Explore Plastic Surgery - Dr. Barry Eppley

Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?

Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.

Many people talk about ‘plastic surgery addicts’ and it is not uncommon that one of my patients in my Indianapolis plastic surgery practice ask if I see many of them. While it is true that there clearly are some who are addicted to getting plastic surgery, and they are well illustrated on the internet and in magazines, but this type of psychiatric pathology is quite rare. It is not as common as it is touted. Just like the rare medical conditions known as Munchausen’s (self-inflicted medical problems) or Lesch-Nyhan syndrome (self-multilating behavior), true plastic surgery addiction (PSA) is equally infrequent. PSA is a body dysmorphic disorder where there is a disconnect essentially between what one sees and how one actually looks. In essence, there isn’t any physical or discernible cosmetic problem.

What is exceptionally common, however, is a different type of psychological response which is not pathologic. That is the patient who returns for further plastic surgery procedures after an initial successful one. A behavior that is well known in psychological circles and is called accomplishment feedback. It is also observed and used in motivational and sales training. The more one achieves, the more inclined one is to do want to do more.

Accomplishment feedback is exactly why an estimated 25% to 35% of patients in any plastic surgery practice account for repeat business. ( I am talking here about a significant commitment such as surgery, not something that is much easier to do like Botox) I have read estimates that are as high as two-thirds of repeat surgery patients but that is not accurate in my experience. Once someone has had a successful change in a body part, it does make them think about moving on to another area of cosmetic concern.

Returning for further plastic surgery procedures for most patients is a healthy and perfectly natural response. Cosmetic plastic surgery is about improving one’s self-image and it usually does this very successfully. Most repeat plastic surgery patients usually only do it twice and occasionally a third time over a several year period. This is a quite different frequency than that seen in PSA. In addition, repeat patients often go to different body areas as they have further procedures. PSA patients will tend to continue to operate on the same body region, most commonly the face.   

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

One of the interesting psychological phenomenons that is very common in plastic surgery is what often occurs after an operation. Patients initially present with a certain problem and state how happy they would be if it was better. For example, a middle-aged female is seen with extra skin and fat on the abdomen and a little waistline overhang. She undergoes a tummy tuck and initially is quite happy. But within a relatively short period of time after surgery (often no longer than a few months), the same patient begins to point out a few areas that she feels aren’t quite right or wishes they weren’t there. The very result that the patient once stated they would have been thrilled with… is now no longer quite as expected.

This is an observation that I call in my Indianapolis plastic surgery practice the concept of cosmetic accomodation. Many plastic surgeons have seen it but it has not had an exact name. The most well known example of it is in breast augmentation surgery. A breast size that initially after surgery was a little too big or just right…seemingly becomes smaller months later. (and the implants have not changed!) And the patient may have wished now that they went bigger from the beginning.

Results after plastic surgery can sometimes, and eventually for some, may appear anti-climatic. This is not to say that they are not happy they had the surgery, it is just that the thrill of the initial results has faded. Much like that brand new car which seems passé and too familiar a year later.

While this psychological observation exists for many new changes in all areas of life, there can be some troubling issues with it in plastic surgery. As the newness of the face or body changes fades, the patient may begin to find small areas to critique or be unhappy with. Some of these changes are real…the facelift that begins to relax and develop a small skin excess under the chin or at the jowls….the rhinoplasty that develops a small irregularity at the tip of the nose as the last bit of swelling fades…or the liposuction patient who finds some asymmetry in the waistline area months later. Some of these changes, however, are an unveiling of pre-existing issues or the failure to achieve absolute perfection from the surgery. This is where the taking of pre-operative pictures and their review after surgery is important.

While cosmetic accommodation is normal and well tolerated by the vast majority of patients, other patients may desire revisional or touch-up surgery to further improve the result or imperfections. Revisional plastic surgery always brings to the surface issues of another operative experience and  its associated costs. Because of this possibility, it is important that anyone considering plastic surgery be informed beforehand of this need or desire on their part…and who is responsible for this expense.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

When I see a new plastic surgery consult, it is very common that they bring up their concern about vanity. If they are describing what bothers them they may say…’I don’t want you to think I’m vain’…or…’I don’t want to seem vain’. Or they may even ask near the end of our discussion…’You don’t think I am too vain do you?’ Having heard this vanity concern so often, it prompted me to investigate what vanity really is and are they really being vain.

Why do we look in the mirror every time we pass one? It is hard for most of us not to. We are all more obsessed with our appearance than we would like to admit. But that does not make us vain. According to Merriam-Webster’s Online Dictionary, vanity means excessive pride in one’s appearance or self-worth, in other words, conceit. Having concern about one’s appearance, however, is quite normal and understandable and should not be construed as being vain. It is not conceit to want to look one’s best.

While concern about appearance has been present since antiquity and in every culture, today there is a greater degree of concern about it. Advances in technology, particularly that of the media and the internet, has caused normal concerns about how we look to become obsessions for some. In the work place, there is great concern to look one’s best and not look tired to help one make the next sale or get the next promotion. Because of mass marketing and advertising, we see attractive people all the time leading us to believe that good looks are the norm and should be sought after. This is certainly true when it comes to weight where only a fraction of the population is as thin as the media would have us to believe based on the images that they put forth. All of this can create insecurities for some, particularly the young and to those who must compete with the young.

