First published in A2: Aesthetic Surgery and Anti-Aging magazine (2014)
A misshapen nose can undermine one’s confidence and self-esteem. This suggests that the benefits of Rhinoplasty are psychological. Some surgeons define a ‘nose job’ as, ‘psycho-surgery;’ the result, an almost instantaneous resolution of a previously held inferiority complex.
Since the nose is the most prominent feature on the human face, it’s not surprising that Rhinoplasty has evolved into one of the most popular procedures in plastic surgery. A disproportionately shaped nose, at the focal centre of the face, not only undermines aesthetic harmony, it attracts unwelcome attention. Oddness like this evokes relentless teasing in childhood. Rhinoplasty, in this context, has a huge potential for profound, life-changing psychological transformation. Evidence gleaned from cosmetic surgeons, psychologists and patients suggests that the mere ‘correction’ of a physical abnormality can neutralise social anxiety, and reverse low self-confidence.
Growing Pains
The case of 17-year old Ansie Maree from the East Rand in Gauteng is an example. Ansie was born with a ‘hump’ nose. After years of taunting, she made a decision – after discussions with her father, businessman Andre Maree – to change the shape of her nose. She’d had enough.
Rhinoplasty surgeon, Dr Pieter Swanepoel, recalls examining Ansie during the winter of 2013. He’d formed a valuable first impression of the girl as she walked into his consulting room. She had the constrained bearing of a child attempting to mask the awkward embarrassment of a pronounced nasal hump and beneath it, a receding chin.
The ensuing ‘hump removal’ surgery, one of the most common procedures in Rhinoplasty, included ‘tip work’ and a chin augmentation. The result had an instantaneous affect. From the moment Ansie saw the result, says Swanepoel, it transformed her from an awkward teenager into a happy young woman.
“I can say that within the space of a few seconds, after I showed her the result, something spontaneous occurred,” Swanepoel recalls. “All the earlier, negative feelings vanished. I cannot describe the relief and the joy she and I shared in that moment.”
Transformations on this scale are pivotal, so, it’s worth stepping back, figuratively, to the actual moment of this revelation, as it occurred in Swanepoel’s rooms.
A glimpse behind the scenes
Rhinoplasty surgeon, Pieter Swanepoel, leans forward and gently removes the skin coloured aluminium brace from 17-year-old Ansie Maree’s nose. He leans back, hands her a mirror and waits.
She grasps the mirror with both hands and appraises herself, rotating her head side to side. Relief, a great emotional release, washes through the young child. “Wow, oh, wow,” she cries. Tears trickle down her cheeks.
Andre Maree, her father, standing off to the left, edges closer. Tears glisten in the corners of his eyes. The surgeon too, feels a familiar surge. This, he knows, observing Ansie, is cosmetic surgery’s ‘magic moment,’ a moment he’s often shared as patients first glimpse a nose transformed by cosmetic surgery. It’s the moment when the pendulum magically pauses between heartbeats, between what is old and not yet gone, and what is yet to become. In that moment, a breath-taking psychological shift transforms a human life, the transformation itself, an instantaneous, gushing release of self-negating, ‘I am not good enough’ feelings.
“Surgery like this changes lives,” says Swanepoel, comparing digital images taken of Ansie before surgery with images taken 10 days later. The joy she felt, and the joy I shared with her is the reason why I practice cosmetic nose surgery; it is almost a spiritual experience.”
A glimpse into Ansie’s private world
The teasing started at school. She remembers the day it started. She was 11. Walking past a group of boys, she overheard a comment that so shocked her, she had to confront the possibility that she was different, perhaps ugly, and in a previously concealed way, socially unacceptable.
“That was the day that those boys were on the field playing soccer,” she recalls. “They simply turned around and said, ‘oh look, here comes the girl who looks as if her nose got stuck in an elevator.’ I was so shocked at what they had just told me that I went to the bathroom by myself, and I stood there by myself for about an hour after school thinking to myself, was what they said really true?”
The incident changed her life. She developed what psychologists term a ‘coping style’ to manage the socially unacceptable nose. “You get to a breaking point where you can’t take it anymore,” she says.
What does it mean?
Why do memories of trauma linger? To answer this, we need to understand the affect trauma has on the neural system, and how the system encodes memories of trauma into the ‘wiring’ of the human mind.
Dr JO Steenkamp, the Pretoria based pioneer of SHIP therapy (Spontaneous Healing Intrasystemic Process), the process for facilitating the release of emotional trauma, says cosmetic surgery definitely has an enormous, and positive affect on patients. “I have, and have had, many clients that went for various surgeries. Most are extremely glad they did. Their sense of quality of life definitely improved.”
He explains nevertheless, that we store memories of teasing, abuse and shame in the nervous system. These feelings occasionally show themselves later in life, whenever the patient re-encounters a situation that evokes memories of the earlier abuse. “The person will then be flooded by … the unresolved past (unconscious information) still lodged in their neurology.”
How? Psychologists use the term, ‘developmental trauma’ to describe the intensely destructive affect trauma has on ‘dendrite formation’ in the nervous system (dendrites aid the transmission and reception of signals). There is growing evidence – linked to a vast library of academic information – showing the affect trauma has on different areas of the brain, and that with appropriate treatment, recovery is possible.
Conclusion
“There are always exceptions,” says Swanepoel. “There is a small category of patients that a surgeon can never please. But, I can tell you this, that the almost instantaneous way a patient’s brain accepts a good result is amazing. It happens within seconds; you notice an immediate change in the patient’s eyes. “Whatever may yet still lie ahead in a patient’s later years, rhinoplasty changes lives.”
