Survey shatters plastic surgery myth

By JOAN WHITLOW

For years most studies on the psycho-logical aspects of cosmetic surgery cast a negative light on the emotional makeup of the patients and suggested they expected too much from their surgery and were generally disappointed with the results.

But Dr. Alvin I. Glasgold of Highland Park said his research shows that perception is a myth. Today's cosmetic surgery patients, particularly the younger ones, are getting what they want.

Glasgold is the chairman of the Department of Otolaryngology, Head and Neck Surgery at St. Peter's Medical Center and Middlesex General-University Hospital in New Brunswick. He also is chairman of the facial plastic surgery section of the New Jersey Academy of Opthalmology and Otolaryngology.

Working with psychiatric social worker Susan B. Horowitz, Glasgold questioned some 200 patients who had nose surgery, rhinoplasty, for purely cosmetic reasons. Asked to rate their satisfaction on a scale of one to 10, patients most frequently answered 10. The mean score was 9.5.

Glasgold said he was surprised at the high rate of satisfaction, even though he had expected positive results.

He explained that studies dating back to 1940 indicated that plastic surgery was the choice of entertainers and the wealthy. Those earlier studies claimed there was a high degree of emotional disturbance among the patients, and the commom belief was that these unhappy people had such unrealistically high expectations that the surgery was doomed to be a failure in their eyes.

Glasgold noted that as recently as 1980, some researchers emphasized the psycho-pathology behind the desire for cosmetic surgery and suggested that psychiatric screenings should be required routinely of all patients.

	Yvette Furman of East Brunswick contemplates her old profile in a picture that was taken before she had plastic surgery on her nose and chin

"That was not what I was seeing in my practice," Glasgold said.

Attitudes about cosmetic surgery have changed and the techniques have improved. He said his patients come from all walks of life, seem as emotionally stable as any group and seem generally satisfied with the surgery.

He decided to do the survey to test his observations.

His study of patients 15 to 57 years old found that those under 20 had higher expectations for positive changes in their appearances, self-esteem and social relation-ships.

All age groups reported positive benefits from surgery, but the younger patients had the highest levels of satisfaction.

The subjects were interviewed at least six months after surgery.

All of the age categories said the change in their appearance was greater than the change the operation had made in other aspects of their life but they reported significant benefits in self-esteem and social relationships.

"When a mature individual comes to me, they say, 'I'd like to look better, but I don't want to look like someone else,' " Glasgold noted.

The older patients want what they see as a blemish removed, but they are satisfied with themselves and do not want major changes, the doctor said.

The effect on the more mature individual's personality is not as great because that personality is already established, he suggested.

Even so it is not unusual for those people to get new hairdos and change their makeup and wardrobe to go with the changes in their faces, he said. He noted that face lifts and other types of plastic surgery give a more youthful look to the face. Of all the operations, rhinoplasty is one which can actually change the way a person looks.

The younger patient is more likely to expect, and get, emotional and psychological benefits from the surgery, according to Glasgold.

Very often younger people want the surgery done during the summer between a move from one school to another. They want to start in a new environment, as a new person, he said.

And they seem to get their wish, based on Glasgold's survey. In the under-20 category patients rated the positive change in appearance 8.5 on a scale of one to 10. They rated self-esteem 7.3 and social relationships 7.5.

That compares to an overall rating of 7.4 for appearance, 6.0 for self-esteem and 5.2 for social relationships.

Some doctors recommend rhinoplasty be delayed until after the child stops growing. But Glasgold said that some children suffer from their appearance, some are teased by other children.

"I'm not operating on 11- and 12-year-olds, but I may do someone 14 or 13 after an interview with the youngster and parents, if I feel it is warranted," he said.

"When, at an early age, an individual overcomes what they consider a physical deterrent, there is a tremendous change in personality," he said.

Whatever the patient's age, spouses and family members very often consider cosmetic surgery a bad idea. The partner or family fear a change in their relationship with the person, they may fear that they will be seen as less attractive if the one they love be-comes more attractive, the doctor added.