Our exploding nip & tuck culture has produced some extreme trends. Consumers today are well informed about techniques, and have many options in terms of practitioners, procedures, products. With the constant flow of new devices and lifts with catchy sounding names into the market, it is an ongoing challenge for doctors to balance medical integrity, professional ethics, and inherent skepticism, with the natural desire to stay on top of the trends. New technologies often become part of the public domain before manufacturers and physicians have had sufficient time to collect the clinical experience needed to determine efficacy, safety, duration and the best applications. Consumers have an insatiable appetite for cosmetic enhancements of all kinds, which can lead to dangerous misconceptions about what these procedures can and cannot achieve.
We are seeing a growing number of people, especially young women, who suffer from body dysmorphic disorder (BDD), also known as "imagined ugliness syndrome." BDD is said to affect 7-12% of cosmetic surgery patients (men and women equally). Psychologists consider it an obsession with an imagined physical flaw to such a point that it interferes with day-to-day functioning. BDD sufferers express distorted ideas about their body, and can become preoccupied with an imagined defect. A slight physical flaw, such as a tiny scar or a slightly raised mole, can cause significant concern, impairing their ability to deal with life. They tend to avoid social situations just because they feel too ugly to be seen, or are convinced that everyone will stare at them, and compulsively try to hide the offending feature with clothing or gestures. They may become recluses; "I can't go out of the house looking like this." Or they may constantly stare in the mirror and point to what is bothering them, "Can't you see it - it's right there!"
Women and men who visit a long roser of cosmetic surgeons with images of celebrities they want to look like, requesting multiple consultations with endless questions, and having repeat procedures present some warning signs. They become so convinced that they are unattractive that they are constantly striving to look different, better, younger, thinner, etc. Yet perfection is not a reasonable goal nor an attainable endpoint, and no amount of surgical enhancement is going to satisfy their desire for change. Cosmetic surgery isn't going to get to the root cause of the problem because physical flaws are not the real issue. Once they have fixed one thing, their concerns may move on to another body part. The disorder starts with how they feel about themselves, and is impacted by the constant reminders they see in everyday life. Rational people accept the fact that at the age of 50 it is not possible to look 25 again. But people who are emotionally unstable or who have crippling psychological disorders, are very susceptible to the power of suggestion.
BDD is usually treated with antidepressants and intensive psychotherapy - definitely not surgery, injections or lasers. Many cosmetic surgeons today are screening patients for emotional stability, but it is sometimes hard to detect after one brief meeting. Regrettably, more doctors today can be persuaded to operate on someone who thinks cosmetic surgery will change her life. It takes courage and conviction to recommend to a prospective (paying) patient that she seek intervention from a therapist, psychologist or psychiatrist. Some surgeons may think, "If she wants it, why shouldn't I do it for her?" But the surgeon can choose not to do it, and he might be doing the patient a huge favor.
Wendy Lewis is the President of WENDY LEWIS & CO LTD, a global aesthetics consultancy. She is known as "THE KNIFE COACH" and has a growing clientele in the USA, Europe and around the world who seek her advice on where and when to get lifted, lasered and botoxed. She is the author of 10 books including PLASTIC MAKES PERFECT (Orion) that will launch in January 2008. http://www.wlbeauty.com, knifecoach@aol.com
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