Cosmetic Surgery

Body Image: Loving Yourself Inside and Out Home > Cosmetic Surgery

• ASPS List of Inappropriate Candidates for Surgery
• Safety
• Check out your doctor's credentials
• Body Dysmorphic Disorder (BDD)
• Additional Information on Cosmetic Surgery
  • Breast Surgery
  • Botox
  • Liposuction
  • Varicose or Spider Veins
  • Safety
• Additional Information on Body Dysmorphic Disorder

If you are considering cosmetic surgery, you must be honest with yourself. Why do you want surgery and, what do you expect surgery to do for you? According to the American Society of Plastic Surgeons (ASPS), there are two categories of patients who are good candidates for surgery. The first includes patients with a strong self-image, who are bothered by a physical characteristic that they'd like to improve or change. The second category includes patients who have a physical defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic surgery can create both physical changes and changes in self-esteem. If you are seeking surgery with the hope of influencing a change in someone other than yourself, you might end up disappointed.

ASPS List of Inappropriate Candidates for Surgery:

• Patients in crisis, such as those who are going through divorce, the death of a spouse, or the loss of a job. These patients may be seeking to achieve goals that cannot be obtained through an appearance change-goals that relate to overcoming crisis through an unrelated change in appearance is not the solution. Rather, a patient must first work through the crisis.

• Patients with unrealistic expectations, such as those who insist on having a celebrity's nose, with the hope that they may acquire a celebrity lifestyle; patients who want to be restored to their original "perfection" following a severe accident or a serious illness; or patients who wish to find the youth of many decades past.

• Impossible-to-please patients, such as individuals who consult with surgeon after surgeon, seeking the answers they want to hear. These patients hope for a cure to a problem, which is not primarily, or not at all physical.

• Patients who are obsessed with a very minor defect, and may believe that once their defect is fixed, life will be perfect. Born perfectionists may be suitable candidates for surgery, as long as they are realistic enough to understand that surgical results may not precisely match their goals.

• Patients who have a mental illness, and exhibit delusional or paranoid behavior, may also be poor candidates for surgery. Surgery may be appropriate in these cases if it is determined that the patient's goals for surgery are not related to the psychosis. In these cases, a plastic surgeon may work closely with the patient's psychiatrist.

Because the changes resulting from cosmetic surgery are often dramatic and permanent, it's important that you have a clear understanding of how surgery might make you feel — long before a procedure is scheduled.

Safety

If you're thinking about getting cosmetic surgery, it's your job to become an informed consumer. Selecting a qualified doctor, with a lot of training and experience in the procedure you'd like to get, is essential.

Ask the right questions to get the best treatment:

• What state is the doctor licensed to practice surgery?
• Is the doctor board certified? With which board? The doctor should be certified by the American Board of Plastic Surgery.
• How many years has the doctor performed this type of surgery?
• Does the doctor have life-saving equipment and monitoring devices?
• Who administers the anesthesia? Ideally, this person is a board-certified anesthesiologist or certified registered nurse anesthetist.
• What are the risks of the procedure?
• What is the expected recovery for the procedure you're having?

Check out your doctor's credentials

If you're thinking about having your surgery in the doctor's office, there are advantages and disadvantages. The office might be convenient, private, and have more amenities than a hospital or ambulatory care center (non-emergency, outpatient facility). But it may not be safe. Don't assume that the doctor has the right credentials or the right equipment to keep you safe in the office.

Contact these organizations to find out your doctor's education, licensure, and board certification in addition to the doctor's or ambulatory care center's accreditation:

• Accreditation Association for Ambulatory Health Care, Inc. (AAHC)
  Accredits physician offices with surgical facilities.
  Phone: 847-853-6060

• American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)
  Certifies ambulatory surgery facilities and provides practice guidelines for surgeons working in ambulatory surgical facilities.
  Phone: 888-545-5222

• American Society of Plastic Surgeons (ASPS)/ The American Board of Plastic Surgery (ABPS)
  All of the surgeons listed through this service are ASPS members who are board-certified by the American Board of Plastic Surgery. They have graduated from an accredited medical school and completed at least five years of surgical residency, usually three years of general surgery and two years of plastic surgery.
  Phone: 888-4PLASTIC

• Federation of State Medical Boards (FCVS)
  FCVS verifies medical education, postgraduate training, licensure examination history, board action history, and identity.
  Phone: 888-ASK-FCVS

Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder (BDD) is a serious illness when a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose. A person with BDD tends to have cosmetic surgery, and even if the surgeries are successful, does not think they are and is unhappy with the outcomes.

