Experiences of living with a visible difference and social support among individuals seeking appearance-altering surgery

This study explored the psychosocial experiences of living with a visible
difference and social support among individuals seeking appearancealtering
surgery. Appearance-altering surgery is a common intervention for
individuals with visible differences and research is important for helping
services better understand and respond to the experiences of serviceusers.
This study employed a mixed-methods approach, including questionnaires
and semi-structured interviews. Participants were recruited from a Plastic
and Reconstructive Surgery department within an NHS Trust Hospital
during a five-month period. 11 participants who met the inclusion criteria
for the study completed questionnaires. Due to the small sample, it was
only possible to conduct a descriptive analysis of the questionnaire data;
this indicated variation between participants' experiences of living with a
visible difference and social support. Eight participants who completed
questionnaires also participated in semi-structured interviews. Thematic
analysis was used to analyse interview data. Findings from the thematic
analysis are presented in terms of four main themes and 11 sub-themes.
These suggested appearance-related thoughts and feelings are triggered
by particular circumstances, including when people reacted to participants'
visible differences and when participants thought that people might react.
Participants attempted to manage appearance-related concerns and
difficulties through concealment, social avoidance and seeking surgery.
Participants described barriers to accessing support from others, such as
concerns about the risks associated with talking to others and the view that
visible difference is a problem with physical appearance that cannot be
resolved through social support. Despite barriers, participants valued
some forms of social support, including others looking beyond their visible
difference, support being available when needed, understanding from
others regarding their experiences of living with a visible difference and
seeking surgery and finally, affirmation of the decision to seek surgery. These findings are sample-specific and cannot be generalised to other
populations. However, the considerable variation between participants'
experiences suggests that plastic surgery services need to tailor
assessments and interventions to the diverse needs of their service-users.
The findings are discussed with reference to previous theory and research.
Clinical and research implications are considered.

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