Nearly 90% of all plastic surgery procedures, surgical and non-surgical, are done by women. Women are much more critical of their appearance than men and have more distortions in their image perceptions. This is because women are judged more by their appearance than men are. Men tend to be judged more by what they do and have. This results in men generally have a more positive self-images (they would say they care less about what they look like) often to the point of overestimating their appearance. This is particularly true in men of wealth and position. Many men will suffer some body dissatisfaction between the ages of 45 to 55 during the male menopause or so called midlife crisis period or if they have to re-enter the social dating world due to divorce or loss of a spouse.

My conclusion is that the vast majority of patients seeking plastic surgery are not vain and nor should they be concerned about being so. Their objectives are not to get ahead of their neighbors or fellow employees nor are they likely to walk around after feeling that they are superior to everyone else. Vanity or conceit is a destructive life force. Rather, they simply want to look their best and be as good as they can be…even if the reason is not to be left out or endure unspoken prejudice because of the way they look. The desire to fit in and be viewed as healthy and vibrant…to improve one’s self-image…is a constructive and positive life force. After all, cosmetic plastic surgery is really about self-image improvement…and that is not vain at all.

Dr. Barry Eppley

http://www.eppleyplasticssurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

While it is true that the overall number of plastic surgery procedures performed in the past few years is up, and the number of men as a percentage of this total is increased, women still far outnumber male patients by about 10:1 for most practices. While male plastic surgery procedures are somewhat different from woman’s, their motivations for undergoing plastic surgery are also different.
While both men and women undergo plastic surgery to look physically better, you have to dig beyond this obvious level to understand what their true motivations are. The desired physical concerns or desired changes are just a reflection of their unspoken concerns. As a general statement, most women’s motivations for plastic surgery are true self-image issues. They want to fell better about themselves. Correcting a physical flaw is one approach to self-improvement. (and perhaps the easiest?) Whether it is to have a breast augmentation to look better in clothes or to have a facelift to not look old, women seem to be much more concerned about doing the surgery truly for themselves. I hear this over and over…’my husband doesn’t think I need it…or…’my friends say I look fine’. But yet, women want to have the surgery anyway…becasue they want to fell better about themselves. Men, conversely, often undergo plastic surgery because they want things. Whether it be to have more women, sex, money or power…it most always deep down is motivated by a desire for external or more tangible things. As a plastic surgerycorollary to ‘Men are Venus, Women are from Mars’…Women do things for themselves, Men usually do things for somebody else.
Men undergoing plastic surgery also are different from women in other ways as well. They usually are not interested in complex procedures that involve any significant recovery, they are usually less compliant than women, their response and tolerance to pain is often more pronounced, and they often are more critical of the results. (or they are at least more vocal) Much of this has to do with the general greater impatience of men who want to get to the final result quickly…and usually more discretely. This is why smaller more subtle procedures for men are often better, even if the result is not as significant. Men get no accolades, and certainly little sympathy, in society for suffering through a plastic surgery recovery. Women, conversely, garner more empathy if they are suffering to look more ‘beautiful’. In fact, our society expects them to do so.
The handling of the male plastic surgery patient, I have found, is quite different from a female patient. And not all plastic surgeons can work well with men. They often require more time and patience than most female patients. And the demands of the younger male patient are higher than that of an older man. The young ‘narcisistic’ male patient can be the most demanding and the most likely to require revisional surgery to achieve a mutually satisfactory result.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

A single day doesn’t go by in the office where a new patient doesn’t say in an initial consultation….”You might think I am vain….” or “You might think I am crazy…..” and then they go on to describe what bothers them or why they are there. I, of course, go on to reassure them they are not vain or crazy…….and that they realize they are talking to the choir, so to speak…..as this is what I do for a living……and I have heard it all.

 
Essentially, what the patient is doing is justifying why they want a cosmetic change and often are still convincing themselves that this is acceptable to do. The deep seated ‘guilt’ of desiring a cosmetic procedure comes out even when talking to their plastic surgeon. The source of this guilt and the justification to express it may be internal or often comes from others (spouse, friends) whom have told them that they look just fine and they don’t see the problem.This is particularly true, and sometimes causes some familial strife, when it comes from the spouse (almost always husband to the wife, wifes are almost always very supportive of the husband having cosmetic surgery) who may even be significantly opposed to any consideration of cosmetic surgery. And yet, the wife still comes in and pursues information about the procedure(s). The biggest illustration of this marital scenario is with Botox, a simple office-based procedure in which there is no visible sign that it was done immediately afterward. I have noticed that a significant number of women pay cash or pay with their ‘own’ credit card or checking account. They clearly want to keep their spouses from knowing their discretionary spending habits.

 
The question begs….why do people want cosmetic changes? The simple answer is…because they are unhappy with their appearance. Contrary to popular perception, it is the rare patient whose motivation for change is truly driven by another. When I first started in practice in town, I noticed a yellow pages ad for a plastic surgeon (now retired) that used the slogan…’If it bugs you….fix it!’ I used to think that was such a crude and unsophisticated method of advertising. Over the years, I have learned that that slogan is very accurate….albeit simplistic. While I still wouldn’t use that phrase for my practice advertising, the core of it rings true………something won’t stop bothering you until you do an action step. No amount of thinking, convincing of others, or logic can change how you feel about something so emotional (your appearance). Only an action step, in this case, plastic surgery can affect that emotional feeling.

 
So when a patient asks me….”Dr., do you think I need this….”…..my answer always is.. it is not whether I see the problem, but whether you do. If the patient sees it, then it is real. My job as a plastic surgeon is to determine whether an operation can improve that perceived problem…and at what risk.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis