Many patients expect plastic surgery will improve not just their bodies but also their mindset by increasing their self-esteem or confidence. Plastic surgery can be life-changing, but it's not magic.
Plastic surgeons are talking about mental health with patients before ever stepping into the operating room to make sure their expectations will match the actual results. It's not about trying to diagnose a mental health issue but making sure you understand and are up for a mentally challenging journey.
Ultimately, patients who choose the right procedure for their body can be incredibly satisfied with their new look. Yet, plastic surgeons want you to know upfront there can be some wellbeing stumbling blocks for any patient, even if you consider yourself mentally tough.
Final results take time
While you may see a marked difference immediately after a plastic surgery procedure, it's critical to remember final results aren't immediate and often take longer than you expect. Bruising and swelling can last for weeks. It can be months, sometimes more than a year, before the ultimate outcomes appear.
"You're going to go through stages and changes," said Jerry Chidester, MD, a board-certified plastic surgeon in South Jordan, Utah. "You're not going to all of a sudden just wake up to this perfectly beautiful nose. It's going to take 12 to 18 months."
Experiencing regret about the decision to have the procedure during the early stages of healing is normal.
"To make a point, I jokingly say, 'You're going to hate me for about a month, and then you'll love me forever,'" said Ryan Neinstein, MD, a board-certified plastic surgeon in New York. "I tell them they are going to have some tough moments in recovery. They are likely to say to themselves, 'Why did I do this? I look ridiculous. I look worse. I'm in pain. I don't know why I paid for this.' You will have a down moment."
You'll need to be patient while you wait to see your final outcome.
Rest and recovery aren't as easy as they sound
You may find it difficult to rest and restrict your movements for several weeks as you recover.
"I find that very active patients have a very hard time mentally in their recovery period," said Kelly Killeen, MD, a board-certified plastic surgeon in Beverly Hills, Calif. "People that are used to being up and around and moving their body every single day, they have a really hard time sitting still and being present in their body and not moving. These patients have a hard time no matter what's going on in their recovery because it's not their normal."
Plastic surgery can't change some realities
It's important you consider your relationship with yourself and others before deciding to have plastic surgery. The outcome may not be what you hope unless you are doing it for the right reasons.
"When people say things like, 'This is going to make my husband love me again. This is going to help me find a boyfriend. This is going to make me want to work out.' That's not what surgery does," said Dr. Killeen. "Surgery makes an objective change to your body. It can't make you feel differently about your body, and it can't make other people feel differently about you."
Consultations are key for surgeons so they can suss out why you are choosing to have a certain procedure.
Understand while you can make changes to your body it is unlikely to make changes to someone else's attitude towards you.
Getting to know the new you
Obviously, you're already familiar with how you looked before the surgery. Now, there is a different face or figure reflected back at you in the mirror. It can take a bit of time before your eyes fully recognize the new you.
"You could be very excited to change some feature that wasn't to your liking, but you sometimes forget that feature was how you identified for decades, and maybe all of a sudden it's different," said Dr. Killeen. "I think some of the mind games that go on when you're sitting still not doing your normal things, and dealing with these changes can be really traumatizing for the first month or two after surgery."
Improvement, not perfection
Intake paperwork for many plastic surgeons now includes more than just your name, height, weight, medications and previous surgeries. They want the bigger picture of your wellbeing.
Plastic surgery may also worsen existing mental health problems for some patients. It's important to remember procedures can improve your appearance but can't perfect it.
"That's really some of the magic of plastic surgery that they don't teach you in training is how to evaluate a patient and figure out whether they should have a surgery," said Dr. Killeen. "The key is having an understanding of whether the surgery is the right thing to do for that patient."
Setting realistic expectations
The best fit is when you have an understanding of what a procedure can and can't do.
"Patients that ask good questions about the risk of surgery, complications of surgery, board certification – those are all green flags because, to me, they've done their homework," said Dr. Chidester. "They are serious about it. They're invested in it and they can get a result that is reasonable."
Difficulties can happen when expectations don't match outcomes.
Expect to answer questions not only about your health but also your mental health, sometimes even before the consultation.
"We call our patients ahead of time, maybe six months in advance of their consultation," said Dr. Chidester. "We go through their medical history, but we also ask on a high level about mental health. We actually do ask, 'Have you ever been diagnosed with body dysmorphia? Have you ever been treated for anxiety or depression?'"
Patients will then be referred to a mental health professional if the surgeon has any concerns before scheduling the procedure.
"They need help from the right people, and plastic surgeons are not the right person for that," said Dr. Killeen.
No ifs, ands or buts
You may be told no if a procedure can't meet your expectations.
"I say no all the time," said Dr. Killeen. "I think most plastic surgeons really work hard to not do surgery on patients that we don't think it's going to benefit or it's not going to give them what they think it's going to give them."
Although it's rare, sometimes it comes down to a day of decision.
"It's hard to do," said Dr. Chidester. "Even up to the last minute, if something doesn't feel right, you have to say no."
The right results do impact wellbeing
Yet, results often can substantially change your wellbeing for the better.
"There's nothing better than that first postop appointment when you take their bandages off, and they jump out of the chair and look at the mirror, and the tears come to their eyes because they're so excited about what they see," said Dr. Killeen. "The positive impact from these surgeries is massive."
It can also change how you interact with the world.
"A lot of patients tell me the lens with which they see the world is different," said Dr. Neinstein. "They have a true sense of mind-body connection, something they couldn't do with diet or exercise, and they truly enjoy living their life more."
Patients can experience a range of emotions after surgery, ranging from regret to uncertainty to happiness. It's important to know that surgery can be just as much of a mental journey as a physical one.
The best to ensure both your physical and mental wellbeing when considering a plastic surgery procedure is to connect with a board-certified plastic surgeon who is an ASPS member for the best results.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.
