The advancements in technology in medical science have opened the doors to better treatment possibilities with minimal side effects being witnessed post treatment. People are now able to avail treatments for such complications which require highly complex and minute procedures to be performed where the implications of the existence of errors are highly fatal. With the inclusion of robotic technology and advanced medical equipment infrastructure, procedures have now become highly convenient and accessible to the people and this feasibility has also enabled the healthcare professionals to provide better medical service to the consumers (Reconstructive Plastic Surgery Overview, 2008).

The development of plastic surgery that has been witnessed over the recent years has given rise to various opportunities wherein the use of medical technologies are being used to enhance personal physical features rather than seeing the medical procedures as a means of treatment of illnesses. Among these procedures, plastic surgery is the most widely sought feature modification and enhancement methods which have enabled further developments in the medical field. Plastic surgery had originated as a means to provide reconstructive measures for the damaged parts of the physical parts of the body. These parts can get damaged or injured due to accidents or various other stimuli. Plastic surgery aims at reconstructing and / or modifying the appearance as well as the function of the respective limb (Reconstructive Plastic Surgery Overview, 2008).

Plastic surgery is divided into two parts, cosmetic plastic surgery and reconstructive plastic surgery. Cosmetic surgery seeks to improve the patient’s features on a purely beauty level. Reconstructive surgery seeks to fix any physical feature, which is deformed by illness, accidents or birth defect or imperfection. It also provides a significant degree of functional enhancement so as to enable the patient to regain most of the actual functionality which existed for the respective part. Traditionally these processes have been used to treat damages and hide the scars arising out of deep wounds or skin damage. Reconstructive surgery is also being considered as a viable option for those who want to enhance one’s mobility and functionality in cases of incidents which render a person partially disable (Reconstructive Plastic Surgery Overview, 2008).

Cosmetic plastic surgery however is one of the most popular medical procedures to be undertaken today with the progress of this procedure being witnessed geographically. This has been further strengthened by the presence of medical tourism possibilities which has enhanced the possibilities for availing the cosmetic treatment in foreign locations. One of the primary reasons which can be attributed to the increase in the utilization of cosmetic surgery procedures is the desire of the people to resemble their favorite celebrities in terms of physical appearance and beauty. People have been known to spend huge amounts of money and have undertaken painful efforts in order to make themselves similar to the celebrities. Though this may seem like a mere fascination and appreciation of the celebrities by the fans, there is a dark side to the continuous utilization of such procedures wherein an obsession is created in the people regarding the frequent utilization of the procedures for maintaining their desired levels of features. Plastic surgery is associated with a wide range of outcomes witnessed mainly on the emotional, psychological and physical levels. All of these levels have positive and negative aspects associated with them (Reconstructive Plastic Surgery Overview, 2008).

However the current trend of becoming competitive in terms of physical features has led to the adverse outcomes being witnessed in cases where the patients have resorted to the use of new untested drugs or in cases when there is a natural adverse reaction to the procedure. In either case, there is a severe impact of these procedures on the social environment wherein various individuals and groups are subjected to the outcomes (Reconstructive Plastic Surgery Overview, 2008).

General Impacts of Lipoplasty:

The growing obese and overweight population in the world today has led people to seek liposuction which is one of most sought cosmetic procedures for reducing the fat content in the body. However this procedure has now diversified into procedures being conducted on specific regions of the body wherein the fat is removed usually by equipment which is used to suction the fat that is previously made into a more liquid state by means of certain chemicals. It is due to this suction of the lipids that the procedure has been popularly termed as liposuction. This procedure is an instant solution to overweight and people are provided significant relief from going to the gym or to undertake strenuous workout schedules. But this procedure is an invasive process involving the surgical intrusion of the equipment into the body and hence like any other surgery, there is a moderately high risk of the occurrence of adverse reactions to the procedure. These risks are inclusive of bad bruising, thrombophlebitis, inflammation, Contour Irregularities, numbness, puncturing of the internal organs, infections, pulmonary edema, pulmonary embolism, skin burns, and allergic reactions to the procedures and / or the drugs used, complications in the lungs or the heart, lidocaine toxicity and in some cases, even death. There is a significant lack of awareness about such procedures in the society wherein the people are usually awed by the benefits of the procedure and in their efforts to achieve the desired outcomes they overlook the possible adversities which could be experienced by them if adequate precautions are not undertaken (Sunishka Wimalawansa, 2009).

