because it's the external, visual part

我們的臉部非常重要

that everybody else sees.

因為我們的臉部裸露在外

Let's not forget it's a functional entity.

大家都會看到

We have strong skull bones

但我們不要忘記，臉部也是有實際功用的。

that protect the most important organ in our body: the brain.

我們有強壯的頭顱骨，

It's where our senses are located, our special senses --

用來保護我們身上最重要的器官：腦。

our vision, our speech,

這是我們感官的所在，我們特別的感官 ——

our hearing, our smell, our taste.

視覺、說話能力、

And this bone

聽覺、嗅覺、味覺。

is peppered, as you can see, with the light shining through the skull

這塊骨頭上

with cavities, the sinuses,

分散着一些別的東西，你可以透過光看到，上面有

which warm and moisten the air we breathe.

一些孔洞，這是鼻竇

But also imagine if they were filled with solid bone --

可以將我們吸入的空氣加溫加溼。

our head would be dead weight,

但想想看，如果這是塊實心的骨頭，

we wouldn't be able to hold it erect,

我們的頭會非常重，

we wouldn't be able to look at the world around us.

重到我們無法將之豎直。

This woman is slowly dying

我們也就沒有辦法看我們周遭的世界。

because the benign tumors in her facial bones

這位女性正在步入死亡，

have completely obliterated her mouth and her nose

因為他她臉部骨頭上的良性腫瘤

so she can't breathe and eat.

已經封住了她的口鼻，

Attached to the facial bones

導致她無法呼吸和進食。

that define our face's structure

臉骨上連著

are the muscles that deliver our facial expression,

的肌肉構成了臉部的結構

our universal language of expression,

這些肌肉也讓我們可以有臉部表情，

our social-signaling system.

一個人類中共通的語言

And overlying this is the skin drape,

一個人與人交往的信號系統

which is a hugely complex

在這外面是皮質層，

three-dimensional structure --

是一個很複雜、

taking right-angled bends here and there,

立體的結構：

having thin areas like the eyelids,

在恰當的地方凹折

thick areas like the cheek, different colors.

有像眼皮這樣很薄的部份、

And then we have the sensual factor of the face.

也有像臉頰般厚、不同顏色的部份。

Where do we like to kiss people?

然後臉部還有負責感官的部份。

On the lips. Nibble the ears maybe.

我們最喜歡親吻的哪裡？

It's the face where we're attracted to with that.

嘴唇，或是輕咬耳朵。

But let's not forget the hair.

我們被臉部所吸引，想要親吻

You're looking at the image on your left-hand side --

但我們也別忘記了毛髮

that's my son with his eyebrows present.

你們現在看看左邊的這張照片。

Look how odd he looks with the eyebrows missing.

那是我兒子有眉毛的樣子

There's a definite difference.

看看他沒有眉毛時有多奇怪。

And imagine if he had hair sprouting from the middle of his nose,

這裡有一個很明顯的差別。

he'd look even odder still.

想像一下他鼻子中間冒出毛髮

Dysmorphophobia

他鐵定看起來會更怪。

is an extreme version

醜狀恐懼症

of the fact that we don't see ourselves

是一種極端的例子，

as others see us.

是一種我們看到的自己

It's a shocking truth

與他人看到的我們很不相同的症狀。

that we only see mirror images of ourselves,

很驚人的事實是

and we only see ourselves

我們只能從鏡子中看到我們自己，

in freeze-frame photographic images

或是從

that capture a mere fraction of the time that we live.

不動的照片等圖像中看到自己，

Dysmorphophobia

但這些只是我們生命中的一小部份。

is a perversion of this

醜狀恐懼症

where people who may be very good looking

是這個現象的一種變態的症狀，

regard themselves as hideously ugly

表現是長得還不錯的人

and are constantly seeking surgery

認為自己極度醜陋

to correct their facial appearance.

且不斷地尋求整形手術

They don't need this. They need psychiatric help.

來改正他們的臉部外貌。

Max has kindly donated his photograph to me.

他們不需要整形手術，他們需要的是心理幫助

He doesn't have dysmorphophobia, but I'm using his photograph

Max很好心的捐了這張照片給我。

to illustrate the fact that he looks exactly like a dysmorphophobic.

他沒有醜狀恐懼症，但我用他的照片

In other words, he looks entirely normal.

來顯示他長得就跟一個醜狀恐懼症病患一樣。

Age is another thing

換句話說，他長得非常正常。

when our attitude toward our appearance changes.

