Posttraumatic Stress Disorder: Reason for or Consequence of Facial Plastic Surgery?

Facial plastic surgery may be undertaken for a variety of reasons. Patients may have had traumatic experiences prior to surgery, such as an accident, a physical assault, or severe illness resulting in facial damage, and they may have used inadequate coping strategies. These patients usually appear suspicious toward medical staff and need special attention because they are at high risk of being unsatisfied with the outcome of surgery. Some patients may hold unrealistic assumptions about the outcome of plastic surgery. Yet other patients may suffer from complications of surgery and may thus experience facial plastic surgery as a trauma. In all such events these patients require special attention. First of all, careful exploration of traumatic experiences prior to surgery should take place even if this does not seem to be part of the standard treatment and requires additional time. Patients usually experience strong relief when their concerns are taken seriously, and treatment outcomes can thus be improved. Moreover, patients should be checked for acute stress disorder (ASD) or posttraumatic stress disorder (PTSD), and if so diagnosed, specialized treatment should be initiated postoperatively. Patients with ASD or PTSD will experience the surgical intervention and the treatment postsurgery with more confidence and greater satisfaction if the surgeon also engages in the psychosocial aspects of their history.