There is a high level of competitiveness in the society which is characterized by the excessive emphasis being maintained on the looks of a person. The current trends indicate the need for every individual to possess the perfect body and fat free personalities so as to be able to seem acceptable in the social realm. The fear of being made fun of and being pushed away by the society has driven the people, especially the youth and the elderly segment to undertake such measures. While the youth and the elderly faction of the population have differing needs from the liposuction procedure, the outcomes have been reported to be drastic which not only has a long-lasting impact on the emotional realm of the people but it has also driven people to eccentric behavior. The elderly are motivated for adopting this procedure as it helps them to look younger even though their natural capacity and resistance is maintained as per their actual age. Social norms and peer pressure agents dictate the extent to which the people may go to transform and modify their appearance (Sadick, 2008).

The older faction’s need to look young and mask one’s true age has reached paramount importance in people. They try to imitate the celebrities and take efforts to be able to have a youthful personality like them. These instant changes are risks for the people as the celebrities undergo countless procedures involving large expenses made in this regard. As a result of the high demand for these procedures, the medical practitioners have increased overall costs of the procedures which have resulted in the existence of another issue for the society in terms of monetary insufficiency. People have been known to spend huge amounts of valuable money to undertake these procedures which may have a direct impact on the other finances which the people may have. Their obsession with beauty has caused more harm than good when a majority of the income of the members of the society is being diverted to the payment for the plastic surgeries. Another aspect of this situation is that people have been known to acquire loans for obtaining the funds for the treatment procedures. These procedures are not only short lived but in order to maintain the effectiveness of the outcomes, these procedures need to be repeated after specific intervals which not only affects the health of the individual but also incurs huge expenses for the patients (Jávo, 2012)

Emotional and Psychological Impact of Lipoplasty on the Society:

Obesity is a serious social evil where obese people are often made the subject of mockery and are looked down upon in the society. This behavioral response of the people in the society drives the people to undertake such drastic measures to achieve the desired physical features. But in this process, the people establish very high expectations from the procedures with unreal and overly ambitious outcomes being expected from the medical practitioners. In the event of the achievement of fewer outcomes in comparison with the desired outcomes, the people might enter a state of depression which is further complicated by the lack of emotional support being provided to the patients. Another adverse outcome which is evident in such cases is the recurrence of obesity which would affect overall perception of the patient. When faced with this contradiction, the patient either loses all faith in the procedures or is driven to undertake more procedures till the time the desired outcomes are achieved. However the human body has adaptability duration and such drastic and frequent changes in the body might lead to the rejection of the changes and could give way to severe complications that would have a long term impact on the patient (David J Castle, 2007).

Studies have shown that obesity is one such condition which can affect the psychological perspectives of the individual. In the event of the development of complexities and contraindications in the patients, they may also be exhibit bouts of emotional outbursts due to their perceived self image being much more glorious than the actual outcomes. However the psychological aspects of liposuction do not always have a negative outcome. The other aspect of this procedure is that the reduction in body weight and fat have enabled to make themselves more presentable in social circles and this has been one of the major factors for the development of self confidence in the people. In some cases, the effects of liposuction have also provided the individuals with the chance of coping with the dilemma of social identity and presence dilemma. Other plastic surgery procedures have enabled people to mask their scars and other such features such as gynaecomastia which may seen socially unacceptable due to their bizarre features and outlook. In terms of liposuction, gynaecomastia is the major issue concerning the male population as this condition leads to the enlargement of the mammary regions in males which makes them resemble like female breasts. This is not only an awkward feature considering the image of the male in the society but also subjects the patient with social mockery and rejection at times. With the help of liposuction, the people are able to make themselves more presentable to the society and thereby escaping mockery or being made the subject of rejection. This is an example of the benefits of the utilization of plastic surgery procedures on the emotional and psychological aspects of such procedures (David J Castle, 2007).

People globally have generated a belief in the society where the need to have perfect body proportions defines the manner in which the image of a person is perceived in the society. This perception has also infiltrated the confines of the families where husbands have expressed an interest in the physical outlook of their life partners. If the wives are unable to comply with their expectations, then their martial relation is often nullified as the men seek more beautiful counterparts for their wives. Every culture puts forward certain characteristics that are preferred in both men and women and the absence or lack of such features causes depression in the people as they are not seen in a viable position in the society. This also drives them to undertake the surgical procedures in order to overcome their shortcomings. The need for these procedures to be adopted by women is getting attention of their husbands. The positive aspects of this scenario are that they are made capable of meeting the expectations as per social norms and in turn they are able to beget partners with good physical characteristics. They also develop a higher level of confidence which enables better interactions to be maintained in the social realm. The negative aspects of this scenario is that the possible complications arising from such procedures could prove to be fatal for the patient and their determination to comply with social norms would only lead to grave outcomes being faced by them (David J Castle, 2007).

