Social and Psychological Sequelae

Hitherto a standard conservative approach has been to deny operation to all applicants with mild or minimal deformities, since it is claimed that they must necessarily have severe underlying psychiatric problems and therefore operation must inevitably prove disastrous. Another symptom might be substituted, the patient is likely to become dissatisfied and possibly litigious, and a florid psychosis might even be precipitated. By contrast, patients with marked deformities were thought to have few basic psychological difficulties. Any maladjustment was considered as secondary to the deformity and was expected to remit after an adequate surgical reconstruction. Nevertheless, several research projects and a growing body of clinical experience have indicated that the psychological distinction between the marked and minimal disfigurement groups is much less than had been supposed. There are instances of patients with major deformities being quite dissatisfied after