Surgery and Mental Health: Why Pre-Surgery
Counselling is Essential
In my years working in the aesthetic industry alongside plastic surgeons, I observed a recurring and often challenging reality: many clients entered the surgical journey without fully understanding what to expect. This was particularly evident in how they reacted to scarring. Despite thorough pre-surgery consultations, some clients were shocked by the appearance of scars and insisted they hadn’t been informed.
This disconnect wasn’t due to surgeons neglecting their duty. In Australia, it’s a legal requirement for surgeons to comprehensively explain all aspects of the procedure, including potential side effects. Yet, time and again, clients would focus solely on fixing their perceived flaws, tuning out crucial discussions about scarring or healing.
As surgeons confided during many lunch breaks, their role often shifted to that of a counsellor when managing clients’ post-surgery emotions. This mismatch of expectations led to disappointment and frustration, making it clear that the physical changes achieved through surgery often didn’t address deeper emotional issues.
When I transitioned careers due to health reasons, several surgeons asked if I would help assess clients’ readiness for surgery. Today, I counsel individuals referred by surgeons who suspect their focus on “fixing” a perceived issue might overshadow the realities of surgery.
The psychological journey of plastic surgery
Plastic surgery doesn’t begin in the operating room; it begins in the mind. It often starts with dissatisfaction—a fixation on a body part perceived as flawed. This dissatisfaction fuels a spiral of obsessive research, comparisons with celebrities, and the belief that achieving physical “perfection” will lead to happiness.
The process often unfolds as follows:
- The consultation: After finding a surgeon, clients are presented with surgical options. They envision a future version of themselves and often place unrealistic expectations on how this change will transform their lives.
- The surgery: Excitement peaks as the big day approaches. For many, the surgery feels like the first step toward becoming the person they aspire to be.
- The reality check: Post-surgery, clients wake up to pain, swelling, bruising, and scarring. Recovery is far from glamourous, and scars can take up to a year to heal. Complications, such as infections or delayed healing, can exacerbate frustration.
- The emotional rollercoaster: As physical healing progresses, emotions often fluctuate. Some clients realise the issue they hoped to “fix” wasn’t entirely physical. While the surgery may improve their appearance, deeper emotional struggles remain untouched.
Healing is influenced by numerous factors, including genetics, skin type, and lifestyle choices. For instance, those with autoimmune conditions, poor circulation, or who smoke may experience prolonged healing. Additionally, individuals with Asian or African heritage are more likely to develop keloid or hypertrophic scars, as their skin tends to produce excess collagen during the healing process, leading to thicker or more prominent scarring.
Why pre-surgery counselling matters
Surgery isn’t a cure-all. It won’t resolve underlying emotional issues, repair relationships, or create lasting happiness. This is where pre-surgery counselling plays a critical role.
Counselling sessions provide clients with the opportunity to:
- Clarify motivations: Understanding why you want surgery is essential. Is it to enhance your self-esteem, or are you hoping to solve unrelated life challenges?
- Address underlying issues: Counselling can uncover emotional concerns driving the desire for surgery and help clients develop healthier coping mechanisms.
- Set realistic expectations: Clients gain a clearer understanding of what surgery can—and cannot—achieve. This ensures they approach the procedure with eyes wide open.
When clients have the chance to explore these questions, they are better equipped to embrace the outcomes of surgery without misplaced expectations.
The long road to healing
It’s important to acknowledge that surgery is a journey, not a quick fix. The physical recovery process can take months or even years, and it’s often accompanied by emotional highs and lows. Understanding the factors that impact healing—such as scar placement, genetics, and health conditions—can help clients prepare for the reality of recovery.
Equally significant is the societal pressure to conform to ever-changing beauty standards. What is considered “ideal” today may be out of fashion tomorrow. Trying to keep up with these trends is not only exhausting but futile.
Instead, self-love and appreciation for your body are the greatest gifts you can give yourself. Your body works tirelessly to support you, and as it ages, you’ll likely look back and marvel at how strong and capable it once was—even if you couldn’t see it at the time.
The true value of surgery
Plastic surgery can be transformative, but only when approached with the right mindset. It’s a tool for enhancing confidence, not a solution to life’s challenges. Clients who address their emotional readiness beforehand often find greater satisfaction with their results because they understand what surgery can realistically offer.
If you’re considering surgery, take the time to assess your motivations and expectations. Schedule a counselling session to explore your emotional readiness and gain clarity. Plastic surgery is an investment—in time, money, and emotional energy. Ensuring you’re fully prepared will help you enjoy the results for what they truly are, rather than what you hope they’ll fix.
Ultimately, your body is already remarkable. Appreciating it as it is while making mindful decisions about enhancing it is the key to a positive, fulfilling experience.
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