Psychological aspects and legal considerations
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For all plastic operations, and particularly for nasal surgery, psychological preparation is of great importance. Above all the patient should be enlightened about what will happen to him, and in doing so one should never promise him too much. There are patients who can not be satisfield, even with the best operation, and who always have new complexes after the operation. Patients who are unhappy because of small defects even expect the most. The emotional behavior of patients with facial deformations, especially nasal ones, is just as various as their reaction after a surgical correction. In many cases today psychotherapy is necessary in support of surgical treatment. Naturally one can not go so far as Robin, who asks for previous psychological examination prior to every cosmetic operation. Fomon divides patients into three groups. Patients who undergo an operation with no worry have hypoesthetic reactions. Orthoesthetic reactions are had by people with the proper attitude toward blemishes or defects in beauty. People who place too much value on the defects have hyperesthetic reactions, and paraesthetic reactions appear in the mentally ill, such as in schizophrenics. An impressive example for the last ist the tragic case of Alexander, who was shot to death by a psychopath on whose nose he had operated (Kraus).