What is Plastic Surgery Addiction? What is Not?
3 December 2019 onur
Plastic surgery procedures have become almost a part of daily life. You are less likely to take a tour around the streets of Nişantaşı and not see someone with a plastered nose and swollen face than you would seeing your favorite singer flying with wings spread. The ISAPS data shows that nearly 300,000 plastic surgeries were performed in Turkey in 2017. In other words, hundreds of thousands of people were operated to become beautiful, many people spent their limited financial resources to have a more beautiful body, and their jobs and relationships were affected by these processes. Moreover, these are just surgeries and there are at least twice as many non-surgical procedures.
Plastic surgery has secured a place in our lives and it doesn’t look like it will lose popularity anytime soon. But when does plastic surgery evolve into an addiction? When do individuals, families, physicians and the country’s economy suffer? Let’s seek an answer to these questions.
The origin of plastic surgery addiction is a psychological problem we call Body Image (Dysmorphic) Disorder. We cannot understand plastic surgery addiction without understanding this highly important problem that causes patients to go under the knife many times.
Individuals with body image disorder are obsessed and preoccupied with a minor defect in their body. Sometimes there is a mild defect, and sometimes neither the social circle nor the plastic surgeon can see the defect the patient complains about. What the patient perceives as a defect is often the details of normal human anatomy that everyone presents. For instance, the face of each person, even the most beautiful and handsome, is asymmetrical, but a person suffering from a body image disorder perceives this as a very serious problem that must be corrected. An individual with body image disorder is so obsessed with their perceived physical flaw that this obsession disrupts their daily activities, work life, relationships and ability to fulfill their responsibilities. Such individuals spend a significant amount of time every day to prove, camouflage, better understand and find a solution to their physical defect. For instance, they spend hours in front of the mirror, take hundreds of photos on their mobile phone and look at these photos for hours. Out of hundreds of photographs, one of them highlights the perceived defect more obviously than it is, depending on the light, angle, body position and fatigue. While individuals with body image disorders focus on minor flaws, they may not be bothered by real physical flaws and inconsistencies. Psychiatric disorders such as depression, anxiety, obsessive-compulsive disorder as well as emotional traumas such as separation, cheating and exclusion often accompany the body image disorder.
Individuals suffering from body image disorder do not have an insight into their problem. They never admit that they have a psychological problem, and therefore it is very, very difficult to treat them. When a plastic surgeon tells the patient, “I think you have a body image disorder, and I think you need to see a psychiatrist,” it’s a big deal. All hell breaks loose and neighbors come to see if everything’s OK.
It is quite challenging for individuals with body image disorder to be “satisfied” with plastic surgery procedures and non-surgical practices. Individuals with body image disorder often reflect their post-operative dissatisfaction and disappointments to their plastic surgeons, and they can turn not only their own lives but also the lives of their doctors into a nightmare. Even if the patient sees that the surgery has been successful and their body has changed for the better and they receive positive support from their social circle, they eventually return to their own depression, thinking, “Okay, it’s better, but that’s not what I wanted”. In the “rare” cases where the patient is satisfied with the outcome of the surgery, they find a new defect after surgery and stick to it.
The classic story goes as follows: A patient with body image disorder faces their doctor after surgery and states they are not happy with the result of the operation. They request to undergo another surgery to get the issue corrected. They insist. The doctor is harassed and threatened with legal action. Sometimes the doctor succumbs to the patient’s insistence and performs “corrective” surgery, but of course the desired improvement is never achieved. Now that doctor is incompetent, ignorant, greedy, rude, insensitive and many other things in the eyes of the patient. At that point, the patient goes to another doctor and repeats their request. Most of the time, a significant portion of the doctors will refuse the patient’s request. Therefore, the patient starts to shuttle among doctors and is so determined that they eventually find an inexperienced doctor or an ego-tripper who will operate on them and then get the surgery or non-surgical practice they want. Here is a brief summary of plastic surgery addiction.
Come on, you call yourselves a doctor! Then just don’t operate on these patients and it’s over!
Unfortunately, things are not that simple. Of course, we do not operate on patients with undisputed body image disorders. If we could recognize a patient with body image disorder before the operation, we would run away without looking back. No plastic surgeon would want to deal with such a patient group just because they would make money. However, in the vast majority of patients, it is not possible to recognize the problem before surgery. The most important diagnostic challenge is the coexistence of a physical problem that creates an aesthetic defect in patients and a covert body image disorder. We analyze the risk factors for body image disorders during the preoperative examination. It is easy to diagnose a dysmorphic disorder if the patient has seen many doctors, slanders the doctors they saw before, constantly corrects something manually during the interview, asks if the surgery will make them happy, states that they are obsessed with physical defects, says they spend almost an hour in front of the mirror every day, tells they take a hundred photographs each day and has a history of emotional trauma such as depression, anxiety disorder, separation or cheating. However, most of the time, individuals with body image disorder hide the decisive details of this disorder from their doctor very professionally. The dysmorphic disorder may be rather covert before the surgery but becomes more severe and obvious after the surgery. Therefore, sometimes even the most experienced physicians can only make this diagnosis after the operation, complaining about how they could not understand it.
But we plastic surgeons are not the only players in this game. There is a huge, informal aesthetic industry, against which the Turkish Plastic Surgery Society has been struggling for years. There is this problem of border violations among specialties that we have not been able to sort out for years. So even if we don’t do it, patients find someone to perform the operation they want.
What is not plastic surgery addiction?
We all dislike some parts of our body and wish it to change for the better. This is completely natural and is the main reason for the existence of aesthetic surgery. The fact that a person undergoes multiple aesthetic interventions consciously and with realistic expectations is not a “plastic surgery addiction” as people suggest.
One of the basic principles in aesthetic plastic surgery is the principle of integrity. For instance, the more holistic the treatment planned for the rejuvenation of an aging face is, the more natural and harmonious the results will be. In a patient who has a facelift but excludes their neck and periorbital area in the treatment, the lifted face will appear unnaturally young, while the untreated areas will look older. In that case, the patient wants to have the intact parts of their face done in the second and third sessions, which cannot be regarded as plastic surgery addiction but a requirement of the principle of integrity.
Another basic principle in aesthetic surgery is the principle of “maintenance”. Time triumphs over all surgical changes. If there is a desire to maintain the result obtained in plastic surgery procedures, it may be necessary to repeat the treatment after a certain time. For example, in periodical treatments such as Botox/Fillers, the effect of the application wears off and it becomes necessary to repeat it to maintain the effect. The patient’s visit to the doctor for a repeated application of Botox / Fillers every 6 months is not plastic surgery addiction but a requirement of the principle of “maintenance”. Similarly, a young woman who had breast implants at the age of 18 may need additional surgical procedures to preserve her breast shape after giving birth, in case of weight gain or loss or during the aging process. In that case, repetitive surgeries should be considered as a requirement of the maintenance principle, not plastic surgery addiction.
It would be useful for all plastic surgery candidates to sit back and openly ask themselves one question: “Is it possible that I have this body image disorder?” You may not be able to answer this question by yourself, but you can always get advice from a psychiatrist or plastic surgeon. Scientific studies of our day show that more than 80% of adult individuals are not satisfied with their physical appearance and are “concerned” about it. A study found that approximately 30% of rhinoplasty patients presented symptoms of body image disorder. If what you read in this post reminds you of yourself, stop and think. This may be the last exit for you.
Take good care… of yourself and your beauty.