Nuestra imagen es nuestra carta de presentaci&oacute;n al mundo y, a pesar de que la gen&eacute;tica es una loter&iacute;a y su encanto reside precisamente en lo aleatorio de ello, desde que llegamos al mundo comenzamos a estar sujetos a una serie de leyes al respecto. Es lo que conocemos como el canon de belleza, lo que se espera de nosotros en la cuesti&oacute;n est&eacute;tica, que adem&aacute;s gira en torno a una serie de tendencias que van cambiando seg&uacute;n referentes y el momento social, pol&iacute;tico y econ&oacute;mico que estemos atravesando. De este modo, nuestro cuerpo, nuestra salud, se acaba convirtiendo una vez m&aacute;s en un bien de consumo. En estos &uacute;ltimos a&ntilde;os la medicina est&eacute;tica, la medicina est&eacute;tica avanzada y la cirug&iacute;a est&eacute;tica (hay una diferenciaci&oacute;n de acuerdo a lo invasivos que sean los tratamientos, las herramientas que se usen y la presencia o no de anestesia) se han normalizado. Y esto tiene su parte buena, ya que el estigma con el que cargaban las personas que se somet&iacute;an a ellos y los profesionales que se dedican a realizarlos ha ido desapareciendo, o al menos disminuyendo, pero tambi&eacute;n su parte negativa, que b&aacute;sicamente se trata de que nuestros referentes est&eacute;ticos no son reales, especialmente aquellos que consumen los j&oacute;venes a trav&eacute;s de las redes sociales. El miembro del Grupo Espa&ntilde;ol de Dermatolog&iacute;a Est&eacute;tica y Terap&eacute;utica (GEDET) de la Academia Espa&ntilde;ola de Dermatolog&iacute;a y Venereolog&iacute;a (AEDV), el doctor Antonio Clemente, nos indica que estamos mostrando en redes un mundo, una vida, que no es real. "Cuando eres adolescente te comparas y pretendes conseguir objetivos irreales, no solo en la piel, sino en la vida en general, y cuando no los alcanzas&nbsp;piensas que eres un fracasado". La psic&oacute;loga y psicoterapeuta experta en psicoan&aacute;lisis relacional, terapia humanista y an&aacute;lisis existencial In&eacute;s B&aacute;rcenas tiene una misma l&iacute;nea de pensamiento destacando la importancia de esa sobreexposici&oacute;n en redes que hacemos y recibimos, los referentes a los que decidimos seguir. De acuerdo al &uacute;ltimo estudio presentado por la Sociedad Espa&ntilde;ola de Medicina Est&eacute;tica (SEME) sobre la penetraci&oacute;n de estos tratamientos en Espa&ntilde;a, la edad media de acceso a la misma ha pasado de los 35 a los 20 a&ntilde;os. Seg&uacute;n la m&eacute;dico est&eacute;tico y tesorera de la organizaci&oacute;n, la doctora Petra Vega, el peligro de ello reside principalmente en el tipo de tratamiento que se demande y la motivaci&oacute;n que haya realmente. "No es lo mismo aplicar rellenos que toxina, un peeling o un tratamiento para mejorar la silueta corporal. En el caso de los rellenos hemos de pensar que son sustancias sint&eacute;ticas que alteran el volumen de la piel y pueden dejar alg&uacute;n tipo de residuo. En ese caso la edad de inicio s&iacute; que importa puesto que habr&aacute; que aplicarlo muchas m&aacute;s veces, mientras que en el resto de tratamientos no se da esta circunstancia. Diferente es seguir un canon o moda, ya que no todas las anatom&iacute;as se pueden adecuar a ello. No estamos hablando de un maquillaje o un vestido, estamos hablando de estructuras anat&oacute;micas a veces imposibles de modificar o cuya modificaci&oacute;n puede ser muy traum&aacute;tica. En esos casos creo que el m&eacute;dico debe ayudar al paciente, joven o no, a entender de que se trata de conseguir la mejor versi&oacute;n de uno mismo, no de dejar de serlo. Debemos huir de la alienaci&oacute;n est&eacute;tica". El doctor Antonio Clemente apunta por su parte que habitualmente cuando se decide hacer un tratamiento de este tipo a una edad tan temprana se debe a una cuesti&oacute;n de tendencias, precisamente, algo totalmente vol&aacute;til. "La medicina est&eacute;tica no se debe banalizar, aunque hablemos de tratamientos temporales o tengamos dinero.&nbsp;Hay cosas que no se pueden revertir". Relacionado precisamente con la edad media de la penetraci&oacute;n de la medicina est&eacute;tica en Espa&ntilde;a tenemos el concepto de los tratamientos preventivos. El doctor Antonio Clemente comenta que est&aacute;n indicados en pacientes entre los 30-35 a&ntilde;os y que por norma general se deber&iacute;an adelantar s&oacute;lo en tres supuestos: si se considera que hay algo concreto a mejorar por una cuesti&oacute;n relacionada con la salud mental resultando algo excepcional; algo a corregir, como pueden ser determinadas cicatrices, lo que adem&aacute;s se suele aconsejar; o el caso de pacientes que por su forma de gesticular son susceptibles de tener esos signos de envejecimiento prematuros. "Lo que no tiene ning&uacute;n sentido, y es algo que cada vez estamos viendo m&aacute;s, son esos pacientes de 18, 19 y 20 a&ntilde;os con la piel perfecta que empiezan a ponerse b&oacute;tox de forma preventiva. Los dermat&oacute;logos somos fieles defensores de estos tratamientos, no tenemos que hacerlo como antiguamente y esperar hasta los 60 o 70 a&ntilde;os, un concepto que hay que desechar, pero no se puede banalizar ni la medicina ni la dermatolog&iacute;a est&eacute;tica. Hay que estar bien asesorado".
"LA MEDICINA Y LA DERMATOLOGIA ESTETICA NO SE DEBEN BANALIZAR&trade;
LA OBSESI&Oacute;N POR LA TENDENCIA 
Los datos confirman que los tratamientos de medicina est&eacute;tica faciales han sufrido una fuerte demanda y tiene una sencilla explicaci&oacute;n: la obsesi&oacute;n y la tendencia del skin care, la belleza coreana, el clean look, no make up make up y mil nombres m&aacute;s. Todo ello puesto de moda gracias a las redes sociales. "Hay ciertas cosas que los dermat&oacute;logos recomendamos siempre, desde la m&aacute;s tierna infancia. Evitar quemaduras solares, tener unas rutinas adecuadas, tratar las enfermedades de la piel cuando salgan. Somos firmes defensores de rutinas sencillas, no de lo que ahora se promociona en redes.&nbsp;Una rutina cosm&eacute;tica adecuada lo es porque acaba siendo sostenible en el tiempo, no por hacer diez pasos. De hecho, las recomendaciones principales que hacemos consisten en el uso de una hidratante, una fotoprotecci&oacute;n y una limpieza adecuada. Si queremos un extra podr&iacute;amos a&ntilde;adir alguna crema antienvejecimiento por la noche con retinol o retinoides, pero no en la adolescencia ni reci&eacute;n comenzada la veintena. El problema es que muchas veces no estamos bien asesorados. En lugar de ir a un dermat&oacute;logo se prueba lo que sea y vemos muchos problemas derivados de ello.
Hay gente que acaba con acn&eacute; o si ya lo ten&iacute;a, lo agrava. Ese es el peligro que tienen estas rutinas generalizadas. Todo esto se extrapola al mundo del maquillaje, por eso llegamos a ver casos de acn&eacute; cosm&eacute;tico tambi&eacute;n aunque se trate de una enfermedad cut&aacute;nea que suele tener base hormonal". A ra&iacute;z de revisar el estudio de la SEME, hacer scroll en redes sociales y mirar a nuestro alrededor es normal plantear ciertos temas relacionados con las adicciones a este tipo de tratamientos y la salud mental. Si bien es cierto lo que coment&aacute;bamos de que el estigma hacia los usuarios de la medicina est&eacute;tica ha ido disminuyendo, tambi&eacute;n lo es que los n&uacute;meros pueden resultar preocupantes si no se comprenden las razones que hay tras ellos y a las personas, sobre todo. "S&iacute;, hay casos de adicci&oacute;n a estos tratamientos, pero por suerte no es algo sobre lo que podamos generalizar, es decir, no suponen un gran n&uacute;mero. Sin embargo, si caemos en la banalizaci&oacute;n, s&iacute; que es un problema que se puede agravar. Hay que confiar en profesionales que pongan l&iacute;mites y que sepan decir que no cuando algo no est&aacute; indicado", comenta el doctor Antonio Clemente, miembro de la GEDET de la AEDV. La tesorera de la SEME y m&eacute;dico-est&eacute;tico Petra Vega comenta que, en esos casos, cuando se detecta la adicci&oacute;n, el proceder consiste en detectar en el paciente dismorfofobia, enfermedad psiqui&aacute;trica muy grave que genera una imagen distorsionada del propio cuerpo. Se observa a trav&eacute;s de la historia cl&iacute;nica y son pacientes que no deben ser tratados, sino remitidos al especialista en salud mental. "Sin que se presente esta patolog&iacute;a, de vez en cuando hay pacientes que pueden desarrollar cierta adicci&oacute;n y solicitar tratamientos que no necesitan o no est&aacute;n indicados. La detecci&oacute;n es igual y por supuesto deben ponerse l&iacute;mites al propio paciente, explic&aacute;ndole los motivos.&nbsp;A veces simplemente se trata de posponerlo.
"LOS PROBLEMAS DE AUTOESTIMA COMIENZAN A PARTIR DE UNA COMPARACI&Oacute;N"
UNA CUESTI&Oacute;N DE AUTOESTIMA 
Las causas suelen darse m&aacute;s en personas con muy baja autoestima, tras situaciones muy traum&aacute;ticas o alteraciones leves de la imagen corporal". Tambi&eacute;n resulta curiosa la relaci&oacute;n entre la edad media de entrada de la medicina est&eacute;tica y el porcentaje de&nbsp;usuarios que alegan como motivaci&oacute;n envejecer bien, solo un 7% con el mayor porcentaje concentrado en la franja de 46 a 70 a&ntilde;os. Destacable tambi&eacute;n resulta la respuesta de obtener un aspecto descansado y fresco, la m&aacute;s seleccionada por las mujeres de entre 26 y 35 a&ntilde;os, y de aqu&iacute; podr&iacute;amos saltar a una relaci&oacute;n con la maternidad, el concepto de la supermujer, la brecha salarial, jornadas de trabajo maratonianas a las que se le suma el trabajo en casa o el tiempo en ir y venir del trabajo. Sobre la autoestima tambi&eacute;n arroja datos y nos lleva a conclusiones muy interesantes el estudio de la SEME. Este aspecto unido al de verse bien son dos de los imperantes entre las razones para optar por este tipo de tratamientos. Sin embargo, solo el 2,7 % lo hace por aceptaci&oacute;n social. Como ambos doctores comentan, cuando respondemos a una encuesta siempre hay un sesgo. Adem&aacute;s, son conceptos que est&aacute;n &iacute;ntimamente relacionados, pero a los que les podemos otorgar un sentido muy diferente. Actualmente es un argumento mucho m&aacute;s v&aacute;lido socialmente lo primero que lo segundo, cuando los problemas de autoestima, a pesar del prefijo de la palabra, tienen mucho de colectivo, ya que parten de una comparaci&oacute;n.
"HAY QUE CONFIAR EN PROFESIONALES QUE SEPAN DECIR 'NO' CUANDO ALGO NO ESTA INDICADO"
Es por eso tambi&eacute;n importante un caso concreto que destaca la psic&oacute;loga In&eacute;s B&aacute;rcenas. "Trabajo con un chico que se someti&oacute; a una otoplastia a los 18 a&ntilde;os.&nbsp;Antes hab&iacute;a sufrido bullying en el colegio por tener las orejas de soplillo. La operaci&oacute;n arregl&oacute; el problema por fuera y le ayud&oacute; a mejorar en su autoestima. Sin embargo, pasados los a&ntilde;os ha tenido que venir a terapia porque se da cuenta de que esas inseguridades siguen dentro y le afectan en su forma de relacionarse, aunque el exterior se adec&uacute;e a los c&aacute;nones sociales. Tambi&eacute;n he visto como pacientes m&iacute;as de mediana edad han mejorado notablemente su autoestima al inyectarse b&oacute;tox y &aacute;cido hialur&oacute;nico porque sus rostros les recordaban m&aacute;s a ellas mismas, ya que con la edad los rasgos se van perdiendo. El mayor peligro de nuestra sociedad actual es lo hacia fuera que vivimos. Hay que cultivar lo de dentro primero".

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