When we look at nature, it is like we’re looking at a work of art. Most of the time we appreciate it, enjoy it, and just take it all in. But looking at ourselves or at someone else is quite different. I believe that in the case of appreciating somebody else’s looks, the old adage “beauty is in the eyes of the beholder” still holds true to this day. It only means that whatever your criteria for beauty are, it will never be the same for everybody.
Aesthetic dermatology and surgery (which involves making people more attractive) is a challenging, demanding job especially with regard to patients who, most of the time, expect an extraordinary result. Patients expect a miracle. Their expectations are beyond the bounds of reality. If they do not get the look they expected immediately, it will be a disaster. Most of the time, they just can’t wait. Let’s take the case of Art, a 16-year-old student who wanted a nose job. His nose was so flat with a wide thick base. Surgery was a big success, but after a month, the scars started contracting (beginning to tighten) so the nasal orifice (opening) was becoming smaller and smaller. After a lot of arguments, this was successfully resolved.
Then there’s the case of a breast augmentation (enlargement) patient whose incision site (where the cut was made to insert the breast implant) dehisce or opened up. In this case, surgery was necessary to remove the implant and see if it was secondary to infection. Then skin healing is important before a third surgery can be performed again to put back the implant, which was removed. Dehiscence (splitting open) is not the fault of the surgeon. It does happen to anyone occasionally either because the patient did not follow instructions, the patient was smoking, taking alcohol or engaging in strenuous activities even before the wound had healed completely. Or it could be due to an infection.
Then there was this girl who wanted a nose job but did not want friends or relatives to notice the change. Then my question is why change it?
Another patient was consulting for a lip change when the actual problem was the eyes and nose.
Another patient, who underwent a procedure by another doctor, wanted me to promise her that the botched procedure made by that famous doctor would be corrected a hundred percent.
Lastly, a patient was consulting for a skin problem when the obvious problem was his receding (smaller, shorter and backward retreated) chin.
For the emotionally stable person, who simply wants to improve his/her looks, cosmetic surgery or dermatology can lead to increased self-esteem. But there are people for whom cosmetic surgery may not be a good choice. Like the patient who has great expectations of his/her future appearance and a widely improved social life after surgery. Reality may lead to a severe letdown. Sometimes, awkwardness and shame about the way one looks can inhibit honest communication with one’s surgeon. It is vital that one speaks candidly to his/her surgeon. The surgeon should tell patients clearly how reasonable these expectations are and paint a clear and realistic picture of the surgery’s outcome.
Poor-risk candidates for aesthetic dermatology and surgery:
• The perfectionist: This person has unrealistic expectations of surgery — like he/she believes surgery will restore his/her exact youthful appearance. Or the person who wants to look exactly like a celebrity whom he/she wants to emulate. I remember a particular patient who brought a picture of herself, post surgery. The lighting in the picture was edited, making her nose look very thin. She told me I should have copied exactly what was in the picture.
• The confused: This person is in a crisis and needs to be “fixed.” Examples of a crisis would be divorce, rejection, or death of a loved one. All are examples of losses. The chaotic believes that cosmetic surgery will heal or eliminate their grief, then they even get more disappointed if the crisis remains unsolved.
• The volatile: This person is psychologically unstable, has a severe personality disorder, or is simply a psychotic. The surgeon may think this person odd, but since a cosmetic surgeon is not trained in psychiatry, a mental health diagnosis may not occur. I once had a rich young patient who was a reformed addict. The relatives wanted him to get surgery for excessive sweating. I was hesitant at first, but when the relatives assured me there would be no problems, I did the procedure and luckily, the relatives were happy.
• The jumper: This person jumps from surgeon to surgeon, looking for the doctor who will tell him/her exactly what he/she wants to hear. They will not accept the answers they are given by competent cosmetic surgeons so they continue their search. A person obsessed with a feature that only he/she perceives as a defect will continue to seek out someone who will fix something that is not flawed.
• The pleaser: This is the person who seeks out surgery to please someone else. This person hopes that his/her significant other would accept him/her more if he/she had cosmetic surgery. An example would be a patient whose lover told her he’d find her more desirable if she looked differently. The pleaser doesn’t understand that surgery will not cause personality changes in her lover. If the lover is not satisfied before surgery, he will probably remain unsatisfied after surgery.
• The moneymaker: This is a person who makes money out of his/her procedure. After a perfect surgical procedure, they complain of so many things to you even if none of these is directly related to the procedure that you did. Like, for example, a lot of pimples coming out after a nose job. They just want their money back with their newfound features intact.
• The obsessed patient: This is a preoccupied patient with a very minor defect who believes that once his/her defect is fixed, life will be perfect. Born perfectionists, they may still be suitable candidates for surgery, as long as they are realistic enough to understand that the surgical results may not precisely match their goals.
Just a reminder to people who intend to change their looks: If you are thinking of improving your appearance, remember that there is so much more to cosmetic surgery than going to sleep and waking up a changed person, perfect and a hundred percent according to what you expected.
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For questions or inquiries, call 0917-4976261, 0999-8834802 or 263-4094, or email gc_beltran@yahoo.com.