General Principles - Patient Selection
Any form of cosmetic surgery is a personal matter and should be undertaken for patients who have an intrinsic desire to improve their self esteem. Ideally, this desire should not be governed by outside pressure from society, family or friends, and the any decision on surgery is a personal one. The desire to have an obvious blemish treated or to look younger and feel one’s best are natural desires. However if these natural desires for improved cosmesis become of paramount importance in the life of the patient, this may lead to anxiety.
As a general rule, patients who have increased anxiety about a cosmetic problem are the most difficult to help, and there is a much greater chance of dissatisfaction following surgery. In such cases there is often a lack of insight by the patient with respect to the magnitude of cosmetic problem and level of anxiety. The mind may become focussed on the perceived problem, sometimes to the degree of obsession (Dysmorphobia). Patients may spend hours self examining in front of the mirror, and often attend for consultation with photographs taken at every angle to demonstrate non existent blemishes. Such patients have an unshakable view of their problem and are not good candidates for surgery. Patients in this category may see numerous surgeons in their desire for treatment, until eventually one agrees to carry out surgery.
Sometimes surgery can produce profound depression as a result of disappointment in this group of patients. A minor imperfection can affect some anxious patients to the degree that they may become a recluse. Such individuals are not good candidates for surgery. Patients and their families must therefore consider these issues very carefully and seek appropriate counselling.