Cosmetic Surgery

Body Image: Loving Yourself Inside and Out Home > Cosmetic Surgery

• ASPS List of Inappropriate Candidates for Surgery
• Safety
• Check out your doctor's credentials
• Body Dysmorphic Disorder (BDD)
• Additional Information on Cosmetic Surgery
  • Breast Surgery
  • Botox
  • Liposuction
  • Varicose or Spider Veins
  • Safety
• Additional Information on Body Dysmorphic Disorder

If you are considering cosmetic surgery, you must be honest with yourself. Why do you want surgery and what do you expect surgery to do for you? According to the American Society of Plastic Surgeons (ASPS), there are two categories of patients who are good candidates for surgery.

1. The first includes patients with a strong self-image who are bothered by a physical characteristic that they'd like to improve or change.
2. The second category includes patients who have a physical defect or cosmetic flaw that has diminished their self-esteem over time.

ASPS List of Inappropriate Candidates for Surgery:

• Patients in crisis, such as those who are going through divorce, the death of a spouse, or the loss of a job. These patients may be seeking to achieve goals that cannot be met through an appearance change — goals that relate to overcoming crisis through an unrelated change in appearance is not the solution. Rather, a patient must first work through the crisis.

• Patients with unrealistic expectations, such as those who insist on having a celebrity's nose, with the hope that they may acquire a celebrity lifestyle; patients who want to be restored to their original "perfection" following a severe accident or a serious illness; or patients who wish to find the youth of many decades past.

• Impossible-to-please patients, such as individuals who consult with surgeon after surgeon, seeking the answers they want to hear. These patients hope for a cure to a problem which is not primarily, or at all, physical.

• Patients who are obsessed with a very minor defect, and may believe that once their defect is fixed, life will be perfect. Born perfectionists may be suitable candidates for surgery, as long as they are realistic enough to understand that surgical results may not precisely match their goals.

• Patients who have a mental illness, and exhibit delusional or paranoid behavior, may also be poor candidates for surgery. Surgery may be appropriate in these cases if it is determined that the patient's goals for surgery are not related to the psychosis. In these cases, a plastic surgeon may work closely with the patient's psychiatrist.

Because the changes resulting from cosmetic surgery are often dramatic and permanent, it's important that you have a clear understanding of how surgery might make you feel — long before a procedure is scheduled.

Safety

If you're thinking about getting cosmetic surgery, it's your job to become an informed consumer. Selecting a qualified doctor, with a lot of training and experience in the procedure you'd like to get, is essential.

Ask the right questions to get the best treatment:

• In which state is the doctor licensed to practice surgery?
• Is the doctor board certified? With which board? The doctor should be certified by the American Board of Plastic Surgery.
• How many years has the doctor performed this type of surgery?
• Does the doctor have life-saving equipment and monitoring devices?
• Who administers the anesthesia? Ideally, this person is a board-certified anesthesiologist or certified registered nurse anesthetist.
• What are the risks of the procedure?
• What is the expected recovery for the procedure you're having?

Check out your Doctor's Credentials

If you're thinking about having your surgery in the doctor's office, there are advantages and disadvantages. The office might be convenient, private, and have more amenities than a hospital or ambulatory care center (non-emergency, outpatient facility). But it may not be safe. Don't assume that the doctor has the right credentials or the right equipment to keep you safe in the office.

Contact these organizations to find out your doctor's education, licensure, and board certification in addition to the doctor's or ambulatory care center's accreditation:

• Accreditation Association for Ambulatory Health Care, Inc. (AAHC)
  Accredits physician offices with surgical facilities.
  Phone: 847-853-6060

• American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)
  Certifies ambulatory surgery facilities and provides practice guidelines for surgeons working in ambulatory surgical facilities.
  Phone: 888-545-5222

• American Society of Plastic Surgeons (ASPS)/ The American Board of Plastic Surgery (ABPS)
  All of the surgeons listed through this service are ASPS members who are board-certified by the American Board of Plastic Surgery. They have graduated from an accredited medical school and completed at least five years of surgical residency, usually three years of general surgery and two years of plastic surgery.
  Phone: 847-228-9900

• Federation of State Medical Boards (FCVS)
  FCVS verifies medical education, postgraduate training, licensure examination history, board action history, and identity.
  Phone: 817-868-4043

Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder (BDD) is a serious illness in which a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose. A person with BDD tends to have cosmetic surgery, and even if the surgery is successful, does not think it was and is unhappy with the outcome.

