Motivational Patterns in Patients Seeking Elective Plastic Surgery

Abstract

Thirty consecutive women seeking elective rhinoplasty were referred for psychiatric and psychologic study after initial interview by the plastic surgeon (MTE). Pre-operative tape-recorded psychiatric interviews and a battery of self-administered psychological tests constituted the method of study. Twenty-two patients were operated upon. Post-operative studies are being made at 2 weeks, 2 months, 6 months and 1 year. The 30 women patients ranged in age from 14 to 43 years. In all patients preoccupation with the nose as too large, ugly, or inappropriate to the rest of the face dates from the period of adolescence. The problems of the adolescent patient and the period of adolescence of older patients are regarded as crucial in confirming the defensive use of feelings of deformity of the nose in the attempted mastery of psychosocial conflicts. Patterns of motivation in patients seeking rhinoplasty vary with the age and life situation of the patient and include Conscious wishes for beauty and attractiveness and the wish to avoid being stereotyped as "alien." A. pre-conscious link between the felt deformity of facial body image (the nose) and undesirable traits of personality function. Unconscious and conflicted identifications of the patient with one or both parents. The operative procedure functions symbolically as a disavowal of the restrictive aspects of paternal identifications and an active striving towards greater comfort in the feminine role. In the older patients current interpersonal stress which threatens the patient with depressive affect is a frequent finding.