Sometimes Plastic Surgery Isn’t The Answer
It is human nature to strive for perfection, be it in our careers, education, and even when it comes to our appearance. However, there are times the desire to achieve so-called ‘perfection’ when it comes to our outward appearance crosses into unhealthy territory - one where an individual is preoccupied with self-perceived defects or flaws which are either unnoticeable by others or are viewed by others as variations of what can only be considered normal. This may be part and parcel to a disorder referred to as Body Dysmorphic Disorder (BDD) or Body Dysmorphia.
Some of the tell-tale signs of an individual with this disorder include excessive self-consciousness to a degree that interferes with daily activity, has a marked impact on the emotional and psychological state of the individual, an overwhelming preoccupation with appearance and signs of anxiety surrounding the fear of rejection or humiliation based on their looks. The concern is present for at least an hour in any given day and interferes with at least one area of life – work, social interaction or interpersonal relationships. An individual suffering from this condition will seek surgery as a perceived solution to ‘correct’ the flaw(s). In these cases, plastic surgery is not the answer.
Board-certified plastic surgeons (and other professionals that provide advice on matters of appearance and self-esteem) have different methods of handling such individuals – from counseling the individual on the dangers of seeking satisfaction from the desire to be ‘perfect’ and informing them of the risk versus benefit ratio of undergoing operations and interventions with minimal chance of patient satisfaction, to recommending counseling by psychologists and psychiatrists who have experience in the treatment of BDD.
Saying no to a patient who expects/demands/requests surgical procedures for self-perceived physical imperfections that are magnified in the patient's mind or that are constantly changing, or that, (in our opinion), will not bring happiness to the patient is one of the hardest situations to handle, but it is the right thing to do. If the problem is not a physical one, then surgery is not the answer, and calmly and methodically explaining that addressing the angst the patient has by means other than surgery is required.
I have had family members of such patients speak to me and thank me privately for being respectful but firm in my conviction that surgery is not the answer and professional counseling is the proper route. Despite my practice's and other board-certified plastic surgeons' efforts in this arena, I am afraid that many patients with this disorder keep hunting for someone to operate on them – even after they’ve been told no by other physicians, often resorting to individuals whose qualifications and motivations are suspect.
Not all patients who come in seeking a cosmetic procedure that isn’t ideal for them have BDD. Instead, most are trying to reconcile all they hear and see in social media, on TV, and in the tabloids and try to reach an honest opinion about what they feel they need done. It is our responsibility as board-certified plastic surgeons to give them the range of options that might be correct and integrate that information with the health status, physical state and psychological state of the patient.
To learn more about Body Dysmorphic Disorder, visit the Body Dysmorphic Disorder Foundation.