Why plastic surgery is not for everyone who dreams about it?

The operation is definitely life changing. Changes in appearance affect self-esteem, and as a result, relationships with other people: children, partners, friends, employers.

Remember the story of Nadezhda Teffi “Life and Collar”. The whole life of the heroine changes under the influence of one impulsive purchase – a starched collar with a yellow ribbon. The wardrobe item first requires a change of wardrobe, and in the end it completely takes over the girl’s personality. But what if you have a “new” nose, ears, chest?

Plastic and psychological state

So far, there are no large-scale studies that would accurately establish a connection between the desire to have plastic surgery and psychological or psychiatric problems in patients. But psychologists keep coming back to this question and found some correlation.

The doctor judges whether the operation was successful, not only by purely medical indicators. It is important to understand whether the patient is satisfied with the result. Those who were not pleased with the work done are more likely to have a history of depression and anxiety.

Moreover, after the procedure, they are more likely to experience depressive states, experience communication problems, demonstrate self-destructive behavior or open aggression towards the surgeon and medical staff.

Australian psychologists have found * that three categories of patients are most often dissatisfied with the results of plastic surgery:

• people with psychological or psychiatric disorders;
• those who had surgery to strengthen relationships with a partner;
• those who had unrealistic expectations of the intervention.

The first category of patients will be helped by treatment by specialists of a completely different plan: by a psychologist, psychotherapist, psychiatrist. Plastic surgery not only does not resolve, but sometimes even aggravates the situation.

An experienced plastic surgeon often guesses about the psychological characteristics of the patient, noticing small but important details. Before the operation, he tries to find out what actually brought the potential patient to the office. If doubts arise, includes a consultation with a psychologist or psychiatrist in the preoperative examination plan.

What difficulties do physicians face?

In the practice of a plastic surgeon, there are patients with body dysmorphic disorder – an obsessive concern about imaginary defects in their body. People with dysmorphophobia are fixated on one or another of their “shortcomings”, which most often do not exist in reality or are completely invisible to others.

Some studies show that 7-12% of plastic surgery patients suffer from body dysmorphic disorder in one form or another, and surgery does not bring them relief. Such patients sometimes require increased attention from the doctor, they have a high level of anxiety and distrust.

According to studies**, people with body dysmorphic disorder have much lower self-esteem and a higher level of perfectionism towards themselves. These people strive for some inner ideal and are never completely satisfied with themselves. Often such patients require to redo the operation. And although there are situations when corrective plastic surgery is required, its need is determined by the surgeon, not the patient.

It happens that the desire to change appearance is caused by the desire to keep a partner. If the plastic surgeon understands that the reason is this and only this, most often he refuses to operate. After all, the partner can change, but the lips “like Angelina Jolie’s” will remain.

With unrealistic expectations from the procedure, surgeons work by demonstrating to the patient through computer simulations what and how can really be done with his data.

Motivation, health, expectations

You may get the wrong impression that all patients of plastic surgeons are psychologically unstable people. Far from it. Plastic surgery often helps patients feel better.

A study by the Medical University of Pennsylvania showed that 87% of patients a year after plastic surgery reported a significant improvement in their attitude to the operated part of the body, to the body as a whole, and to themselves. They also noted that they experience fewer negative emotions when interacting with other people.

In addition, there is reconstructive surgery, when surgeons work with the consequences of injuries, burns, operations, with birth defects, and correct unsuccessful plastic surgery. For example, they restore the respiratory functions of the nose after a fracture or injury, and at the same time, at the request of the patient, make aesthetic changes to its shape.

Here are two stories demonstrating that every intervention must be justified, and the doctor must pay attention to the patient’s condition before taking up the scalpel.

One patient had severe droopy ears since birth. She was very complex because of this defect, hid her ears under her hair and from early childhood dreamed of plastic surgery on her ears, but it can be done only after 14 years. The girl waited, counted the days.

Shortly after the fourteenth birthday, the operation was carried out, and the happiness of the heroine knew no bounds. Now she can wear any hairstyle and feels beautiful. The girl remained very grateful to the doctor and never again turned to surgeons.

Another patient did not like the shape of the nose, although there were no visible aesthetic defects in it. Had a rhinoplasty with good results. However, the woman remained dissatisfied, demanded to redo the operation. Subsequently, the intervention was repeated three times, and each time the patient did not like the outcome. The woman developed anxiety, severe insomnia, she complained that she heard voices. She blamed the surgeon for all this, claiming that the doctor, under anesthesia, implanted a “bug” in her brain, which “transmits voices”, “torments”, “does not let me sleep at night.”

The woman was examined by other doctors, trying to confirm the presence of foreign objects in her head, threatened with complaints for implanting “bugs” in the heads of patients without their knowledge. As a result, the woman was consulted by a psychiatrist, who revealed a severe mental disorder. The patient was treated, and although her nose did not look the best after so many interventions, she did not turn to surgeons anymore.

For successful plastic surgery, you should pay attention to the following indicators:

• realistic expectations. A person understands that he comes to the doctor’s office, and does not fall into the fairy tale about Cinderella, where you can magically transform in a second.
• Appropriate requests. It is not uncommon for patients to come in with strange, abnormal, provocative requests. A good surgeon will never do anything that is contrary to his ideas of beauty and common sense.
• Healthy motivation. You should not have an operation just to please your mother, partner, girlfriend. What is healthy motivation? Return the shape that has changed after childbirth when sports and diet do not help. Correct serious age-related changes. Correct a defect that affects the public image and perception of a person by others.
• mental health. Psychiatric diseases often become a contraindication to plastic surgery. It is possible to perform plastic surgery on a patient in remission, but only after the permission of the attending psychiatrist. A tendency to depression, anxiety, personality disorders, taking antidepressants and other psychopharmacological drugs are a reason for additional consultation with a psychologist before deciding to have an operation.
• Positive attitude. For successful recovery after plastic surgery, the patient’s body must be in a stable, stable state both physically and psychologically. Excessive worries and anxieties, negative attitudes, fears, bad thoughts interfere with fast, high-quality rehabilitation.

Many of us are absolutely sure that physically attractive people are more successful in life. In an effort to change our appearance, we seem to be looking for a better relationship with ourselves, we want to be loved more, noticed.

The reasons for this desire are in non-acceptance of oneself, distrust of the world, the desire to be better than we are, perhaps problems in relations with parents. But plastic surgery does not solve the complexity of a personal nature – it is important to remember this for both patients and doctors.

^* https://www.apa.org/monitor/sep05/surgery

^** https://aps.onlinelibrary.wiley.com/doi/abs/10.1080/13284200601178532