American plastic surgeon Dr Steven Dayan lifts the lid on a think tank that is brainstorming the future of skin health.

Was there really a time when kids could die from strep throat? This was a question from my 12-year-old daughter while we were at the International Museum of Surgical Science viewing an exhibit on the discovery of antibiotics. She seemed astonished to learn that there was a time when antibiotics didn’t exist. Even as a physician I too had to take a moment to appreciate the impact antibiotics has had on medicine and humanity. I then thought to myself: 25 years from now will my daughter’s children be asking her if there was a time when people died from cancer?

My grandmother who was born in 1897 could have never imagined radio, telephones, automobiles, airplanes and answering machines, (which she could never figure out). I always thought if someone were to tell her that one day she could pick up a hand piece, speak into it and have a real-time conversation with another person half way around the world she would have never understood, let alone accept the possibility of getting into a 500 tonne metal object and fly through the air over an ocean and in less than 12 hours be visiting family members who live 5,000 miles away.

My mom, in her lifetime, has witnessed air conditioning, TV and remote controls. I have already seen the invention and advancement of cell phones, computers and the internet. And with technology doubling every 18 months, what will the future hold for us, our children and our profession?

Recently, I have had the opportunity to consider it… I have been invited to participate in a think tank sponsored by a division of Nestle that is contemplating and committing to establishing the future of innovating and educating both doctors and consumers on dermatologic and aesthetic skin health. The Project is called SHIELD and it stands for Skin Health Investigation Education Longevity Development. They have earmarked funds to open multiple SHIELD centres across the continents. The first one to open is in New York in a few months.

These futuristic think pods are certain to be an idealised cross between an Apple store and an outer space laboratory. Like nodes they will be linked electronically and virtually so that in real time free flowing ideas and resources can incubate.

The SHIELD pods will be open to anyone with a brilliant idea on skin health who lacks access to universities or research centres, or for those who want to bypass the hierarchies and hurdles that may exist in such institutions. Groups of individuals from all aspects of life and all fields of arts, humanities and science will have a chance to meet and interact with each other and brainstorm the future. Great ideas, whether conceived in isolation or within the multidiscipline groups, will be eligible for funding or triage to the most appropriate outlet. For the creative innovator with the next big idea and no place to go with it, the SHIELD centres will serve as an inviting community to cultivate and grow an idea.

The premise is bold and exciting and up to now nothing like it has existed. To just think what medical education and our field will look 60 years from now is awe-inspiring.

To this extent, I read an article on the recent uncovering of postcards from French artists who in the year 1900 painted pictures of what they predicted the future would look like in the year 2000. Most were measurably off from today’s reality but a few were rather close. So it got me wondering what will the future have in store for our specialty. In the spirit of free thinking, I thought I would offer up 10 predictions for what plastic surgery and aesthetic medicine will look like in the year 2075.

Plastic surgery and aesthetic medicine: Top 10 predictions

1. Non-surgical treatments will continue to grow exponentially, outpacing surgical.

2. Facelifts as we know them today will rarely be performed in 2075. In fact across all the surgical fields the actual cutting open of skin with a scalpel will become a rare last resort measure only called for in emergencies or unusual situations. And rarely will surgery be indicated for cosmetic reasons.

3. Rhinoplasty will still remain the most difficult of all cosmetic procedures and the last cosmetic surgical procedure to be done in large numbers, however, true rhinoplasty as we perform it today will be significantly decreased in numbers. For the primary rhinoplasty, 3D printers will be able to create a nasal skeletal structure composed of an absorbable material that can be inserted just under the skin and act as a scaffolding. And along with a filler, the two will be used to finely shape the nose into a predetermined ideal structure in just minutes.

4. Surgical training, proficiency and certification will be based on simulators as residencies will have to adapt to the decrease in surgical case loads.

5. Topical translucent products embedded with sunscreen will be spread on the skin much like a cosmetic foundation. The product will polymerize and become imperceptible to the eye or touch yet completely smooth out the wrinkles and homogenise the skin texture and tone. It will come in different colours and shades, dyschromias will be camouflaged and tanning will become obsolete. Expect it to also lift and tighten the skin and be removable at the end of the day.

6. Health and wellness strategies such as nutraceuticals and possibly hormone replacements, genetic medicine, yoga and more will become part of our practices. Likely the days of solo private practice in facial plastic surgery will come to an end and we will work in multidisciplinary groups offering services and products that can meet the lifestyle request of a modern generation.

7. Aesthetics will be used to treat mood disorders – from depression to anxiety and it will be a reimbursable procedure.

8. Aesthetic academic societies that at one time were adversarial will recognise their mutually aligned interest and work together closely. They also likely will become more distant from their parent organisation. (Keep in mind nobody 75 years ago would have imagined that Germany and Japan would be two of the US’s most trusted and reliable allies, and nobody at all could have foreseen that the Cubs would win the World Series and Donald Trump would be the US President!)

9. Academic meetings will be available to us both virtually and in person. We will have the option to attend via our avatars. Podiums, screens and PowerPoints will be replaced by large circular meeting rooms where everyone participates freely and democratically. Each will be logged in with their personal handheld device to view, interact and communicate with anyone else in the room at the same time.

10. Aesthetic medicine will be one of, if not the, most highly coveted and desirable fields. As the anatomy and nuances of the face are so intricate, and important to self-awareness and recognition, it will be the last and perhaps only field of medicine to not be commoditised. The best of each medical school class will be drawn to the field due to its reigning autonomy and the ability for a physician to be appreciated for his or her individual expertise. Remote devices products and surgical robotics will not be able to fully replace the hand-eye coordination, artistic sense and more importantly decision-making process necessary to working in what is perhaps the most identifying part of the human body.

Perhaps like many of the French painters I’ll be off the mark, but maybe some of them will be right on. Either way, it’s fun to consider. These are just a few of my predictions; what are yours?

About the author

Dr Steven Dayan is a facial plastic surgeon, professor and researcher based in Chicago, USA.

Dr-Steven-DayanHe has published over 110 articles in medical journals and five books and is a NY Times and USA TODAY best-selling author. Dr Dayan is an internationally recognised keynote speaker and has presented all over the world, including Australia.