The psychology of cosmetic surgery: old problems in patient selection seen in a new way--Part II.

Numerous patient referrals and discussions with the plastic surgeons of the Zurich University Hospital, and the lack of "hard" data in the literature motivated me to delve more into the problems of patient selection in cosmetic surgery. The first section of this article consists of a discussion of the selection criteria in the literature. Although they may be important in single cases, none of the criteria proves to be statistically significant in regard to the outcome of cosmetic surgery. After a short outline of the development of research in cosmetic surgery, a systemic-interactional model of thinking is introduced and applied to the patient selection process. The sections on coping, the patient/surgeon/psychiatrist triangle, and management of the patient in the screening interview illustrate that the systemic hypothesis can enhance the understanding of patient attitudes and behaviors. Practical implications are discussed.