Psychological assessment and therapy for patients considering cosmetic surgery
I specialise in preoperative and postoperative psychological assessment and therapy for patients having cosmetic surgery. I work with a number of plastic surgeons both in the NHS and privately. I have a particular interest in supporting patients who are considering rhinoplasty, septorhinoplasty and secondary rhinoplasty. I am listed as a specialist psychologist on the British Association of Aesthetic Plastic Surgeons (BAAPS) website.
If you are a patient seeking assessment or therapy please do feel free to contact me directly and we can discuss this further.
I work as part of a Special Interest Group of Psychologists (SIG) click here established by Professor Nichola Ramsey and Professor Alex Clarke in conjunction with the British Association of Aesthetic Plastic Surgeons (BAAPS).
This article states:
‘Psychology is to plastic surgery what physiotherapy is to orthopaedics – you wouldn’t give someone a joint replacement without being clear you had physiotherapy lined up and someone engaged in their aftercare.’
The group has been formed following a need identified by surgeons as well as psychologists to ensure the psychological wellbeing of patients considering cosmetic surgery. Surgeons often find that psychologists ask questions they do not necessarily consider but are very important in terms of assessing a patient's suitability for surgery.
How is preoperative therapy helpful?
It gives patients an opportunity to explore their expectations and motivation for surgery in a non-judgmental space. As part of the preoperative session/sessions, a psychological assessment can be completed. I base my practice on the BPS Guide for Practitioner Psychologists working with patients having surgery click here. Therefore, as part of the assessment, and if appropriate, I would use the Derriford Appearance Scale (DAS) and the Hospital Anxiety and Depression Score (HADS).
Some key aspects explored in the preoperative sessions:
Are there any major life events that have contributed to the reason why somebody may be seeking surgery at this particular time?
Together with the patient, I would explore in depth their motivation for surgery. Research by Locatelli et al (2017); von Soest et al. (2005), as well as my own all indicate that if a patient’s reasons and motivation for pursuing cosmetic surgery are conscious, physical, realistic ones, they are more likely to have a good outcome post-surgery.
Certain life events may be a contraindication for surgery and it would be important to help the patient understand why.
To ascertain whether there are underlying mental health issues, for example, borderline personality disorder, body dysmorphia, severe anxiety and or depression that means surgery will result in a poor outcome?
How is post-operative therapy helpful?
It gives patients an opportunity to discuss whether their expectations for surgery have been met. If not, how we can help the patient process this and what the next steps may be.
If the patient is experiencing any form of psychological distress post-surgery, the psychologist can help to put the relevant support in place for the patient.
The BAPRAS Standard of Practice BAPRAS list two important psychological points for surgeons to consider these are listed below:
'19. When you discuss interventions and options with a patient, you must consider their vulnerabilities and psychological needs.'
'23. You must talk to the patient about any adverse outcomes that may result from the proposed intervention, paying particular attention to those the patient is most concerned about. You must talk about the potential adverse physical and psychological impact of the intervention going wrong or failing to meet the patient’s expectations.'
Can you confidently discuss and explain how your patient's psychological needs are taken into account in terms of best practice guidelines? If you are unsure about this, please do get in contact and we can discuss this further. We can talk over the phone or I can come along to the practice or hospital where you work. I can also provide you with leaflets to give to your patients on how and why psychological support can be of benefit.
Locatelli, K., Boccara, D., De Runz, A., Fournier, M., Chaouat, M., Villa, F. and Mimoun, M. (2017) A Qualitative study of life events and psychological needs underlying the decision to have cosmetic surgery. The International Journal in Medicine, 52, 1, pp.88-105.
Von Soest, T., Kvalem, I.L., Roald, H.E., and Skolleborg, K.C. (2005) Psychosocial Factors Predicting the Motivation to Undergo Cosmetic Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery 117 (1), pp.51-62.
Psychological therapy and assessments for cosmetic surgery patients in Berkshire, Hampshire, and Oxfordshire.