[Psychological implications of esthetic surgery. Apropos of a study of 68 cases]

The candidate to cosmetic surgery is not, contrary to a too common idea, a frivolous creature trying to become more beautiful. He is generally a person with a physical disgrace that induces a frustrating sense of inferiority. The role of the surgeon is to help by removal of the disgrace. The operative indication is thus only psychologic and in some extreme cases, difficult to establish, because the surgeon is badly prepared to this role. A study was performed to understand better the motives and psychologic results of cosmetic operations. Sixty-eight candidates were chosen by the surgeon who considered their disgrace operable. All accepted a psychologic analysis. Following this they were divided into 3 groups: "adapted" (39), "worried" (21) and "perturbated" (8), according to the increasing importance of their emotional disturbances. None of these patients was really psychotic. In the great majority of cases (83%), the interviews with the psychologist disclosed parental difficulties during childhood, followed by a sensation of frustration and of insecurity. Of the 64 operated patients, 62 were reviewed by the psychologist. Fifty-four (87%) were satisfied with the result, among which 45 felt improvement in their psychologic state. Eight were disappointed. Among these, 7 had been classified as "worried" or "distressed". Only 2 patients had reasons to be dissappointed, the others focussed a depressive tendency on a minor and temporary unperfection. Cosmetic surgery thus produces the best psychologic results in "adapted" patients, but is also justified in "worried" or "distressed" patients as the majority will benefit from the operation. In these a careful psychologic contact with the surgeon is mandatory to diminish the postoperative emotional disturbances.