 90s, big butts and fat lips have become all the rage. These are temporary fads. Look, in Paris in the 1800s, small breasts were considered desirable and big breasts undesirable. So people making permanent changes to their bodies to chase temporary fads is worth discussing. No judgment. What exactly is driving the plastic surgery craze?

25:33Is it just social media? Because we've had TV for a long time and we've had the ability to do this, but the uptick is recent. I mean, you even mentioned 2015 to 2019. That's like a four-year span. It's a myriad of drivers. But one thing that's easy to understand is that little worldwide tragedy that we all lived through. Will Smith slapping Chris Rock at the Oscars? No, the other one. COVID. All that time spent in virtual meetings staring at ourselves had consequences. Plastic surgeons are calling it the Zoom effect or the Zoom boom. But whatever you call it, requests for neck and brow surgery procedures rose 55 % from 2020 to 2021.