Symptoms of BDD:

• Being preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose, such as acne, scarring, facial lines, marks, pale skin, thinning hair, excessive body hair, large nose, or crooked nose.
• Having a lot of anxiety and stress about the perceived flaw and spending a lot of time focusing on it, such as frequently picking at skin, excessively checking appearance in a mirror, hiding the imperfection, comparing appearance with others, excessively grooming, seeking reassurance from others about how they look, and getting cosmetic surgery.

Getting cosmetic surgery can make BDD worse. They are often not happy with the outcome of the surgery. If they are, they may start to focus attention on another body area and become preoccupied trying to fix the new "defect." In this case, some patients with BDD become angry at the surgeon for making their appearance worse and may even become violent towards the surgeon.

Treatment for BDD

• Medications. Serotonin reuptake inhibitors or SSRIs are antidepressants that decrease the obsessive and compulsive behaviors.

• Cognitive behavioral therapy. This is a type of therapy with several steps:
  1. The therapist asks the patient to enter social situations without covering up her "defect."
  2. The therapist helps the patient stop doing the compulsive behaviors to check the defect or cover it up. This may include removing mirrors, covering skin areas that the patient picks, or not using make-up.
  3. The therapist helps the patient change their false beliefs about their appearance.

Additional Information on Cosmetic Surgery

Breast surgery

Publications

1.   Breast Implants — This site provides information about breast implant studies, breast implant complications, and other resources. It also includes the FDA Breast Implant Consumer Handbook.

   http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/defaul...

2. Breast Lift (Mastopexy) (Copyright © ASPRS) — This publication provides information about breast lift surgery. It discusses who should get the surgery and provides detailed information on the procedure.

   http://www.plasticsurgery.org/Patients_and_Consumers/Procedures/Cosmetic_Procedures/Breast_Lift.html...

3. Breast Reduction (Reduction Mammaplasty) (Copyright © ASPS) — This publication discusses who should consider breast reduction surgery and what the procedure entails. This surgery is not recommended for women who intend to breastfeed.

   http://www.plasticsurgery.org/Patients_and_Consumers/Procedures/Reconstructive_Procedures/Breast_Reduction....

4. Breast reduction surgery: When less is more (Copyright © MayoClinic) — This online publication provides consumers with information about breast reduction. It includes why some women opt for it and what happens before, during, and after surgery.

   http://www.mayoclinic.com/health/breast-reduction/WO00021/UPDATEAPP=false&FLUSHCACHE=0...

5. breastimplantinfo.org — The Implant Information Project of the National Research Center for Women and Families provides information on breast augmentation, breast reconstruction, what to do if your implant breaks, and more.

   http://www.breastimplantinfo.org/

6. BreastImplantSafety.org — This site provides information on the safety, risks, and costs of breast augmentation, reconstruction, and implants. It also provides answers to frequently asked questions and links to additional resources.

   http://www.breastimplantsafety.org/

7. General Frequently Asked Questions (FAQ) About Breastfeeding after Breast and Nipple Surgeries (Copyright © Breastfeeding After Reduction) — This Web site answers common questions about breastfeeding after breast and nipple surgery, including whether it’s safe, how it will affect your breast milk, and when you should see your doctor.

   http://bfar.org/faq.shtml

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Botox

Publications

1.     Medication Guide: Botox™ — This fact sheet describes the uses and symptoms of Botox™. The publication also includes tips to consider when thinking about using Botox™.

   http://www.fda.gov/downloads/Drugs/DrugSafety/UCM176360.pdf

2.   Wrinkle Fillers: Information for Patients — This fact sheet explains the factors you should consider before choosing to have Botox™ or injectable cosmetic wrinkle fillers. It discusses the safety concerns, the risks, and who should not use these types of treatments.

   http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/CosmeticDevices/WrinkleFillers/ucm126662.htm...

