Selling Confidence
December 31, 2008 by dr. lam · Leave a Comment
I just finished this book, The E Myth Revisited, that focused on why entrepreneurs succeed or fail. In the book, the author Michael Gerber talks about getting to the root “feeling” that you are delivering to a customer. He argues that a company oftentimes focuses on the fact that they are selling a certain type of widget but in fact that may not be what they are truly “selling”. He used Revlon as an example. He said that in Revlon ads, they focus on a certain dream of how beautiful someone will look after using their product, so they were not at its core in the cosmetic business but in the business of selling hope.
I thought to myself, “What is the core thing that I would love a patient to feel after I work on them?” I came up with a pretty quick answer: confidence. It is not pride or arrogance. It is not even vanity. Those have pejorative connotations and to be honest do not reflect the feeling that I want someone to feel. I can tell you certain points in my own life that my confidence soared: getting into an Ivy League college, getting into a competitive residency and then fellowship, getting my first book published. I also remember small things in appearance that boosted my confidence: the end of my acne years, getting nice looking glasses, a good hair cut, and nice clothing. Although these are peripherals to aesthetics, they are all part of a sense of self and a sense of confidence.
I really enjoy seeing the beauty of my work and how I see a patient smile broadly and carry himself or herself a little differently. I particularly like it when I see someone shy and reclusive become more gregarious and open spirited in public. I can see the transformation and the feeling I have is a great one. Of course, I am in the beauty business and in a larger sense the wellness industry but at the core feeling that I am “selling” is confidence. I hope that is the feeling you get when I have finished with my work for you.
The Trouble of Mitigated Speech & Hofstede’s Power Distance Index
December 30, 2008 by dr. lam · Leave a Comment
I can’t help but draw from Gladwell’s Outliers again as source material since it is so rich with ideas that have profoundly shaped my thinking. He talked about why Korean Airlines had one of the worst crash records from the late 80s to the late 90s. Interestingly, what he also found is that when the most experienced pilot flew, there was the highest chance for a crash, whereas when the least experienced pilot flew, it tended to be the safest flight.
What was observed at KAL was that the subordinate or lesser pilot would pay deference to the senior captain so he could almost never overtly challenge the senior captain’s stewardship of the plane. He would then speak in what is termed “mitigated speech”, i.e., very elliptically made speech that never directly attacked the captain. For example, if the plane had too much ice to make flying the plane a safe venture, the co-pilot would say something like, “Boy, it’s cold out there.” Of course, the pilot would have no idea what he was talking about. He could up the ante a bit and say, “Boy, the wings look a bit icy tonight, what do you think?” He might even go so far as to say, “Maybe we should take another look to see if there is too much ice on the wings to fly?” In almost every case, the Korean pilot would be too oblique in his commentary and deferential to change the captain’s mind about something that should have been very obvious.
The Korean language carries many honorifics and many layers of deferential speak that separate societal ranks. Customs further reinforce this behavior. For example, no one can start eating at the table until the most senior person starts. However, the most senior person can start eating way before anyone else is sitting at the table. Gladwell looked at Hofstede’s power distance index of various countries (click here to see Hofstede’s global PDI map). He found that Americans have a very low PDI, i.e., subordinates are very comfortable telling off a senior member whom they found to be wrong. However, even in the U.S., lower-ranked pilots would still at times have trouble telling the captain that there was a problem so that new training required that a lower-ranked U.S. pilot would try 3 times to convince a senior pilot that what he was doing was dangerous and if he could not that he would simply take over the cockpit.
Korean Airlines has become one of the safest airlines today because of a radical overhaul to the culture. All KAL pilots must be fluent in English, which helps them communicate better with international air-traffic control and also minimize the PDI issues. They also trained with U.S. pilots to start breaking down long-held PDI structures.
I have told this story to all of my staff so that they do not engage in a PDI issue with me. I need to know honestly what I am doing right and what I am doing wrong. I have asked them to run my ship with frank candor. I do not hire “Yes Men” and I do not want a “Yes Men” mentality to hold sway over my ship. I have asked the same candor from my patients. Open dialogue is the key to any relationship by breaking down the PDI at a fundamental level.
Lincoln’s Buccal Zone
December 29, 2008 by dr. lam · 1 Comment
I routinely read the New York Times every morning and several weeks ago I came across this very interesting article concerning an art exhibition “One Life: The Mask of Lincoln” featuring two plaster casts of Abraham Lincoln as part of the celebration of his bicentennial year in 2009. The first plaster cast was made in 1860 when he was campaigning for the presidency and the second one made 5 years later in February 1865, just two months before he was assassinated — which reveal the nature of the aging process in stark relief.
Although there is a more corrugated appearance to the latter plaster cast, the volume loss of the face is unmistakable. Looking at both faces, the viewer can see that the face looks older despite the relative absence of wrinkles and gravity. Volume loss is the significant player here for aging in an unequivocal way.
Interestingly, what strikes me the most is the buccal zone, the area below the cheek bone. The scooping out of this area truly makes Lincoln look significantly older and already gives the middle-aged appearance of the earlier cast a wizened appearance. The buccal area is a zone that is so little appreciated and in my opinion is a critical area to focus on for rejuvenating the face. Obviously, this is not the case in every individual. Some individuals who are slightly heavier do not need buccal fat or Asians who have a rounder face certainly in many cases do not need buccal fat. However, I truly believe the buccal hollowing can be one of the most dramatic areas of aging that exists.
In my new book, Aging Face: The New Paradigm, coming out next year I have come up with a unique way of looking at the buccal area, subdividing it into 3 zones, which I have previewed in a lecture that I gave earlier this year in St. Louis. The central buccal zone is the area that we are all familiar with, the area that sits below the cheek bone and that we suck in when we suck our cheeks in. However, a refinement into thinking of the buccal area is that there is an area that is near the mouth that I call the medial buccal hollow that represents bone loss of the teeth that I also target in some individuals. The outer portion of the buccal area that lies immediately below the outer cheek bone and in front of the ear I call a “backfill” zone which I target with fat transfer to create a more uniform transition from the augmented cheek downward.
I think we are so focused on the “midface” (cheek) and the lower face (jawline and neck), we forget to look at the importance of the watershed region that is situated between the mid and lower faces. Remember that a youthful face has very few transition zones. I look at fat transfer as a way to unify areas of the face that have separated and to rejoin these areas. It is almost like airbrush work. In essence, that is how I apply artistic interpretation to facial aging and truly target the face for optimal rejuvenation. So those surgeons out there who suck out the buccal zone in my opinion make no sense to me even if the area is full because it will become eventually depleted and will worsen one’s aging in many cases by doing so.
Story of the Week!
December 26, 2008 by dr. lam · Leave a Comment
I don’t think I’ll have a new patient story for you every week, but this one really touched me a lot. I had a patient who was looking for lip enhancement and had called around town. After Marcy worked her phone magic that she does so well, she really believed that I was the best suited to help her out (which I not so humbly believe to be true). She enjoyed most of the day at my spa then came over to my office for some fillers. I explained to her that fillers could also be used in the face, and I discussed with her the merits of Botox for long-term wrinkle reduction. She decided to do the fillers for facial rejuvenation, lip enhancement, and Botox.
I always see my patients back a week later to make sure that they are doing okay and to show them their before and after photographs. When I was taking her photos in the photo room, she said, “Dr. Lam, I know you don’t know this about me, but my daughter suffered anaphylactic shock when she was 15 years old and died in front of me. I got very close to my second daughter, my only other child, but who was then killed with my sister in a car accident 2 years later.” She then said, “Dr. Lam, you have given me my face back as it was before all this happened to me. You have erased 15 years of grief from my face.”
I can tell you it was hard to hold back my tears when I heard that. I told that story to all my staff. Even something “small” like Restylane can have a profound impact on people’s lives. I always say to my staff we are not in the business of plastic surgery but in the business of “taking care of people and transforming lives”. I can think of no better incidence than this one. I am so proud of performing such a small thing that had such wonderfully unintended benefits. I always remember that every person that I treat is special no matter what the motivations they have or the treatments that I perform. You never know when a small thing can mean a lot to the other person you were so blessed to encounter. Wishing all of you a special holiday season, and I hope this story touched you as much as it did me and my staff!
Merry Christmas and Happy Holidays from LFP!
December 25, 2008 by dr. lam · 2 Comments
A CLASSIC CHRISTMAS
A DISCO CHRISTMAS
A TEXAS CHRISTMAS
Believe it or not, I am actually taking a short break today and not writing a blog. What? I guess I am sort of writing one by writing this. Okay, this is not truly a thought-provoking blog but a jolly good Christmas cheer to all who celebrate Christmas. For those who do not, I wish you a Happy Hanukkah, Merry Kwanzaa, Happy Festivus or simply Happy Holidays. My sister sent me this crazy card, and I decided to create my own versions with my staff just for a good laugh and possible smile. My patients have truly become part of our LFP family. All of us here at LFP wish you and yours a joyous and restful Christmas holiday, as we are closed ourselves for the remainder of the week to enjoy this blessed time.