Optimizing Body Image in Disfiguring
Surgical and Psychosocial Interventions
A visibly disfiguring condition poses considerable challenges to the process of building and maintaining a positive body image and self-esteem (see chapter by Rumsey in Part IV). The pressures that lead affected individuals to seek surgical, medical, and/or psychosocial interventions come from a variety of possible sources: social context, peers and/or family, as well as from personal beliefs. Certainly, this society has well-entrenched standards regarding physical appearance, and the media and advertising exert persistent pressures to correct any and all flaws (see chapter by Tiggemann in this volume). Thompson and colleagues note that, as normalizing technologies become more accessible and it becomes more acceptable and even expected for people to change their appearance, pressure mounts on people with visible disfigurement to "fix" their features.
Clearly, individual differences in the degree of vulnerability to sociocultural influences are ubiquitous. Harter maintains that levels of appearancerelated stress in the general population are affected by the extent to which individuals' body image and self-esteem are dependent upon appearance and the perceived importance of cultural standards as a source of comparison. Recent research on disfigurement focuses on the attribute of "resilience"—comprised of positive self-beliefs, effective social skills, and social support—which buffers an individual against the stresses and strains of living with a visible difference. This chapter addresses these components of resilience in the context of considering how to optimize the body image of individuals with congenital disfigurement.