In Pursuit Of Perfection

Hollywood's pressure for physical perfection has resulted in Sex And The City star Sarah Jessica Parker having a small mole removed from her face. Where celebrities lead others follow, and many women may be inspired to address those niggling imperfections. We face the facts about the remedies and techniques.

Hollywood is a place where perfection rules, but Sex And The City star Sarah Jessica Parker always stood out from the celebrity crowd because of her apparent refusal to consider cosmetic surgery.

The off-beat beauty, 44, condemned the "epidemic" of actors submitting to the surgeon's scalpel and claimed: "I've had no Botox, no collagen, nothing."

But it's been reported that she may have bowed to pressure and had one small blemish removed - her facial mole.

Although she's denying reports that the 'beauty spot' on her chin has been removed, the transformation from a distinctive mole to an almost invisible blemish is unlikely to be the result of make-up artistry.

And while the star may have been unconcerned about the imperfection, it had attracted cruel attention on blogging sights, with some calling it 'witchy' and others criticising it for being 'distracting'.

Jane Lewis, a dermatological expert dealing with mole removal, says: "It certainly looks as though Sarah Jessica Parker has had a mole removed and hers was probably one of the most common - an intradermal naevus. Often people may have had these all their lives or they can suddenly appear from the age of around 30. They normally look just like flesh-coloured lumps."

Lewis adds: "We all like things to be perfect these days and maybe Sarah Jessica suddenly felt the need to get rid of it either because she didn't like it any more, was hurt by the criticism about it, or was advised that there might be a risk that it could become cancerous."

She points out that increasingly many women are influenced to have facial imperfections removed because the media constantly portrays celebrities who apparently have perfect skin.

She says: "Nowadays photographs in magazines are airbrushed so much that it makes it look as though all these stars have flawless, clear complexions.

"That's totally untrue of course, because no-one - not even a celebrity - has totally blemish-free skin. We're all vulnerable to skin damage through a variety of causes - from sun damage over our lifetime through to the effects of smoking and drinking, but ordinary people often don't realise this."

Ironically, hundreds of years ago moles were considered alluring, and people even used to enhance them by painting them black. Even in the late 1950s and '60s moles were still referred to as 'beauty marks'.

Stars such as Elizabeth Taylor and Marilyn Monroe sported them, but nowadays as their appeal has waned stars increasingly banish them.

Madonna has had a mole above her lip removed, singer Enrique Iglesias also had a facial mole removed, and Ewan McGregor has also had two removed - because of concerns about skin cancer.

But supermodel Cindy Crawford insisted on keeping her signature dark mole on her top lip, despite being encouraged to remove it at the beginning of her career. The beauty spot became her sexy trademark.

Celebrity psychologist, Dr Alisdair Ross comments: "If you ask good-looking celebrities about their bodies many will still have parts they'd like to change.

"It can be a fine line for them between having a quirky feature and an off-putting flaw."

Ross points out, though, that in Australia we tend to champion the underdog and still prefer quirkiness and character in faces.

He says: "We're not into the identikit mass-produced starlet you see in America."

However, where today's celebrities lead, others follow. Undoubtedly many people, especially women, may be tempted to follow Parker's example and explore having an unsightly mole removed.

We asked an expert for advice on facial moles and how they can be treated...

:: HAVING A MOLE REMOVED

Mr Nicholas Parkhouse, consultant plastic and reconstructive surgeon from the McIndoe Surgical Centre, says the reasons for seeking the procedure are generally due to self-consciousness.

"Patients may have been teased about a mole in their childhood or a mole may develop in later life, or it may get larger as the years go by and people become increasingly self-conscious about them. It's amazing how much self confidence can be improved by the removal of a mole," he says.

There are a variety of skin lesions or blemishes that are commonly known as moles, including coloured and pigmented moles as well as non-pigmented lesions.

As well as those on the surface of the skin, a significant number will be within the thickness of the skin. It's that position which will determine the choice of removal techniques.

Lasers or surgical shaving can be used, but these methods are only likely to be effective on superficial moles that are on the surface of the skin and do not go very deep.

Parkhouse says: "In many cases - such as an intradermal naevus which often extends deeply into the skin - surgery is the most effective method of removing a mole as it allows the surgeon to be sure to remove it entirely and reduce the possibility of it regrowing."

"Having a facial intradermal naevus removed is one of the most straightforward cosmetic procedures you can have," he adds.

"But there is an important proviso - it must be done expertly to ensure any scarring is minimal."

:: GET IT CHECKED FIRST

Before embarking on any cosmetic procedure, Parkhouse advises first seeking medical advice from a GP to ensure a mole isn't cancerous. This particularly applies to pigmented or coloured skin lesions.

He says: "In general, a mole which has been present and growing slowly over a very long period with no significant symptoms or changes is
likely to be harmless or clinically benign.

"When there is any doubt it should be removed and sent for a laboratory examination for medical reasons."

Always consult a GP or specialist about a mole if you notice any changes such as the colour, size, the edges become ragged, or it begins to itch or bleed.

:: PROCEED WITH CARE

Parkhouse says women should be aware that with any surgical mole removal there will be an element of scarring.

He says: "What you don't want is to substitute a conspicuous or bad scar for a mole, and so any work on the face should be considered seriously and people should get expert advice on the realistic outcome."

Prior to surgical removal, the extent of likely scarring and any potential risks or complications including rare occurrences such as wound infection, and other facts about the length of healing time and the final outcome should be made clear to you.

He emphasises the importance of careful placement of the wound to help minimise scarring, and says the line of the eventual scar should follow the natural lines of the face closest to it.

:: UNDERGOING TREATMENT

Mole surgery usually involves a local anaesthetic and takes 30 minutes or less. Some patients may have a little bruising or swelling for a week or two afterwards.

Stitches may vary - those which are dissolvable; fine stitches through the skin which are removed five to seven days later; or a combination of glue and stitches.

Parkhouse says: "I believe in fine skin stitches which are removed later help to minimise scarring. Initially after surgery patients can wear a skin-coloured tape over the wound which makes the scar almost invisible."

The scar may look pink and fresh for some weeks and it takes a scar around six months to fully mature.

The majority of patients benefit from massaging a fresh scar with moisturising cream such as Vitamin E cream or an oil like Bio Oil. He says: "There are topical creams available over the counter which claim to promote scar reduction but the majority of this effect is probably due to the massage which is beneficial in helping skin heal."

If the scar becomes red and lumpy then further treatments such as silicone gel may be required.

:: For information on skin cancer and being sun smart, visit www.cancer.org.au/cancersmartlifestyle/SunSmart

:: For information on the Australian Society of Plastic Surgeons, visit www.plasticsurgery.org.au
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