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
Indianapolis, Indiana