Sick patients may get cosmetic surgery to look healthier

Patients dealing with serious illnesses may want cosmetic procedures to make them look healthier, reports a small new Northwestern Medicine study. The patients believe cosmetic surgery may help them feel better in social situations with their friends, family or when they're at work.  

"Patients dealing with serious illnesses have visible signs of their health problems, which make them feel unhappy about themselves," said senior author Dr. Murad Alam, vice chair of dermatology and chief of cutaneous and aesthetic surgery at Northwestern University Feinberg School of Medicine. "Cosmetic procedures that improve appearance make these patients feel better and more confident during a time when they are already going through so much."  

The paper, published recently in the Journal of the American Academy of Dermatology, is the first to ask patients who are sick why they are undergoing cosmetic procedures.   

Patients diagnosed with major medical illnesses seek cosmetic procedures to maintain their physical and mental well-being and to become comfortable in social settings, the study reports. Patients believe cosmetic procedures may help their reintegration into society and reinvigorate their relationships, without standing out or looking sick. 

Individuals in the study included patients who had experienced stroke, advanced melanoma, prostate cancer, advanced cervical cancer, advanced thyroid cancer and Hodgkin's lymphoma, among other illnesses. Most participants reported seeking cosmetic treatments directly because of their major medical illness (75%) or treatment (66%). Participants' motivations included maintaining mental well-being, enhancing social acceptance, counteracting aging, alleviating impact on work success and responding to suggestions provided by friends, family and doctors.

One 54-year-old woman, with breast cancer and sagging eyelids, said, ''I feel as though the medical treatments I've gone through have left me looking a little more aged, a little more tired than my peers.'' 

''Post-treatment, you look in the mirror negative-wise," said a 34-year-old woman with breast cancer. "You have no hair, no eyebrows, no eyelashes, nothing. My immune system was severely low, so I looked really pale and anemic. It's like you don't even recognize yourself anymore.'' 

The cosmetic procedures that participants underwent ranged from non-invasive treatments, such as neurotoxin and filler injections, lasers, chemical peels, radiofrequency devices, dermabrasion and microneedling, to invasive procedures such as face lifts, liposuction and eyelid lifts.

For the study, 12 patients with serious illnesses who underwent cosmetic procedures after the onset of illness or during treatment were interviewed one-on-one by a trained investigator. They were asked questions about what procedures they had and why. Their most important reasons were highlighted.   

Many cited the safety of noninvasive cosmetic procedures as a feature that made these more attractive. Finally, several participants stated it was important for their doctor, friends and family to endorse particular cosmetic treatments before they proceeded. 

Choosing a cosmetic procedure to mitigate the visible signs of disease is a well-thought-out and deliberate choice made by many patients with major medical illnesses, Alam said. Improved physician-patient communication and shared decision-making may help sick patients who are considering cosmetic procedures arrive at solutions that best meet their needs while ensuring safety. 

"These findings may help improve conversations between physicians and patients who are interested in getting cosmetic procedures, so that they have information on procedures that are most safe and helpful for them," Alam said. 

Future studies may include larger numbers of patients and determining if the particular cosmetic procedures patients are requesting are related to their specific illness.