Do you ever refuse to perform cosmetic surgery on a patient with a history of depression, and if so, what are your criteria?
Refused to Perform Cosmetic Surgery on Patient with Depression
Doctor Answers 6
Depression and cosmetic surgery.
Yes, I have refused to operate on patients but only when, in my opinion, their depression is associated with :
- unrealistic expectations or a
- negative body image that will interfere with their acknowledging the results to be obtained i.e., body dysmorphia, or a
- compulsive habit such as eating disorder, or picking, or trichotillomania. etc., that may have a negative impact on their outcome
Depression is not a contraindication, unrealistic expectations are
Unfortunately, depression is incredibly common in our population. Depression is increasingly prevalent given the brutal economic climate this country has been faced with. However, I have had many patients with well controlled depression on newer generation antidepressants who have done well with surgery and proceded to live happy, healthy lives. A patient who is profoundly depressed is not a good candidate for surgery and needs to be controlled pharmacologically prior to having surgery.
From a psychological standpoint, a specific contraindication to cosmetic surgery is a patient with unrealistic expectations. If a patient voices a series of expectations which cannot be fulfilled with surgery, and cannot be convinced otherwise, I will not do the surgery. The majority of patients are clear about their expectations and I am clear about what I expect to occur. Occasionally, unrealistic expectations are not revealed to a surgeon, and this is where problems tend to occur.
History of Depression Does Not Prevent Cosmetic Surgery
There is no solid rules about operating on patients with a history of depression. It is noteworthy that even patients without a history of depression can experience some degree of depression after cosmetic surgery. This will quickly resolve as the end results of improvement appear. While I operate on patients with a history of depression and on anti-depressant medications, the patients must be doing well otherwise. In some cases, I will speak with a patient's counselor or psychiatrist to ensure that hey are doing well, have a good support system, and are considering cosmetic surgery for the right reasons. Patients who think cosmetic surgery will cure their depression are not good candidates for surgery.
People with well controlled depression can have cosmetic surgery.
Of course, the particular details of your condition are very important. But we often operate on people who are on anti-depressants and whose depression is well controlled. If in doubt, I speak with their therapist.
Cosmetic surgery should not be treated as a mood elevator.
Cosmetic surgery in depressed individuals
Many patients seeking cosmetic surgery have a history of depression and are on medications for it. If their condition is stable and if they have a good support system and if they are stable and good candidates for a nice result, it is reasonable to proceed.
Do you EVER refuse to perform cosmetic surgery on a patient with a history of depression
It is WAY easier to operate on everyone who walks into our offices without asking any question. And many Plastic surgeons do just that.
Increasing economic pressures may have shortened our consultations and for some of us, some patients begin to look like they have a procedure price tag on their foreheads.
The first question an ethical Plastic surgeon SHOULD ask is :" IS WHAT HE / SHE ASKING FOR A REALISTIC / REASONABLE REQUEST?"
If the answer is "YES" - we should be asking ourselves : "CAN I, AS A PLASTIC SURGEON, DELIVER SUCH A RESULT ?"
If the answer is again "YES" - another important question should be asked by the Plastic surgeon : "I KNOW I WILL BENEFIT FINANCIALLY FROM PERFORMING THE OPERATION. BUT, WILL SHE BENEFIT OR BE HAPPY WITH SUCH AN OPERATION? "
I have no problem operating on patients with clinical depression as long as it is medically controlled.
As a Plastic surgeon, I would NOT want to operate on a patient who THINKS Plastic surgery would change their lives because it never does. But, having depression, in itself, should not disqualify you from having cosmetic surgery.
Peter A Aldea, MD