September Video
Realistic Expectations from Cosmetic Surgery
Saving Face
Friday, 17 August 2012
Tuesday, 7 August 2012
Dropping & Fluffing
A Guide to JARGON in Cosmetic Surgery!
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Please Note: I am not a surgeon and I do not profess to offer surgical information. This is a guide to jargon based on my own personal understanding of the healing process.
The decision has been made. You have printed out A Good Consultation Guide and you have had your consultation. You have booked your surgical date. You have paid for your surgery. You have printed out The Well Informed Patient Guide. You have all your emergency phone numbers to hand in case you need them including food delivery numbers. You have plenty of food in the fridge and freezer. You have organized time off work. You have organized child-minding and dog-sitting. You have plenty of food and water at home and you know where all your medicines are. You have charged your phone, iPod, iPad and put some magazines at the side of the bed to read. You have your remote controls to hand so you dont have to move around too much. Everything is in order and under control. The sheets and pillow cases are all lovely and clean and ready to welcome you home to recover from surgery. *Sigh*
Your surgeon says your surgery has gone well and that you are fine and ready to go home. You zip up your jacket ready to go home, you look down at your surgically enhanced breasts and you don’t feel ‘fine’ at all. Uh oh - what is happening?
General Anaesthetic:
General Anaesthetic can create short term depression. The best way to deal with this is to be aware of the havoc that general anaesthetic can create in the mind and the body and try not to allow yourself to become dehydrated. Drinking water is one way to keep hydrated. Coffee, tea, juice or any other soft drink is a perfectly acceptable way to keep hydrated but just be aware of any caffeine or sugar in the products. It is important to get the toxins flushed out as quickly as possible to help with the rest of the healing and to give you a better frame of mind.
My personal favourite healing drinks will be posted up on www.cosmeticsupport.com soon.
So, you’ve drunk lots of water and you’re not feeling tearful, miserable or depressed any more but you are still not happy when you look at yourself. Why not? Has something gone wrong?
Dropping
Dropping and Fluffing are best used to describe what happens after a first breast augmentation surgery as opposed to a re-do or any other type of breast surgery. It is almost specifically related to the first time breast augmentation patient although it can also apply to re-do too.
During breast augmentation surgery, the surgeon will create a pocket (or wound) either sub-mammary or sub-pectoral to place the implant. Creating this surgical pocket creates trauma in the body. The body responds to this trauma with the breast muscles tightening down around the implant causing consequent muscle and/or tissue swelling. *ouch* The implant has been squeezed into a tight space and cannot really settle into place until the muscles relax and all the surrounding swelling has gone down. It is part of the healing process. As a result, the implant may initially look completely different from the patient’s desired results. The implants can look too high or too tight or too shiny or just generally mis-shapen, lopsided or uneven.
It might be better to think of breast augmentation as two surgeries because each breast will have its own rate of healing. Patience is the key during healing. Timeframes for healing are only guidelines as everyone heals differently. Follow the post-surgical guidelines your surgeon will have provided you with. Log on to helpful websites for additional support during this emotional time: www.cosmeticsupport.com
Try to remember that you are experiencing ‘dropping‘. The muscles will relax and the swelling will go down and the implant will settle into place. Having been squeezed into a tight space, the implant cannot really settle into its true place until the muscles relax and all the surrounding swelling has gone down. It is part of the healing process.
Dropping and Fluffing are two pieces of jargon that are useful if you are recovering from breast augmentation surgery. These two words might save you from having a massive panic attack after surgery when you look down at your surgically enhanced breasts and feel worried or disappointed with how you look.
Dropping and Fluffing are great descriptive terms and commonly used as a kind of verbal shorthand when patients are chatting with one another in forums or chatrooms or in person about their surgery.
Fluffing
It takes some time to happen, but the muscles and the breast tissue will stretch and relax and this will allow the implant to settle into the pocket that the surgeon has created. Once the implant has ‘dropped’ into place and the swelling starts to dissipate, the implant can begin to ‘fluff’ out fully after its period of time of being so compressed by the swelling. In other words, the implant that had previously been squeezed into place and constricted by the surrounding swelling is now free to resume the size and shape it was originally created to be.
