Plastic Surgery | Cosmetic | Reconstructive

Does plastic surgery improve health and increase longevity? Several studies over the years have demonstrated that some cosmetic or reconstructive surgery may have profound physical, psychological and emotional effects that create greater happiness, improve quality of life and increase the will to live. Of course, overindulgence in cosmetic surgery may be not only unattractive but also unhealthy.

Plastic surgery uses

The difference between plastic, cosmetic, aethetic, elective and reconstructive surgery is that reconstructive surgery may be utilized for health problems as well as aesthetics. There is a debate as to whether or not some elective surgery may also serve for health purposes, as studies have shown that some individuals undergoing plastic surgery benefit from improved psychological and emotional health. There are many reasons people elect to "go under the knife," whether for cosmetic or reconstructive purposes, including the following:

The methods for skin smoothing to remove wrinkles and any scarring from acne or other condition include Botox injections, chemical peels, dermabrasion, injectable fillers such as collagen, laser therapy and sclerotherapy for varicose veins. The most common cosmetic or aesthetic surgery involves the breast, while nose jobs and liposuction constitute the next most popular procedures.

Benefits of plastic surgery

Breast reduction and reconstruction surgery has been found to be helpful in relieving physical and psychological pain and discomfort, which in turn improves health overall, including in enjoyment of life and relationships. In an article entitled, "Surgical Breast Procedures Provide Physical and Psychological Benefits for More Than 150,000 Women," the president of the American Society of Plastic Surgeons, Walter Erhardt, MD, states:

The detrimental health effects of large and heavy breasts that can be relieved through surgery include "skeletal deformities and breathing problems," as well as social and psychological handicaps. Cosmetic breast augmentation and surgery to correct asymmetry or different breast sizes have also been shown to produce beneficial psychological effects and to improve quality of life.

In many cases of breast reconstruction after mastectomy there is a marked improvement in the quality of life and, therefore, a psychological benefit that would lead to a more positive outlook and potentially increased longevity. "Breast reconstruction after a mastectomy, today is considered the best choice to improve the quality of life for the patient."2 A study published in 2003 cautions, however, that health professionals "should be careful of assuming that breast reconstruction necessarily confers psychological benefits compared with mastectomy alone."3 Another study published in the journal Plastic and Reconstructive Surgery concluded, "Although overall satisfaction with breast reconstruction is undoubtedly determined by multiple and complex clinical, emotional, and psychological factors, this study suggests that postoperative complications are a particularly important indicator of dissatisfaction with reconstruction."4 In other words, those who experience minimal discomfort after the surgery are likely to experience the great psychological and emotional benefits from breast reconstruction.

Women who had abdominoplasty or the removal of excess skin on the abdomen reported feeling "less self-conscious in general and during sex, and became less depressed."5 Other studies have shown that adolescents - a group highly vulnerable to the ill effects of being teased based on their looks - strongly benefit psychologically and emotionally from cosmetic and reconstructive surgery, particularly those who undergo breast surgery. It is cautioned, however, that only those who already possess psychological maturity and the appropriate reasons for having elective surgery are positively affected. Those adolescents who are not mentally or emotionally mature or stable may actually worsen with plastic surgery.6

In early 2006, a study was published in the Aesthetic Surgery Journal entitled, "Women's Self-Image and Sexual Satisfaction Increase After Cosmetic Surgery," which provided data demonstrating that women who "undergo common elective cosmetic surgery procedures not only feel better about their bodies, but also have higher degrees of satisfaction with their sex lives, including ability to orgasm."7 The most common procedures in this study included facelifts, nose jobs, breast augmentation and lift, and body countouring such as liposuction and tummy tucks.

Studies have shown that men and boys who undergo successful genital and penile correction and reconstruction experience fuller lives.8 Medical techniques to correct a malformed or malfunctioning penis that may not have been considered highly successful - such as penile implants, lengthening and girth-increasing surgeries, with their attendant difficulties - nevertheless bestowed important psychological effects on men: "Positive comments emphasized the psychological benefits of renewed masculine self-esteem, repair of humiliation, and reduction of marital guilt."9

A study published in Rhinology determined that some people who receive nose jobs which meet their pre-operative expectations experience noticeable "psychosocial" benefits.10 Other plastic surgery such as following burns or to correct other facial and bodily deformities is certainly felt by both patients and physicians to improve quality of life. Concerning reconstructive ear surgery, an American surgeon concluded, "A survey of 1000 microtia patients indicates that surgically constructed ears remain durable, withstand trauma well, and provide consistent emotional relief and psychological benefits through the repair."11

Other reconstructive facial surgery such as that done by the organization "Operation Smile," which corrects cleft-palate deformities in poor children worldwide, can produce extremely positive results. Such deformities can severely impact children and their families in a negative manner, not only psychologically but also physically. Therefore, correcting these deformities as best as can be done is imperative for improving the well-being of these children and their families. The work done by Operation Smile and other such organizations may also have a positive effect on the health and longevity of the doctors, nurses and others involved.

