Why Some Patients Are Unhappy

Abstract

Potentially causative links exist between trauma (abuse/neglect), body image disorders, and obsessive plastic surgery. Body dysmorphic disorder may be a model of the disordered adaptation to abuse or neglect, a variant of posttraumatic stress disorder. Our satisfied and dissatisfied patients shared common characteristics and therefore may be identifiable preoperatively.

Association Between Mental Health Status and Patient Satisfaction With the Functional Outcomes of Rhinoplasty

“…60 Our study population had a more balanced representation of the sexes compared with previous studies in which women made up the overwhelming majority of patients undergoing rhinoplasty. 6,7,11,14,18,[24][25][26][27][28][29][30][31][32][33] A significant sex difference in mental health status was not reflected in our study, refuting suggestions (based on nonsignificant findings) 7,36 that men undergoing rhinoplasty have a greater prevalence of psychopathology. Sex made no difference for rhinoplasty satisfaction assessed by ROE in 24 men and 34 women.…”

“…Moreover, the lack of sex difference in perception of nasal function was interesting, given that women tend to report more symptoms than men, perhaps because of sociocultural influences more than physical differences . Our study population had a more balanced representation of the sexes compared with previous studies in which women made up the overwhelming majority of patients undergoing rhinoplasty . A significant sex difference in mental health status was not reflected in our study, refuting suggestions (based on nonsignificant findings) that men undergoing rhinoplasty have a greater prevalence of psychopathology.…”

“…Anecdotally, men are less satisfied with cosmetic rhinoplasties than women . However, previous studies have been unable to confirm whether satisfaction differs between the sexes because women make up the overwhelming majority of patients undergoing rhinoplasty. In this way, the demographic characteristics of populations undergoing rhinoplasty are a barrier to analyzing whether sex may influence patient satisfaction.…”

The Prevalence of Adverse Childhood Experiences, Body Shame, and Revision Request Rate in 218 Plastic Surgery Patients: What Drives Postoperative Dissatisfaction?

“…[21][22][23][24][67][68][69][70][71][72][73][74] The picture painted by our dissatisfied, body-shamed patient demographic is also the portrait of many body dysmorphic disorder patients: depressed, perfectionistic individuals with other health problems who have already undergone multiple cosmetic operations starting at a young age but want still more, neglectful of potential complications, and often dissatisfied postoperatively. [9][10][11][64][65][66] Our added piece is the connection to families manifesting multiple types of dysfunction imposed before age 18 and their relationship to body shame, which might help explain first-degree family prevalences. It is likely that body dysmorphic disorder could be diagnosed in some of our patients.…”

“…The authors have previously tabulated these behaviors. 19,64,65 Finally, listen for catastrophic and victim language: “I look disgusting, like an animal.” “I trusted him and he betrayed me,” “She made me ugly” (Table 10).…”