More Than Just a Pretty Face: How Cosmetic Surgery Can Improve Your Looks and Your Life by Thomas D. Rees, MD, with Sylvia Simmons (Little, Brown) 263 pp., $19.95.
"More Than Just a Pretty Face," written by Dr. Thomas Rees, professor of plastic surgery at New York University Medical Center, is a potential patient's best introduction to plastic surgery. Rees, the author of the definitive physicians' textbook in its field, "Cosmetic Facial Surgery," has traveled the world teaching his exacting, delicate and artistic technical skills to surgeons in Asia, Africa, Europe, Latin America, Australia and New Zealand.
The book clearly explains the emotional, physical, anesthetic, aesthetic and other aspects of cosmetic facial plastic surgery so crucial to those contemplating such surgery. It also offers in-depth discussions of rhinoplasty, blepharoplasty and otoplasty -- nose, eyelid and ear repair, respectively, plus a comprehensive look at facelifts and "the forehead and brow lift."
Rees advises readers, before they undertake any steps toward facial surgery, to explore critical issues such as possible complications, blood loss, types of anesthesia, healing phases and realistic versus neurotic expectations from the postsurgical result. He also devotes an entire chapter, "The Consultation," to helping the reader come to terms with precisely what an initial meeting with a qualified plastic surgeon will entail. There, he brings sharply into focus the kinds of questions and fears a patient might have; the matters of informed consent, physician credentials and fees; and particularly, the all-important psychological assessment.
The psychological assessment depends on one of the key skills of a plastic surgeon -- scrupulous preoperative patient selection. This is because some patients are not suited for these procedures. For example, a paranoid person, convinced that people don't like him because his nose has a bump on it, is not likely to be rid of his paranoid delusions even with postsurgical improvement of his looks by an artistic rhinoplasty. And minus his nasal scapegoat for being "disliked by people," he could be precipitated into a psychotic break with whatever reality his "bump on the nose" helps him cling to.
Sometimes, in fact, psychotherapy may be in order rather than a change of face. The plastic surgeon who turns down a patient because of unrealistic fantasies of the power such a change would bring, is also saving himself or herself a great deal of predictable woe. Such individuals are prone to become dissatisfied with any result, and lawsuits are their legacy.
In a book so carefully thought out, backed by such exhaustive medical and surgical expertise, one would wish for extensive graphic illustrations, including photographs and drawings, demonstrating the before-and-after appearance of Dr. Rees' cosmetic surgery benefits. This would have been valuable in a work written ostensibly to help people take the first difficult step toward their initial consultation with a plastic surgeon. Schematics of the simplest procedures would also have gone a long way to demonstrate what prospective patients will actually undergo at the surgeon's hands and could have served to mitigate fears of intolerable pain or excessive tissue invasion by the surgical knife. Alas, there are few drawings and only two before-and-after sets of photos.
And about those before-and-after photos: Rees' warns that relying on a computer projection of what you will look like after common cosmetic facial surgery, as advertised on television, may be disappointing, since such technology is only in the research stage. For a more detailed and realistic prediction of what to expect, ignore the commercial and read the book. It's an uplifting eye-opener.
Helen Borel, RN, PhD, who writes fiction as well as medical and psychological nonfiction, is a psychoanalyst in private practice in New York City.