Cosmetic Surgery and Mental Health
Today’s society has been flooded with all forms of media whereby the focus is on the material wealth and superficial beauty. The amount of social media personalities and influencers dominating screen time has led to an increase in the desire to attain a certain look or image. Marketing through these platforms has enabled make-up artists, cosmetic practitioners and plastic surgeons to capitalize on these urges. As a result, we have seen an exponential rise in non-surgical aesthetic procedures and cosmetic surgery. These are now readily available more than ever before, having access to these in your local mall or down the high street. With the rising competition in the industry prices are discounted and attainable to most.
There are many patients who benefit from such procedures but there can also be negative consequences. The psychological effect it can have on many patients is barely discussed. This can lead to discontentment in one’s body image, loss of self-confidence and some instances mental health issues such as Body Dysmorphic Disorder (BDD).
Dr Peter Loizou, Consultant ENT/Head and Neck Surgeon, and Facial Plastic Surgeon at King’s College Hospital, delves deeper into cosmetic surgery and the psychological effects that come with it.
According to Dr Peter, aesthetic procedures, which include both surgical and non-surgical, have been on the rise globally. “This is not only happening in the western world, but also in the Far East and the Middle East. Here in Dubai, we have seen an increase in non-surgical and surgical aesthetic procedures.” And as a result the aesthetic clinics and cosmetic surgery day case units have also mushroomed throughout the region.
Common Procedures
Dr Peter notes that the most common procedures which are increasingly being requested are those of botulinum toxin treatments, commonly known as “Botox”, and soft dermal fillers. “These treatments are increasing by about 10% each year, and we’ve also seen an increase in our male clientele requesting non-surgical procedures.”
Unrealistic Cosmetic Requests
That said, there are times that the doctor may receive an unrealistic request such as ‘doctor are you able to shrink my ears?’ or ‘doctor are you able to make my nose look like this person’s’.
“Obviously, there are certain limitations with what we can provide depending on whether the person wishes to proceed with a surgical or non-surgical procedure. So, the most important thing any plastic surgeon must do, is to have a detailed dialogue with the patient to pinpoint their main concerns and discuss possible treatment strategies, what can be achieved with cosmetic surgery versus non-surgical procedures, or by using a mixture of both to optimise an outcome,” explains Dr Peter.
Again, he states, we need to understand what the expectations are of the patient and if they are realistic as to whether we can address them and achieve the desired outcome, mitigating the downtime and reducing the chance of any complications. “To do this we must recognize our limitations which may be dependent on the patient’s anatomy, age and previous medical history but also the patient’s mental wellbeing.”
Mental Health Matters when it Comes to Cosmetic Procedures
When it comes to patients looking to have any aesthetic procedure, says Dr Peter, it's always important to assess the patient holistically. “What I mean by this is not only from a physical point of view but also to understand the motives behind the surgery or the treatment, and also to ascertain their mental health and emotional maturity before they go ahead with such a procedure.”
Obviously, he adds, now that the non-surgical procedures are temporary, and some procedures can be reversed, patients tend to take these procedures rather lightly. “After all, according to them, it's just a short visit to the office during a lunch break”. Sometimes a patient may ask ‘So, doctor what can you do for me?’ without any specific request but just a generalization on what can be improved. However, with any procedure, whether it is non-surgical, reversible or temporary, there are still risks involved.
“By assessing the patient holistically, we will be better informed on making the decision to treat or not to treat. What I mean by this is whether they truly need a cosmetic procedure vs treating an underlying psychological condition.”
Body Dysmorphic Disorder (BDD)
Body Dysmorphic Disorder, which is an example of OCD (obsessive compulsive disorder) is present in about 1 in 50 of the population. “However, in an aesthetics practice we may see this being the case in up to 10% of our clientele” states Dr Peter.
He adds that it is important to see how life-changing the patient feels about the area of focus and if they highlight it as a ‘deformity’ or a ‘flaw’. In some instances they may wish to hide this from others or even themselves by avoiding mirrors and cameras. Others may signify the focus on this body part or facial characteristic by constantly looking at it in the mirror. “This can lead to anxiety and sometimes even depression around this focused area, which more often than not is usually on the face.
“In this COVID-19 era we are currently living in, we are seeing some of these patients attending the clinic very comfortable in wearing a mask but can become rather anxious when asked to remove it. This would raise caution and be consistent with someone who may be suffering from BDD.”
According to the doctor, if this patient’s focus is on something that looks within the normal range of what is expected for anatomical size and proportion, and the focus is exceedingly exaggerated and considered a deformity or flaw, then this is typical of BDD. “So, what we do in this sort of case is recognise early on in the consultation by carrying out a detailed assessment and then provide them with the appropriate support.
Treatment for Body Dysmorphic Disorder
“Within the King’s College Hospital Aesthetics practice in Dubai Marina, we have trained Family Medicine doctors, one of who is Dr Ali Razzak, who is also an aesthetic practitioner, and has experience with mental health management. Some of these patients who suffer from BDD may require medical therapy with a course of antidepressants, while some may benefit from cognitive behavioral therapy.”
About King's College Hospital London in Dubai
King’s College Hospital London in Dubai was established to provide for the healthcare needs of the whole family for both simple and complex medical conditions. We deliver the finest levels of healthcare, including consultations, diagnostic tests, treatments and recovery support.
At King’s, our priority is patient care, and we offer the same high-quality trusted healthcare, modern techniques and evidence-based procedures at our medical centres in Dubai as we provide at our internationally renowned hospital in the UK. Everything we do is driven by Best Practice Care pathways, and our desire to put the health outcomes of our patients before anything else.
The UAE’s strong ties with King’s College Hospital go back to 1979 when the nation’s founder, His Highness Sheikh Zayed bin Sultan Al Nahyan, provided a donation that helped establish the King’s liver research centre, which is now among the top three specialist liver centres in the world.
