Tom Decates on the rise of cosmetic surgery

Doortje Smithuijsen: My name is Doortje Smithuijsen and in this podcast I will be investigating aesthetic capital because next the more known forms of capital like social capital and cultural capital there's also something that is called aesthetic capital. It captures the way we look and the way these looks sort of define our class and our chances in society. And well, due to the rise of social media and the increased visibility of our physical appearance, this aesthetic capital is becoming increasingly determinant for our social opportunities. Therefore I would really like to investigate this form of capital with all kinds of researchers, some are from the VU (Vrije Universiteit Amsterdam), some are from different areas of this society, and together in this podcast we will investigate what this aesthetic capital is and how it shapes our society today. So welcome to this third episode of the aesthetic capital podcast, the podcast from the Connected World division of the VU. I’m very pleased to be joined here today by Tom Decates. As a journalist in in the Netherlands you write, or you make television about fillers and botox, you are the very obvious person to call. Tom Decates: Thank you so much. Doortje: You just told me that every week you are in touch with journalists on the topic of botox and fillers on which you are specialized. You studied medicine here at the AMC, you worked as a plastic surgeon and since 2011 you've been specializing in botox and fillers and you're also doing a lot of research on the complications that botox and fillers can cause. This is also a topic that you are very vocal on, that you want to educate on a lot. Which is very good I think because we live in a world right now where botox and fillers are very popular, increasingly popular, so a ittle bit of knowledge can be good, on the subject I feel. Tom: Exactly that's where it's all about for me, to create awareness in society. Going back a few sentences, I was a resident at the plastic surgery department, so I didn't work as a plastic surgeon. So in short, the plastic surgeon cuts and he operates, and the aesthetic physician or what we have here in the Netherlands is a specialty to become an aesthetic physician. We’re the only ones in the world who have that, and the level of aesthetic physicians is very high in the Netherlands. The aesthetic physician injects botox and fillers and works with energy-based devices, so that's what I do on the one hand, I inject them in my own private practice. And on the other hand, at the Erasmus University in Rotterdam, we have an outpatient clinic to solve complications of filler treatments and that's where I got my PhD. And that's where I’m now an assistant professor, that's where we tried to teach other doctors, dermatologists, yeah - injectors of botox and fillers- with also a sense to do good for society, but I think we will touch based on that. Doortje: I think we will yeah, you really want to help people realize, at the one end the physicians, not to just inject botox on everyone and not think about it anymore, and on the other hand, the patients and the people who want to get botox injected to maybe think about it twice. Tom: Exactly this, but we're still going to continue the interview, aren't we? Doortje: Yeah, we're not done yet. All right, so you have also been researching the increase in demand for botox and fillers. What is there to see right now? Because I mean you don't have to do a lot of research, I think you can also just look around yourself and and realize that botox is very popular and fillers are popular, but what do you see when you do research on this? Tom: Yeah, and that's the important thing, so you can see things around you, but also as a scientist you want to have proof. So everywhere in the world and in every television program, everybody is saying, “wow, this and that”. Hard proof, it wasn't there, so nobody in the world knew what's going on, like incidence, prevalence, how much treatment and the Netherlands. Very small, over-controlled country, so it was rather easy for us to find out which numbers on treatments and also on possible trends there are in the Netherlands. So we started out researching on this in 2016, we did the same research in 2019 and now in 2022. We also did the research, and in a few weeks or months we will publish on this and the Netherlands will know. But yes it has risen and risen and risen. Doortje: Yeah so what do you see: the demand for botox is rising? Or demand for every aesthetic treatment? Tom: Yeah the demand for every aesthetic treatment is rising. But Doortje you have to interrupt because if you ask me I will continue please. So what we see is it rises and rises and rises and whether it's good or not… It's still Holland, it's still a bit less than other countries, less than America or something. So you can say that we're now in Amsterdam, and Amsterdam there are more treatments and more aesthetic private practices than in the rest of the Netherlands. But compared to other big Southern European countries or North America, South America, Asia is crazy. Doortje: And in the same treatments? Tom: Yeah, so it's all botox, fillers, cosmetic treatments. So on the one hand, in the Netherlands we look on the street and say, whoa, we see a rise but compared to other worldwide big countries it's nothing. Doortje: So what do you see when you look at these numbers in a broad sense? What do they tell you? Tom: We see a higher demand from the market. So people want those treatments. Doortje: So what are they demanding when