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22.11.2015
That became obvious to me as I treat an enormous number of men who suffer from gynecomastia. I’m not sure of the explanation for these findings, but I have recommended for years that if you think you have gynecomastia, you have it.
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Plastic surgery is a booming trade in countries across the world, and Britain is no exception.
But in the UK, as more and more people chose to undergo procedures to “enhance” or alter their bodies, medical professionals are voicing increasing concern over the processes currently in place around such surgeries. In April 2013, Professor Sir Bruce Keogh, the medical director of the NHS in England, published a highly critical Department of Health report in the wake of the PIP breast implants scandal on the lack of regulation and inadequate patient care on offer in the multi-billion-pound cosmetic surgery industry.
And Britain’s General Medical Council has begun urging aesthetic plastic surgeons in the UK to look out for signs of any underlying psychological problems that people may be trying to “cure” by going under the knife.
Stressing that they have “particular concerns about patient safety” and question whether “the sector operates in an ethical manner,” the GMC, in its new guidelines, calls for a minimum two-week period between the initial consultation and the procedure being carried out, to make sure that “unjustified” claims are not being made by practitioners and that they are not “trivializing” the risks involved. It is clear that the GMC is  attempting to address the money-making aspect of the cosmetic surgery trade by more stringently regulating the ethics around it.
The guidelines also put a lot on emphasis on the psychological well-being of people who want to have cosmetic surgery.
But they fall short of requesting psychological screenings to be made part of consultations in aesthetic procedures. The Centre for Appearance Research at the University of the West of England is calling for it to be made mandatory. A person going in for cosmetic surgery, is 15 times more likely to suffer from the disorder than the general public. The Evidence for Policy Information and Co-ordinating department at the University of London is one of a few that have tried to tackle the issues, along with the Centre of Appearance Research. As things stand, the onus is on the patient to consider their own mental state and to “ask the right questions” of the surgeon. Catherine Lowe is a 34-year-old Londoner who has had several invasive and non-invasive procedures: breast implants, skin laser therapy, cosmetic teeth whitening and lip fillers so far. Lowe says she had her braces removed on the Thursday, scheduled a consultation on Friday and on the following Monday, she was in the nurse’s chair having the procedure done. She acknowledges that she “jumped into it” but at no time, she says, was she asked to take some time to think about her decision or consider whether she could just get used to her natural lips. Lowe hasn’t completely sworn off aesthetic surgery since the experience back in 2010, but says she now does a lot more research and consults her friends before going for a procedure.


However, Taber adds that although Treatment You Can Trust “fully supports” the research being carried out by CAR, it does not recommend a two week cooling off period for injectables.
The General Medical Council believe that “patients need to be better protected from the risks” associated with the current patchy regulations in place to safeguard them when undergoing procedures involving injectables and laser therapy. The GMC and Royal College of Surgeons are set to release the findings of their studies early next year.
About seven percent of Norwegian women between the ages of 18 and 65 have undergone cosmetic surgery.
Mental health may worsenThis is both before and after the surgery, which suggests that the plastic surgery does little to alleviate mental health problems.
The conclusion of this paper also fits my conclusion: gynecomastia has little association between the appearance of gynecomastia and the degree of psychosocial disability (burden).
Patients with very little fullness of the chest suffer as much, or more than a patient who has breasts similar to a woman. In the year to 2014, there was a 17 percent rise in overall cosmetic procedures, according to the British Association of Aesthetic Plastic Surgeons. In January this year, the Royal College of Surgeons made draft proposals for cosmetic surgeons, including requirements to obtain specific qualifications for different procedures. The GMC monitors and regulates medical practitioners, and has issued guidelines that must be followed by all its members. Doctors are being told not to “falsely claim or imply that certain results are guaranteed from an intervention” and so risk an unhappy patient post-procedure. And for many looking to clean up the profession, there seems to be a crucial step missing: how can doctors, who are not trained in psychology, discern whether or not a patient may have potential underlying mental health issues that have led to them seeking surgery? Anxiety disorders, depression and mental health issues are disproportionately higher in those looking to get surgery or injectables, say researchers. After examining a plethora of studies, they found that people who want surgery are “significantly more likely” to have mental health issues or suffer from domestic violence. According to research carried out by the British Association of Plastic Reconstructive and Aesthetic Surgeons, 59 percent of postoperative patients are less confident if they’ve rushed into a procedure and 45 percent of people who have had surgery, say that social pressure was a major contributor for them.
I was warned that it would dissolve my natural lip tissue, so I might end up with thinner lips than before any filler. She recognizes that a lot of the pressure she feels to be perfect comes from feeling that she wasn’t the prettiest in her family growing up. Doctors, surgeons and nurses are subject to the controls of the GMC and the Nursing and Midwifery Council, but it’s possible to perform laser therapy, botox and filler injections as a beauty therapist with no medical training. Advocates hope that the underlying reasons for undergoing cosmetic procedures and patients’ mental well-being will feature highly in their new guidelines for doctors—and that psychological screenings will be as highly regarded as medical ones.


The researchers used data from a survey of thousands of school children between the ages 12-19 years and followed them up with additional questions, two, seven and 13 years later."Cosmetic surgery doesn't solve all problems," says Associate Professor Ingela Lundin Kvalem. It seems that you either have it in your head or you don’t, and the appearance of your chest has little to do with how much you suffer. At the top of the list was a 41 percent increase in liposuction procedures to remove unwanted fat, followed by rhinoplasties and otoplasties (corrective nose and ear surgeries, respectively).
Both say that assessing the psychological reasons why people want plastic surgery needs to be at the center of any consultation. Nicola Paraskeva, a research fellow at the CAR has been researching effective methods of incorporating mental health screenings into the consultation stage for anyone wanting to go under the knife. Those who suffer from the anxiety disorder fixate on a body part and often obsess about it. Paraskeva is critical of this one sided approach as often, she says, patients are the least likely to be aware of their mental health problems. A few days after getting what she thought was the perfect pout, she experienced a severe allergic reaction. So I wanted to get fillers to get the same look.” She says that the person who did the consultation was not a nurse, but a “technician,” and was really chatty and convincing.
Not since before the recession has the industry seen double digit rises in patient figures, 90 percent of whom go through private practices. She and her colleagues believe that a questionnaire they are developing is a vital tool that should be completed by every single plastic surgery patient.
It may mean that they avoid going to work and it can even stop them from forming relationships, therefore increasing their  alienation. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare.
He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.



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