Impact of Psychosocial on Seniors after Plastic Surgery - Research Paper Example

 Table of Contents I. Introduction ……………………………………………………………… 3 II. General Information with Regards to Psychosocial and Plastic Surgery …………………………………………………………... 4 III. Common Factors that Requires Old People to Undergo the Process of Plastic Surgery ……………………………………………… 5 a. Significance of Civil Status with the Need to Undergo Cosmetic Surgery ………………………………………………. 5 b. The Presence of Environmental and Chemical Agent Causing Skin Cancer ………………………………….. 7 c. Other Health and Non-Health Issues that Requires Elderly Patients to Undergo Plastic Surgery ……………… 8 c.1 Accident- and Non-Accidental Skin Scarring ………. 8 c.2 Bone and Knee Fracture caused by Falls ………….. 9 c.3 Breast Cancer among Aging Women ……………….. 10 IV. Reasons behind the Obsession of Old People with Plastic Surgery .. 11 V. Psychosocial Impact of Plastic Surgery on Seniors based on the Eight Psychosocial Developmental Stages as proposed by Erik Erikson ………………………………………………………………… 12 VI. Scope and Limitations of Plastic Surgery ………………………………. 15 VII. Conclusion…………………………………………………………………. 16 References …………………………………………………………………… 18 – 22 Introduction Since 1997, the number of individuals who receive plastic surgery has significantly increased especially now that the generation of Baby Boomers is ageing (The American Society for Aesthetic Plastic Surgery, 2008; Woloch, 2008; Krämer & Schikowski, 2006; Alam & Dover, 2001). Based on the report that was published by the American Society for Aesthetic Plastic Surgery, roughly 5% of the 8.5 million plastic surgery cases were done on the people more than 65 years of age back in 2001 (Moody, 2002). It has been noted that the estimated figures of expected number of Americans who would reach the age of 65 would increase from roughly 6,000 each day up to 10,000 by 2030. (Foster, 2008) Since plastic surgery offers the promise of a better self-confidence and self-esteem, a large population of our geriatric society has been open to the idea of going through the process of cosmetic surgical procedures (Becker & Castellano, 2004; Shumrick, Campbell, & Becker, 1999). With regards to the increasing importance of plastic surgery over the psychosocial aspects of people more than 65 years of age, the number of patients above 65 years old who received cosmetic surgery increased from 121,000 in 1996 up to 425,000 in 2001 or approximately 352% during the past five years (Moody, 2002). For this study, the psychosocial impact of plastic surgery on seniors will be thoroughly discussed. In the process of going through the main discussion, general information with regards to psychosocial and plastic surgery will first be provided to give the readers a better understanding of the subject matter. Eventually, some specific cases which causes the elderly individuals to undergo the process of plastic and/or aesthetic surgery including the possible reasons that makes some of them become obsessed with plastic surgery will be tackled followed by analyzing and discussing the psychosocial impact of plastic surgery on seniors using the eight psychosocial development stages as proposed by Erik Erikson. Prior to conclusion, the scope and limitations of plastic surgery will be provided. General Information with Regards to Psychosocial and Plastic Surgery Elderly individuals who are 65 years old and above are facing higher risk of suffering from physical illnesses which significantly affects their psychosocial development. In general, psychosocial is actually referring to each individual’s psychological development and interaction within a social environment. With regards to improving the psychosocial aspect among the elderly individuals, Grossbart & Sarwer (1999) revealed that plastic and/or cosmetic surgery can help reduce psychosocial distress by improving a person’s personal perception with regards to his or her own physical attractiveness. Because of psychosocial improvements that is significantly associated with the practice of plastic surgery, it remains a challenge for geriatrics to promote a positive view on ageing among the old individuals since a longitudinal study that was conducted in Ohio revealed that old people who were able to develop a positive outlook in life especially on issues related to the consequences of ageing usually live as much as 7.6 years longer as compared to old people who has a negative view on ageing (Levy, 2002). In general, the main purpose of plastic surgery is to repair defect body form and/or function through surgical repairs whereas the main purpose of aesthetic or cosmetic surgery is to “improve the elderly patients’ psychological well-being by modifying their body image” (Allen, 2003). Basically, elderly individuals who undergo plastic surgery has a physical defect or physical flaws that needs to be repaired to prevent them from losing their self-confidence and self-esteem over time whereas aesthetic or cosmetic surgery already has a strong self-image but wishes to improve their physical appearance to enable them to feel better about themselves (American Society of Plastic