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Archive for February 3rd, 2010

The news has been full of reports of Heidi Montag-Pratt and her claim to have undergone 10 separate plastic surgery procedures in one day.  That includes rhinoplasty (a nose job), breast augmentation, lip collagen injections, chin reduction, and god only knows what else.

“I’m beyond obsessed,” is the frequently cited quote.

It certainly sounds like it.

The death of Michael Jackson also put plastic surgery into the news this winter.  Fans – and others – pored over photographs documenting the strange transformation that rendered him unrecognizable from his early days as a child star.

The question, amid all this hullaballoo, is whether there’s anything really wrong with plastic surgery.

A person clearly has a right to alter his appearance, and if he thinks the results are beautiful, that’s his business.  Plenty of people choose to cover themselves with tattoos, or get a multitude of piercings.  There isn’t much difference between that and having your nose straightened or your chin or breasts made larger or smaller – is there?

Not really.

We all have the right to look however we want to look, and I’m fine with plastic surgery – unless it becomes an addiction.  That’s when it stops being about controlling your appearance and making yourself happy, and starts to become a compulsion that can make you miserable.

The definition of an addiction is simple:

1) you no longer receive the same pleasure from the activity; and

2) you lose control over it.

That’s where the trouble starts.

It can feel very good to have plastic surgery.  If there’s some funny little quirk of your appearance that bothers you, and you finally get it addressed, it can be immensely liberating.  Several of my patients have had “boob jobs” and they might laugh about it, but say in all seriousness that it made them feel more confident and that they’re happy with the results.  One of my patients had a face lift, and was similarly pleased with how it made her feel – more youthful, less wrinkly, more confident.

The problem is that something that feels very good can become addictive if you become fascinated with that good feeling and try to recreate it again and again.

Along the way, you can ignore underlying problems.

There is a tendency, when you don’t feel good about yourself, to locate what bothers you in one particular physical feature.  That bump on your nose, or smallish bosom, which others hardly notice, might be inflated to enormous significance to you – until you become convinced that you would feel entirely better if you could just correct that one problem.

Initially, it might work.  At last – bigger breasts.  Or a smaller chin.  Or fewer wrinkles.  Or whatever.  Other people might not notice, or vaguely think you look better.  But to you – it’s a vast relief.

Then you go back to do it again.

One of my patients had her nose done, and was happy with it – even if other people didn’t much notice.  That’s when she decided to have her chin done, too.  And then get it re-done, to get it just right.  And then a piece of bone came loose, and she had to repeat that surgery.

That’s when she realized the chin surgery was probably a mistake all along.  Instead of getting the same good feeling after each surgery, she only felt worse.

She realized it was becoming an addiction, and that she needed to stop using plastic surgery to escape doubts about herself, and her ability to find love.  There was nothing more that a scalpel could do for her.  She needed to find out why she didn’t like who she was – and address it in therapy.

It is impossible to say whether Heidi and Michael are examples of addiction, or just people who enjoyed altering their appearance to suit their own tastes.  But the signs – chiefly the sheer number of surgeries – are there.

Plastic surgery tends to have diminishing returns.  You can only operate on your body so many times before features scar up or grow distorted.  There’s also the issue of losing what makes your appearance special in the process.  The “ideal” features produced by plastic surgery tend to have a certain blandness.  The goal of plastic surgery, in most instances, seems to be making someone look more like everyone else, instead of making him look more himself.

If you’re considering plastic surgery, ask yourself whether you are really addressing a simple matter of a physical quirk, or whether there’s more going on that you need to stop and examine.  If the insecurity seems to involve more than just a bump or a wrinkle, it might be time to look deeper, and ask yourself what’s wrong with accepting yourself just as you are.

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