Editor's Note:
With the emergence of various types of Internet celebrity plastic surgery, more and more beauty seekers are caught in the paranoid pursuit of perfection, but they do not think of the possible cost behind it.
This article was first published on July 6, 2018, and once again posted in the hope of sharing a doctor's sincere statement in the midst of the overwhelming hype about plastic surgery: seeking beauty should be moderate and rational.
This article is written by Dr. Shen
Because of the operation, I met Li Meng's mother for the first time, she stood by the bedside, her face was vicissitudes, and her eyes were a little red and swollen. As soon as we saw it, we choked up and said, "Thank you doctor, it's good that you helped her with the operation, otherwise, what would she do in the future?"
"Well, what a cry, I'm not dead!" Li Meng interrupted rudely.
After checking the room, Li Meng's mother caught up with me: "Doctor, she will not have sequelae, right?"
"The operation is very difficult, there is a risk of nerve damage, but today's rounds look fine, there is no major problem, there should be no sequelae, you can rest assured." 」
A 17-year-old girl who insists on cutting her cheekbones
"Dr. Shen, I want to have surgery, do you remember me?" A girl in her 20s suddenly stopped me in the hallway.
The girl is tall and tall, her facial features are small and beautiful, and her standard melon face is a good-looking type in traditional aesthetics. I recognized her at a glance—she had visited the director's clinic half a year ago, with a middle-aged man in his mid-40s.
At that time, Li Meng (pseudonym) came to the face for a very clear purpose, to be plastic surgery. The director and I both felt that she was already looking good, and there was no part that needed to be adjusted—no fat jaw angles, not a collapsed nose bridge, no high protruding cheekbones, not a single eyelid, everything was just right.
But Li Meng asked to cut her cheekbones, and she felt that her cheekbones were "a little high and a little wide." She was determined, and no matter how much we persuaded her, she insisted on the whole.
Image source: Visual China
When I saw that she was 17 years old, not yet an adult, and not suitable for major plastic surgery, I began to persuade her on this ground.
"I'll be 18 years old in a month, by the way, can't I get my family to sign it, and I'll ask my uncle to sign it for me?" Li Meng was very insistent.
"Are you her uncle?"
The man shook his head.
"That's... Cousin?"
"No." The man again denied it.
I noticed that the man had a string of English tattoos on his left ring finger, and Li Meng also had a string of the same on his right hand. "Boyfriend?" I asked tentatively.
The man did not speak, and Li Meng said softly, "No."
"The signature must also be an immediate family member, the point is that you are really not suitable for this operation!" 」 In order to completely dispel Li Meng's thoughts, I intensified my tone.
"I don't have immediate family, they don't care about me anyway, I can decide for myself, don't you have a surgical simulation, then I can always do a surgical simulation..." She did not spare.
It seems that Li Meng did her homework in advance and knew about the surgical simulation. Surgical simulation (preoperative simulation) is based on ct image data of the surgical site, using professional software for computer simulation, which is of great help to surgery, especially plastic surgery, and can give beauty seekers a more intuitive postoperative effect display.
I couldn't help her, so I gave Li Meng a preoperative imaging examination such as 3D CT skull CT for Li Meng, and asked her to do surgical simulation later.
A few days later, we performed a simulated operation for Li Meng as scheduled, considering that the cheekbones were too low and flat, affecting the aesthetics, so we just conservatively lowered Li Meng's cheekbones appropriately, resulting in the final result that did not seem to improve much.
Dysfunctional beauty-seeking mentality
During the waiting for the operation simulation, Li Meng kept contacting me, saying that she really needed this operation, her dream was to be an actress, and she was lucky to meet an uncle who said that she could take her into the "circle", but she felt that her cheekbones looked a little high after taking the photo, and suggested that she have an operation.
Her uncle told her that in the "circle", plastic surgery is a common thing, so that it looks good on the camera, the audience will like it, it will look good, it will be popular everywhere, so that it can make a lot of money, and there is hope in life...
I know that the uncle she said was the man who came with her that day, and the "circle" she said was the entertainment industry.
It may be a psychological effect, Li Meng felt that the operation simulation effect was very good, and once again asked us to operate on her.
But I still rejected her because the "risk" was too high. The risk here refers not only to the risk during surgery, but also to the potential doctor-patient dispute.
Plastic surgery is not a treatment of physical diseases for patients with healthy bodies without external deformities, and patients who treat diseases will be satisfied with the cure and recovery of health, but some paranoid part of the beauty seeker is difficult to be satisfied with the face of the whole face.
Plastic and Reconstructive Surgery, the official journal of the American Association of Plastic Surgeons (ASPS), has a paper that says that among plastic and aesthetic seekers, there are many mental disorders, of which narcissistic personality disorder (NPD), performative personality disorder (HPD), and somatic deformation disorder (BDD) account for the top three.
