As aesthetic surgery becomes increasingly popular, proper patient selection becomes even more important to the entire surgery process. Aesthetic surgery is unique because, unlike any other surgical procedure, it is initiated by the patient and not the physician. In addition, this surgery elicits a more acute reaction from its patients than any other type of surgery.
Before agreeing to operate, a surgeon must evaluate the psychological condition of a patient. Whilst some surgeons (a small minority) in the UK will have pathways in place to address the psychological stance of an elective cosmetic surgery patient. Many others clearly do not. Is there evidence to back my claim?
Well let’s commence with my personal experience, as a patient of cosmetic surgery myself having undergone five elective procedures, I can safely say I was not properly psychologically assessed for any of my procedures. In three of my 5 operations the subject was barely touched upon, whilst for the other two procedures there was no mention at all.
Was I ever asked by my cosmetic surgeon why I wanted to undergo liposuction, or rhinoplasty or breast augmentation? NO, I was not. Was I ever asked if I would like counselling pre surgery or post surgery? NO I was not, was I ever prepared for how I would feel? before or after surgery? NO I was not, I think you’re starting to see a pattern emerge here right?
It is a non arguable topic in my case. When I woke up from a routine breast augmentation procedure two years ago, something that many thousands of women have done before me and probably thousands more have done since, nothing prepared me for the feelings that hit me as I exited the surgical theatre and was wheeled away nauseously to my post surgical recovery room.
I remember breaking down into floods of tears shortly after coming round and feeling rather fragile, it wasn’t the pain of the actual surgery that was troubling me, (as I was in ‘pain killer’ territory to address that aspect) but more an inner turmoil and anxiety that I couldn’t quite explain. I remember thinking, ‘nobody tells you about this bit’.
It was the same feeling that had hit me in the pre operative room before my breast surgery, as surgical staff worked busily around me preparing me for the scalpel, the memories of laying on a hospital bed staring at a stark white ceiling still haunt me, overcome by muddled feelings of excitement, fear, anxiety and guilt, I asked myself at the time, Was ‘this feeling normal?’
I never had time to ponder the question much as seconds later I was deep asleep in anaesthetic slumber.
As a Cosmetic Surgery and Beauty Coach, I see dozens of women (and men) monthly who consult with me for information, guidance and referral to the safest ways to shop for image enhancement services, be they doctors, nurses, clinics, or aestheticians, I always aim to inform my clients on the best way to make the right decisions and my ultimate objective is to arm a client with the essential knowledge and skills to empower them as individuals to make the right choices ‘themselves’. As a person who has ‘safety’ at the helm of my core message this stance sits more comfortably with me in terms of ethics, rather than simply reel of a few randomly picked names of medical experts.
However no matter how well informed you are, no matter how well prepared you are physically there is clearly insufficient preparation within the industry when it comes to psychologically preparing a patient for cosmetic surgery pre and post operatively.
My experiences and those of many hundreds of patients that I have dealt with over the years have led me to seriously question this aspect of Cosmetic Surgery, a subject I feel is too easily over looked or brushed aside.
A report by the National Confidential Enquiry into Patient Outcome and Death found many centres in the UK offering cosmetic surgery were failing to assess and care for patients properly, including psychological evaluations.
It was for this reason I set up an e-petition earlier last year calling upon the government to implement mandatory psychological screening for invasive elective aesthetic surgery procedures.
If a surgeon can’t be ‘bothered’ to handle the psychological aspects of surgery as they’re far too busy dealing with the ‘practical stuff’ then may I suggest they refer patients to independent counsellors and experts who now offer pre and post cosmetic surgery counselling such as thewrightinitiative.com
Maybe this way the patients journey is a much more positive and safer experience, and realistic outcomes maybe achieved, after all no matter how skilled a surgeon may be, a scalpel may be able to fix an imperfect body but it doesn’t quite cut it when it comes to healing the mind.
Antonia Mariconda
Printed as a guest editorial for Prime International Journal Issue: Jan/Feb 2013.