I. Postoperative psychological reactions of cosmetic patients 1. Psychological problems of patients after general surgery Generally speaking, the postoperative period is a more concentrated and important stage for patients’ psychological problems. Various practical problems after surgery will appear from time to time during the longer recovery period. (1) Pain and discomfort After surgery, conditions such as pain and discomfort will continue for some time, even for quite a long time. Generally about 1/3 of the recipients respond to extremely severe pain after surgery; 1/4 of them consider the pain to be mild and tolerable. If the pain persists for a longer period of time, consideration should be given to whether it is due to postoperative depression or psychological degeneration. Postoperative depression caused by various factors can prolong the duration of pain. (2) Effectiveness of surgery Since the patients are very sensitive to discomfort and recovery, these elements often become their subjective criteria for determining the success of the surgery. If they believe that the surgery did have a poor recovery and a bad outcome, it is very psychologically devastating. In many cases, the patient does not have a correct understanding of some normal somatic and sensory conditions after surgery and believes that the surgery was done badly or that some function was affected, which leads to psychosomatic disorders. It must be repeatedly emphasized that the psychology of patients during and after cosmetic surgery is more complex than that of patients undergoing general surgery. 2, the emotional reaction process of cosmetic surgery patients (1) anxiety stage General surgery patients have a sense of relief after the end of surgery, cosmetic surgery is not. Many patients often have unstable emotions such as anxiety and depression within a week after surgery because they are not sure how they will look after surgery. Cosmetic surgery, like other surgeries, will have different degrees of tissue reactions and local edema, but these reactions are different in cosmetic patients than in general surgery because they affect the shape and the patient may mistakenly think that the surgery is not successful, especially when the post-operative period is sometimes more ugly than the pre-operative period, and the patient may be upset. The medical staff should explain in advance that postoperative edema is a normal tissue reaction and the healing pattern of the tissue, and that one should wait patiently for the tissue to recover. (2) Trance stage Generally speaking, after cosmetic surgery, if the patient is satisfied with the result of the surgery, he or she will have a corresponding aesthetic pleasure. However, many cosmetic surgery patients, even though they think the surgery is successful, may have a special psychological process of emotional trance, i.e. loss reaction, because of the sudden change in appearance. If the patient lacks psychological support from the physician before the surgery or if the patient is psychologically immature, the more pronounced this loss reaction will be. Because there are environmental stereotypes of human psychological behavior that are compatible with society, it is often difficult to adapt to a sudden change in someone’s appearance, which will be presented to the world with a new face. The greater the degree of change in appearance, the longer the psychological state will last. Some people are afraid that others will make fun of them, discriminate against them, and even worry that the people around them will not accept them. The author once performed chin augmentation surgery for a young woman with small chin deformity, and after the surgery, the physician, the nurse and herself thought that the appearance was significantly more beautiful than before, but the family and companions of the patient could not accept it, so the prosthesis had to be taken out and restored to its original form. According to a psychometric study of 74 patients after orthognathic cosmetic surgery by Zhang Kang et al, the patients’ self-rated body image indicators rose a few days after surgery, and the self-confidence indicators began to rise when they were preparing for surgery before surgery. However, there was a significant period of decline in both body image indicators or self-confidence indicators at 9 months postoperatively, and then an increase after 24 months postoperatively. This indicates that postoperative patients’ reactions go through a process of change in self- and others’ evaluations, and that there is a postoperative psychological adaptation phase, which can last up to 2 years, so physicians should continue to provide psychological support to patients after surgery in order to help them get through this phase for a successful outcome. (3) Stabilization stage For a successful cosmetic surgery, after the above two psychological processes, the patient gradually has a new adaptation and coordination to the surrounding environment with the passage of time, gets balanced psychologically, lifts the long-suppressed emotional barriers, and feels relieved for achieving beauty