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Plastic surgeon cautious of repeat patients

TAIPEI, Taiwan -- A plastic surgeon urged caution when treating repeat patients because they are more likely to initiate malpractice suits and other damages.

Medical practitioners who deal with cosmetic surgery met at a dermatology and aesthetics conference at the Tri-Service General Hospital (三軍總醫院) yesterday.

Repeat patients are more likely to be suffering from body dysmorphic disorder, the symptoms of which are depression, social isolation and hostility, according to Yang Tsung-tsair (楊聰財) of the psychiatry department at Cardinal Tien Hospital (耕莘醫院).

An affected patient's emotional distress can be turned against his plastic surgeon, leading to medical malpractice lawsuits or worse, said Jean Lin (林靜芸) of Jean's Clinic of Plastic Surgery.

At the conference, Lin pointed out that six U.S.-based plastic surgeons have been killed at the hands of repeat patients. She also noted cases of patient-to-physician violence in Taiwan, after surgeries were perceived as botched.

“A patient with body dysmorphic disorder is anathema for a plastic surgeon,” she said.

In one classic case, the son of a general requested that she perform his ninth rhinoplasty to give him an aquiline nose like his father's. She declined the case, and then referred the man to a mental health professional.

1 Comment
April 4, 2013    drbranman@
Determining what is too much cosmetic surgery varies with each patient. The first consideration is safety. Is this person a candidate for the procedure, is it needed, feasible, and is the person in good health. Feasible refers to realistic expectations and whether or not the goal can be reached safely. Whether or not a procedure is needed may be a touchy subject. Some people may obsess over a particular body part that seems fine. This is a dead give-away that the patient may be dealing with Body Dysmorphic Disorder (BDD). About 2% of the population has BDD. However, up to 12% of cosmetic surgery patients have this disorder. The desire to look like a particular star or someone else is also a red flag to cosmetic surgeons. When you see pictures of badly done cosmetic surgery on the Internet, or stories about the human Ken or Barbie doll, you can bet these people are victims of BDD. What is disturbing is that there are cosmetic surgeons that will continue to operate on people going to these extremes. Some psychologists say that too much cosmetic surgery can result in detrimental identity issues.

Dr Rhys Branman
Little Rock Cosmetic Surgery Center
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