Effectiveness of the Plastic Surgery Procedures:

The effectiveness of the plastic surgery procedures has always been a topic of debate as the evaluation of the outcomes is significantly dependent on the perceptions of the people and the extent to which the surgical procedure is able to stand up to their expectations. There are several factors which may lead to the development of complications or may even worsen the complications that have surfaced in the patients. The majority of the factors pertain to the physical characteristics of the individual and the ability of the person’s immune system to incorporate the drugs that are administered in the process (What Is Liposuction? Liposuction Risks And Benefits, 2012).

The following is a summarization of the factors that contribute to the development of the complications in the patient post operation:

Sl. No.

Factors affecting Surgery

Possible Complications

Factors worsening Complications

1

Age of Patient

Infection at the operation site.

Smoking and / or Consumption of liquor in any form

2

Overall Patient Health

Excessive bleeding.

Damaging of connective tissues.

3

Patient’s Medical History

Bruising of the operated site / region.

Occurrence of skin damage due to provision of radiation therapy.

4

Extent of the abnormality / deformity

Incomplete healing of wound.

Adverse effects of weakened immune system due to the presence of HIV+ in the patient.

5

Expectations of the patients

Surgical complications

Poor nutritional habits.

6

–

Complications based on the type of anesthesia used during the procedure.

Decrease in blood flow post operation which could delay the healing of the operated site and could lead to the incurrence of various infections.

(Reconstructive Plastic Surgery Overview, 2008)

The above mentioned factors determine to some extent the predicted outcome of the surgeries in such conditions. The procedures conducted on the patients are irrevocable and irreversible but this does not mean that the effects of the surgery are also permanent. These changes last for a limited time on the basis of the precautionary measures and the environmental factors affecting the same (What Is Liposuction? Liposuction Risks And Benefits, 2012).

Procedures such as liposuction have been recently reported to have ineffective outcomes. But the patients do not consider their own personal characteristics or the lack of adequate attention being given to the operated site. In the case of such lack of care, there is a high risk of developing complications. If news of such drastic outcomes are made public then the people are misled either intentionally or unintentionally to deter from using a particular technology. While this may be considered as a positive move being made by the people, the negative aspect associated with this is usually ignored as the people do not feel that the other aspects have a significant impact on their lives. But the mass deterrence to use a particular technology has driven people to undertake such procedures in haste which are not certified by authorized bodies and this subjects them to high risk of damaging themselves and their external looks drastically (What Is Liposuction? Liposuction Risks And Benefits, 2012).

Research Data Analysis:

In order to understand the implications of plastic surgeries, a survey was conducted so as to obtain the opinion of the people regarding the impact of plastic surgery procedures, especially liposuction, on the social realm. (Please refer to Appendix A for a copy of the Survey Prepared for obtaining the views of the people regarding plastic surgery.)

The sample size was maintained at 100 respondents comprising of people from all age groups and ethnicity. No specific population has been identified for the research as the society in general is constituted of people belonging to diverse cultural segments.

Discussion:

On the basis of the answers obtained by the survey designed for this report, it was noted that people generally indulge in plastic surgery nowadays to enhance their features and make themselves more attractive while avoiding the actual functional use of the plastic surgeries. The attainment of a perfect figure was the primary reason stated by the respondents in the context of the need to undertake such surgeries. This is in support of our argument which highlighted this need as the driving factor behind the utilization of these procedures. Mixed responses were obtained from the respondents in the context of the provision of emotional support which clearly indicates the fact there is no facility to provide the require support to the patients by means of which they may be able to overcome their complications or even develop the required confidence to cope with the changes. People have also expressed their hesitation in accepting those members of the society who indulge in surgical procedures for the enhancement of their features. This is clearly a society specific perspective where the views may differ from society to society. A majority of the respondents were unsure of the effectiveness of the surgical procedures and were not sure whether these effects lasted forever or for a specific duration. In this regard it should be noted that the provision of adequate public awareness is quintessential for maintaining the efficiency and effectiveness of the process.

Almost 80% of the respondents have agreed to the fact that these procedures have been highly beneficial in the development of self confidence in the people and the people have been enabled to make themselves more presentable to the society. Mixed responses were obtained when the respondents were asked whether people could be driven to obsession and addiction with respect to these procedures. Similar responses were obtained in the case of the risks associated with these procedures which further strengthen the need for public awareness to be made in this regard.

Recommendation:

In order to ensure the effectiveness of the plastic surgery procedure, the following recommendations are made:

Awareness should be generated among the people regarding the risks involved with these procedures and the outcomes / complications which could develop if adequate precautionary measures are not undertaken.

The expectations from the procedure should be maintained realistically with no extraordinary and outlandish aims being defined by the people.

Tested and adequately certified procedures should be sought by the patients in order to minimize the risk of the development of post operative complications.

The patients should evaluate their own personal physical characteristics and the resilience of the immune systems before undertaking any procedure.

The society should be encouraged to accept people in their actual identity without defining strict perspectives based on physical characteristics. This is a form of complete biasness towards the members of the respective society.

Conclusion:

Plastic Surgery is definitely a great tool for rectifying physical deformities and overcoming social negligence due to the presence of these deformities in a person. However the misuse of this boon has resulted in the lives of many people with an equally large population still suffering from the dire consequences of the surgeries. Most of these effects are realized after a significant time has elapsed after the surgery has been conducted. It is quintessential for people to understand the risks associated with these procedures before opting for it. The disillusionment offered by widespread publicity of such procedures by celebrities has endangered the health and lives of many who undergo this life altering procedure just to achieve perfection instantly. A thorough knowledge of such surgeries should be availed to save not only one’s own life and health but also of those who have been influenced into opting for such procedures. Hence the implications of plastic surgery portray a significant negative impact on the people (Holley, 2011)

The following reflection is based on my experience of observing the care of MJ, a diabetic patient, using the model proposed by Boud, Keogh and Walker (1985). The reason for choosing this reflective cycle is because it provides space in its third phase, for analysing the learning acquired after the field experience is finished (Boud, Keogh and Walker 1985: p10). This stage of the model is commensurate with the current reflective activity. Furthermore, various characteristics within this phase of the Boud et al (1985) approach are offered, which I was able to integrate into the present reflection of learning account. For instance, I was able to revisit the learning experience, attend to affective behaviour and re-appraise the learning event. These elements facilitated a recollection of the initial practical experience, as well as the feelings that were triggered in response to it. In effect, I was able to incorporate new information and assimilate this in a meaningful way, into my existing knowledge base (Boud et al 1985: 21). The concept of meaningful learning, from the perspective of the learner is supported by theorists such as Kelly (1963). In his personal construct theory, he argues that each individual has their own set of constructs that they use to make sense of the world. Thus ‘people can be seen as differing from each other, not only because there might have been differences in the events they sought to anticipate but also because there are different approaches to the anticipation of the same event’ (1963:55). Thus, what someone may regard as representing the ‘truth’ may not be applicable to my internal representation of reality. Another reason for choosing to use the Boud et al (1985) approach is due in large part to it’s’ flexibility. As this reflective activity proceeds, it will be seen that some aspects of their cycle become more salient than others. This aspect of the model is highlighted by Boud et al (1985) who emphasise that the reflective process may involve ‘…repetitions of important elements and lingering over particularly significant components.’