Therefore, when receiving a beauty seeker, assessing his psychological state is a very important part of the face-to-face consultation process. After all, plastic surgery is not magic, if the beauty seeker has too high or unrealistic expectations of themselves after plastic surgery, the plastic surgeon will not hasty surgery, but inform its interests, euphemistically refuse surgery, and recommend that they receive corresponding psychological counseling.
The hospital once received a request from a woman to cut the angle of the jaw, and after evaluation, her jaw angle was not too large, and we did not recommend surgery, but in the case of her every request and guarantee of absolute satisfaction with the postoperative effect, the hospital operated on her. The operation was removed according to her requirements, but the moment the gauze was removed, the face in the mirror was beyond the lady's expectations, and she felt that it was "too much polished" and now became a "snake face", which had been a long time.
After learning the real reason why Li Meng requested surgery and the similar patients who had been treated, my judgment was to refuse.
Went to Korea for plastic surgery failed
Now, half a year later, Li Meng appeared in front of me again, and I always felt that she was a little different, without the agile temperament she had before, and somewhat decadent. After careful observation, it was found that her cheekbones were somewhat asymmetrical.
"Dr. Shen, I want to do surgery, before you did not help me do it, my uncle took me to Korea to do, at that time I thought the operation was OK, the effect was basically achieved, last month I felt a little wrong, I went to a hospital for follow-up, the doctor said that the operation is a bit problematic, suggested that I come to the big hospital to see..."
I looked at her CT, the cheekbones were misaligned, and there were no titanium plates and titanium nails! That is to say, at that time, when the surgery was performed in Korea, only the bone was broken and lowered, and it was not fixed with titanium plates and titanium nails, so that the broken end of the bone was "suspended", which looked similar to the fracture of the cheekbone.
Li Meng was reconstructed on CT of the right side of the face at the time
Source author
Plastic surgery in South Korea is not uncommon, "Is it done in a big hospital in South Korea?" I can't help but doubt the qualifications of plastic surgery institutions and doctors who performed surgery for Li Meng.
"I don't know, my uncle took me there, it feels similar to the domestic beauty institutions, I can't understand what they are saying, anyway, the operation was done, Dr. Shen, what is the problem with this operation?" 」
I was shocked that the general beauty institutions did not have the qualifications to do this kind of general anesthesia surgery, and this type of surgery was risky, and the beauty institutions basically did not have supporting rescue emergency equipment.
图源：《Undercover Asia: Botched Beauty》
Although the correct surgical procedure is indeed to break and lower the cheekbones, it is the most basic to fix the titanium plate and titanium nails after the operation, otherwise the broken ends of the bones cannot be healed in alignment.
"Dr. Shen, now that I'm 18 years old, I can sign it myself..."
"Why didn't your uncle accompany you this time?" I suddenly remembered the middle-aged man who accompanied him to the hospital last time.
"Hmm... That one...... he...... We broke up..." To avoid embarrassment, I turned to asking for medical history.
When I asked about the medical history, I was very distressed to learn that she had miscarried 3 times, but what hurt me the most was that she told me that when I had 3 miscarriages, I was very calm and felt that it didn't matter.
Secondary repair surgery
Because it was a second repair surgery, we chose the site of Li Meng's first surgery, and after opening it, we found that the relevant anatomical structure was a mess - muscles, fascia, etc. were a mess. If it was my main surgeon, I would definitely not know how to start, I would not be able to distinguish any structure, and I might have done it badly during the first surgery. Fortunately, the director is skilled, and the repair surgery is relatively smooth in the end.
Because of the repair surgery, I met Li Meng's mother for the first time, she stood by the bedside, her face was vicissitudes, and her eyes were a little red and swollen. As soon as we saw it, we choked up and said, "Thank you doctor, fortunately you helped her with the operation, otherwise, what would she do in the future?"
"Thank you doctor, I don't know what surgery she ran to South Korea, a person ran to this side, I don't have time to take care of her, she has 5 younger siblings, there are still a lot of farm work at home, life is difficult..." 」
Only then did I learn that her family's financial situation was really strained.
Three months later, I received a WeChat message from Li Meng: Dr. Shen, I am very happy, I am now in the group filming, although it is a very small role, but I believe that as long as I work hard, I will be able to succeed. Attached to the letter was a photograph of her in a period costume.
I replied: Congratulations and wish you success!
As a plastic surgeon, I know that endlessly invasive plastic surgery has become a pathology that can eventually take its toll on yourself.
I hereby sincerely advise all beauty seekers: choose rationally, stop in moderation, and seek help from a psychologist if necessary.
Acknowledgements: This article has been professionally reviewed by Dr. Yang Shude, Doctor of Plastic Surgery, The First Affiliated Hospital of China Medical University
Curated by: Joy, Z7, Carollero
Executive Producer: Gyouza
Title image source: Visual China
bibliography:
1.Shridharani, S. M., Magarakis, M., Manson, P. N., & Rodriguez, E. D. (2010). Psychology of plastic and reconstructive surgery: a systematic clinical review. Plastic and reconstructive surgery, 126(6), 2243-2251.
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