Symptoms of BDD

Being preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose, such as acne, scarring, facial lines, marks, pale skin, thinning hair, excessive body hair, large nose, or crooked nose.

Having a lot of anxiety and stress about the perceived flaw and spending a lot of time focusing on it, such as frequently picking at skin, excessively checking appearance in a mirror, hiding the imperfection, comparing appearance with others, excessively grooming, seeking reassurance from others about how they look, and getting cosmetic surgery.

Getting cosmetic surgery can make BDD worse. They are often not happy with the outcome of the surgery. If they are, they may start to focus attention on another body area and become preoccupied trying to fix the new "defect." In this case, some patients with BDD become angry at the surgeon for making their appearance worse and may even become violent towards the surgeon.

Treatment for BDD

• Medications. Serotonin reuptake inhibitors or SSRIs are antidepressants that decrease the obsessive and compulsive behaviors.

• Cognitive behavioral therapy. This is a type of therapy with several steps:
  1. The therapist asks the patient to enter social situations without covering up her "defect."
  2. The therapist helps the patient stop doing the compulsive behaviors to check the defect or cover it up. This may include removing mirrors, covering skin areas that the patient picks, or not using make-up.
  3. The therapist helps the patient change their false beliefs about their appearance.

Additional Information on Cosmetic Surgery

Breast surgery

Publications

1.   Breast Implants - This site provides information about breast implant studies, breast implant complications, and other resources. It also includes the FDA Breast Implant Consumer Handbook.

   http://www.fda.gov/cdrh/breastimplants/index.html

2. breastimplantinfo.org - The Implant Information Project of the National Research Center for Women & Families provides information on breast augmentation, reconstruction, what to do if your implant breaks, and more.

   http://www.breastimplantinfo.org/

3. BreastImplantSafety.org - This site provides information on the safety, risks, and costs of breast augmentation, reconstruction, and implants. It also provides answers to frequently asked questions and links to additional resources.

   http://www.breastimplantsafety.org/

= Indicates Federal Resources

Botox

Publications

1.   Botox Cosmetic: A Look at Looking Good - This on-line publication illustrates how botox works, explains the recommendations of the FDA, and provides a list of what to look for if considering botox injections.

   http://www.fda.gov/fdac/features/2002/402_botox.html

2.   Botox™ - This fact sheet describes the uses and symptoms of Botox™. The publication also includes tips to consider when thinking about using Botox™.

   http://www.fda.gov/womens/getthefacts/botox.html

3. Botox Injections (Copyright © AAFPRS) - This fact sheet provides recommendations for those considering botox injections.

   http://www.aafprs.org/media/media_resources/fact_botox.html

4. Injectablesafety.org - Injectablesafety.org is designed for consumer safety and information about injectable cosmetic enhancement.

   http://www.injectablesafety.org/

= Indicates Federal Resources

Liposuction

Publications

1.   Liposuction - This publication explains what liposuction is, how it is done, and the pros and cons.

   http://www.fda.gov/womens/getthefacts/liposuction.html

2. Do's and don’ts for liposuction (Copyright © ASDS) - In this fact sheet the American Society of Dermatologic Surgery offers some tips to ensure a positive result from tumescent liposuction. The list of do's and don'ts encourages you to do your research and understand your options, but not to have unrealistic expectations, among other things.

   http://www.asds-net.org/DosAndDontsLiposuction.aspx

= Indicates Federal Resources

Varicose or Spider Veins

Publications

1.   Frequently Asked Questions - Varicose Veins and Spider Veins - This publication contains information on varicose and spider veins, what they are, how they are caused, why they appear in the legs, if they are dangerous, how to prevent getting them, and how they are treated.

   http://www.womenshealth.gov/faq/varicose.htm

2. Do's and Don’ts for the Treatment of Spider and Varicose Veins (Copyright © ASDS) - This fact sheet contains information on spider and varicose veins, who develops them, sclerotherapy, possible side effects and other treatment options available.

   http://www.asds-net.org/_ConsumerPage.aspx?id=932

3. Spider Vein, Varicose Vein Therapy (Copyright © AAD) - This brochure provides information on how spider and varicose veins occur. It Includes information on sclerotherapy, a treatment method use for unwanted blood vessels.

   http://www.aad.org/public/Publications/pamphlets/SpiderVein.htm

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Safety

Publications

1. Consumer Information (Copyright © ASDS) - This section of the American Society for Dermatologic Surgery’s web site provides information for the public about different types of dermatologic surgery and patient safety.

