Are Surgeons Supposed to Psychologically Evaluate Their Possible Patients?

I had a rhinoplasty done cause i kinda didn't like my nose, but now i realize i didn't need the surgery (of course no one needs cosmetic surgery, but i felt like i wouldn't be my happiest without it). my old nose was just fine, and now im depressed every second everyday because my new nose looks worse than my original and is asymmetric thanks to my awful surgeon. I feel this all could have been avoided if he had done a psychological evaluation first. he must have just wanted my money.

Doctor Answers (2)

Plastic Surgeons do NOT do Psychological Profiles on everyone of their Patients

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Regarding: "I had a rhinoplasty done cause i kinda didn't like my nose, but now i realize i didn't need the surgery (of course no one needs cosmetic surgery, but i felt like i wouldn't be my happiest without it). my old nose was just fine, and now im depressed every second everyday because my new nose looks worse than my original and is asymmetric thanks to my awful surgeon. I feel this all could have been avoided if he had done a psychological evaluation first. he must have just wanted my money."

When a patient walks into a Plastic surgeon's office dressed like Napoleon, Jesus, or Abe Lincoln wishing a Nose job - the diagnosis is easy and every Plastic surgeon that I know would decline operating on that individual.

When a patient faces a Plastic surgeon during consultation and tells us that he/she is having the operation because voices in his/her head are ordering her to do it - All Plastic surgeons would decline such a patient.

When a single, narcissistic, immature young man comes in Rhinoplasty consultation with a folder full of Photo shopped pictures of how his nose can be more like Brad Pitt's telling you that had it not been for his nose he would be a Hollywood star and he picked you because you, Dr. Wonderful, are the BEST surgeon breathing Go's air - most Plastic surgeons would suspect Body Dysmorphic Syndrome and decline to operate on the patient

But when a patient who does NOT have a perfect nose and seeks one of us out to have his/her nose improved walks into one of our offices, few if any Plastic surgeons would demand that each such patient be first cleared by a psychiatrist before he/she had Cosmetic Surgery. This does not happen because few people who make themselves vulnerable to rejection by confiding their appearance in security to a Plastic surgeon would take kindly at being insulted by ALSO being called neurotic or worse by that surgeon.

You asked for the surgery PRESUMABLY after researching it and the surgeon. You agreed to the surgery. You thereby assumed the responsibility for everything that goes along with that procedure.


Memphis Plastic Surgeon
5.0 out of 5 stars 63 reviews

Psychological evaluation for body dysmorphic disorder or unreasonable expectations

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The vast majority of our patients would be insulted if we demanded a psychological evaluation. It sounds as if you are taking no personal responsibility for the decision. If you are of sound mind, in this country, then your informed consent to proceed with surgery is generally considered reason to proceed. However, that having been said, when "red flags" arise, and it appears that a person is being unreasonable in expectations or may suffer from Body dysmorphic disorder, then a psychological evaluation may be a prudent suggestion.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.