Psychiatric Issues in Cosmetic Plastic Surgery

The objective of cosmetic surgery is increased patient self-esteem and confidence. Most patients undergoing a procedure report
these results post-operatively. The success of any procedure is measured in patient satisfaction. In order to optimize patient
satisfaction, literature suggests careful pre-operative patient preparation including a discussion of the risks, benefits,
limitations and expected results for each procedure undertaken. As a general rule, the patients that are motivated to surgery
by a desire to align their outward appearance to their body-image tend to be the most satisfied. There are some psychiatric
conditions that can prevent a patient from being satisfied without regard aesthetic success. The most common examples are
minimal defect/Body Dysmorphic Disorder, the patient in crisis, the multiple revision patient, and loss of identity. This
paper will familiarize the audience with these conditions, symptoms and related illnesses. Case examples are described and
then explored in terms of the conditions presented. A discussion of the patient’s motivation for surgery, goals pertaining
to specific attributes, as well as an evaluation of the patient’s understanding of the risks, benefits, and limitations of
the procedure can help the physician determine if a patient is capable of being satisfied with a cosmetic plastic surgery
procedure. Plastic surgeons can screen patients suffering from these conditions relatively easily, as psychiatry is an integral
part of medical school education. If a psychiatric referral is required, then the psychiatrist needs to be aware of the nuances
of each of these conditions.