Plastic Surgery Remorse Linked to Deeper Issues

Are cosmetic procedures sending more and more people back for do-overs?

August 31, 2010, 3:13 PM

Sept. 1, 2010 -- Reality starlet Heidi Montag turned more than a few heads when she recently told Life & Style magazine that she was unhappy with the breast augmentation surgery she had back in January that turned her into a G-cup.

"I'm obsessed with fitness but it's impossible to work out with these boobs," she told the magazine. "It's heartbreaking. I can't live an everyday life. I feel trapped in my own body."

She's now reportedly looking for a surgeon who will reduce the size of her breasts.

Celebrities aren't the only ones with buyer's remorse over plastic surgery. Laura Pillarella knows that very well. The 40-year-old author, personal trainer, massage therapist and yoga instructor underwent 15 plastic surgeries on her face at a cost of more than $60,000.

She had her first procedure -- the removal of the bags under her eyes -- when she was just 25.

"To me, that was such a clichéd marker of age," Pillarella said.

After that surgery, she continued with reconstruction for about the next 15 years, having around one procedure done a year.

She blames her obsession with her looks on an unhappy, neglected childhood, and her belief that the only way to feel loved and get attention was to be beautiful.

"When I first saw the bags under my eyes, I panicked. I thought I would be invisible. I thought I would die."

Regret over her multiple surgeries hit Pillarella after second chin implant. She still wasn't satisfied with her face, and went to another surgeon, who told her she "looked like a freak."

Though she went through a period of depression and felt suicidal after hearing that from a doctor, she finally realized he was right, and she embarked on a crusade to learn how to feel better about herself. Because she said some of the previous surgeries were botched, she underwent a deep facelift to repair the damage.

Since then, she's lived with a lot of regret over everything she did to her face.

"You're still yourself, but now you look in the mirror and you don't recognize yourself," she said.

Some cosmetic surgery procedures -- like Montag's breasts, for instance -- are relatively easy to reverse, usually with only a few scars to tell the tale. However, others -- including many facial procedures -- are difficult if not possible to undo.

Remorse Bred By Psychological Issues

Psychologists say women like Pillarella who experience plastic surgery remorse are troubled by other issues they believe will be alleviated by changing their appearance, such as what Pillarella said were unloving, inattentive parents.

"In younger women, if you have a history of depression or anxiety, you tend to feel less good about the surgery, especially if you buy into the 'myth of transformation,'" said Ann Kearney-Cooke, a psychologist in private practice who specializes in weight and body image issues.

Women who have multiple surgeries also tend to have psychological stressors.

"It changes the look, but if you have a problem that you haven't resolved, you'll have a temporary positive feeling, but then something else is the problem," said Kearney-Cooke.

Plastic surgeons disagree over whether there's been an increase in the number of people who have procedures done but are unhappy afterward.

"I think it's actually increasing, and I think in part it's increasing because of the drop in reimbursement by insurance companies, which is driving doctors in other specialties into the plastic surgery market," said Dr. Julius Few, director of The Few Institute for Aesthetic Plastic Surgery in Chicago.

"Maybe I've seen it a few times in my practice, but it's very rare," said Dr. Timothy Miller, chief of plastic surgery at the David Geffen School of Medicine at UCLA.

They agree, however, that plastic surgery remorse can potentially be avoided if patients and doctors alike recognize a problem exists and address it.

"I have a therapist who works in my practice," said Few. "We know in plastic surgery that if somebody has undue stress, the risk of complication is higher."

"Most plastic surgeons will tell patients to work out their problems -- go talk to a psychiatrist or confide in somebody else," said Miller.

Surgeons also agree that communication between doctors and patients is key.

"It's really important that both the patient and the physician understand what the motivation is behind the surgery," said Dr. Malcolm Roth, director of plastic surgery at Maimonides Medical Center.

While experts say it's difficult to say for sure because there are few data available, they believe certain procedures are more likely to breed buyer's remorse, including nose jobs and breast enhancements.

A recent study published in the journal Plastic and Reconstructive Surgery found an association between complex psychological factors and rhinoplasty.

"Most people feel good after a nose job, but there's a subgroup that almost experience a loss of identity," said Kearney-Cooke. "They wanted the change, but then they don't feel like themselves anymore."

Laura Pillarella said it's now her mission to help other women battle whatever psychological issues they're dealing with so they don't obsess over their appearance the way she did. She wrote a book, "Chasing Beauty," to drive home the message.

"I want to save women from my mistakes and show them how damaging it can be to have low self-esteem," she said.

It's still something she's dealing with herself - right after she turned 40 a few weeks ago, she had breast augmentation surgery.

"I feel really silly and ashamed, but it's a great reminder about my weaknesses," she said. "All I have to do is look down."

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