年齡是另一個

So children judge themselves, learn to judge themselves,

改變我們對自己的外表的態度的因素。

by the behavior of adults around them.

孩童們經由周圍的大人們的行為來

Here's a classic example: Rebecca has a benign blood vessel tumor

評斷、學著評斷他們自己。

that's growing out through her skull, has obliterated her nose,

這是個經典的例子：Rebecca有一個良性的血管腫瘤

and she's having difficulty seeing.

從她的頭顱內長出來，已經埋沒了她的鼻子，

As you can see, it's blocking her vision.

並且影響到了她的視力

She's also in danger, when she damages this,

你們可以看到，腫瘤已經擋到她的視線了。

of bleeding profusely.

如果她弄傷這個腫瘤，她也有

Our research has shown

大量失血的危險。

that the parents and close loved ones of these children

我們的研究顯示

adore them.

這樣孩子的父母親及關愛他們的人

They've grown used to their face; they think they're special.

非常喜歡他們。

Actually, sometimes the parents argue

他們已經習慣了他們的臉蛋，他們覺得這很特別。

about whether these children should have the lesion removed.

事實上，有時候他們的父母親

And occasionally they suffer intense grief reactions

會為了是否要將這些缺陷移除而起爭執。

because the child they've grown to love

偶而他們會感到強烈的悲傷

has changed so dramatically and they don't recognize them.

因為他們已經漸漸愛上的孩子

But other adults

有了非常大的轉變，使他們無法認出孩子。

say incredibly painful things.

但有些其他成年人

They say, "How dare you take this child out of the house

會說一些非常傷人的話。

and terrify other people.

他們說：「你怎麼可以帶這樣的孩子出去

Shouldn't you be doing something about this? Why haven't you had it removed?"

會嚇到其他人！

And other children in curiosity come up and poke the lesion,

你不是應該做些甚麼嗎？你不是該把那個東西拿掉嗎？」

because -- a natural curiosity.

然後其他小孩好奇地圍過來戳病變的地方，

And that obviously alerts the child

純粹是因為好奇。

to their unusual nature.

這樣很顯然地會讓這孩子

After surgery, everything normalizes.

警覺他自己與別人不同的特質。

The adults behave more naturally,

手術過後，一切都回歸正常。

and the children play more readily with other children.

成年人表現得更正常，

As teenagers --

孩子更容易和其他孩子玩耍。

just think back to your teenage years --

在青少年時期，

we're going through a dramatic

就想想你們的青少年時期，

and often disproportionate change

那時我們都會經歷一些巨大的變化，

in our facial appearance.

尤其是我們的臉部

We're trying to struggle to find our identity.

會有一些相比而言更加顯著的變化

We crave the approval of our peers.

那時的我們為了找到自己的定位而努力

So our facial appearance is vital to us

我們渴望得到同齡人的肯定。

as we're trying to project ourselves to the world.

當我們試圖向世界展示自己的時候

Just remember that single acne spot

我們的臉部的樣子對我們就至關重要

that crippled you for several days.

想想那個臉上冒出來的一個青春痘

How long did you spend looking in the mirror every day,

就讓你不開心了好幾天。

practicing your sardonic look, practicing your serious look,

你一天花多少時間站在鏡子前面

trying to look like Sean Connery, as I did,

練習你的嘲諷表情，練習你的嚴肅表情

trying to raise one eyebrow?

或像我一樣試著看起來像sean connery（蘇格蘭演員）那樣

It's a crippling time.

只揚起一邊的眉毛。

I've chosen to show this profile view of Sue

那是一段令人不正常的時間

because what it shows is her lower jaw jutting forward

我選了這張Sue的側面照

and her lower lip jutting forward.

因為可以看出她的下巴突出

I'd like you all in the audience now to push your lower jaw forward.

且她的下唇也往前突出。

Turn to the person next to you,

請在座各位把你們的下巴往前推，

push your lower jaws forward. Turn to the person next to you

然後看看你旁邊的人，

and look at them -- they look miserable.

把下巴凸出，轉向你旁邊的人，

That's exactly what people used to say to Sue.

看看他們--他們看起來很慘兮兮的

She wasn't miserable at all.

那就是人們一直跟Sue說的。

But people used to say to her, "Why are you so miserable?"

但她一點都不感到悲慘

People were making misjudgments all the time

但人們一直跟她說：「為什麼你那麼慘兮兮的？」

on her mood.

