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A person’s recovery from facial cosmetic surgery has several unique aspects that are relevant to psychiatry.  In this article I will talk about some of the unique challenges to recovery and discuss some of the ways that these issues can be addressed.

Expectations for a surgical procedure determine how the outcome of that surgery is interpreted by a patient.  Full recovery from a facial cosmetic surgery can take weeks to months.  Pain levels can exceed what was expected.  When the pace of recovery, pain levels or the surgical outcome are not what a patient had anticipated, a sense of frustration is common.

Every surgical procedure contains an element of unpredictability and because of this, anxiety is often seen during recovery.  Facial cosmetic surgery procedures are no different.  Two common postoperative variables are the time it takes for swelling to reduce and the time for bruising to resolve.  Swelling and bruising are inherent to any surgical procedure.  In an abdominal procedure, these can be masked with clothes.  With a facial procedure it is difficult to disguise swelling or bruising.  This can raise self-consciousness and make social interactions uncomfortable.

Up to 55% of patients undergoing facial cosmetic surgery develop some degree of anxiety or depression in the postoperative period.  Many of these patients will experience a gradual reduction in these symptoms over time without the intervention of a psychiatrist.  A smaller percentage of patients will continue to struggle with anxiety and unmet expectations, and in some cases these concerns may escalate.  For these patients, reassurance from the surgical team does not provide any relief.  In these cases, treatment by a psychiatrist can be helpful in reducing anxiety and coming to terms with the surgical outcome.  Treatment can consist of medication, psychotherapy or both. Specific recommendations are based on current and past symptoms and patient preference.

Psychotropic drugs are big business: in 2009, roughly 300,000,000 prescriptions were written for these agents.

Introduction: Ethical Dilemmas Old and New

May 18, 2010  |  Posted by Psychiatric Times | No Comments
Bioethicists often debate whether the rapid pace of medical science truly generates new ethical questions or whether what appear to be novel dilemmas are really ancient conflicts presented in modern terms and contexts.1 The valuable essays in this Special Report offer support for each position and, more important, provide clinical wisdom for mental health professionals struggling with ethical issues both profound and prosaic in a variety of practice settings.

Undue Pharmaceutical Influence on Psychiatric Practice

May 18, 2010  |  Posted by Psychiatric Times | No Comments
Within the past few years, increasing concerns have arisen about the ways in which corporate sponsorship of clinical trials and continuing medical education activities may bias the information that is published and disseminated about the benefits and risks of medications. Questions have also been raised about the extent of industry influence on the American Psychiatric Association’s diagnostic and treatment guidelines—namely, its DSM and Clinical Practice Guidelines.

A New Treatment Option for Major Depression

May 18, 2010  |  Posted by Psychiatric Times | No Comments
Transcranial magnetic stimulation (TMS) is noninvasive focused brain stimulation that uses pulsed magnetic fields. The underlying mechanism depends on the principle of electromagnetic induction, the process (discovered by Faraday in 1839) by which electrical energy is converted into a magnetic field and vice versa.1