When considering plastic surgery,few prospective patients spend a lot of time thinking about the emotional aspects of the decision to surgically alter one’s looks. If they do give it any thought, their introspection is usually focused on the positive effects they believe plastic surgery will have on their confidence and self-esteem. While these positive psychological benefits are certainly a part of it for many people, there is much more to the picture than a boost in confidence. You may be surprised to learn that having surgery to improve your looks can also have some adverse emotional side-effects.
The incidence of post-surgical depression is much higher than most people realize, and it’s one area that I believe too often gets glossed over in the “risks and complications of surgery” pep talk given by most surgeons to their patients. It has amazed me in my career to find how many doctors do not warn their patients specifically about this phenomenon.
So let’s examine some of the major contributors to post-surgical depression, most of which are common to any type of surgery:
Effects of General Anesthesia
Did you know that traces of the chemicals used to “put you under” in general anesthesia can remain in your body tissues, affecting you both physically and emotionally, for up to three weeks? These residual effects can include lethargy and depression, and even bouts of unexplained weepiness or despair. Incidence of these effects seems to increase in proportion to the age of the patient.
Post surgical pain management usually requires at least a brief period of the patient being on prescription narcotic pain killers. As you may or may not know, most narcotic pain killers are in a class of drugs considered depressants. This does not necessarily mean that they will make you depressed. In layman’s terms, it just means that they tend to slow everything down, much like alcohol, but on a larger scale. Just as people have different emotional reactions to intoxication with alcohol, they also have differing reactions to being on pain meds. Sometimes, these reactions are similar to (and compounded by) those related to the residual effects of general anesthesia, as listed in the paragraph above.
Physical Restrictions Inherent to Recovery
Let’s face it: Almost nobody enjoys being stuck in bed, depending on others for help with basic tasks, being forced to abandon our usual routines and take time out for healing. Feelings of restlessness, boredom, helplessness, and even uselessness are quite common. In addition, the lack of physical activity usually means a short supply of endorphins, which is never a good thing, mood-wise.
Bruised and Battered
In a nutshell, when you look and feel terrible physically, you’re likely to feel terrible emotionally as well. Imagine lying in bed in pain, doped up on medication which makes you feel slightly nauseated… Then you get up and go to the mirror to sneak a peek, and the sight that greets you is a shell of your former self. Besides being creased with pillow marks, your face is bruised and swollen, sporting visible stitches reminiscent of Dr. Frankenstein’s monster. It hardly sounds like a recipe for bliss, does it?
It’s All Temporary
It is important to remember that all of the above contributors to post-surgical depression are temporary, and as they say, time heals. Give it time, and always keep the end result in mind.
What to Do About It
- Make sure you have a strong support system in place. Spouses, siblings, parents, adult children, and friends can be of invaluable help to you in your recovery. If a loved one has had any kind of plastic surgery before, that’s all the better. Talk out your anxieties and feelings with them. It can be very comforting to know that you’re not alone in this.
- Have a plan. Set up your “recovery station” before you go in for the surgery. At the very least, you should have all these things within easy reach: books and magazines, healthy snack food, a pitcher of cool water, a phone, TV and remote, warm slippers, a few changes of comfortable clothing. You should also be set up very close to a bathroom.
- Follow your surgeon’s instructions. Be sure to take all medications exactly as prescribed by your doctor, and refrain from strenuous activity for as long as he or she advises. And please, DO NOT pull at stitches or remove any bandages before you’re supposed to. Obviously, accidentally pulling out stitches could have a very negative effect on your outcome. Plus, touching the incision sites can lead to infection, and removing the dressings too soon can be an impediment to the healing process. Besides, wouldn’t you rather wait and see the result when it’s not looking so scary?
- Give yourself a break. Don’t try to be a super-hero. This is the time when your loved ones are supposed to be taking care of you, not the other way around. Don’t go back to work before you’re ready. If your surgeon says that you can go back in two days, take four days off.
- Be patient with the healing process. Don’t make judgments on the outcome while you’re still swollen, bruised, and stitched up.
- Eat as well as possible. For the first day or two, you probably won’t have much of an appetite. When you do feel ready to eat, do yourself a favor and eat the freshest, most nutritious food you can find to help your body heal. (Not only will this accelerate the healing process, it will do a world of good for your mental and emotional state as well.) Also, drink plenty of water and get lots of rest.
- Avoid alcohol for at least three weeks. Check with your surgeon for specific recommendations.
- When in doubt, call your surgeon. Your surgeon is trained to deal with not only physical complications of surgery, but also with emotional after effects. He or she understands what you’re going through, and can help talk you through it. Your surgeon may also decide to change your medication if he believes that your current prescription is contributing to any adverse emotional issues you are experiencing. Furthermore, if necessary, he can refer you to a mental health professional who is qualified to deal with post-surgical depression.
Interview, Adam Tattelbaum, MD - 12-17-07.