satisfaction. They show increased self-confidence, reduced shyness, and can now accept changes in their appearance. This spiritual effect becomes a motivation to be positive and to move on to a new life, so that the patients become easy to get along with people and actively participate in their daily work and study, so that they can return to society in a healthy way. Second, the state of mind of the patient during the rehabilitation period of cosmetic treatment During the rehabilitation period of cosmetic treatment, most of the cosmetic patients are calm, showing normal expectation, waiting, and actively cooperating with the treatment, but there are also a considerable part of the patients, who are emotionally unstable, and the psychological preparation for the rehabilitation transition is not sufficient. 1.Negative psychology of patients during the recovery period of cosmetic treatment (1) Anxiety mainly manifests as anxiety after treatment, requesting to remove stitches in advance, or hoping to use more drugs to shorten the recovery period, and some even disobey the doctor’s orders and do it on their own. For example, after the freckle surgery, the patient tears off the scab in advance or asks to be discharged from the hospital early. When encountering the above situation, medical personnel can only use language, photos or other examples of cosmetic patients to give targeted explanations, explaining that anxiety is not beneficial to normal recovery and ensuring the efficacy of treatment, so as to eliminate their anxiety. (2) Doubt The doubt and apprehension presented by the uncertainty of the effect of cosmetic treatment. This state of mind can arise because the beautician cannot give a definite answer to a certain difficult to treat defect, such as the poor curative effect of melasma, and the physician can only give an uncertain answer to the curative effect; it can also arise because the patient is eager for treatment and has high expectation. For this kind of patients, we must explain the treatment effect according to the facts and must not exaggerate the efficacy. (3) fear is the recipient of cosmetic treatment is not expected to effect, or the treatment means is not easy to accept and show the panic, fear and anxiety. Fear of cosmetic surgery patients, in addition to a strong emotional response, but also showed a rapid heartbeat, pale, and even trembling, sweating, fainting or restlessness, loud calls, resulting in treatment difficulties. Such cosmetic patients should be well guided and pacified. For those who have a high degree of fear, some treatment measures should be suspended and treatment should be carried out after their fear is gradually lifted. This strong mental reaction is mostly seen in patients with multiple plastic and cosmetic surgery, especially patients with late burn plastic surgery, the patient strongly requested surgery to change the appearance before surgery, the real surgery, the patient has a fear of possible death, plastic surgeons should be highly concerned about such patients, and constantly spiritual guidance, at the same time, plastic surgeons to grasp their emotions, to complete the surgery to shape the beauty. (4) disappointment cosmetic effect is not good, ineffective or even failure, or fail to meet the expectations of the cosmetic recipient, cosmetic recipient will appear disappointed emotions. The lighter ones are quiet and sullen, with self-blame and complaints; the heavier ones are depressed and irritated with uncontrollable language disorder. Because the cosmetic failure is like disfigurement, some produce despair and even suicide psychology, the cosmetic surgeon lightly scold, reprimand, or take aggressive behavior. Therefore, the cosmetic surgeon to the invalid operation or even failure of the cosmetic recipient, should be in the corresponding explanation work at the same time, prudent to take the necessary remedial measures, and should seek social power, from many aspects of the work, so as not to cause irreparable consequences. 2.Psychological adjustment of cosmetic patients Even if the objective effect of cosmetic surgery is very good and the patient himself recognizes it, but he does not necessarily feel satisfied with it, which is a very complex psychological reaction, mainly because the change of appearance brings psychological discomfort. A 48-year-old woman said, “Doctor, if I can be as beautiful as the girls now, I’ll be happy to die for once in my life! But how to wear a face full of wrinkles is unsightly.” According to her request, the physician made a comprehensive wrinkle removal surgery for her. The surgery was a success, and on the day she had her stitches removed, she couldn’t help but cry when she got up the courage to look in the mirror, and she looked at least 10 years younger. It was better than before the surgery. This story leads to a very important truth, women must pay attention to adjusting their psychological age after receiving wrinkle surgery, and their psychological age must be “operated” together with their physical appearance, so that they can maintain a harmonious overall beauty of the human body.