they want those treatments? Tom: So more and more and more, it's very quantitative. Yeah, so I know what you do and where you did your research on, and I know that you dived into social media and all what it does: people are making themselves crazy, and thinking this is the new normal and we should all do this, Doortje: How do you feel about this? Tom: So on the one hand, I think we're beautiful the way we are. And if you have completely embraced yourself, who you are, and you come to me and you say “Tom, can you tweak this a little bit?” then I’m willing to do that. On the other hand, since I've been doing this for 15 years now, I also learned that there are people who like other things than you and I like. And at first 15 years ago I was pointing at them and “You're stupid and you shouldn't do that” but in time I also learned that it's very important to listen and to respect the view of other people… Doortje: … Judge and maybe also lecture and be a little bit maybe elitist also in a way “I know better, I have better taste than you on faces” or what. Tom: That is the old me. So the new me is they say to me “Tom look at Cardi B she's a very strong woman and she she decided herself that she wanted to look like this, and I also want to look like this”. And then I say “Okay, I’m not going to do it but I’m going to refer you to somebody with a different moral compass than I have, but I know he or she is well trained and educated and she or he can help you”. Doortje: Yeah, and you say that there's a new normal, right, and maybe there's a new normal every year or so. So what is that new normal would you say when it comes to the way we look at our faces? Tom: So specifically if we look at cosmetic medicine and again referring to people like Kim Kardashian and Cardi B five to 10 years ago it was of having big buttocks and luckily enough that has changed. So now they come to me and colleagues of mine to get the volume removed out. And the same we had with lip, they wanted to get it injected and now everybody comes to get it removed. And now everybody wants a sharp jawline like Kylie Jenner has for instance and big cheekbones. Again things I’m very hesitant to do but if you ask me “Tom what are the things that people want?” This is what: sharp jawline and high cheekbones. Doortje: How fast do these ideals change? Is it a standard duration for an ideal? For example the sharp jawline, or maybe the lip fillers, I guess they were five, six years or so. Tom: Yeah, so it's like with everything. I think it's with hair, it's like fashion so it comes and it goes. And if somebody on television who is world famous and goes berserk on TikTok or Instagram, then younger -mostly women- they follow that trend and they go to the doctor. And I get the most ridiculous questions from, again mostly women, who said to me “Yeah, Tom, this is a trend in in south Korea, can you do this and this?”. Crazy. Doortje: And why do you think it's mostly women? Tom: Yeah, Doortje, what I can say is that the percentage of men is rising and rising and rising. Yeah, so I do a lot of research with a group of women who are a million times smarter than me. And they studied sociology, and they are in philosophy and together we're trying to get these questions answered. But up until now as an expert opinion from me is that women go on TikTok and Instagram and they make each other crazy, they compare themselves. And we men, especially the younger men, we know from science that three years later than women they use the entire brain. And when I look at my sons, they're 10 and 11, they're breaking stuff but girls in their classes, they're sending them love letters already. But they don't care, they don't understand because men are… So I think that at the younger age women are interested in fashion, in cosmetic medicine. And in guys although it's rising, it starts at a later age. But that's an expert opinion. Doortje: Yeah well I was also wondering because you do a lot of research on the numbers. Do you also do research on the why? Tom: Yeah but it's really sad. We in the Netherlands, we are doing the research and have a lot of enemies, I’m threatened by a lot of people. Because what I do as a whistleblower, I’m trying to do something which is the opposite of what my industry wants. Doortje: Right? What do they want? Tom: What do you think they want Doortje? No research and sell, sell, sell; money, money, money. So it's a circle of of trust: there's the creator of the filler, of the botox who wants to make more and more money, then it's the doctor that injects and injects more and more, so he gets more money, and then it's the client who wants more and more. So it's a vicious circle of money, money, money. And whatever we think of it, that's capitalism. But we tried to do in an other way because from 15 years on journalists was asking me “Tom, what are the numbers on complications, what are the numbers on injections, why do people do it” I say “my friend…”. Yeah, so that's why we started to do this research and to find crazy people like me who are willing to put time and energy without getting paid for it to do good for society. Doortje: And you also host a consultation at Erasmus MC, say for people who have complications with their fillers. What kind of complications do you see there? Tom: So mostly overfilled faces, so too much filler in the wrong layer. And mostly done by doctors or non-doctors who are not trained to do the treatment and who should think about starting to find another work. Doortje: Do you see an increase also in these complications in the last couple of years? Tom: In the last couple of years we saw an increase. But due to the fact that we don't have that much doctors willing to do what we and my colleagues are doing, the waiting list is rising and rising .Yeah so we don't have more time and people to solve complications yeah. Doortje: And when you speak to these people who have these complications I can imagine they feel pretty bad because they they wanted to look prettier and they end up looking very different way. What are they like? Tom: Yeah, so again, the interesting thing is… I’m a group of people, so in my group -the expertise group cosmetic treatments- we're with a group of women who are a sociologist and a philosophist. And we did qualitative research on why do you do it and we recently published an article and we called it “Oups I did it again”. But the facts in the article are that on the one hand they did the treatment, it went wrong… Doortje: … and then they did again really. So they don't come out of it with fear or whatever… Tom: This is going to be a very long conversation Doortje. But what happens is they undergo the treatment, things go wrong, and then sometimes a few months later I see them again. And they got treated again and it didn't work out and they come to me and say “Tom can you solve it again”, which is really hard. Doortje: But I mean don't you ever get quite depressed with these people? Because then you start to imagine how big their self-doubt is, how low their self-worth is and that they go through this terrible phase, again. Tom: But again Doortje, that's why I think we are on this earth to help other people. And I come from a background currently, and also with my friends and with my family… I’m literally the richest man in the world, because I have friends, family, children, wife, I’m healthy. And I know that many people don't, and they can be influenced by bad people. Doortje: And do you think that is what lies underneath these extreme treatments…? Tom: Again, this is for now an expert opinion, but if I talk to those people, they are physically, mentally mutilated. They come from a different social demographic background as you and I come from. It's sometimes, literally they want to put put on a mask to be another person. And sometimes they have a husband or a friend who says “You're ugly, you should do this” etc. It's really sad. Doortje: So it's also a form maybe even of inequality and maybe increases inequality between people. Tom: I know that's a subject that's very important… Doortje: …close to my heart. Tom: Come again with the question Doortje: So maybe the people who show up at your consultation it's a sign of inequality? Tom: It would be an expert opinion of you and me saying this. And again I’m also a scientist so I cannot prove it but if I speak from the heart as an expert on this matter I would say yes. Doortje: Yeah and I mean I've gotten to know you as a journalist talking to you for quite some time now, I guess maybe eight years or something. And I remember you were probably the first one that actually really told me “I say no all the time when people approach me like I want to do fillers, I want to do botox”. We charged upon it briefly earlier in this conversation, I was just wondering how do you decide when to say no? I mean of course there are the obvious like when someone is 16 or whatever I can imagine, but how do you decide on this? Tom: Yeah, but this is the hard part. And this is also the part that every time I have a conversation like this with a journalist or somebody, I also go home and I think “Tom, maybe you should do this the other way or think about it”. But every client is for me in the positive way, I love cosmetic medicine. Every client is for me a canvas where I create a piece of art together with the client. But on the other hand, I also sometimes do what we call in medicine is shared decision making. So together with the client, we say… Literally today it was a 22-year-old girl, and one eyebrow was 2 millimeters lower than the other. So if she would have come to me 10 years ago, I would say “You can go out of my office immediately” because I think it's bullshit. But over time I learned also to listen to them and to take the question seriously, so now we had a 30-minute conversation. I took it seriously, her question, and I said to her what from an anatomical point of view would be possible with botox and fillers and then she said to me “Tom, but what do you think?”. Honestly, I say “I think it's BS” and then we laughed, we high fived, and she went outside with a big smile on her face and I went in again with a big smile on my face and she was not treated. Doortje: But so what's the difference between 10 years ago? Tom: That 10 years ago I would say “you're stupid”. They would then go around the corner to a doctor, asks half the money and has one millionth of the training and then six months later I would see her back at my out-patient clinic. Doortje: Yeah so it's also an empathy thing for you or it has become more of an empathy thing to try to relate with people and their questions and where they come from. Tom: Yeah it's 50% is psychology, psychiatry sometimes and it's also communication and yeah learning how to conversate. Doortje: Yeah do you say “No” more often now than 10 years ago? Tom: Yeah it's very hard. So the thing is that whether you like it or not the business model is that you have returning customers. So whether you like it or not fillers stay for at about one year and botox half a year. So I've been doing this for 16, 17 years: I only inject botox and fillers two days a week or else I would go