   http://www.asds-net.org/consumerinformation.aspx

2. Cosmetic surgery: What to know beforehand (Copyright © MFMER) - This publication provides information on whether or not cosmetic surgery is right for you. It explains what the risks are, how to find a qualified surgeon, and what to expect from the consultation.

   http://www.mayoclinic.com/health/cosmetic-surgery/SN00006

3. Medical Tourism: Is It Safe? (Copyright © ASPS) - Consumers considering plastic surgery can choose among a wide range of providers and facilities, with some even offering low-cost “medical tourism” packages in exotic locales. This publication explains what to look for to keep safe.

   http://www.plasticsurgery.org/patients_consumers/patient_safety/Medical-Tourism.cfm?CFID=94652190&CFTOK...

4. Patient Safety Tips (Copyright © ASAPS) - This page contains links to articles that will help you make informed decisions and know what to expect when you choose to undergo a procedure before deciding if plastic surgery is the right choice for you

   http://www.surgery.org/public/safety

5. Psychological Aspects of Plastic Surgery (Copyright © ASPS) - This concise publication will provide information on proper and improper candidates for cosmetic surgery, plastic surgery for children, timing your surgery, adjusting to the change, coping with post-operative depression as well as handling critics.

   http://www.plasticsurgery.org/public_education/procedures/psychological_aspects.cfm...

6. Safety Tips for Patients Considering Cosmetic/Dermatologic Laser and Light Based Device Procedures (Copyright © ASLMS) - This fact sheet informs patients who plan to undergo cosmetic/dermatologic and light based device procedures of important safety precautions to take. It contains information about what questions to ask your doctor, what to expect from the procedure, and what to do if you experience complications.

   http://www.aslms.org/public/patientsafetytips.shtml

7. What You Should Know About the Safety of Outpatient Plastic Surgery (Copyright © ASPS) - This fact sheet provides information on what plastic surgery is, what the difference between cosmetic and reconstructive surgery is, how to learn if your surgeon has the appropriate credentials, how to learn about the facility's safety standards, and what other safety issues you should consider before having plastic surgery.

   http://www.plasticsurgery.org/patients_consumers/ps_faqs/FAQ-What-You-Should-Know-About-the-Safety-of-Outpa...

Organizations

1.   Food and Drug Administration, HHS
2. American Board of Plastic Surgery, Inc.
3. American Society for Aesthetic Plastic Surgery
4. American Society For Dermatologic Surgery
5. American Society of Plastic Surgeons (ASPS)

= Indicates Federal Resources

Additional Information on Body Dysmorphic Disorder:

Publications

1. Body Dysmorphic Disorder (BDD) (Copyright © ADAA) - This article describes what BDD is, the symptoms of BDD, and how it is treated.

   http://www.adaa.org/gettinghelp/MFarchives/MonthlyFeatures(June).asp

2. Body dysmorphic disorder (Copyright © MFMER) - This fact sheet describes body dysmorphic disorder, which is characterized by an excessive preoccupation with a real or imagined defect in your physical appearance. Learn more about signs and symptoms, causes, self-care, and when to seek medical advice.

   http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559

3. Body Dysmorphic Disorder (Copyright © Nemours Foundation) - This article, specifically for parents, describes what causes BDD, it’s impact, and how it is treated.

   http://www.kidshealth.org/parent/emotions/feelings/bdd.html

4. Body Dysmorphic Disorder (Copyright © The Cleveland Clinic Foundation) - This fact sheet explains what body dysmorphic disorder or BDD is, what causes it, what the signs and symptoms are, and how it is diagnosed and treated.

   http://www.clevelandclinic.org/health/health-info/docs/3700/3776.asp?index=9888

5. Less-Well-Known Eating Disorders and Related Problems (Copyright © ANRED) - This fact sheet briefly describes some of the less-well-known eating disorders and other problems in relation to body image and mental health. It provides information on purging, compulsive exercise, body dysmorphic disorder, muscle dysmorphic disorder, and other conditions.

   http://www.anred.com/defslesser.html

6. More Information about Body Dysmorphic Disorder (Copyright © Butler Hospital) - This fact sheet contains information about body dysmorphic disorder (BDD) and findings from 500 people Butler hospital studied with BDD. It describes some preoccupations and disliked body areas, common BDD behaviors, and how BDD affects a person's life.

   http://www.butler.org/body.cfm?id=239

Organizations

1.   National Mental Health Information Center, SAMHSA, HHS
2. Anorexia Nervosa and Related Eating Disorders, Inc.
3. National Eating Disorders Association

= Indicates Federal Resources

Content last updated March 19, 2008.