Surgeons, 2008). As part of recommending an elderly patient to undergo plastic surgery, cosmetic or aesthetic surgery which includes facial rejuvenation procedures, eyelid and/or nose surgery, forehead and face lift, chin and cheek implants, liposuction and breast augmentation aside from other long list of body enhancement procedures are performed to each patient depending their physical needs. (The American Society for Aesthetic Plastic Surgery, 2008) Even though plastic surgery and cosmetic surgery are interrelated with one another, Hamilton, Carrithers, & Karnell (2004) explained the significant differences between the two such that cosmetic surgery is often perceived as temporary and is done using less complicated procedure as compared with plastic and/or reconstructive surgery. Common Factors that Requires Old People to Undergo the Process of Plastic Surgery Significance of Civil Status with the Need to Undergo Cosmetic Surgery Aside from a long list of health concerns, several studies show that old men and women who are either married, unmarried, widowed, and separated or divorce has a significant impact over their mental, physical, and social health in the sense that elderly individuals who are married, widowed, and single individuals have a significantly active mental, physical, and social lives as compared to those individuals who are divorced and/or separated (Lee & Shehan, 1989; Kiecolt-Glaser et al., 1988; Glenn & Weaver, 1981). In line with this matter, Lee & Shehan (1989) explained that elderly individuals who are satisfied in their married life have positive self-esteem which contributes to their ability to socially interact with other people. Since most individuals who are either divorced and/or separated or women who have never been married or are not employed are psychologically not happy with their life and has a significantly lower level of self-esteem, these people often experience more acute and chronic health problems such as a wide-range of infectious diseases which causes them to voluntarily withdraw from social gatherings (Lee & Shehan, 1989; Kiecolt-Glaser et al., 1988). In line with this matter, the research survey result of Schofield et al. (2002) which analyzes the relationship between the psychosocial and health behavioral covariates of individuals who underwent cosmetic surgery in the past revealed that individuals who received cosmetic surgery are mostly women who are not satisfied with their love life or has been a victim of verbal abuse in the past. In general, elderly individuals consider their physical appearance as one of the major factors that can significantly affect their social life (Becker & Castellano, 2004; Burke, Wang, & Cook, 2004; Allen, 2003; Drisco & Baker, 2001; Shumrick, Campbell, & Becker, 1999). Because of aging, it is common for skin problems like wrinkles to become visible. In order to maintain the youthful image of our elderly individuals, some of them would end up going through a face-lift procedure (Becker & Castellano, 2004; Allen, 2003), chin augmentation which improves the elderly patients’ facial symmetry (Chang et al., 2001). Since the application of plastic or cosmetic surgery does not only improve the social lives but also the overall physical, mental, and emotional health of the elderly patients (Becker & Castellano, 2004; Burke, Wang, & Cook, 2004; Allen, 2003), it remains a challenge on the part of the American aesthetic plastic surgeons to do their best in keeping the physical appearance of the elderly patients as normal as possible. The Presence of Environmental and Chemical Agent Causing Skin Cancer One of the common factors that increase the ageing process of each individual is caused by the presence of chemical pollution in our environmental surroundings. In general, not only does these harmful chemical and environmental agent fast track the ageing process but also causes people to acquire a wide-range of skin diseases such as skin cancer (Krämer & Schikowski, 2006; Shumrick, Campbell, & Becker, 1999). In general, skin cancer is strongly associated with ageing and excessive exposure to ionizing radiation especially on the face area particularly the nose. Since elder individuals who are exposed to harmful chemical and environmental agent are likely to suffer from either facial or nasal carcinomas (Shumrick, Campbell, & Becker, 1999), a large population of elderly individuals who were diagnosed with this type of skin cancer undergoes plastic surgery as part of removing the nasal carcinomas as a way of extending the life span of the elderly patients and reconstructing the nasal defects in order to help them regain their self-confidence and self-esteem as a person. Based on the clinical experiences of Menger et al. (2005), the most common factor that causes a patient to encounter difficulty in nasal breathing and aesthetic discomfort is caused by ostenosis of the nasal vestibule which can be due to either congenital deformation or acquired vestibular stenosis. Upon evaluating the impact of aesthetic and functional results of reconstructing the nasal alar subunit of each patient, Drisco & Baker (2001) found out that elderly patients who underwent to nasal reconstructive process were able to breath normally aside from having a higher level of self-consciousness. Other Health and Non-Health Issues that Requires Elderly Patients to Undergo Plastic Surgery Accident- and Non-Accidental Skin Scarring Aside from skin diseases caused by the presence of chemical pollution in our environmental surroundings, skin scarring caused by vehicular-related and other accidents caused by burn, shot gun, and/or deep wounds on face and other body parts like arms or legs is another common factor that can require the elderly patients to undergo plastic surgical procedures. In line with the significance of skin scarring with the patients need to undergo a plastic surgery procedure, Bayat, McGrouther, & Ferguson (2003) explained that skin scarring or the abnormal outcome of mammalian tissue repair causes negative impact on a person’s perception about themselves causing them to feel less motivated in socializing. Since the psychosocial functioning of individuals with unattractive skin scarring can be disabled, encouraging these people to undergo aesthetic surgery is often considered as the best option to improve the patients’ social life. In general, skin scarring does not only develop from the wounds caused by pure accidents. Skin scarring can also be caused by coronary artery bypass grafting among elderly patients who has been diagnosed with coronary artery disease (The Patient Education Institute, 2007; Ascione et al., 2002). Bone and Knee Fracture caused by Falls Fall is defined as a sudden, unintentional change in position causing an individual to land at a lower level, on an object, or the floor (Tinetti et al. 1997). In line with this type of accident, the Department of Health reported that 30% of people over the age of 65 and 50% over the age of 80 will fall at least once a year (O'Loughlin et al., 1993). The incidence of falls frequently happens among the elderly individuals. In fact, physical injuries related to fall are one of the most common causes of mortality and morbidity among the elderly individuals (Lord, Sherrington, & Menz, 2001). Even though more than half of the incidence of fall does not result to injury, there is still a big probability that falls could result to bone fracture on the hip and/or knee which may require knee antroplasty for distal femoral fractures among the elderly patients. (Abdelhafiz & Austin, 2003; Lord, Sherrington & Menz, 2001; Bell et al., 1992) Physical injury caused by fall has a significant effect on the psychosocial of the elderly individuals due to the fact that even minor falls can cause them to lose their self-confidence when walking. Since physically injured elderly individuals may end up suddenly losing the independence associated with their reduce mobility, there is a higher possibility for some of them to isolate themselves from other people without the undergoing necessary surgical procedures (Abdelhafiz & Austin, 2003; Lord, Sherrington & Menz, 2001; O'Loughlin et al., 1993). Breast Cancer among Aging Women Aside from causing as much as 46,000 deaths annually, roughly 183,000 breast cancer cases have been reported each year in the United States alone (PennState. Milton S. Hershey Medical Center - College of Medicine, 2008). In general, women who are above the age of 45 years old face a higher risk of developing breast cancer. In order to save the women’s lives from breast cancer, there is a strong need for breast cancer patients to undergo mastectomy procedure which is referring to the surgical removal the cancerous lump or the breast tissues that are affected by cancer cells and/or one or both breasts. When it comes to women having breast cancer, developing the attitude of optimism combined with having a very supportive husband matters a lot in terms of feeling attractive (Abend & Williamson, 2002). In order to minimize the risk that the patient would lose their self-esteem related to feeling less attractive, Bian, Krontiras, & Allison (2008) reported that 13% of inpatient mastectomy cases and 4% of outpatient mastectomy patients willingly received breast augmentation. Not all aging women who undergo the procedure of breast reconstruction had mastectomy. There are also cases wherein patients above the age of 65 years old would undergo breast augmentation, breast reduction, or breast lift procedures in order to make them feel attractive as a person despite their age (Allen, 2003). Reasons behind the Obsession of Old People with Plastic Surgery There are some cases wherein aesthetic plastic surgery could cause the elderly patients to prolong their stay at the hospital. (Harari et al., 2007) Even though there will be some risk associated with graft displacement after performing mucosal, cartilage, and skin grafting procedures as part of the nasal reconstructive surgery (Burke, Wang, & Cook, 2004) including other related post-operative complications and unsatisfactory results caused by face-lift operations (Becker & Castellano, 2004) and chin augmentation (Chang et al., 2001) among other forms of plastic and/or aesthetic