Laura Pillarella became trapped in a vicious cycle of surgery
Laura Pillarella was hugely disappointed the first time she had plastic surgery. The naturally-attractive, but insecure, young woman had hoped the procedures to remove the bags under her eyes and insert a chin implant would improve not only her looks, but also her life. They didn’t.
‘When the bandages came off, I was disappointed,’ she says. ‘I wasn’t beautiful — just different. It wasn’t enough.’ So Laura planned another operation … and then another. For the next decade she became trapped in a vicious cycle of surgery, dissatisfaction and more surgery. Finally, after her 15th procedure, a plastic surgeon told her the real problem with her looks was that she had had excessive amounts of surgery. It was too much for Laura to bear. After spending more than £40,000 trying to be beautiful, she seriously thought about taking her own life.
Naturally pretty: Laura, pictured before her surgery, had procedures to remove the bags under her eyes and insert a chin implant
‘I had my suicide all worked out. I was going to rent a room in a hotel, get some sleeping tablets and wash them down with red wine,’ says the American personal trainer and author. ‘I wasn’t going to leave a suicide note. People would know why I’d killed myself. One look at my face said it all — I’d made myself look hideously ugly. My face was lopsided, my nose was too skinny, my lips were distorted and my chin was crooked.’ Laura is typical of many cosmetic surgery patients who are left profoundly depressed by their appearance afterwards. New research shows that behind the ‘easy glamour’ of nip’n’tuck lies a silent epidemic of disappointment, leading to a wave of suicides. Women who undergo plastic surgery have a much higher risk of killing themselves, say experts in the journal, Current Psychiatry Reports. Their conclusions were based on five large-scale, independent studies, which found that the suicide rate is up to three times higher in women who have had breast implants. The toll is not only restricted to suicides — cosmetic surgery patients had a three-times higher rate of death due to self-destructive acts, such as binge-drinking, drug overdoses and reckless driving.
Psychological damage related to plastic surgery is ‘a critically neglected area’, said researchers from the International Epidemiology Institute in the U.S.. Meanwhile, another study found that in eight out of ten cosmetic surgery practices, former patients had developed post-traumatic stress. Surgeons were seeing at least as many psychological side effects as physical complications. ‘Disappointment, anxiety and depression were the most frequently seen psychological problems,’ says the report, published in the journal, Plastic And Reconstructive Surgery. ‘The next frontier for the specialty is to improve patients’ emotional and psychological results.’ It’s a problem not just confined to women — indeed, men are thought more likely to be distraught at the outcome of their cosmetic surgery, even if they have had a ‘technically good result’, say researchers. Last year, in journal Annals Of Plastic Surgery, Melbourne University researchers advocated increased psychological screening before surgery and support for patients afterwards. Such help was sadly never offered to Colin Phillips, 62. In 2009, an inquest in Cardiff heard how he hanged himself in a wood, distraught at how his third facelift had gone.
Phillips, a retired managing director, was ‘fanatical’ about his looks and had twice before undergone plastic surgery on his face. But he felt his appearance had been butchered after a third procedure by a Harley Street surgeon and refused to leave his £600,000 home. His wife, Janice, 62, said: ‘After the first facelift he felt tremendous.’ But her husband’s original surgeon refused to operate on him a third time, so he searched the internet for a Harley Street doctor who would. The mother-of-two said: ‘He was pinning his hopes on having a maxi-facelift. But after the operation he would look in the mirror shaking.’ A month later, Mr Phillips, a grandfather, took an overdose of drugs and was admitted to hospital. After being discharged, he made two other failed suicide attempts. Finally, eight months after the operation, Mr Phillips killed himself. As the demand for cosmetic surgery grows, such post-operative distress can only increase, say experts. A study carried out for the Girl Guides recently found almost half of secondary school girls said they plan to have plastic surgery.
‘Girls and young women tell us they are finding it hard to accept their appearance, and it is starting at a much earlier age than we had previously thought,’ says Nicola Grinstead, of Girlguiding UK. Experts such as Professor Nichola Rumsey, a director of the UK Centre For Appearance Research, fear the underlying psychological issues that trigger the desire for plastic surgery are not being addressed. People seeking cosmetic surgery often believe that it will solve dissatisfactions with their lives.
On a knife edge: Laura in 1997 after having work done to her chin, eyes and lips (left) and in 1998 (right) after having a rhinoplasty
Laura Pillarella, the woman driven to plan suicide after 15 unsatisfactory procedures, said: ‘I was manipulating my face to build a new self. I was lonely as a child. My parents split up when I was six. Mum would often say giving birth to me and my brothers had ruined her looks and body. I was distant from my dad and lacked emotional security so I was trying to boost my self-esteem. But plastic surgery never worked and each operation strengthened my quest to fix myself.’ Mercifully, her suicide plans stopped when her brother asked her to speak at his wedding. Suddenly, she says, she felt valued and began, slowly, to realise her unhappiness came from emotional problems.
Now aged 41, she has written a book charting her experiences, Chasing Beauty: My Cosmetic Surgery Takeover. ‘If I had my time again,’ she says, ‘I wouldn’t have surgery. I’d have therapy.’
It’s a message that Charles Nduka, an NHS plastic surgeon, wishes many patients could hear. ‘We are seeing a lot more people with psychological problems seeking plastic surgery,’ says Nduka, who works at the Queen Victoria Hospital in East Grinstead, West Sussex. “There are two types of these patients,” he says. “Those who have pre-existing psychological issues with their appearance, such as body dysmorphic disorder, and should be having psychiatric help rather than surgery; and young women who are perfectly attractive, but have been made deeply unhappy with their bodies by constantly comparing themselves with airbrushed models. ‘Often, these young women have a small amount of breast asymmetry, which causes them anxiety due to the “perfection” they see in magazines. But 90 percent of women have a degree of asymmetry.’” “Unrealistic expectations of surgical results are another growing problem,” says Nduka. ‘Ethical surgeons spend a lot of time talking to patients about their motivations for surgery and what they will achieve,’ says Nduka, who runs the not-for-profit website safercosmeticsurgery.co.uk
. He increasingly finds himself referring patients to psychologists. Indeed, one survey found that surgeons refer about 20 percent of patients to psychologists due to unrealistic expectations — they may believe it will improve their lives dramatically by getting them the glamorous job or the partner they want. But Nduka warns that often patients never go to the psychologist and seek out a less scrupulous cosmetic surgeon. Such patients can get caught in a costly and traumatic spiral of serial surgery, says Professor Rumsey. ‘Vulnerable customers are initially pleased, but when the euphoria wears off, their disappointment with their looks returns. So they have another procedure. ‘The problem is exacerbated by hard-sell incentives that are offered by some non-mainstream providers. Some even offer discounts for people who want more operations,’ she says. Nduka says many UK clinics do not follow good practice and is worried by the ‘buy one get one free’ (BOGOF) offers and aggressive marketing that ‘plays on people’s insecurity’. ‘Often in these places, you meet a salesperson before a surgeon. One lady I saw went in for a consultation about eye wrinkles and the salesperson said: “Never mind your eyes, what about those wrinkles around your neck?”’ Three years ago, the British Association of Aesthetic Plastic Surgeons (BAAPS) launched a campaign to halt bad practice, such as bonus cards and BOGOF offers. However, the association — which represents about a third of cosmetic surgeons — is not a regulatory body and has no powers to take action. Mr Nduka wants to see health warnings on overseas treatment. ‘Patients who end up going abroad only get one follow-up appointment. But they need more than this. ’ This is also an issue in the UK, as doctors can set themselves up as plastic surgeons without being properly trained. Nigel Mercer, president of BAAPS, says: ‘In Britain you can call yourself something — such as a facial plastic surgeon — and need no relevant qualifications or training. In this respect, we are worse than anywhere else in Europe. Terrible things are happening to patients.’ BAAPS and the Care Quality Commission (the independent health care regulator) are drawing up Europe-wide standards of safe practice and regulation. Mercer says: ‘Patients ought to be able to get referrals to good clinical psychologists after the event if someone is having problems. It is very important.’
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This is SO relevant! I’m happy to know that there are professionals pushing for psychological care after surgeries, however I think more needs to be done even before a patient schedules a procedure. Ethical surgeons such as Nduka are too uncommon – most surgeons don’t care to find out if a patient has an underlying mental hangup that can be addressed without surgery – it’s all about the money.
I think that Laura’s book will be helpful to a lot of women. People usually regard plastic surgery as a quick and easy way to fix themselves, but there isn’t enough talk about the deeper side effects. If the patient is unhappy in their life and thinks that changing their appearance will make everything better, it won’t take long after the surgery for them to realize that they were wrong. I think people need to be more realistic about cosmetic surgery.
I can’t believe almost half of secondary school girls would consider plastic surgery – they’re not even done growing up! This shows how powerful the media can be – people are conditioned to reject their appearance and grow up with an ideal of perfection that they feel pressured to adhere to.