crazy. We can talk on that matter later. But I do it for only two days a week, so I only have returning customers, I don't have any more room for new for new customers. But today I had one and it just happened a few hours ago. Doortje: And I read actually that one of your specialties now is to have your mouth curling up a little bit or at least don't curling down to make you look sad. I was just wondering because as someone who is often told that I look very angry when I feel like I’m looking neutral. I was wondering why is it so important to have a a mouth that curls up? Tom: So again I’m going to say what all my clients say, so mostly middle-aged women. You can see the face as a balloon, the metaphor of a balloon: so when we age we lose bony tissue, we lose fatty tissue, and the skin gets thinner, so things go downwards. And then if you are very energetic and happy woman and you look in mirror and the corners of your mouth are downwards then you feel that you're looking at somebody else than how you feel inside. And that's the amazing thing about cosmetic medicine that people bring me warm baked apple pie that they made theirselves because when they look in the mirror again they see how they feel in the inside. Doortje: But that's of course a very beautiful thing about cosmetic surgery, an interesting slope right, because where does the way you want to look or where does it become a total illusion. Tom: Exactly, like Fata Morgana, yeah, and that's what the doctor decides. So they say to me “Tom, the corners of the mouth are downwards” and if I see that it's true, that I can visually see it, I do something about it. But of course there are also colleagues of mine that such a lady has the corners of the mouth going downwards, and the doctors say “Yeah, but look at your nose, are you willing to go outside with a nose like this?”. And that's how some of my colleagues work. Doortje: And do you speak a lot of people who also visited colleagues like that? And what does it do to the way you look at yourself? Tom: Yeah, very good question. So again I go to my situation. So I was loved and am loved, so it's very easy for me to accept everything I have, for instance the big nose and the big ears and everything I have, so I embraced myself. But I can imagine that if you don't have that love then you can see everything in your face. Doortje: So is this whole boom in the world, of aesthetic physics? Is this a problem of people not being loved or not feeling loved enough? Tom: Yeah, again, it's a part of my expert opinion, but if you ask me that question it's social media. Because then we can say this wasn't something that was there 20, 25 years ago. Doortje: Yeah, so do you study a little bit of social media? Tom: But I started on social media myself. Doortje: Yeah, I know, you have quite a quite a quite a following on tiktok actually! Tom: Thank you so much, but I’m anti-influencer. Doortje: Why is this? Because it's funny, that you say this, because , I mean… Tom: So if you look at the the definition of the influencer, I’m an influencer. But when it comes to cosmetic medicine, I try to do the opposite. Doortje: No it's funny that you said it because right now I’m 32 so I’m totally in the the the bucket for botox right now, when I open my Instagram it's all botox ads. Tom: So no more diapers and stuff? Doortje: No also. So it's botox and babies, that's my main bucket. And it's so funny because I did realize that at some point I really was thinking maybe it’s time to start with the botox right. And then all of a sudden I thought “okay is this something that I want or that I’m being told” right, with my phone. And this is something that I was curious to hear your opinion on because I think we often don't even realize how much we are pushed toward the decision. Also when it comes to our face or music by our phones or influencers etc. Tom: But it also happens in the real world, so when I’m in a country somewhere in the world lecturing. Then again we the Dutch calvinistic people, we don't have that much, but they are high on their own supply; so their trophy wifes and men… And then I go home and I talk with my colleague and we're like “Maybe we also have to do all those treatments”. Because they didn't, now sometimes they do, they didn't tell us we also had to undergo treatments, but everybody's doing it. And you think it's normal, and that's in real life but on social media of course that's what's happening. Doortje: Yeah, and do you speak about this with your clients as well? Tom: Yeah, of course. Doortje: And do they realize that they are being pushed? Tom: Yeah, but again, I don't- Doortje: And do they care even? Tom: So few answers, so I don't have that population in my private practice. Those are middle age women who did their research. But at the out-patient clinic at the Erasmus University, yes, there are only women that even when they got a complication- they show me a picture, if I've solved the complication- how they wanted to look… Crazy. Doortje: And what kind of pictures do you see when you look at these? Tom: Yeah, Kylie Jenner, Kim Kardashians… That's the sadness about modern days. Young people want to become a Youtuber or, I don’t know if we're going to touch base on Andrew Tate kind of people. People want to become influencer, youtuber, TikTok famous. Doortje: And this is why they get these treatments, you think? Tom: Yeah Doortje: But I’m also wondering why are the faces of, for example, the Kardashians as popular as they are right now? Why do they attract so many people? Tom: Yeah, their faces are flawless. So I also show my