«Let’s cut some more»: how a plastic surgeon reveals a lack of self-acceptance in a patient

Many people have a tendency to exaggerate the shortcomings of their own appearance. Almost everyone at least once found flaws in himself that no one but him notices. However, with dysmorphophobia, the desire to correct them becomes so obsessive that the person completely ceases to be aware of how his body looks in reality.

Body dysmorphic disorder is when we focus too much on a certain feature of the body and believe that we are judged and rejected because of it. This is a serious and insidious mental disorder that requires treatment. Cosmetic surgery works daily with people who want to improve their appearance, and identifying this disorder is not an easy task.

But this is necessary, because dysmorphophobia is a direct contraindication to plastic surgery. Is it always possible to recognize it before the first operations? We tell real stories from the practice of the candidate of medical sciences, plastic surgeon Ksenia Avdoshenko.

When dysmorphophobia does not manifest itself immediately

The very first case of acquaintance with dysmorphophobia was imprinted in the memory of the surgeon for a long time. Then a young pretty girl came to her reception.

It turned out that she is 28 years old and she wants to reduce the height of her forehead, increase her chin, breasts and remove a small excess of subcutaneous fat on her stomach under the navel. The patient behaved adequately, listened, asked reasonable questions.

She had indications for all three operations: a disproportionately high forehead, microgenia — insufficient size of the lower jaw, micromastia — small breast size, there was a moderate contour deformity of the abdomen in the form of excess subcutaneous adipose tissue in its lower section.

She underwent a complex operation, lowering the hairline on her forehead, thereby harmonizing her face, enlarged her chin and chest with implants, and performed a small liposuction of the abdomen. Avdoshenko noticed the first «bells» of a mental disorder at the dressings, although bruises and swelling passed quickly.

She insistently asked for another operation.

At first, the chin seemed to the girl not big enough, then she stated that the stomach after the operation “lost its charm and became not sexy enough”, followed by complaints about the proportions of the forehead.

The girl expressed doubts at every appointment for a month, but then she suddenly forgot about her stomach and forehead, and she even began to like her chin. However, at this time, breast implants began to bother her — she insistently asked for another operation.

It was obvious: the girl needed help, but not a plastic surgeon. She was denied the operation, gently advising her to see a psychiatrist. Fortunately, the advice was heard. Suspicions were confirmed, the psychiatrist diagnosed dysmorphophobia.

The girl underwent a course of treatment, after which the result of plastic surgery satisfied her.

When plastic surgery became a routine for a patient

Patients «wandering» from surgeon to surgeon also come to Ksenia Avdoshenko. Such people undergo surgery after surgery, but remain dissatisfied with their own appearance. Quite often, after another (completely unnecessary) intervention, quite real deformations appear.

Just such a patient recently came to the reception. Seeing her, the doctor suggested that she had already done rhinoplasty, and most likely more than once. Only a specialist will notice such things — an ignorant person may not even guess.

At the same time, the nose, according to the plastic surgeon, looked good — small, neat, even. “I will note right away: there is nothing wrong with the fact of a repeated operation. They are also carried out according to indications — including after fractures, when at first they urgently “collect” the nose and restore the septum, and only after that they think about aesthetics.

This is not the best scenario, but not all hospitals have plastic surgeons, and it is not always possible to do something right away. And if the patient tries to return the old nose after rehabilitation, it is not always possible to do this in one operation. Or it doesn’t work at all.

And in general, if the patient is categorically dissatisfied with the result of any operation, the surgeon can pick up the instruments again,” explains Ksenia Avdoshenko.

I want like a blogger

The patient, despite the operations already undergone, did not suit the shape of the nose categorically. She showed the doctor photos of the girl blogger and asked to «do the same.» The surgeon looked at them carefully — advantageous angles, competent makeup, light, and somewhere photoshop — the bridge of the nose in some pictures looked unnaturally thin.

“But you have a no less neat nose, the shape is the same, but it’s not in my power to make it thinner,” the doctor began to explain. «How many times have you had surgery already?» she asked. «Three!» the girl replied. We moved on to inspection.

It was impossible to do another operation, not only because of possible dysmorphophobia. After the fourth plastic surgery, the nose could be deformed, unable to withstand another intervention, and perhaps breathing would have worsened. The surgeon sat the patient on the couch and began to explain to her the reasons.

The girl seemed to understand everything. The doctor was sure that the patient was leaving, but she suddenly approached her and said that «the face is too round, the cheeks need to be reduced.»

“The girl was crying, and I saw how much she hated her attractive face. It was painful to watch!

Now it remains only to hope that she will follow the advice to contact a specialist of a completely different profile, and will not decide to change something else in herself. After all, if the previous operations did not satisfy her, the next will meet the same fate! sums up the plastic surgeon.

When the patient gives an SOS signal

Experienced plastic surgeons, according to the expert, have their own ways of testing the mental stability of patients. I have to read psychological literature, discuss with colleagues not only surgical practice, but also methods of communicating with difficult patients.

If at the first appointment with a plastic surgeon something is alarming in the patient’s behavior, he can delicately advise you to contact a psychotherapist or psychiatrist. If a person is already visiting a specialist, he will ask to bring an opinion from him.

If a person hates his body and appearance — he needs help

At the same time, according to Ksenia Avdoshenko, there are alarming signals that can be noticed not only by a psychologist, psychiatrist or plastic surgeon at the reception, but also by relatives and friends: “For example, a person without a medical education, after listening to the opinion of a doctor, comes up with his own method of surgery, draws diagrams.

He does not study new methods, does not ask about them, but invents and imposes his own “inventions” — this is an alarming bell!

If a person begins to cry, talking about his own appearance, for no good reason, this should by no means be ignored. If a person decides to have plastic surgery, but the request is inadequate, you should be wary.

An obsession with a wasp waist, a small nose with a thin bridge, too thin or too sharp cheekbones may indicate body dysmorphophobia. If a person hates his body and appearance, he needs help!” concludes the surgeon.

It turns out that sensitivity, attention and respect for both patients and loved ones is a simple but very important tool in the fight against dysmorphophobia. Let’s leave the treatment of this disorder to psychiatrists.

Leave a Reply