cosmetic-surgery recipients had mental-health histories, and 18 percent were taking psychiatric medications, compared to five percent of non-cosmetic patients. In Canada, at the University of British Columbia’s Perfectionism and Psychopathology Lab (where perfectionism is classified as a maladaptive personality trait associated with crippling social and personal problems that can even lead to suicide) one recent study found that 79 percent of “extreme perfectionists” had had cosmetic surgery.
“Psychiatric evaluation is important, especially in severe body dysmorphic disorder—an obsessive preoccupation with a perceived physical-features defect—where a person may make repeated requests for unwarranted cosmetic procedures. It is also a legal requirement for sex-change operations, in conditions such as gender identity disorder, ” says Dr Roshan Jain, senior consultant psychiatrist at Apollo Hospitals, Bangalore. “Many individuals may be seeking surgical solutions for deep-seated psychological problems. The root cause of some of these problems can be neglected or discontinuous upbringing, or even sexual or physical abuse. This can impair development of the self, of identity and lead to a sense of inadequacy. Abuse can also be as simple as a plump kid being bullied in school—which can cause an enormous dent in self-esteem.”
Increasing cultural fixation with youthfulness as well as exposure to idealized representations of beauty, too, create distorted perceptions in people, what with growing media emphasis on slimmer bodies or fairer skin. “Notions of going size-zero are promoted all over,” adds Dr Jain. “Our idea of good appearance is often ill-perceived.”
A dangerous addiction
Indeed, for many, cosmetic surgery can become addictive. A young woman in her mid-twenties, who had been physically and sexually abused as a child, was referred to Dr Jain by a cosmetic surgeon. She kept going back to the surgeon for various procedures. First, she requested hymenoplasty. She then came back for a septoplasty, done to straighten the nasal septum. She also kept requesting other facial procedures.
“After counselling her, it became apparent that she misperceived being abused for her “ugly looks” and perhaps was seeking a closure to her past, surgically,” says Dr Jain.
“She needed long-term exploratory psychotherapy more than surgery.” Because of all this, the best cosmetic surgeons are careful while accepting patients. Dr Murarka recalls a handsome male model in his twenties, who had come to him for a rhinoplasty. “He was delighted with the result,” says Dr Murarka, “and then asked for surgery on his chin and chest. We had to turn him down.”
Dr S. Raja Sabapathy, immediate past president of the Association of Plastic Surgeons of India (APSI), who is also head of plastic surgery at Coimbatore’s Ganga Hospital, opines that 70 percent of men coming for aesthetic procedures need psychological evaluation because even after the surgery, the original problem of inadequacy remains unsolved. “They blame
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