A comprehensive screening, education, and training tool for the psychological assessment of patients seeking aesthetic surgery: "DESIRABLE OP?".

Patients may seek aesthetic surgery for many reasons. They may present with expectations for both the surgical outcome and the impact that their changed appearance will have on their lives. The desire for an aesthetic procedure is usually driven by increased levels of self-consciousness. The surgeon must be able to identify those patients where the psychological outcome of aesthetic surgery is likely to be poor, and where the self-consciousness of the patient is abnormal. A mnemonic (DESIRABLE OP) is presented with the aim of providing surgeons with a screening tool that can lead them through the psychological assessment of any patient seeking an aesthetic procedure and enable them to determine whether its undertaking constitutes a desirable operation?

Meeting the psychological needs of patients with facial disfigurement.

Those with congenital or acquired disfigurement are faced with the challenges of social reactions and their own psychological responses to looking different. There is no simple linear relation between the degree of disfigurement and the degree of experienced distress. Factors that influence an individual's ability to cope include the social meaning of the disfigurement, life history, social and family support, and developmental stage. Decision-making about surgery, including that for those seeking aesthetic surgery, should take account of these complex factors to understand the patient's needs, ensure informed consent, and avoid unnecessary or ill-timed surgery. All those working with patients with disfigurement should have an understanding of their psychosocial needs, and there should be access to an identified member of staff such as a clinical nurse specialist with counselling skills, and a recognised referral route to a psychologist or liaison psychiatrist.