What's the Strangest Thing Anyone Has Asked You During a Consultation?
Doctor Answers 9
A certain percentage of patients have thought disorders.
Dear Real Beauty News
The strangest thing is our attachment to the cultural myth of the extreme make over: Getting the right combination of surgeries will somehow transform my life so that I will be loved, sought after, and ultimately rich and famous. This is the promise of shows like Extreme Make Over, The Swan, and even the 15 minutes of fame of individuals featured in Dr. 90210. It is for good or bad that part of the job the cosmetic surgeon is to also be the psychotherapist and try to figure out the dynamics of what is going on. We don't do our patients any favors by rushing to get them booked for surgery.
For many individuals, it is apparently much less painful to go under the knife than to confront the psychological demons with a psychotherapist. Yet the insecurity that makes one think that a spouse may leave you if you don't get breast surgery and liposuction does not go away after surgery. The feeling that everyone in a social setting is whispering about how your eyelids look (even though there is basically nothing wrong with them and no one cares anyway) that a person suffering body dysmorphic disorder experiences is not going way just because one gets eyelid surgery.
Even normal vanity that motivates people to get the facelift, the eyelid surgery, or services like BOTOX and Restylane only slows the clock. The key is a realistic understanding of what is and is not possible. Cosmetic surgery is not a panacea for depression, adult issues of early child abuse, body image problems, or disorganized psychological thinking. The best cosmetic surgeons approach our patients with compassion. The unrealistic or inappropriate request should not be used as grist for the mill. We understand these requests for what they are: a misdirected attempt at helping one's self to resolve a psychologically troubling issue. The ethical cosmetic surgeon attempts to discover these misdirected motivations to have cosmetic surgery and direct the individual to get appropriate help. The fact that this type of individual may get inappropriate cosmetic surgery is a testimonial to the free market reality that not all surgeons spend the necessary time to get to the bottom of their patients reasons for having surgery. The reason for this may be lack of psychological sophistication or the rather obvious financial motivation
Interesting questions during a consultation
The most frequent strange question we receive in our office practice is whether I've ever had my nose done (the answer is no). The other strange (but valid) question that has come up is that when patients can resume normal sexual activity after their rhinoplasty without fear of hurting, bumping their nose.
I once had a professional gambler see me in consultation. He wanted to totally change his physical appearance because he was being monitored in Las Vegas and Atlantic City casinos. There was no limit on the amount of surgery, but he wanted a guarantee. Needless to say the surgery was not done by me. I don't know if he changed professions or hired a Hollywood make-up artist, but I never saw him again.
Interesting Consultation: Sisterhood of the Traveling Pants (Girdle)
Dear Real Beauty News:
Our patients have given us so many great anecdotes and comments. A delightful story came from one of our patients during her pre-operative visit. She told us she was a member of The Sisterhood of the Traveling Girdle. The story is on our blog February, 2009.
Wanted to Look Better in Her Coffin
I once had a 78 year old lady who came in for a Rhinoplasty Consultation. I asked her why she had waited so long and she replied that she had always wanted a different nose and now that she was getting up in years she wanted to make sure she looked good in her coffin.
I think one of the strangest discussions involved a patient who was to undergo breast augmentation. I had seen her initially, and again in a pre op visit and throughout each, came to agreement as to goals and her size choice.
The morning of surgery, she told me that she had been thinking all night, and had come to the conclusion that "she was going to pay a lot of money" for the procedure and actually really decided that she wanted to be as "big" as possible because she felt it would be "ok if they looked fake"! She wanted everyone to know she had it done!
That one was pretty good.
I consulted with a vet who came back from Iraq with extensive burns, skin grafts and scars from an IED explosion. His face was a confluence of thick ugly scars and skin grafts that distorted his (remaining) features. His nose was partially reconstructed. As I sat with him and mentally started envisioning his reconstruction he pointed out why he was there. He had a nubbin of skin that had puckered up next to his nose from one of his previous 10 or 11 surgeries that he didn't like. The scars didn't bother him; the nubbin drove him nuts.
I removed the nubbin, he was one of my happiest patients.
Want to look good for Funeral / Tape Facelift
I had a patient who had been diagnosed with intra-ductal breast carcinoma and had undergone mastectomy as well as chemo. Sadly for her the cancer had recurred and she had for all intents and purposes failed additional treatments. She had been given the very sad "six months to live" news by her oncologist.
When I met with her and her family she was still in health and good spirits overall. She brought both of her children and husband with her and wanted a facelift so she would look her best for her funeral -- she didn't want loved ones to see that cancer had "beat her up." She was very clear minded and all of her family supported her.
For the obvious medical reasons, I refused to do the surgery. The ethical concerns were evident as well, but I have to admit the sincerity with which she presented herself and the universal support her family gave her, made her request compelling but unfortunately unfullfillable. I did advise her on some skin care regimens that would improve some of the blemishes that had occurred on her face during her treatment.
A very unsual patient I consulted with looked pretty good when I first saw her -- it wasn't until I examined her that I saw she had very carefully taped her neck skin and jowls back with adhesive and tape to the back of her neck. She had been doing this for the last ten years and wanted the exact same look surgically. Naturally, this was one consultation that was kindly declined.
Two strange comments come to mind.
I had performed hair restoration on a gentleman who was bald in the front, top and back. He fought forest fires in the northwest for many years and when the process was completed and all of the hair had grown in to the length he liked (abut 5" at that time) he said to me:
"It's the first time in 20 years I could feel the wind in my hair!"
Many plastic surgeons probably have gotten this one. I have had it several times:
"What do you mean you are going to give me a scar! I thought you were a plastic surgeon!"
To which I responded: "I am a plastic surgeon, not a magician!"
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.