clients the face on Instagram and how they really look because it's all photoshopped, it's all literally fake. But people are looking for that that flawless -that you can't see any lines. Why do they want that? Maybe to escape their own lives and to be more near a fantastic famous future?...I have a fun fact for you on TikTok. Doortje: Oh tell me. Tom: Yeah, but again, I learned it from other people but it's a crazy fun fact. So TikTok is Chinese, and Chinese young people want to become a doctor or an astronaut, American young people want to become famous on Instagram and an influencer. Doortje: Yeah, yeah, I've heard this too. Tom: The chinese they created TikTok. Yeah, you're laughing, but this is crazy. So they're ruling America from the inside, very smart. Doortje: So you've been working in aesthetic physics for a few decades now, and I’m wondering how has that field changed or what are the big changes that you've seen? Tom: Yeah, the amount of treatments people want to undergo, and the age of the people who want to be treated, Doortje: Yeah, so it's getting younger. Tom: Yeah and that's also what we literally proven in our scientific research: the percentage of young adults has risen in the last couple. Doortje: What age are we talking about, young adult? Tom: If you look at the scientific definition, it's between 18 and 25, yeah. But if you are in this field for 17 years, I’m not surprised by that age. Again, so on the one hand if we look at the sexual revolution, women and men are losing their virginity older and older and older, but when we look at cosmetic medicine they start with it younger and younger and younger. I don't have the answers right now but it's very interesting. Doortje: Is it just like a new form of makeup or whatever for young people? Tom: Yeah but it's getting extrememer, extrememer, extrememer. I also talked about this in podcast looking at the future because there's Google glass but in the next few decades it will be a lens on our lens. But is the next step is that we're all in the metaverse and that we can create?... Looking great. Yeah, again Doortje, you’re laughting but this is where we're heading. Doortje: Yeah, you think to towards the metavese… Tom: No, but towards that everything is fake Doortje: Yeah, and how do you feel about your own role in this transition? Tom: Again, I’m a very naive, romantic person, so what I do all the time is cuddle and kiss my children. Doortje: Because you talk a lot about self-acceptance right? I feel like that is maybe even your main theme when it comes to your work. Tom: Yeah I would say that it is. Doortje: And I’m wondering, because it's also your bread and butter to help people look -in their view- better so how do those things come together for you? Tom: It's a constant, also for me hard to constantly challenging myself: am I doing the right thing? And sometimes I ask my clients “This is something we decided together?”. And I’m in the lucky position to have a very smart wife who sometimes I ask “I doing the good a good thing?” and she says, yes, you're right Tom, you should shut the fuck up a little bit more. Doortje: Yeah, and what moments does she say “Maybe this is not the right thing”? Tom: Yeah when I’m over overshouting my opinion. Doortje: So maybe also pressing it on others too much? Tom: Or using swear words on national television with millions of people watching. Doortje: But that's great, then they keep watching Tom: Yeah on the other hand. But yeah I’m advocating a very serious thing as a scientist and sometimes I get emotionally attached because I see so many desperate physically and mentally mutilated-for-life women. And again I’m a very naive romantic person so it literally sometimes makes me cry and it hits me, it hurts me. Doortje: And when it comes to this self-acceptance right, I’m just thinking it's also for me, it's a little bit of a dilemma right: can you be truly self-accepting and also have cosmetical surgery you think? Tom: Now so talking about me. And talking about you, you also said a few sentences ago, sometimes “People say to me that I look angry, although I’m not angry.” If 10 people a day, say that to you, that at a certain point you think it must be the truth. So for instance I was in Paris on a congress and three people came up to me and said “Tom it's really time to fill your temples with a filler because it's really getting hollow.” Doortje: Filling your temples? Oh my god this is never heard about this before. Tom: Yeah but and then you go home and you think “Yeah my temples”. Doortje: So these congresses that you have, you guys all tell each other “You should do this you, you should do that” Tom: No in my opinion in my specific case, it's the other way around, I talk about complications, people don't want to hear that. So 10 years ago I was in the the smallest room somewhere at the back with two people listening to me, and at the end they were in the wrong room. But now we are on main stage with thousands of people listening, so what we're doing, advocating on guys, we're doctors doing medical treatments, we should think about what we're doing, it works. Doortje: But then again, I mean, when 10 people a day come to you and say “Do you look angry” or whatever. Also maybe it's even the same where you look at your phone and 10 people on your phone tell you “Maybe it's time to start botox” right. Yeah and still I feel like, is it self- acceptance or can it be self-accepting in a way, to decide all right when people keep telling me that I look angry all the time or whatever I should do something about this. Tom: Yeah you