(p: 27). As a result of my practical placement, I was able to observe the nursing care provided for MJ, a 50 year old female patient who has been suffering from Type II diabetes for the past 10 years. Upon reflection, I realise that being involved with MJ’s care, albeit indirectly facilitated important knowledge that I was hitherto unaware of. As a result, I have gained practical experience that has engendered the ongoing development of my knowledge and skills base. This feature of reflective practice is reiterated by Boud et al (1985: 7) who argue that ‘reflection is an active process of exploration and discovery which often leads to very unexpected outcomes.’ In the first instance, I am more sensitised to the NMC code of conduct regarding the provision of high standards of practice and care at all times (2008, p: 4). This came about as a result of observing the due consideration given to MJ as an individual diabetic patient, with her own history and specific needs. To this end, an effective assessment was conducted by the nurse I was observing, who explained to me that this was necessary in order to ensure that MJ received the nursing care that was required. An interview revealed that the day before, she started to feel shivery, was feeling nauseated and ached all over. By morning she began to vomit and also had diarrhoea. As a result of the vomiting MJ lost appetite and was unable to eat. This triggered the fear of developing a hypoglycaemic reaction and consequently she refrained from administering her insulin injection. The next morning her husband became very concerned, because she was drowsy and breathing strangely. He called for an ambulance, and MJ was taken to hospital immediately. A measurement of appropriate vital signs revealed that her urine contained large amounts of glucose and ketones. As a result of these assessments, it was decided to administer insulin and fluid into a vein, after which MJ felt considerably better. As a result of reflecting on this particular practice placement, I have been able to generate a variety of new constructs, in relation to my existing knowledge of respect for patient individuality. Boud et al refer to this procedure as association, and may be seen as a necessary precursor to the integration stage of reflection. This is because it allows earlier knowledge to be modified to accommodate new ideas (1985:31). Learning theorists such as Ausubel (1968), believe that the ability to link new material to previous knowledge constitutes one of the most important features of learning. Boud et al, argue that integration involves drawing inferences based on the information that we are appraising (1985, p: 32). I have incorporated into my cognitive structure of ‘considering all patients as individuals’ the recognition that assessment is important in achieving this goal. This acquisition of new perspectives, is referred to as insight by gestalt psychologists, and is when the student becomes aware of the relevance of a particular learning experience (Reece and Walker, 1997: 105).

Hence, I have developed awareness that the nursing process enables the planning of interventions to meet the particular needs of the patient. This is echoed by Nettina (2006:4) who stresses that ‘assessment constitutes a planned, problem solving approach to meeting a patient’s health care and nursing needs’. Thus, I observed the implementation of personalised care, that enabled MJ to survive an episode of diabetic ketoacidosis. Therefore, I have also learned the value of the nursing process in providing a framework to alleviate the problems that the patient may be confronted with. My experience has afforded me the chance to merge theory with the reality of practice, which has enhanced my skills development. I am therefore able to acknowledge the significance of the NMC code of conduct, which emphasises the importance of practical experience in order to advance professional practice and competence (2008, p: 4).

Prior to discharge, MJ worked in collaboration with the nursing team by discussing the best ways to manage her diabetes. This process bodes well with the Framework for Managing Long-Term Conditions which emphasises the importance of a personalised care plan for people with chronic illnesses (DoH, 2008:19). As a result of observing the planning of MJ’s post-discharge care, I now recognise the value of appreciating the experience and knowledge of individuals with a long-term condition in general, and diabetic patients in particular. Upon reflection, I am conscious of how presumptuous it is to criticise diabetics for bad self management by focusing solely on overall blood control. Indeed, the consultation revealed that MJ had good adherence to the various aspects in the self-management of her diabetes. Therefore, she did not need information on how to manage her condition on a day-to-day basis. On the other hand, MJ agreed a plan that involved a range of practical tools to help in assessing risks and planning what to do in the case of illness. The Diabetes National Service Framework stresses the importance of offering patients the opportunity to be partners in their own care (DoH, 2008:18). This provides a structure in which care is chosen to respond to the individual patient’s needs, in addition to their different requirements, rather than assuming a ‘one size fits all’ attitude. According to Boud et al, the final stage of reflective activity is concerned with outcomes which can be affective in nature (1985:34). This is supported by the fact that, I am looking forward to more opportunities to develop my professional practice, in order to expand my professional value base and competence. Boud et al, confirm this aspect of the outcome of reflection, by stating that ‘reflection has the objective of making us ready for new experience’ (1985:34). Considering patients as individuals has become part of my value system which I know, will play a significant role in informing my continuing professional development. Boud et al, describe this as appropriated knowledge, and argue that other integrated constructs may be appraised in the light of it (1985, p: 34). This is demonstrated by the general theme running through the present review: Treating patients with a long term condition as individuals, is essential in order to be able to deliver high standards of health care.

Ausubel, DP (1968) Educational Psychology: A Cognitive View. Holt Rinehart & Winston.

Boud D, Keogh R & Walker D (1985) Turning Experience Into Learning. Routledge

DoH (2008) Five Years On: Delivering the Diabetes National Service Framework. DoH: London

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications

Kelly GA (1963) Theory of Personality: The Psychology of Personal Constructs. W W Norton and Company. New York

Nettina SM (2006) The Lippincott Manual of Nursing. Lippincott Williams & Wilkins. USA

NMC (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives

http://www.nmc-uk.org

Reece I, Walker S (1997) Teaching, Training and Learning: A Practical Guide. Business Education Publishers. UK