The August 2005 issue of Plastic and Reconstructive Surgery included a study entitled, "Health-Related Quality of Life in Children with Craniofacial Anomalies," which outlined the benefts of reconstructive surgery for the facial deformities in children.12 This surgery included correcting deformities of the face, neck and skull, and was determined to provide gains in "the functional tools that will help [these children] lead a fuller life."

It was found that children with deformities who underwent reconstructive surgery benefited from not only improved social relationships but also learning enhancement.

The startling concept of facial transplants is becoming a reality for the very small percentage of people who need them in order to gain improvement in the quality of life, including a reduction in shame and isolation associated with disfigurement. As concerns their uses, "Given the complexity of human facial movements," states plastic surgeon Dr. Pat McMenamin, "what you're look at is taking a burn patient and getting them back to social acceptance."14 Doctors caution that such patients would still appear disfigured to a degree, based on the state of the technology and the complicated nature of the procedures. A complete facial transplant - essentially wearing a dead person's face - could be very traumatizing for the patient.

Other than financial concerns, procedural limitations and possible side effects, there is little reason for an individual with a deformity to suffer the often horrendous physical, psychological and emotional effects of such deformity, if relief may be had through plastic surgery. Moreover, the suffering of such individuals is not limited to themselves but spreads itself to their families, caregivers, teachers and society at large.

In a study entitled, "Quality-of-Life Outcomes after Cosmetic Surgery," the authors concluded:

Psychological problems present prior to cosmetic surgery, which may show improvement because of such surgery, include anxiety, depression, hypochondria, lack of self-confidence and sleep disorders.

Complications and contraindications of elective surgery

Physical side effects such as pain, bleeding, bruising and scarring are routinely cautioned as risks in undergoing plastic surgery. In addition to these, complications that occur in a small percentage of patients include:

In some studies women with breast reduction or implants showed an increase in the risk of suicide, but this risk may be attributable to psychological difficulties present prior to the surgery.16

Cosmetic surgery is contraindicated if the patient suffers from obsession with, and a distorted image of, a body part or parts that may in fact not be as egregious as he or she believes. A study published in The Medical Journal of Australia entitled, "Does cosmetic surgery improve psychosocial wellbeing?" concluded: "Some people are never satisfied with cosmetic interventions, despite good procedural outcomes. Some of these have a psychiatric disorder called 'body dysmorphic disorder'."17

In an article concerning medical malpractice, Dr. Mark Gorney of Stanford University discussed the "Psychological and Psychiatric Aspects of Modifying Anatomy," including characteristics of the best candidates for elective aesthetic surgery. Dr. Gorney stated that of the two characteristics that disqualify a patient for surgery, physical unsuitability and psychological inadequacy, "the latter is by far the more important, [and] the surgeon must differentiate between healthy and unhealthy reasons for seeking aesthetic improvement."18 In the case of psychological inadequacy, Dr. Gorney suggests that the "anxiety expressed over the perceived deformity is merely a manifestation of inner turmoil that is better served by a psychiatrist's couch than a surgeon's operating table." Gorney's study basically concluded that a "strong, motivated patient has less pain, a better postoperative course, and a significantly higher index of satisfaction regardless of result." Numerous factors can positively or negatively affect the outcome of cosmetic, aesthetic, plastic and reconstructive surgery, including, as in Dr. Gorney's survey, "secretiveness," "familial disapproval," "personal dislike" and "surgiholism."

In the case of reconstruction and transplantation, there are risks from the continued use of immunosuppressive medicines that prevent the patient's body from rejecting donor tissue and organs. In many instances, skin tissue can be grown on the patient's own body, minimizing both the risk of rejection and use of immunosuppressive drugs. In the case of severe deformities, the risks of transplant may outweigh the poor quality of life being endured.

The type and provider of cosmetic, plastic or aesthetic surgery being considered should be reliable and approved. People electing to have plastic surgery may be in a vulnerable emotional and psychological state, desperate for relief from their perceived maladies, and are advised to be thoughtful about what procedures and surgeons they choose. Cost, of course, is always a factor in whether or not to have elective surgery, particularly of the cosmetic nature where physical function is not an issue.

When considering whether or not to have aesthetic surgery, it is wise to keep in mind the risk/benefit ratio that may help in determining whether or not the possible benefits will outweight the potential risks. In other words, a person electing for aesthetic surgery needs to be firm but realistic in his or her own decision. Although studies show elective surgery can be very helpful in establishing a decent quality of life and a fuller life, one cannot put all of one's eggs in one basket and expect miracles that lead to fairytale endings. Nevertheless, a wide variety of plastic, cosmetic and reconstructive surgery procedures are available that, when used judiciously and performed by a competent and qualified practitioner, may in fact improve health and increase lifespan because of positive psychological effects.

Does Plastic Surgery Improve Health?

Plastic surgery uses

Benefits of plastic surgery

Complications and contraindications of elective surgery