3.   Wrinkle Relief: Injectable Cosmetic Fillers — This fact sheet demystifies the wrinkle-filling process, explaining which methods the FDA has approved, what the filler materials are made from, and what side effects you may experience. It also explains how wrinkle fillers differ from Botox™ injections.

   http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049349.htm

4. Botox™ Injections (Copyright © AAFPRS) — This fact sheet provides recommendations for those considering Botox™ injections.

   http://www.aafprs.org/media/media_resources/fact_botox.html

5. Injectablesafety.org — Injectablesafety.org is designed to provide consumer safety information about injectable cosmetic enhancement.

   http://www.injectablesafety.org/

= Indicates Federal Resources

Liposuction

Publications

1.   Liposuction — This publication explains what liposuction is, how it is done, and the pros and cons.

   http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118540.htm

2.   The Skinny on Liposuction — If you are considering liposuction, there are many factors to consider. This Web page discusses regulations, risks, and other factors about liposuction.

   http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049314.htm

3. Do's and Don’ts for Liposuction (Copyright © ASDS) — This fact sheet offers some tips to help achieve a positive result from tumescent liposuction.

   http://www.asds-net.org/DosAndDontsLiposuction.aspx

4. Tummy Tuck (Abdominoplasty) (Copyright © ASPS) — This online publication provides basic information about abdominoplasty, also known as "tummy tuck." It includes information about what to expect before surgery and afterwards.

   http://www.plasticsurgery.org/Patients_and_Consumers/Procedures/Cosmetic_Procedures/Tummy_Tuck.html...

5. What You Should Know About the Safety of Outpatient Surgery? (Copyright © ASPS) — There are many safety risks to consider before opting to have plastic surgery. This fact sheet discusses the important information to know before having surgery, such as the qualifications of your surgeon, the accreditation of the facility, and why it is so important to be honest about your personal and family health history.

   http://www.plasticsurgery.org/Patients_and_Consumers/Plastic_Surgery_FAQs/What_should_you_know_about_the_sa...

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Varicose or Spider Veins

Publications

1.   Fact Sheet — Varicose Veins and Spider Veins — This publication provides information about varicose and spider veins, including the cause, potential dangers, how to prevent getting them, and how they are treated.

   http://www.womenshealth.gov/faq/varicose-spider-veins.cfm

2. Dos and Don’ts for the Treatment of Spider and Varicose Veins (Copyright © ASDS) — This fact sheet offers tips on diminishing the appearance of varicose veins. It also explains what raises your risk for varicose veins, and what you can do to prevent them.

   http://www.asds-net.org/_ConsumerPage.aspx?id=932

3. Spider Vein, Varicose Vein Therapy (Copyright © AADS) — This brochure provides information on how spider and varicose veins occur. It also includes information on sclerotherapy, a method used to treat unwanted blood vessels.

   http://www.aad.org/public/Publications/pamphlets/SpiderVein.htm

4. Vein Treatments: What to Expect Before, During, and After (Copyright © American Academy of Dermatology) — This publication explains varicose vein treatment option, including how they work and what you should expect as a patient.

   http://www.skincarephysicians.com/agingskinnet/vein_treatments_expect.html

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Safety

Publications

1. Consumer Information (Copyright © ASDS) — This section of the American Society for Dermatologic Surgery’s Web site provides information for the public about different types of dermatologic surgery and patient safety.

   http://www.asds-net.org/consumerinformation.aspx

2. Cosmetic surgery: What to know beforehand (Copyright © MFMER) — This publication provides information on whether or not cosmetic surgery is right for you. It explains what the risks are, how to find a qualified surgeon, and what to expect from the consultation.

   http://www.mayoclinic.com/health/cosmetic-surgery/SN00006

3. Medical Tourism: Is It Safe? (Copyright © ASPS) — Consumers considering plastic surgery can choose among a wide range of providers and facilities, with some even offering low-cost “medical tourism” packages in exotic locales. This publication explains what to look for to keep safe.

   http://www.plasticsurgery.org/patients_consumers/patient_safety/Medical-Tourism.cfm?CFID=94652190&CFTOK...

