Personality types and Plastic Surgery

While the vast majority of our patients are lovely, well-adjusted people who I enjoy meeting and helping, Plastic Surgery certainly does attract some of the more unusual personality types… Sometimes, it’s actually better for everybody not to operate.
When I was researching for this post, I found this wonderful piece by my colleague, Dr. Ramona Bates (link to blog). She has graciously allowed me to reproduce it here.
*****
Patients I need to watch for when doing aesthetic procedures – Dr. R Bates
1. Inflated Expectations
– Patient tends to be “deaf” to any attempt to educate them as to what their surgery will entail.
– They seem to have difficulty digesting the fact that there any major procedure carries some degree of inherent risk.
– Will use the results of computer imaging as a warranty, rather than the possibility intended. Computer imaging does not take into account healing quirks, skin thickness/elasticity, etc.
2. The Demanding Patient
– The patient who brings you celebrity photographs with modifications that they want you to duplicate even though the celebrity is a completely different body type (apple vs pear).
– The patient who brings you a picture of themselves with overlays of the changes they would like. If they can be made to understand that the human body is not clay, but tissue that heals with scars (sometimes predictable, but not always) then this can be a good start to a discussion.
– The patient who demands no scar. Plastic surgeons are not magicians. When skin it cut, there is always a scar.
3. The Surgiholic
– Patients who have had multiple (There does not seem to be a good number to put here. Is three too many or is six?) previous aesthetic surgeries.
– The patient who had multiple surgeons for their previous surgeries. You will be compared to Dr. X.
4. Marital or Family Disapproval
Yes, the adult patient seeking aesthetic surgery does not require anyone’s approval or consent, but … Secrecy from a spouse or significant other can add stress for both the patient and the surgeon. Someone will need to know how to care for them in the postop period. It helps if they know what was done.
5. Capitulation
The other side of the coin. No patient should be pushed into surgery to please someone else. That other person may not be around in five years, whether by divorce, separation, or death. Will the patient still be glad they had the procedure?
6. Incompatibility
There are some people with whom you just don’t feel comfortable. This may be for a variety of reasons. And it may be true from the patient side also. Both may be “nice” people, but may not be comfortable with each other.
7. Body Dysmorphic Disorder
In its simplest definition, it is an obsessive preoccupation with a slight, imperceptible, or actually nonexistent anatomic irregularity to the degree that it interferes with normal adjustment within society.
This disorder may be present in varying degrees. It is the most common aberrant personality characteristic seen by the plastic surgeon.
When postoperative dissatisfaction occurs (and in most cases, it will), it almost always is based on what the patient understood rather than what was actually said.
The bottom line: Not everyone is a good candidate for aesthetic surgery. Sometimes the best decision is not to operate.