surgery, it remains a fact that many people agree that plastic surgical procedures can significantly improve the psyche and physiological status of the elderly patients (Shumrick, Campbell, & Becker, 1999). With regards to the possibility that some of the elderly individuals would become obsessed with plastic aesthetic surgery, Rankman (2005) explained that the media has a significant role in making the elderly individuals become very conscious with their physical appearance. Since TV commercials and other advertisements continuously use flawless women with slim body and pretty faces aside from good looking, well-toned and muscular men in promoting different types of product (Park, 2004; Grogan & Richards, 2002; Alam & Dover, 2001), the audiences including the population of the elderly individuals are becoming very concern with the way they look. Given the fact that physical beauty is considered important among the Americans, some elderly individuals who do not mind receiving plastic aesthetic surgery are more than willing to spend large sum of money and take the risks associated with undergoing extreme make-over (Rankman, 2005; Park, 2004; Alam & Dover, 2001). Plastic aesthetic surgeons have spent many years in practicing and enhancing the procedures and surgical techniques used in delivering plastic surgery. For this reason, the risks associated with this type of medical procedure had significantly decreased over time (Park, 2004). Considering the fact that many people who have tried having a plastic aesthetic surgery are very much satisfied with the results they receive out of the surgical procedures, a large number of the elderly individuals who are very particular with their physical appearance end up becoming obsessed with plastic aesthetic surgery. Psychosocial Impact of Plastic Surgery on Seniors based on the Eight Psychosocial Developmental Stages as proposed by Erik Erikson Extended from Freudian psychosexual theory, Erik Erikson’s eight psychosocial developmental stages discusses the life cycle of human beings which specifically recognizes the impact of societal influences, history, and culture over the personal traits of each individual (Erikson, 1975). Erik Erikson suggests the fact that each individual need to undergo several stages in life. Basically, Erikson’s eight psychosocial developmental stages are basically known as: (1) oral-sensory – trust vs. mistrust (birth to 18 months); (2) muscular-anal – autonomy vs. shame or doubt (18 months to 3 years old); (3) locomotor – initiative vs. guilt (3 to 6 years old); (4) latency – industry vs. inferiority (6 to 12 years old); (5) adolescence – identity vs. role confusion (12 to 18 years old); (6) young adulthood – intimacy vs. isolation (19 to 40 years old); (7) middle adulthood – generativity vs. stagnation (40 to 65 years old); and (8) maturity – ego integrity vs. despair (65 years old and above) (Suny Cortland, 2008). According to psychologist Erik Erikson, “the nearness of death precipitates a crisis during which a person evaluates his or her personal accomplishments and failures in order to find meaning in life” (Hausman, 1981). Even though Erikson assumes that people 65 years old and above have a positive development of identity as they reach the old age (Tornstam, 2005, p. 9), elderly individuals are actually expected to face conflict between ego integrity and despair under the maturity stage (Suny Cortland, 2008). It means that this is the time wherein elderly individuals would spend time reflecting on what they have done in life. In general, reflection of the past includes thinking whether or not they have been successful in their social relationship with other people, in school activities, in career, and/or as a parent. Depending on each individual’s life achievements as they reach the age of 65 years old, elderly individuals tend to either feel fulfilled (integrity) or unfulfilled (despair). Given that an elderly individual is not satisfied with his or her personal life achievements or anything that pertains about themselves such as their physical, mental, or emotional health and well being aside from their physical appearance; there is a strong possibility for him or her to withdraw socializing with other people. In general, elderly individuals who feels that something is missing in their life tend to be more conscious about themselves. (American Society of Plastic Surgeons, 2008) This personal characteristics make them develop a lot of inhibitions about life which makes them less effective not only in performing their work but also in maintaining a satisfying relationship with other people. Particularly in the area of physical beautification, some of the elderly individuals are very much determined in going through plastic aesthetic surgery to enable them to regain their self-confidence and self-esteem which are both needed to enable them to have the courage to mingle with other people despite a long list of their personal despairs and/or dissatisfactions in life. Since elderly individuals who receives a successful plastic aesthetic surgery feels better about how they look