It may be a good idea in all cases to do a brief psychological
assessment and then do a further investigation where that would be indicated.
Psychological evaluation are generally not a requirement for plastic surgery but
there is debate suggesting more attention should be paid to this facet of
To qualify as a a cosmetic surgery patient one should be in good physical
health; good mental health; have a reasonable expectation of the procedure; be
capable of informed consent; and have the time needed to have the procedure and
Certain practitioners find psychological assessments very useful in patients
they consider may have psychological or psychiatric issues. Some examples would
be a patient who appears to have an exaggerated concern over a minor or
nonexistent problem or a patient that has undergone repeated surgical procedures
by other surgeons/ physicians. The concern is over what is called Body
Dysmorphic Syndrome (http://en.wikipedia.org/wiki/Body_dysmorphic_disorder).
Often the reason why these surgeons are performing these psychological
evaluations is in the best interest of their patients. Body Dysmorphic Syndrome
is most appropriately treated by medical treatment not surgical intervention.
It is important for a surgeon and the staff of the clinic to have the
opportunity to get to know a patient before rushing into surgery.
The consultation process in the practice of many other plastic surgeons
goes as follows
1) First consultation with a surgical consultant to discuss general information
about the plastic surgery procedure they are considering. A PA, RN, or NP will
review health history and medications.
2) Second consultation, generally takes place a week or more after the first
consultation. During this consultation, I will meet with the prospective patient
and discuss the particulars of their surgery including recovery. This is an
hour long consultation.
3) Patient will receive a quote for surgery and if the patient desires, surgery
will be scheduled. Busy plastic surgeons have a schedule that requires a wait
period of almost always at least a month and in some cases much longer
4) Pre-operative appointment. This is the final meeting with surgeon and patient
prior to surgery to review surgery and recovery and answer any questions.
This process allows patients to get to know their plastic surgeon well and visa
versa. If there is doubt about a patient being a good candidate for surgery for
any reason, we have many opportunities to discover this. Some patients perhaps
should wait on surgery.
Sometimes people are in the very early healing process of a divorce or death of
a spouse, others feel pressured by another person to have surgery.
Still other people think that plastic surgery is an answer to all their
problems. Sometimes it take a little time to get to know someone before some of
these issues are revealed.
Unfortunately, too many physicians practicing cosmetic surgery seem more
interested in getting a patient pre-qualified for financing and scheduling
surgery as quickly as possible. In fact, some physicians even offer reduced
rates for scheduling and paying for surgery by a particular date, creating
additional pressure for a prospective patient. In this scenario, there is a
higher likelihood that a person who is not psychologically prepared for surgery
will end up on the operating table. Be wary.
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