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Erica's WLS Book
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For Darn Good Writing Ask Erica
THE PSYCHOLOGY OF FACELIFTS
From childhood we're admonished that "Beauty comes from within," or "Beauty is as beauty does," and that we should "Grow old gracefully." On the other hand, we know from experience that a homely face means fewer dates and job offers, and too many wrinkles means we may be traded in for a younger model or permanently downsized. Those conflicting messages war with each other in our heads, making us feel guilty and crazy about wanting to change our appearance. Because of such mixed messages, women, and it's 90% women who have facial plastic surgery, are bound to face major conflicts when it comes to changing the way we look.
Women who seek facial plastic surgery fall into two broad categories–younger women, usually between the ages of 16 and 25, who go for nose jobs, chin implants, or other improvements to their facial features that enhance attractiveness, and middle aged women over 45 who go for collagen implants, skin peels and/or facelifts.
Often a trigger event propels a women to have facial surgery. "A trigger event can happen any time or any place to an adult of any age," says Helen Bransford, author of Welcome to Your Facelift; What to Expect Before, During and After Cosmetic Surgery. "It can be a comment from a stranger or a criticism overheard. It may be an awkward attempt at praise that fails and goes belly up. It can be an insult hurled in anger, or a passing glance in a well-lit mirror. It can even be seeing the positive results of a friend's cosmetic surgery. The trigger event forces us to suddenly reconsider our physical selves–and to assess ourselves objectively–as a new acquaintance might see us."
Bransford's research shows that most facelifts are triggered by a woman leaving a long marriage; trying to protect her position in a youth-oriented career market; having a relationship with a younger man; sudden discovery of the deterioration of her jaw line, neck and jowls; or distress about feeling younger than she looks. Younger women have surgery for basically the same reasons as older women, explains psychologist Tina Tessina, Ph.D., author of 10 Smartest Decisions A Woman Can Make Before 40. "They want to be more successful in a career or they want to attract men."
The good news is that wanting plastic surgery is not a sign of pathology, but quite the opposite–it's totally healthy and normal, according to Sonia E. Brody, Ph.D., a Los Angeles psychologist who works with plastic surgery patients. "I don't think there's anything crazy about wanting plastic surgery." Dr. Brody asserts. "Body image and self-esteem are inextricable. Appearance goes to the core of who we are and we can't deny that fact. I think that striving to look the best you can is perfectly OK. It's not vain or narcissistic in the least."
For those who worry about being excessively concerned with appearance, Dr. Brody reassuringly states, "Appearance concerns are on a continuum. Most of us are somewhat concerned. However, when your appearance becomes a preoccupation to the detriment of everything else in your life, that's pathological. The good plastic surgery patient is someone who is functioning well in all aspects of her life regardless of whether she feels her nose is too big or her eyes are drooping." Brody, who evaluates patients for surgery, looks at variables like: Is she stable? Does she have secure relationships and good family support? Or, is she on drugs or dysfunctional? She concludes that "A good citizen is a good plastic surgery candidate."
We are all fascinated by people who are so obsessed with cosmetic surgery that they deform themselves to fit some fantasy image, like the young woman who was determined to look like a Barbie doll, or the wealthy divorcee who wanted to have a face like a cat, or Michael Jackson's obsession with erasing his former face completely. Such plastic surgery junkies are suffering from a condition called "body dysmorphic disorder," and most ethical plastic surgeons avoid them like the plague. "Plastic surgeons screen patients carefully. They weed out seriously depressed patients, people who bring in pictures and say "I want to look like that," and those with unrealistic expectations in general," says Brody. "Red flags go up when a patient thinks that a nose job will result in finding Mr. Right and a career in Hollywood."
The ordinary facial surgery candidate, however, far from wanting repeated surgeries, is probably terrified of any surgery. She's seen or heard the horror stories– from the friend of a friend who died on the operating table, to the colleague who wound up with an ugly ski jump nose, to the movie star who looks like her face is frozen. Or she might have to deal with family concerns, such as a husband who insists "You look great the way you are, darling," or a daughter who worried that mom will wind up looking younger than her.
Dr. Tessina feels that anyone who is considering cosmetic surgery should have at least one or two counseling sessions to find out if she's clear about the emotional issues surrounding surgery.
What you can expect from counseling:
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Support. Expressing your fears, fantasies, and expectations prior to surgery can reduce anxiety and improve your satisfaction with the results.
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A realistic appraisal of your motives. You may need to examine your motives to make sure you're having surgery for the right reasons and don't have unrealistic expectations.
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Help dealing with friends and family. If you're facing criticism from others who think you shouldn't have cosmetic surgery, a psychologist will help you delve into what their motives might be. For example, your husband may be worried that if you look ten years younger, you'll leave him.
To find a counselor, first ask your surgeon. He may have someone on staff who counsels patients, or know someone who specializes in the field. If your surgeon can't refer you, go to a referral agency like the American Association of Marriage and Family Therapists. Ask for a counselor with experience in body image issues.
Dr. Tessina warns that the psychological ramifications don't end on the day of surgery. "Just like when you get totally different hairstyle, you may not feel comfortable immediately with what you see in the mirror" she notes. "Spend some time with the mirror and get familiar with your new face. Have pictures taken that you can look at. Eventually you'll experience that wonderful surge of energy and mood uplift that often accompanies cosmetic surgery."
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