Cosmetic Surgery - The Role of the Surgeon as Counsellor

Sarah Brechon
By Sarah Brechon

Sarah Brechon regularly Blogs and writes articles about the cosmetic surgery and medical aesthetic industries.

Many cosmetic surgery companies try to persuade you that bigger breasts could change your life; Botox will restore teenage confidence or a tummy tuck could create a New You. But all good surgeons know that no amount of surgery can change who a patient already is. Cosmetic or plastic surgery can provide the outer, aesthetic “icing on the cake”.

It can improve self-confidence. But it cannot actually alter who you are: or the external forces in your life before or after.

That is why the role of any great surgeon is far more than just as a medic or even artiste; the best Consultant Surgeons are great Counsellors too.

Working in aesthetics, it becomes more and more apparent that beauty is very much a state of mind.

It is very interesting that a person can be perceived as “ugly” by the world as a whole and yet be blissfully happy, whilst others are envied for their beauty but utterly miserable and would do anything to change.

It’s how we feel about the way we look that matters.

beauty is a state of mind

Despite what we are continuously told, about becoming a more beauty-obsessed society, evidence points to the contrary – many people actually seem to feel that what we are like inside is more important than our outer image.

On sites like, thousands of viewers rank and rate inspirational beauty quotes with a ‘thumbs up’ or thumbs down, providing profound social insight. Overwhelmingly, quotes with multiple ‘thumbs up’ reactions are those discussing the triumph of internal over external beauty.

‘Beauty is not in the face, Beauty is a light in the heart' – Kahlil Gibran 

‘Beauty might bring happiness, but happiness always brings beauty’ – Kevin Aucouin

‘Beauty is only skin deep’ – Jennifer Lopez’

In contrast, the beauty quotes on this site provoke negative responses to revolve around pageant queens, and consumerism and fakeness.

'the beautiful eyes of my cash-box’ – Moliere

‘beauty is our weapon against nature’ – Camille Paglia

So, if we are well aware that beauty comes from within and that others perceive it that way too, why are we not investing more time and money in self-development – counselling if needs be – rather than cosmetic surgery, skincare, and beauty products?

Perhaps because we are increasingly using Cosmetic Surgery as a form of counselling – a way to try and ‘reconstruct’ or ‘improve’ the mind as well as the body.


There are many cases where the lines between Plastic and Cosmetic surgery are blurred, but equally where psychology and surgery overlap.

Take the Breast Reduction candidate who has suffered years of physical pain under the weight of heavy breasts and emotional distress feeling that men sexualise her.

The rhinoplasty or otoplasty patient who says they have been bullied since childhood for prominent facial features.

Those patients who have worked exceptionally hard to conquer obesity but want liposuction or tummy tuck surgery to help deal with the excess skin and stretch marks remaining.

Even more complex are those battling inner demons. Patients with body dysmorphia will never be happy with what they see in the mirror, no matter what they do to try and ‘improve’ themselves.

Those who feel unloved or have just ended bad relationships are venting their emotions into trying to change themselves into somebody else. Those with terribly low self-esteem, are desperate to be like the impossible images of celebrities they see around them.

The attention-seekers, who will do anything on the spur of the moment for the shock factor – but may well regret it later. And those in negative relationships where their partners are actually pressurising them to change themselves.

All of these are case studies which a Consultant surgeon encounters on a regular basis and it is their job to be able to identify the signs. This is why the consultation process of surgery is so vitally important. Any qualified surgeon can perform your surgery (with varying degrees of skill). But the best surgeons will also counsel you through the whole process, from start to finish. You should be listened to respectfully, and your expectations of the surgery and reasons for wanting it are thoroughly noted. And it is the mark of a good surgeon if they are prepared to say “No”: to advise that a procedure may not be for you or that, perhaps, you would be better with something a little less extreme.

If a surgeon feels that you are not emotionally stable enough, or that your reasons for wanting surgery are not in your best interests, then he has a duty to advise you not to proceed. If you do go ahead with surgery, a good surgeon will thoroughly explain the procedure, letting you ask questions at all stages…you should never feel pressurised and should feel able to back out at any point.

You should be able to see examples of their work and their past results should look natural, not fake or over the top. You should be frequently asked if you are sure; if you feel happy to proceed; if this is really what you want. Above all, you should always be in control.

Oddly enough, I think the quote that was the most accurate on actually came from a celebrity!

Jennifer Lopez is quoted as saying ‘I think what’s really important is finding a balance of mind, body and spirit’ and she is spot on. Both cosmetic and plastic surgery really do have their place and can bring tremendous improvement to self-confidence and self-esteem.

But they are not miracle cures or ‘quick fixes’: Alone these procedures are nothing – you need to work on your mind and spirit too to make sure you are not just trying to reconstruct damage inside. The very best surgeons are excellent counsellors, but even they can only help you to feel in control, fully informed and focused.

If you want to read more, the experts at Consulting Room really know what they're talking about and have put together some Botox, eyelid lifttummy tuckfaceliftBreast implantsnose jobsrhinoplasty and cosmetic surgery treatments treatment FAQs just for you. 

If you have more questions, you can use the Botox, eyelid lifttummy tuckfaceliftBreast implantsnose jobsrhinoplasty and cosmetic surgery treatment questions feature to talk to our panel of trained medical experts. 

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