Body Image (Complex Psychological Abstraction)
Body Image (Complex psychological abstraction)
is subjective perception of the body as seen thru the mind’s eye.
There are four stages of body image development:
- Early Childhood (Infantile stage) where environmental influence is the foundation of the body image
- Starting School (preschool stage)– 5-6 years where body image is directly related to school peer competition
- Adolescence (teenage stage)
As physical changes occur, the teenager will respond to the objective changes with impressions that will be tested repeatedly against the opinion of peers, leading to positive or negative body image.
- Aging stage where chronological and environmental (sun damage) changes affects body image.
Plastic Surgery is effective and useful to many patients because it changes body image. It is significant that Plastic Surgery tends to be undertaken at the time of one of the four stages of body image development for eg.
1) Childhood st – deformity/defects/functional problems are dealt with such as cleft lip
2) Pre School st – Ears, webbed toes, scar, birth mark are common
3) Teenage st- nasal hump, humiliating condition such as gynaecomastia (male breast), breast asymmetry, facial asymmetry requires attention
4) Aging st- Rejuvenation procedures are common
The key is selection of Patients. To determine whether a person is a suitable candidate for requested procedure, Plastic Surgeon must have keen eye and intuitive sense.
The core value lies not in the objective beauty of the visible result but in the patients’ opinion of and response to the change.
As several body changes are occurring, the teenagers cognition abilities expand. Thinking become more abstract, multidimensional, complex and subtle. They depend upon heavily on what others think and are vulnerable and respond with complex emotional reactions.
In this context, plastic surgery to correct a truly unattractive feature can be remarkably successful in changing body image in a positive way. Self perception is altered and youngster grows in comfort and confidence.
Based on the Data from National Claring house of Plastic Surgery Statistics, 2003 reported by American society of Plastic surgeons, teenagers represented 3% of patient having plastic surgery in US in the year 2002.
According to that report Teenage surgery( 13-18 years)
Rhinoplasty was 40,696
Ear pinning 3919
Breast Augmentation 3095
Chin Augmentation 1316
However in my experience, gynaecomastia is the commonest procedure among teenagers followed by Rhinoplasty & Breast Asymmetry
Studies indicate that when surgery is affirmed by parental acceptance, represents an area of agreement and common thinking between parents and child at a time almost every other issue has become a source of confusion.
Some of affirmation may flow from parents own narcissistic wish for a more beautiful child and from parental guilt.
I had a teenager (18 years old) brought to me by their parent for nose job and throughout the consultation they described how they wanted the nose to look like, the patient seemed very reluctant about many changes that was asked for. I had another private consultation with the patient where she was more realistic in terms of changes. After the surgery based on my judgement and patients opinion the surgery was carried out. 6 months later the parents brought back the teenager asking for more changes, but the patient seemed very happy. Offcourse I decided not to do any more changes in view of natural and satisfactory result she achieved.
Teenage patients seem to undergo rapid reorganization of their self image after rhinoplasty. A previous over awareness of body part disappears, they tend to forget what they looked like. In general they tend to be more pleased and satisfied than older patients for similar surgery.
Not every teenage who seeks surgery is well suited for an operation. Emotional maturity is required to understand the limitations of plastic surgery and the complications that can occur. In addition, the teenager need to have reached certain growth milestone or physical maturity.
There is no legal age limit for undergoing plastic surgery, however American Society of plastic surgeons developed a position statement about surgery in teenagers.
* The adolescent must initiate and reiterate his or her own desire for plastic surgery improvement.
* There must be realistic goals and appreciation of benefits and risks.
* There must be sufficient maturity to tolerate the discomfort and temporary disfigurement of a surgical procedure.