人們總是誤解她的

Teachers and peers were underestimating her; she was teased at school.

心情。

So she chose to have facial surgery.

老師和同儕總是低估她，她在學校被人嘲笑。

After the facial surgery,

所以她選擇了臉部整形。

she said, "My face now reflects my personality.

整形過後，

People know now that I'm enthusiastic,

她說：「我的臉蛋現在可以反映出我的個性了。

that I'm a happy person."

人們知道我很熱心，

And that's the change that can be achieved for teenagers.

我是個快樂的人。」

Is this change, though, a real change,

而且這是個在青少年身上可以做到的改變。

or is it a figment of the imagination

這樣的改變是一個真的改變嗎？

of the patient themselves?

還是只是病患自己

Well we studied teenagers' attitudes

腦海中的想像？

to photographs of patients having this corrective facial surgery.

我們研究了青少年

And what we found was --

對有過這樣的改正性臉部手術照片的態度。

we jumbled up the photographs

下面就是我們的研究結果

so they couldn't recognize the before and after --

我們把照片弄亂

what we found was that the patients were regarded

讓他們認不出哪些是術前照片哪些是術後照片。

as being more attractive after the surgery.

我們發現，術後的病患

Well that's not surprising, but we also asked them to judge them

看起來更具吸引力。

on honesty, intelligence,

當然這不令人驚訝，但我們也要被試青少年們判斷這些照片人物的

friendliness, violence.

誠實度、智商、

They were all perceived as being

友善度、暴力程度。

less than normal in all those characteristics --

在術前他們給人的感覺是

more violent, etc. -- before the surgery.

在這些特質上不正常的

After the surgery,

手術前的形象被認為更暴力

they were perceived as being more intelligent,

術後

more friendly, more honest, less violent --

他們給人的感覺是更聰明、

and yet we hadn't operated on their intellect

更友善、更誠實、較不暴力。

or their character.

但我們並沒有改變他們的

When people get older,

智商或者個性

they don't necessarily choose to follow this kind of surgery.

隨著年紀增長，

Their presence in the consultation suite

他們不一定會選擇這樣的手術。

is a result of the slings and arrows of outrageous fortune.

他們在諮商室的原因是

What happens to them

一連串厄運的結果。

is that they may have suffered cancer or trauma.

他們是經歷了癌症

So this is a photograph of Henry,

或創傷的病患。

two weeks after he had a malignant cancer removed

這是一張亨利的照片。

from the left side of his face -- his cheekbone,

這是他移除左臉上的惡性腫瘤後

his upper jaw, his eye-socket.

兩個禮拜的照片，包括左臉臉頰、

He looks pretty good at this stage.

上顎、眼圈。

But over the course of the next 15 years he had 14 more operations,

他在這個階段看起來很不錯。

as the disease ravaged his face

但在接下來的十五年內他又接受了十四次整形手術，

and destroyed my reconstruction regularly.

因為疾病摧殘著他的臉

I learned a huge amount from Henry.

且定期地破壞我的整形結果。

Henry taught me

我從亨利身上學到很多。

that you can carry on working.

亨利讓我瞭解

He worked as an advocate. He continued to play cricket.

一個這樣的病患可以繼續工作。

He enjoyed life to the full,

他的工作是辯護者。他繼續打板球。

and this was probably because he had a successful, fulfilling job

他很享受著他的生活。

and a caring family

且這很有可能是因為他有一個成功的、有滿足感的工作

and was able to participate socially.

和一個關懷他的家人

He maintained a calm insouciance.

並且他仍然可以進行正常的社交活動。

I don't say he overcame this; he didn't overcome it.

他一種冷靜而漫不經心的生活態度

This was something more than that. He ignored it.

我不是說他克服了自己的問題，他並沒有。

He ignored the disfigurement that was happening in his life

他做到了比克服更難的：他忽視了它。

and carried on oblivious to it.

他忽視他生命中這些扭曲的部份

And that's what these people can do.

然後繼續過他的生活，無視這些扭曲。

Henriapi illustrates this phenomenon as well.

這就是這些人可以做的。

This is a man in his 20s

Henriapi也同樣做到了這點。

whose first visit out of Nigeria was with this malignant cancer

這是一個二十多歲的男人。

that he came to the United Kingdom to have operated on.

他第一次離開尼日利亞就是為了來英國

It was my longest operation.

來移除臉上的這個惡性腫瘤。

It took 23 hours. I did it with my neurosurgeon.