Bear in mind that once the swelling has gone and the implant has room to ‘fluff’, the swelling can still return if you take risks with your recovery so follow all your post-surgical instructions in order to minimize the time you are suffering from post-operative swelling.
Many women post in discussion boards that their implants seem very high up on their body and that they have no swelling. This is impossible because everyone wakes up after breast augmentation surgery with some swelling. For some patients the swelling will be more than for others but nobody is immune to this process. It is part of the process.
Although it is tempting to believe that the size you are after surgery is the size you will be forever after, do not fall for that idea. The size and shape of your breasts will take about 3 months or so to reveal their final results which brings me to my next point...do not go out straight after surgery and buy everything in Agent Provocateur that is not pinned down as you may find yourself with a massive credit card bill and bras that will not fit 3 months down the line. Wait for your implants to drop and fluff and allow yourself to recover and get used to the new look you have, then go and have fun in Agent Provocateur and Myla and wherever else gorgeous bras are sold!
Monday, 30 July 2012
AUGUST Video
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Thursday, 19 July 2012
The Appearance of Cosmetic Surgery
The American Society for Aesthetic Plastic Surgery has issued the following press release: New Psychological screening for plastic surgery patients in the UK (http://www.surgery.org/consumers/plastic-surgery-news-briefs/psychological-screening-plastic-surgery-patients-uk-1037010?utm_source=dlvr.it&utm_medium=twitter).The Press Release is on the American Society of Aesthetic Plastic Surgery website but it was scientists, Nichola Rumsey and Dr Alex Clarke in Bristol who developed the screening process. I have already written about psychological screening and the use of the term ‘dysmorphia’ in a previous blog so I wont go into that again. If you want to read what I said, please scroll up this page. The fact that the American Society for Aesthetic Plastic Surgeons released this information by Twitter is a subject that requires its own individual blog.
In the light of the recent PIP Implant scandals, many plastic surgeons are now calling for change. I must admit I am confused. If the call for change is as a result of the PIP Implants, then why not just call for change in the category of breast augmentation? Calling for change throughout the field of plastic surgery may create chaos. Plastic Surgery covers so many different procedures (and sub-procedures) that surely each individual procedure needs to be considered on its own merits?
Recently I made a video about manufacturers of silicone gel breast implants (http://www.cosmeticsupport.com/info.asp?p=70) and raised the question about why so many women with so many different sizes and shapes were coming out of particular clinics with the same size simplants and the same type of surgery (sub-mammary as opposed to sub-pectoral). So far, I have not seen this question raised even as a soundbite. Although this finding was more to do with commercial clinics than particular surgeons, it was still prevalent even with independent highly trained plastic surgeons. Could the answer be something to do with buying in bulk as opposed to stocking a large range of implants to suit individual body frames? In my video, I show that one particular implant manufacturer has 600 different implants to choose from and yet the majority of women come out of hospital wearing something like a 310 or 340 cc implant.
There is no doubt that the recent PIP Implant scandal has highlighted the need just one question within one procedure within plastic surgery. This one single problem has caused many surgeons to call for change within the entire field. Creating change in plastic surgery, to a certain extent, means looking at the problems that patients currently experience within each individual type of elective aesthetic plastic surgery. For example, the problems I note on my discussion boards about breast augmentation are quite radically different from the problems I note on my discussion boards about either rhinoplasty, liposuction or blepharoplasty. Calling for change in the category of breast augmentation alone is large enough of a mission without lumping all aesthetic surgeries together in one great big call for change. What about the patients? Where is their voice? Not all patients are breast augmentation patients? Have other patients been heard?