4. Patient Safety Tips (Copyright © ASAPS) — This page provides links to articles about what to expect if you choose to undergo a procedure, to help you decide if plastic surgery is for you.

   http://www.surgery.org/public/safety

5. Plastic Surgery: Frequently Asked Questions (Copyright © ASPS) — This fact sheet provides information on what plastic surgery is, what the difference between cosmetic and reconstructive surgery is, how to learn if your surgeon has the appropriate credentials, how to learn about the facility's safety standards, and what other safety issues you should consider before having plastic surgery.

   http://www.plasticsurgery.org/Patients_and_Consumers/Plastic_Surgery_FAQs.html

6. Psychological Aspects: Your Self-Image and Plastic Surgery (Copyright © ASPS) — This publication provides information on proper and improper candidates for cosmetic surgery and plastic surgery for children, as well as tips on timing your surgery, adjusting to change after surgery, coping with post-operative depression, and handling critics.

   http://www.plasticsurgery.org/Patients_and_Consumers/Planning_Your_Surgery/Psychological_Aspects_Your_Self-...

7. Safety Tips for Patients Considering Cosmetic/Dermatologic Laser and Light Based Device Procedures (Copyright © ASLMS) — This fact sheet informs patients who plan to undergo cosmetic/dermatologic and light based device procedures of important safety precautions to take. It provides information about what questions to ask your doctor, what to expect from the procedure, and what to do if you experience complications.

   http://www.aslms.org/public/patientsafetytips.shtml

8. What You Should Know About the Safety of Outpatient Surgery? (Copyright © ASPS) — There are many safety risks to consider before opting to have plastic surgery. This fact sheet discusses the important information to know before having surgery, such as the qualifications of your surgeon, the accreditation of the facility, and why it is so important to be honest about your personal and family health history.

   http://www.plasticsurgery.org/Patients_and_Consumers/Plastic_Surgery_FAQs/What_should_you_know_about_the_sa...

Organizations

1.   Food and Drug Administration, HHS
2. American Board of Plastic Surgery, Inc.
3. American Society for Aesthetic Plastic Surgery
4. American Society For Dermatologic Surgery
5. American Society of Plastic Surgeons (ASPS)
6. Breastfeeding After Reduction (BFAR)

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Additional Information on Body Dysmorphic Disorder:

Publications

1. Body Dysmorphic Disorder (BDD) (Copyright © ADAA) — This article describes what BDD is, what the symptoms of BDD are, and how it is treated.

   http://www.adaa.org/gettinghelp/MFarchives/MonthlyFeatures(June).asp

2. Body Dysmorphic Disorder (Copyright © Mayo Foundation) — This fact sheet describes the symptoms and causes of body dysmorphic disorder. It also offers information about self-care and how to know when to seek medical advice.

   http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559

3. Body Dysmorphic Disorder (Copyright © The Cleveland Clinic Foundation) — This fact sheet explains what body dysmorphic disorder (BDD) is, what causes it, what the signs and symptoms are, and how it is diagnosed and treated.

   http://www.clevelandclinic.org/health/health-info/docs/3700/3776.asp?index=9888

4. Body Dysmorphic Disorder: Kids and Self Image (Copyright © Nemours Foundation) — This article for parents describes the causes of body dysmorphic disorder (BDD), the impact of the condition, and how it is treated.

   http://www.kidshealth.org/parent/emotions/feelings/bdd.html

5. More Information about Body Dysmorphic Disorder (Copyright © Butler Hospital) — This fact sheet discusses results from a research study on body dysmorphic disorder (BDD) conducted by Butler Hospital. It describes common BDD behaviors and how BDD affects a person's life.

   http://www.butler.org/body.cfm?id=239

Organizations

1.   National Mental Health Information Center, SAMHSA, HHS
2. National Eating Disorders Association

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Content last updated September 22, 2009.