The psychology of beauty: what are the right reasons for plastic surgery?

• Author: Sevinor, Sheldon J.

ARISTOTLE said that "Beauty is a greater recommendation than any letter of introduction," but is it? David Hume wrote in 1741 that "Beauty is not a quality in things themselves; it merely exists in the mind that contemplates them, and each mind perceives a different beauty."

More than 2,000,000 cosmetic procedures are performed annually. There are 72,000,000 baby-boomers who are approaching their 40s and associate looking good with success. What do they want to achieve with cosmetic surgery, and are their expectations realistic?

A plastic surgeon must be a keen psychologist and understand why a person decides to change some aspect of his or her appearance. There is a relationship between self-image and the desire to change one's looks. The surgeon must be aware of the patient's psychological stability, mood, expectations, motivations, and goals. A brilliant surgeon and scalpel can not revive an ailing marriage.

Residency training programs in the U.S. do a superb job in teaching young doctors to master the technical skills required for plastic surgery, but little time is spent studying the appropriateness of such a procedure from the psychological aspect of the patient profile.

Choosing the appropriate patient is as important as selecting the correct procedure. Physical appearance is one clue to determine whether he or she is a good candidate. Is the patient disheveled? Does he or she have a defect which is only minimal? Has the patient already had a number of plastic surgery procedures performed? In other words, is he or she a plasti-surgiholic? Is the patient a "super-perfectionist" or a "shopper"?

The manner in which the patient conducts himself or herself during the initial consultation is important. Is he or she rude, overly solicitous, critical of other surgeons, depressed, arrogant, or vague? Any one or a combination of these elements can signal unrealistic expectations. Such a person never can be satisfied.

During the evaluation, it should be determined whether the patient has suffered a loss. Has he or she lost a job or a loved one? Changes in one's life can produce tensions. Some individuals are prompted to seek plastic surgery as a means to cope with added stress. Moreover, if the patient is undergoing psychological treatment, he or she may not be in a position to make a fully informed decision about plastic surgery.

Even if none of the aforementioned elements are present, I still may choose not to perform surgery on an individual...