With all these recent calls for change, and at the risk of repeating myself, I ask myself again why nobody has bothered to ask the people (few and far between though they are) who run plastic surgery patient support sites what they have learned about the ‘field’ over the last decade or so. I have learned so much that I would need to write a book instead of a blog. Perhaps it is difficult for surgeons to find anyone who is both a psychotherapist and a body image sufferer who runs a patient support site voluntarily and with an independent mind-set about the subject. Hello - here I am!
The advent of Twitter and Facebook helps to dole out some delicious sounding bites of information, but nothing beats a good old Discussion Board and Chat Room dedicated to the discussion of plastic surgery, especially one that is hosted by psychotherapists and psychologists with experience of plastic surgery. Discussion Boards, such as my own, which have run for over 12 years have an amazing amount of information to offer. Not having been contacted by any surgeons to find out what I have learned from listening to patients of plastic surgery, makes me fearful that patients will not benefit from any of the potential upcoming changes. Currently, with the advent of the psychological screening, patients might even be in a worse position than they were before (see my comments in previous blog).
Probably the most startling thing to come out of running a patient support site for 12 years is how little information the patient actually receives from the surgeons who pride themselves the most on their experience and training. These surgeons are quick to point out that they are very busy and have huge case loads and perform elective surgery as a sideline to the more important NHS work they do. As a result of their heavy work commitments, they claim that bedside manner is not high on their list of priorities. It is hardly surprising that an elective patient feels more charmed and at ease when going to a less extensively trained surgeon who prefers to charm his patients with champagne evenings and sales people introducing themselves as ‘advisors’ and ‘counsellors’. Hardly surprising at all. If I did not know better myself, I would feel exactly the same. I have spent hours explaining why champagne and chocolate must not be part of the consideration but chocolate is a subtle art!
As a consumer myself, I am not suggesting that the more extensively trained and highly skilled surgeons ought to be wooing my business with champagne and chocolate (I don’t drink and I am at war with sugar) but I would like to see more emphasis being put on the consultation process. I would prefer that my £250.00 consultation take place in calm settings where the surgeon is not being interrupted by phone calls, tweets or secretarial requests. For my £250 (approx) consultation fee, I would like all the attention on me, thank you very much. Oh and by the way, can you install some mirrors and better lighting so I can see what we are talking about. £250 ought to cover that.
A consultation is a very important part of the whole surgical process as it is this period of time which will set the tone for my understanding of what is to come should I decide to go ahead with surgery. I want to leave my consultation feeling as if the surgeon and I are on the same page even if the surgeon has had to revise what I originally had on that page when I walked in the door. I want to walk out that door believing that I have been heard and have respectfully offered the same back in return. Oh .. and I would like to hope that my £250 is redeemable should I choose to book a surgery once I have had time to consider what was said at my consultation.
Friday, 6 July 2012
The strange appearance of ‘dysmorphia’
My name is Debbie. I set my website up 12 years ago in order to create an online community of like minded people looking for facts, information and support with plastic surgery. I am qualified as an existential psychotherapist and have suffered from a life long history of Body Dysmorphic Disorder. I try to blog about Dysmorphia as often as I can so if you want to read more on this subject or my own personal history of BDD or plastic surgery - feel free to nudge me or tweet me either here: www.cosmeticsupport.com or here: @cosmeticsupport
Is the definition of dysmorphia dependent on the definer? Dysmorphia is an abbreviation of a condition listed in the DSM-IV as Body Dysmorphic Disorder or BDD for short. BDD is a disorder best diagnosed by psychiatry and/or psychology. It is listed in the DSM-IV, commonly known as the psychiatrist’s bible.
Dysmorphia is generally understood as someone who suffers from body image issues (nearly everyone has them these days) and BDD has a psychiatric definition of imagined ugliness and is often part of a cluster of other disorders. Someone with BDD will have a preoccupation with a specific body part or parts and believe that a body part or parts is deformed or defective. The preoccupation is significantly excessive and causes clinically significant distress or impaired occupational or social functioning.
