Desire For Plastic Surgery May Be More Than a State of Mind

Course Allows Plastic Surgeons to Better Identify Patients With Psychological Disorders

SAN DIEGO – While plastic surgery is great for the majority of the population, some people’s desire for plastic surgery goes beyond wanting to enhance or maintain their appearance. Rather, a small minority of people may be driven by an obsession or psychological disorder. The focus of an educational course at Plastic Surgery 2003, the annual scientific meeting of the American Society of Plastic Surgeons (ASPS), Plastic Surgery Educational Foundation (PSEF) and the American Society of Maxillofacial Surgeons (ASMS), will help plastic surgeons learn to better identify patients who may not be good candidates for plastic surgery. “Identification and Assessment of Psychiatric Disorders in Cosmetic Surgery Patients” will be offered on Sunday, Oct. 26, 2003 from 3:30 to 5:30 p.m. at the San Diego Marriot Hotel/Marina.

“Approximately seven to 15 percent of people requesting plastic surgery suffer from Body Dysmorphic Disorder,” according to David Sarwer, Ph.D. of the Center for Human Appearance at the University of Pennsylvania. “If we couple those individuals who are profoundly depressed or have substance abuse problems, we are potentially looking at 15 to 20 percent of surgery candidates whose motivation for surgery warrants careful attention.”

“ASPS and its members are dedicated to the safety and satisfaction of plastic surgery patients, which is why ASPS proactively chose to host this educational course at our annual meeting,” said ASPS President James Wells, MD . “We believe assessing any and all issues that may affect our patients’ well-being, including psychological factors, is part of providing total patient care. By holding this course and discussing the matter, we will help our members to best manage the issue in their plastic surgery practices.”

In order to serve their patient’s best interests, Dr. Sarwer suggests plastic surgeons collect a psychiatric history and basic psychiatric status on each patient. “It’s no different from asking about the patient’s cardiac history,” said Dr. Sarwer. “A psychiatric referral should be treated the same as a referral to any other medical professional. The more information we have about the patient, the better we can ensure their health and a positive outcome.”

Body Dysmorphic Disorder is a preoccupation with a slight or imagined defect in appearance. Often, the preoccupation creates serious disruptions in the person’s daily activity. In fact, many people with this illness have difficulty maintaining a job or trouble sustaining social relationships.

“Even though there are patients with Body Dysmorphic Disorder who have a job or are in a romantic relationship, the disorder significantly impacts their quality of life,” said Dr. Sarwer. “These patients are convinced they will feel better about themselves after the surgery, but they actually feel the same, if not worse.”

Sarwer and Wells agree that if a plastic surgeon feels one of his or her patients may have a psychological disorder, then that plastic surgeon should help that patient get appropriate professional help.

ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. ASPS represents physicians certified by The American Board of Plastic Surgery (ABPS) or The Royal College of Physicians and Surgeons of Canada.

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