Plastic Surgery is a Strange World

If you are anything like me, there are parts of your body that you wish you could change. We’re such an appearance-focused culture that outward beauty is often (erroneously) equated with happiness and success. You probably don’t need me to tell you that! But for what it’s worth, a little dissatisfaction is normal. It motivates us to take better care of the bodies and brains that we’ve got. If you’re anything like me, most of the time, you remember to value yourself for what you can do, and for who you are to the people you love.

But then, there’s also plastic surgery…

One might assume that, as a health and fitness enthusiast, I scorn plastic surgery. I don’t. “Plastic” in the surgical sense isn’t referring to that synthetic petroleum-based substance of the same name. It comes from the Greek “plastikos” and Latin “plasticus,” both meaning to mold or shape. Like my bariatric patients, plastic surgery candidates are exploring the effect that the shape of their bodies has on the rest of their lives. Whether for reasons of vanity or health, this is a fascination I can relate to, and a cause I can get behind.

Before becoming a surgical nurse, I never would have considered plastic surgery. I might have thought in passing of the appeals of a breast reduction (so much better for running!), but never as an actual possibility. As part of my daily work I’ve become accustomed to it, and the former aversion has faded away. If you are curious about what goes on behind the scenes, read on! If you are squeamish around medical stuff, maybe give the rest of this article a pass  🙂

Initially, I found the breast reduction cases the worst, most disgusting way to spend a day in surgery. I’m not referring to my feelings for the recipients. I’m talking about a visceral response to the visual impact of a breast whittled to its pulpy core. That poor little nipple adrift in a mass of shapeless of tissue… I digress. Suffice it to say it’s a very different look from the aesthetic curve of an intact breast.

What is important to me to hit home is that in subtractive surgery (like breast reductions and tummy-tucks), you’re leaving a part of yourself behind. Obviously, people don’t wind up in plastic surgery pre-op without a lot of thought on the matter. However, I do worry that my patients don’t always recognize self-hate as a motive, and are seeking their procedure as a false panacea. After all, the tummy tuck won’t change your silhouette entirely; it tightens, but does not tone. Similarly, while a breast reduction can be a blessing for the little lady with macromastia, it doesn’t address the cause of large breasts in a woman who is clinically overweight.

What I wish I could say to my plastics patients is this: Before heading back to surgery, let’s talk about what’s making you unhappy with your body. Is it isolated to the surgical area? If you could change any and as many things about your body as you wanted, what would that look like? How do you envision your life will change after this cosmetic procedure?

Drastic though it is, surgery actually seems to me best fitted for the more minor complaints. Work out 5 days a week for the last 5 years, but still can’t get rid of that little 1-inch bulge around your navel? Chances are you’re going be a lot happier with your procedure than someone who would dearly love to lose 50 pounds. I worry that some of my plastics patients expect to wake up changed women. Nope, it’s still just you in the hospital bed. Surgery doesn’t magically change the neurotransmitters in your brain to make you a happier person, and it doesn’t have a long-term impact on your metabolism. Unless you’re going in for bariatric surgery, it’s exercise and eating habits that are most effective for a whole-body makeover.

I had a poignant moment at work that I’d like to share. My patient was getting a tummy tuck, and I noticed that the little bulges in her belly around her navel were similar to mine. It was familiar to me. Now, the way a tummy tuck works is this: the surgeon makes a horizontal incision a couple of inches below your belly button, and spanning almost the width of your hipbones. Then she incises vertically to a couple of inches above your navel. The belly button itself is preserved on a little island called the umbilical stalk (kind of like the nipples in a breast case). The surgeon then separates the sheet of abdominal skin from the underlying muscle, and pulls it down — like making the comforter taught on a bed. Marks are made to indicate where the overlapping occurs, and the excess is trimmed off.

In this case, those familiar belly bulges got the axe. Now, we aren’t talking big rolls here. Just little hillocks that went into a red plastic biomedical trash bag. It was kind of sad seeing it sitting there, ‘my’ tummy, thrown away. Like I said – you really have to hate that part of yourself to go through this procedure. Some people, I imagine, are happier without it. Others, I picture looking at themselves in the mirror, weeks later, picking at another bulge, or crêpey skin, or flaccid breast, and vowing to make another appointment as soon as they recover.


*On an interesting side note, I wanted to mention what happens to the belly button on its umbilical stalk. The sheet of abdominal skin gets pulled down over it, and while the tissue is being sewn back into place, you are belly-buttonless. After the big horizontal incision is closed, the surgeon makes a little cut in the skin directly over the umbilical stalk, and pulls the belly button through the slit like a button through a its hole, and sutures it in place. Voila, you’re belly button’s back!


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