How can someone suffering from body image issues be in the same condition as someone with BDD? BDD can (and often does ) immobilize the sufferer whereas many people who suffer from body image issues can and do get on with their day to day lives. I am not suggesting that those who suffer from body image issues are not dis-satisfied with their appearance. I have great empathy for anyone suffering from body image issues. However, a person in this condition must not be confused with a patient diagnosed with BDD. It is further important to note that the DSM-IV is a list of operationally defined syndromes, useful for statistical and research purposes and not the 'final say' on anything. Therefore, the question of whether dysmorphia is an abbreviation of BDD is still under the spotlight.
This confusion between ‘dysmorphia’ and BDD is important to try to clarify given that the laws surrounding the nature of advertising within plastic surgery are about to change. The government wants the advertising of plastic surgery to change in order to reflect more realistic expectations for the consumer/patient. This, they believe, will help to protect the weak and vulnerable consumer/patient from developing body image issues and becoming ‘dysmorphic‘ as a result of measuring themselves against impossible standards and air-brushed imaginations prevalent in advertising. Good call. In 12 years running my website, I have never posted a single before or after photo from anyone that has been air-brushed in anyway. Real people, real photos.
Who has the right to diagnose a patient of mental health problems and just what is the mental health disorder exactly? If consumer/patients are being fed false promises by plastic surgery adverts and air-brushing, can we blame them? Should we insult them further by saying that believing in this advertising, they are now suffering from a mental health disorder? In order to work out which plastic surgery patients may be hiding or vulnerable to ‘dysmorphia’, plastic surgeons are going to work with a questionnaire devised by psychologists and psychiatrists to determine which patients may or may not suffer from .. what? It isn’t entirely clear whether these questionnaires will label a patient dysmorphic or suffering from BDD. This confuses me given that many people suffer from body image issues and are not necessarily suffering from BDD. If the questionnaire is there to help the surgeon work out which patient has realistic expectations, should ‘dysmorphia’ or BDD even be used? Is this questionnaire going to be a glorified screening tool or is it something that will turn a consumer/patient into someone walking around with a mental health label that they may or not merit? Does this beg the question that is always secretly lurking: how do patients rate surgeons? Where is their psychological questionnaire?
I do think it is important for a plastic surgeon to know whether the patient who is presenting themselves for a consultation is (or is not) suffering from BDD. I just wonder how a questionnaire can clarify the condition of dysmorphia as it is generally understood today. Dysmorphia (the more general definition) is more of a cultural condition as a result of certain types of advertising within the plastic surgery field. These kind of cultural body image issues might be better helped by a neutral advisor who has experience in the conditions in question. What will it mean to give someone the label of ‘dysmorphia’? Are we labeling them with mental health problems through the back door? Is that fair when the consumer/patient has been fed so much advertising over so many years. How can we help them unravel their body image issues? Do either of these labels (dysmorphia or BDD) preclude the patient from having plastic surgery? The question of whether plastic surgery helps or hinders the patient of BDD is too big of a subject for this quick blog.
Recently I approached the ‘powers that be’. I made a request to put their surgical information on my website. Their response was that if I put their information about surgery on my site, I would be guilty of plagiarism. Patient support is crucial. Where are we to go to get this information unless it is the ‘powers that be’. Do I have the right to re-write surgical information? I would rather be guilty of plagiarism than re-write surgical information. We are discussing elective surgery and the consumer/patient has a right to information about what it is that he/she is buying. They also have the right not to have to become a super-sleuth to find that information. Their trust has already been compromised.
For 12 years I have run my website voluntarily because I suffer from BDD and it is very typical of many patients to want to give back to their own community and become a wounded healer. My website (www.cosmeticsupport.com) helps to heal me as much as it does others. I have been debunking myths and researching facts and information to share with others for as long as I can remember and certainly for the last 12 years online. I can not force consumer/patients to believe that their expectations must be realistic when going for plastic surgery and that advertising is not the same as research but I know that within the community I created many people have benefitted by understanding the actual facts. If you like my blogs and support what I do then please SUBSCRIBE to www.cosmeticsupport.com
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