The Stages of Cosmetic Surgery Acceptance

I recently met with a wonderful, insightful patient. She was in for a preop consultation for a cosmetic procedure. She was very inquisitive and clearly had done her research. I asked her why at this point in her life she had decided to have cosmetic surgery (the type of procedure is inconsequential for the purposes of this article).

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She provided me with a very profound description of the process she went through to ultimately come to this decision for surgery. She was unhappy with a particular area of her body but her first feeling on the subject of changing her body was that 1) God made me this way and I fear manipulating his/her grand plan. This progressed to 2) a feeling of guilt that cosmetic surgery was just a vain exercise in human emotions. Which in turn gave way to 3) rationalization in that she felt that money could be better spent on buying a house or other large purchase. But after a great deal of soul searching, she 4) realized that if this made her happy and gave her a renewed sense of self-confidence, then she should do it.


These are the patients I want! Some patients can rush into surgery, not truly considering all of the possible risks and unintended consequences of purely elective, cosmetic surgery. And with that rush to a decision, they can be unhappy with their decision postoperatively. But this patient had such an insightful and well thought out process of coming to her final realization, that she is more prepared than any educational video could provide.


Luckily, she also has a supportive family. They may not necessarily agree with her decision, but they still recognize that it is her decision to make. My discussion with the patient regarding her stages to cosmetic surgery acceptance reminded me of the stages of grief first described by Elisabeth Kübler-Ross that we learned about in medical school. In this model, when a person is faced with the reality of impending death from illness or the like, they will experience a series of emotional stages (not in any particular order): denial, anger, bargaining, depression and acceptance.


Of course cosmetic surgery should not conjure up the idea of death but clearly, there are similarities in the emotional process during any major decision in one’s life. And cosmetic surgery, while glorified and minimized as real surgery on TV, should always be regarded as a serious decision.The fact that this patient went through 1) fear (of the Divine), 2) guilt, 3) rationalization and 4) resolution shows that she is as emotionally prepared as possible to make the decision to proceed with cosmetic surgery.


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