physically, there is a psychological upliftment from emotional stress which enables them to work effectively and deal with other people in different situations more effectively (American Society of Plastic Surgeons, 2008). Looking better physically also enables them to feel comfortable about the idea of having a new relationship in the case of individuals who are unmarried. In general, plastic surgery can either be classified as aesthetic (cosmetic) or reconstructive. Regardless of the type of plastic surgery used, both surgical procedures promises the elderly individuals to have a positive attitude and perception about themselves. For instance: An elderly woman with breast cancer who had to go through masectomy may feel less a woman. (Allen, 2003) For this reason, some of them may feel ashamed by the way they look physically even though her husband is the only person who can see her with only one or no breast at all (Abend & Williamson, 2002). In line with the insecurities an elderly woman would feel about having only one breast or no breasts at all, undergoing a breast restructuring or breast augmentation can help her psychologically bring back her self-esteem and self worth as a person (Bian, Krontiras, & Allison, 2008; Allen, 2003; Abend & Williamson, 2002). Another good example is when an elderly individual has a serious skin scarring on the face which was accidentally burnt years ago. (Bayat, McGrouther, & Ferguson, 2003) Through cosmetic or aesthetic surgery such as skin grafting, there is a bigger chance for the elderly individual to regain his or her self-esteem which is necessary in enabling him or her to maintain his or her active lifestyle without having to deal with fear of not being socailly accepted by other people. Scope and Limitations of Plastic Surgery The best patients who are qualified to receive plastic surgery are those elderly individuals who are born perfectionist with the way they look physically. (American Society of Plastic Surgeons, 2008) Basically, there will always be a limitation with regards to the qualifications of elderly individual to receive plastic surgical procedures. Even though it is clear that any forms of plastic surgery can improve the way elderly individuals feel about themselves which is necessary in making them able to socially interact with other people, not all elderly individuals are qualified to undergo a plastic aesthetic or reconstruction surgery. Aside from having mental illnesses such as paranoia or delusion, elderly individuals who just recently had or have serious emotional problems caused by relationship failure such as divorce or the death of a spouse, and/or losing a job are not recommended to undergo plastic surgery (American Society of Plastic Surgeons, 2008). Aside from the fact that emotional problems could hinder the healing process among the elderly individuals, the main reason why these group of elderly individuals are not eligible in receiving plastic surgery is due to the fact that the main cause of their grievances is not directly related to feeling bad about how they look like. Conclusion The Erik Erikson’s eight psychosocial developmental stages as discussed earlier in this study enables us to have a better idea on issues that people who are 65 years and above are expected to experience. Based on Erikson’s theory, elderly individuals who are above 65 years of age faces the point in life wherein they would think about their failures and achievements in life. Normally, elderly individuals who are able to become successful in different areas in their personal lives tend to socialize more without any inhibitions as to whether or not other people may think negatively about them. However, those people who feel unsatisfied with their life accomplishments are more likely to withdraw from socializing with other people. In other words, their psychosocial aspect decreases over time. There are many reasons why an elderly individual experience low self-esteem. In case the main cause of their grievances is due to the lost of their love ones, the use of plastic surgery should not be considered as a solution in terms of increasing the psychosocial aspect of an elderly person. Given that the reason why an elderly individual isolate themselves from other people is caused by physical appearance such as having a deformed nose structure, a large and ugly skin scarring, and/or having only one or no breast at all, plastic surgery should be considered since this type of surgical procedure could effectively increase not only the self-esteem and self-confidence of the elderly individual but also improve their social interaction with other people. *** End *** References: Abdelhafiz, A., & Austin, C. (2003). Visual Factors Should Be Assessed in Older People Presenting with Falls or Hip Fracture. Age and Ageing , 32:26 - 30. Abend, T. A., & Williamson, G. M. (2002). 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Retrieved October 31, 2008, from Cosmetic Surgery Statistics – Rising Consumer Interest: http://www.articlesbase.com/wellness-articles/cosmetic-surgery-statistics-rising-consumer-interest-377977.html Read More