Last year I received an email from a farang who was worried about his 17 year
old daughter wishing to have the shape of her nose altered (known as a
‘rhinoplasty’).
I replied and (in part) wrote “Yes, there are always inherent
risks with all surgical/anesthetic interventions, but honestly the risk in this
case is so small as to be almost negligible. On a practical note, I agree with
the decision to delay until she is 18 and can assume some responsibility for
going ahead. Pick a certified cosmetic surgeon working out of an accredited
hospital.”
This month I received another email, with him writing, “It
gives me no pleasure to tell you that (my daughter’s) friend has been having
serious problems with the nose augmentation requiring several doctor visits and
long trips from Si Sa Ket (to the clinic). A second implant surgery to place ear
cartilage has been necessary. I want to reaffirm to you that ‘...almost
negligible’ DOES happen; and as you say, NO surgery is totally safe. Far too
many folks, Thai and Farang alike, believe with today’s technology surgery is
foolproof. They need a pharmaceutical dose of your wisdom that living life with
a bit of a pixie (na-lak) nose shape (one that I personally prefer) isn’t worth
ANY small risk of unnecessary cosmetic surgery.”
In my reply, first off, I am not going to get involved in
criticizing either the surgeon or the clinic, neither of which I know. I will
also emphasize that I did suggest “a certified cosmetic surgeon working out of
an accredited hospital.” It does not sound as if this was the case here, but I
repeat, I am not pointing any fingers in a case where I am not at all appraised
of all details.
To give an idea of the chances of unsatisfactory outcomes, I
have studied the results in my hospital, and also delved into other resources.
It pleases me to report that our incidence of problems, for all our cosmetic
procedures is very much less than one percent. For rhinoplasty, the figures for
‘real’ problems is even less. For the anesthetic risk, Dr David Wilkinson of the
Association of Anesthetists of Great Britain and Ireland states, “Anesthesia is
now very safe, with mortality of less than 1 in 250,000 directly related to
anesthesia.”
However, do take heed of the fact that it can take two to
four months for all swelling to go down after the surgery. In some cases, it can
take up to a year before the patient knows exactly what their nose is going to
look like. Some people become upset with the look of their post-operative nose
in these first months, as crookedness and bumps may show up during the healing
process. Most western surgeons recommend against going through any other
procedures, such as revisions, for at least nine months after having nose job.
This does not seem to have been the case in the situation you mentioned, and
incidentally, my advice has always been one year.
You are quite correct, of course, when you write that adverse
events DO happen; and as you say, NO surgery is totally safe. However, all of
life has inherent risks. Using a pedestrian crossing in Pattaya being a prime
example. It is up to the individual to understand the risks, and then decide for
or against. With cosmetic surgery, which can be a life-changing event, the
patient has to weigh up the risk versus the (hoped for) outcome. It is extremely
important that the patient has realistic expectations of the final result, and
to have that degree of maturity is, in my view, beyond the ken of a teenager.
It is also my belief that all prospective candidates for the
cosmetic surgeon’s knife should have a psychological assessment before any
surgery is carried out. That may sound hard, but unreal expectations are a much
greater source of “problems” post surgery, than any problems related to the
surgery itself.
However, all of us have a degree of vanity. Have you ever
looked in the mirror and pulled at your cheeks to see what you would look like
after a face lift? I am sure you have!
