Too Much Good Stuff – Body Dysmorphic Disorder
September 23rd, 2009
Cosmetic surgery addiction or habituation does occur more frequently than one would expect. At least it appears that way in the media. Websites are full of individuals who have chosen too much plastic surgery. Also featured are people that have chosen procedures which have left them with an unnatural physical appearance, either by design or because of a poor result. I think these situations are related.
The first person who comes to mind is the late Michael Jackson. Throughout his life he underwent a metamorphosis each year toward a more bizarre facial appearance. By examining successive photos, it is impossible to figure out precisely what he had done. Obviously he had multiple nose surgeries. He has also had a variety of facial skin tightening/whitening procedures along with a myriad of facial implants and injections. I really think he suffered the full expression of “body dysmorphic syndrome.” “Body dysmorphic disorder is a mental illness also known as imagined ugliness. It’s just that – a person sees physical flaws that either too slight or nonexistent for anyone else to notice…” The term imagined ugliness perfectly describes this condition. Michael Jackson imagined himself ugly and most likely sought out cosmetic surgeries and treatments in an effort to alleviate his mental anguish. As it has been reported, he also sought some type of escape by abusing numerous prescription drugs. In a way he traded his probable psychiatric diagnosis (socially unacceptable) for a surgical procedures (socially acceptable). Arguably the cosmetic surgery procedures provided him with the publicity he craved and attention he needed on a continued and ongoing basis.
It is unfortunate that he surrounded himself with an entourage that did very little in his best interest, except to simply enable his unhealthy choices and line their own pockets.
Tomorrow I will discuss Jocelyn Wildenstein, known as the “Cat Woman” of New York because of her peculiar desire to look like a cat.
Office Notes: Botox
July 21st, 2009
Today I will be injecting Botox ®. Comments I hear frequently are, “My last Botox ® did not last as long as I would like. The Botox ® did not work as well as I had hoped.” Patients with these complaints usually had their last injections elsewhere. Often times, the injectionist is a non-physician and sometimes an individual with little or no medical training.
Botox ® is packaged in 100 unit bottles. This “unit” measurement is determined through a physiologic assay. The Botox ® package insert recommends 20 units for the frown lines. When the full 20 units is used in this one area, the results are consistent and should last for the full 3 to 6 months. It has become common practice in salons, med-spas and some physicians offices to inject less than 20 units of Botox ® into the frown lines. Injecting less saves money. Reducing the dosage leads to decreased effectiveness and decreased longevity. Patients return for “touch up” injections to get the result they desire.
My advice for the increased likelihood of a obtaining a professional and lasting result, is to consider having the full dosage recommended by the manufacturer (20 units for the frown lines) and consider having your Botox ® done by a physician.
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