這是我做過最長的手術。

We removed all the bones at the right side of his face --

手術花了23小時。我和一個神經外科醫生一起完成的。

his eye, his nose,

我們把他右半邊的臉的骨頭全部拿出來，

the skull bones, the facial skin --

包括他的眼睛、他的鼻子、

and reconstructed him with tissue from the back.

他的頭顱骨、他的臉部皮膚，

He continued to work as a psychiatric nurse.

然後利用他背部的組織來復建。

He got married. He had a son called Jeremiah.

他繼續當一個心理護士。

And again, he said,

他後來結婚且生了一個名為Jeremiah的兒子。

"This painting of me with my son Jeremiah

再次的他說：「

shows me as the successful man that I feel that I am."

這幅我和我兒子Jeremiah的圖畫

His facial disfigurement

顯示出了我是一個成功男人，就像我自己認為的這樣。」

did not affect him

他臉部的變形

because he had the support of a family;

並沒有影響他，

he had a successful, fulfilling job.

因為他有家人的支持

So we've seen that we can change people's faces.

和成功、有滿足感的工作。

But when we change people's faces,

所以我們已經看到我們可以改變人們的臉部。

are we changing their identity --

但當我們改變人們的臉的時候，

for better or for worse?

我們有改變他們的對自己定位嗎？

For instance,

不管是變好還是變壞。

there are two different types of facial surgery.

舉例來說，

We can categorize it like that.

主要有兩種臉部手術。

We can say there are patients who choose to have facial surgery --

我們可以將它分類。

like Sue.

我們可以說有些病患選擇要做臉部手術--

When they have facial surgery,

像是Sue。

they feel their lives have changed

當他們做了臉部手術後

because other people perceive them

他們感覺他們的人生改變了。

as better people.

因為其他人對他們的看法變了

They don't feel different.

認為他們是更好的人

They feel that they've actually gained

他們不會感覺不同。

what they never had,

他們感覺他們真的得到了

that their face now reflects their personality.

他們之前沒有的東西，

And actually that's probably the difference between cosmetic surgery

那就是他們的臉終於可以反映出他們的個性。

and this kind of surgery.

事實上這就是是美容手術和這樣的手術

Because you might say, "Well, this type of surgery

的區別

might be regarded as cosmetic."

因為你可能會說：「嗯，這樣的手術

If you do cosmetic surgery, patients are often less happy.

可以被看成是美容整形手術。」

They're trying to achieve difference in their lives.

如果你做整形手術，病患一般來說比較不開心。

Sue wasn't trying to achieve difference in her life.

他們想要改變人生。

She was just trying to achieve the face

Sue不是要改變人生，

that matched her personality.

她只是想要她的臉

But then we have other people

和她的個性相符。

who don't choose to have facial surgery.

但也有一些其他人

They're people who have their face shot off.

不會選擇臉部手術。

I'll move it off, and we'll have a blank slide for those who are squeamish amongst you.

他們是那些臉被槍打毀的人

They have it forced upon them.

讓我為在座那些較膽小的人把這圖片拿掉，換成一張空白的投影片

And again, as I told you,

他們的臉部是被強加在他們身上的。

if they have a caring family

再次的，讓我提醒你們，

and good work life,

如果他們有個關懷他們的家庭

then they can lead normal and fulfilled lives.

和好工作，

Their identity doesn't change.

那們他們可以有一個正常且滿足的生活。

Is this business

他們的身分並沒有被感變。

about appearance and preoccupation with it

這樣在乎外表

a Western phenomenon?

的情況

Muzetta's family give the lie to this.

只存在於西方文化嗎？

This is a little Bangladeshi girl from the east end of London

Muzetta的家庭告訴我們不是的。

who's got a huge malignant tumor on the right side of her face,

這是倫敦東部的一個孟加拉女孩，

which has already made her blind

她右臉上有一個很大的惡性腫瘤。

and which is rapidly growing and is going to kill her shortly.

這已經讓她變瞎了

After she had surgery to remove the tumor,

並且如果這個腫瘤繼續成長的話，很快就會取了她的生命。

her parents dressed her in this beautiful green velvet dress,

腫瘤移除手術後，

a pink ribbon in her hair,

她父母親為她穿上漂亮的綠絲絨洋裝

and they wanted the painting to be shown around the world,

在她頭髮上系上一個粉紅色的絲帶

despite the fact that they were orthodox Muslims

他們希望這幅畫可以在全世界展示，