Whether a patient is psychologically pessimistic or optimistic has been shown to not be associated with satisfaction after plastic surgery procedures of the face. This is according to to according to research published in the May/June issue of the Archives of Facial Plastic Surgery. Ironically, those patients treated for depression actually showed greater satisfaction than patients who were not being treated for depression.
These study was based on survey responses of 51 patients from a facial cosmetic surgery practice in Michigan. The survey asked questions on demographics and baseline levels of optimism and pessimism as well as a surgery-specific questionnaire before surgery and up to six months after surgery. The study findings showed that patients over the age of 53 were more satisfied with the results of their surgery than younger patients. Also, those currently being treated for depression were more satisfied than those not being treated.
It has long been a belief in plastic surgery that the psychological state of a patient before surgery has an association, if not a strong influence, on how the patient will perceive the outcome of the procedure(s). This is more than a theoretical belief in my opinion but is well documented by a lot of clinical experience in the decades by more than a few plastic surgeons. Every plastic surgeon knows and has experienced the reveal after surgery of a patient’s true state of mind, particularly in the face of some complication or more minor surgical imperfection. Patients that initially seemed psychologically balanced can become anything but.
This study specifically looked at the issue of preoperative depression and interpretation of surgical outcomes. There is certainly a lot of people who are on antidepressant medication. I would estimate that up to 25% of the patients I see have a mood elevator on their recorded medication list. Whether they are significantly clinically depressed I do not know but they are on prescription medication(s) for some degree of it. Yet most certainly don’t seem to be depressed in my limited interaction with them and there is no obvious higher rate of result dissatisfaction afterwards. So these study results are not really a surprise.
Depression is but one altered psychological state and is really benign for a patient considering plastic surgery, unless it is quite severe. But severely depressed patients don’t generally come in for cosmetic operations as they are¦too depressed to do so. And really depressed patients are fairly easy to spot. But many other psychological diagnoses are significant potential problems, including anxiety and obsessive-compulsive disorders, which are much harder to detect as these people seem functional and often are highly so. It is these disorders that are the real psychological landmines for plastic surgeons. If this same study was conducted on patients with these disorders the outcome would be quite different I think. It is also important to separate facial and body plastic surgery procedures. Facial procedures, because of their visibility, are at higher risk for distorted perceptions and an extraordinary amount of critical examination.
Dr. Barry Eppley
Indianapolis, Indiana