could but it's still I hope it's your own decision Doortje: But I mean can it even be your own decision, right? Tom: So what happens if you would have come to me and you would say this, I would say to you Doortje “I wouldn't do it”. Just also to test you, so I do this a lot: “Today people say this to me” and then I say at a certain point “If I were you, I wouldn't do it” and I would be the first one to say the opposite to that person that other people would be hearing. And then I hope they go home and they have enough elephant skin to not be touched by those other people. But in the end I hope that everybody is strong enough for their own decisions, their own will. Doortje: Do you feel you make people happier? Tom: Yes, yeah, whether I do the treatment. But cosmetic medicine is an art. I love doing it for two days a week. Today again, I make 20 people walking outside more happy than they came in. Doortje: And what is it that makes them happy? Tom: It's not only the treatment, but it's also people see that I love what I do. So I put so much energy and in every treatment and they see it, they feel it. And then we look in the mirror prior and after the treatment, and then you can literally see the difference and the combination of things. So somebody who listens to you, talks to you and does a treatment, the combination gives the the the happiness. Doortje: So they need a shrink and a cosmetic surgeon. Tom: No, no, no, you're right. So a big part what we do is talk and listen, from the heart. And people tend to notice that when I say it, I mean it. For again, I could make twice as much money if I would do what they ask me to do. Doortje: So are people happier when they look good in their own opinion? Tom: Yeah, unfortunately, I’m making a sign, but unfortunately scientific research has proven that. Doortje: Yeah, and it's kind of a vicious circle, right? I mean, they are happier when they look good, they look good when they're happier. Tom: Maybe, yeah, and it's also addictive. So if you do a treatment it works for six to 12 months, then you go back because you want to have that feeling again. So for instance I don't do botox but three, four times a year I go to a brow bar to get my brows done; I have a brow lift so optically I look better and fresher. But every time I go out I really feel like I’m a new Tom Decates. That's perfect. It's a slippery slope right, that you are on, because I can imagine people actually leaving your clinic happier than they came in but it's a poison that once you had too much it's hard to return from it I guess. Tom: Now botox is literally a poison so did you mean it?... Doortje: No it was figuratively meant. Tom: But that's really funny. All right so again, it’s not true but I’m going to say it for the the sake of this podcast, but if you look at the women of soccer players, they have a lot of time on their hands and a lot of money. And they all do a lot of treatments and then they're surrounding by women who also do those treatments, so for them it's the new normal. For them it's normal to undergo those treatments and they all think it's also normal, but maybe in your your surroundings and my surroundings it isn't that normal. Doortje: I don't… Does normal even exists? Tom: Yeah, that's another question, what is normal, but it's their normal to undergo so much treatments. And when they come to me, those specific women, I always start with “Okay, I want to be your doctor but for the next two years we're going to do nothing”. Doortje: And how do they react? Tom: “…And I’m going to promise you you look better” Doortje: And do they?... Tom: A few famous Dutch people it worked on. So what I do for myself is twice a year full face laser treatments to enhance the skin quality. Doortje: That's for yourself, for you. Tom: So that enhances the skin quality and if the skin looks better, you look fresher, younger. So I say to those people “No botox and fillers for two years, only skin treatments to enhance the skin quality, and I promise you to look better” and it happens. Doortje: Yeah, well it sounds great actually. It sounds like a a different thing that they wanted maybe, but maybe what they needed. Tom: No, but that's also what happens in a conversation like this, so it's the first time they hear it like this. People are also very surprised that you go to a doctor… This is also what happens, people come, they lay 5000€ on the table, they say to me “Tom, today is your lucky day, yeah, fill me up” and then I say “No, we're not going to do it” for this and this reason. “You could see my colleague, the skin therapy to enhance skin quality, but I’m not going to do it.” And they literally say to me and think “Tom, you're crazy” but that's how I do my profession, that's how I look at it. And sometimes it fits, but sometimes it doesn't fit and then they go to another doctor, that’s ok. Doortje: Thank you Tom, thank you so much… Tom: Was this it? Doortje: Yeah this was it. Tom: Oh my God, I could talk for hours and hours with you. Doortje: I could’ve talked for hours with you but yeah, then the podcast would get a little bit too long. Tom: I hope that all your questions were answered and I had a great time. And again you asking me the sharp questions also got me thinking so I hope the listeners also did go home and think about the specific question of our podcast. Doortje: Yeah about aesthetic capital and how it changes our society. Yeah well we've touched on it again and thank you for that and thank you also for listening to the podcast about aesthetic capital for the Connected World division from the VU, thank you.