ARISTOTLE said that "Beauty is a greater recommendation than any letter of introduction," but is it? David Hume wrote in 1741 that "Beauty is not a quality in things themselves; it merely exists in the mind that contemplates them, and each mind perceives a different beauty."
More than 2,000,000 cosmetic procedures are performed annually. There are 72,000,000 baby-boomers who are approaching their 40s and associate looking good with success. What do they want to achieve with cosmetic surgery, and are their expectations realistic?
A plastic surgeon must be a keen psychologist and understand why a person decides to change some aspect of his or her appearance. There is a relationship between self-image and the desire to change one's looks. The surgeon must be aware of the patient's psychological stability, mood, expectations, motivations, and goals. A brilliant surgeon and scalpel can not revive an ailing marriage.
Residency training programs in the U.S. do a superb job in teaching young doctors to master the technical skills required for plastic surgery, but little time is spent studying the appropriateness of such a procedure from the psychological aspect of the patient profile.
Choosing the appropriate patient is as important as selecting the correct procedure. Physical appearance is one clue to determine whether he or she is a good candidate. Is the patient disheveled? Does he or she have a defect which is only minimal? Has the patient already had a number of plastic surgery procedures performed? In other words, is he or she a plasti-surgiholic? Is the patient a "super-perfectionist" or a "shopper"?
The manner in which the patient conducts himself or herself during the initial consultation is important. Is he or she rude, overly solicitous, critical of other surgeons, depressed, arrogant, or vague? Any one or a combination of these elements can signal unrealistic expectations. Such a person never can be satisfied.
During the evaluation, it should be determined whether the patient has suffered a loss. Has he or she lost a job or a loved one? Changes in one's life can produce tensions. Some individuals are prompted to seek plastic surgery as a means to cope with added stress. Moreover, if the patient is undergoing psychological treatment, he or she may not be in a position to make a fully informed decision about plastic surgery.
Even if none of the aforementioned elements are present, I still may choose not to perform surgery on an individual with whom I do not feel comfortable. The final stage in the evaluation is whether he or she even is willing or capable of following instructions before the proposed procedure. If not, a surgeon seriously must reconsider whether to operate.
There are limits to what can be accomplished by a plastic surgical procedure. Important variables such as a person's state of health, skin texture, age, and personality type will determine how close the operation will come to his or her expectations. Improvements may be expected, not perfection.
A plain-Jane who is convinced that a facelift automatically will bestow ravishing good looks needs to be told a plastic surgeon can not create a Venus, if the basic elements for beauty are not already there. The doctor is working with human skin, not clay. Such a patient must be advised that a facelift will not make her stunning, but can render her free of wrinkles and impart a rested appearance.
The ordinary looking man who persists in the belief that he can be transformed into an Adonis should be reminded of well-known people who fell far short of popular standards of beauty. Winston Churchill is one example. Eleanor Roosevelt, Golda Meir, Indira Ghandi, and Margaret Mead became attractive with age. …