Post-Surgery Thoughts: Medical or Cosmetic?

This is not an update on my progress, so feel free to skip it over, but I needed a space to write down some thoughts I’ve had regarding the surgery – and what better outlet than my jaw surgery blog?

Since my surgery, I’ve met many friends and acquaintances, most of whom expressed at least a small degree of surprise at how my appearance has changed due to the correction of my bite. Many have also asked me a question that has become more difficult to answer after the surgery:

“Is this surgery considered cosmetic?”

Before the surgery, my answer was an immediate ‘no’. I would explain that my most important reasons for deciding to go through with the surgery are to improve the function of my bite. Many would ask me to clarify, because they have possessed a proper bite all their life and don’t understand how a prognathism will affect the functionality of one’s bite. After I explained the specifics, they would accept that the surgery was sought for a medical purpose, and then move on.

It’s amazing how hard it has become to convince people that this surgery is medical now that I have actually gone through with it. Because the surgery has changed my appearance so much, people only focus on its aesthetic impact. While my reasons have not changed, their responses have. After I give my standard answer, people start to ask me if the surgery is medically necessary. I explain that it isn’t, that this surgery is an elective medical surgery. They usually look unconvinced, or crack a joke: “Why didn’t you have your eyes/nose done while you were at it?” In their minds, if the surgery isn’t necessary and it changes your appearance so much, then it must be cosmetic.

I’ve answered this question and dealt with people’s responses so many times that I am beginning to become uncertain of my answer as well. What has changed since before the surgery to prompt this uncertainty? My reasons for seeking the surgery certainly haven’t. But people’s reactions have changed. I can only guess that it is because prior to the surgery, they did not anticipate the impact of the surgery on my appearance.

But why should the degree of aesthetic change determine whether or not a surgery is considered medical or cosmetic? I know people who have had smaller prognathisms than I did, but because their appearance did not change as much (some have barely even changed at all), people accept their reason that the surgery was ‘medical’. Why is my surgery any less ‘medical’ in their eyes, just because it had a greater aesthetic impact, especially when the impact is of a scale that I did not even anticipate (I honestly had zero clue how I would look after the surgery)? If anything, the functional improvement that I benefit from is even greater than those people who have smaller prognathisms and less noticeable changes in appearance. Shouldn’t the degree of aesthetic change merely indicate the severity of the prognathism rather than be a deciding factor in categorising the surgery?

If you asked my surgeon whether she considered this surgery cosmetic, she would say no. “I am not a plastic surgeon,” she told me in my final pre-surgical appointment. She knew there were clear functional benefits that the surgery could bring by correcting a misaligned bite. My insurance company, which denies coverage of cosmetic surgery (as most if not all insurance packages do), approved it – so to them it was a medical surgery.

But it’s more difficult to answer the question and convince others of your answer when you have benefitted from not only the surgery’s functional improvements, but its aesthetic changes as well. It would be a lie to say that I liked the look of my underbite. I did not, and I definitely prefer my post-surgery improved profile. But I did not seek the surgery because I wanted a cosmetic improvement. There are a lot of things that I may not like about my appearance, but I will not willingly undergo cosmetic surgery to enhance or change these features (at the very least, I speak for myself in this point of time). I would still qualify this surgery as an elective medical surgery, but one with a big aesthetic impact. That, however, is still different from a cosmetic surgery, which is sought for a purely aesthetic reason.

Perhaps you believe that I shouldn’t care about what others think. Why the hell should it be of importance whether this surgery is medical or cosmetic? The people who matter shouldn’t change their opinion of me just because I went for this surgery. And maybe I shouldn’t care, but in truth, I do. It’s stupid, and I really wish I don’t care, but unfortunately I do. There is a stigma in most societies, including mine, surrounding cosmetic surgery. It may be wrong and baseless to assign this stigma to it, but it still made me uncomfortable to be associated with it.

Having said that, I did not write this post is to debate about whether the stigma surrounding plastic surgery is justified. Personally, I couldn’t care less whether someone had plastic surgery or not. Beautiful people in no way ‘deserve’ their beauty, so I don’t think it is wrong that some people choose to actively seek beauty which they were not fortunate enough to be not born with. Instead, I wrote this post to sort my thoughts out, because unfortunately, I was – and perhaps I may continue to be – affected by what others thought of me on this issue.

Next time someone asks me that question, my response will still be a ‘no’. I’ll answer them in the same way I did before I went through the surgery. Maybe I’ll even give them a technical answer and tell them my insurance company considers it non-cosmetic. They may not believe me, but hopefully now I won’t care enough about their judgments for their responses to cause me to doubt myself.

10 thoughts on “Post-Surgery Thoughts: Medical or Cosmetic?

  1. Thank you for your honest post. I am considering going through this surgery myself so I understand where you’re coming from. Anyone who would make a comment that, in any small way, imples your surgery was ‘actually cosmetic’ is another word for thinly-veiled jealousy that means ‘YOU LOOK SO PRETTY NOW’ or ‘Maybe you’re prettier than me now and its not fair that you became that way by surgery (cosmetic or medical)’. I am kind of looking forward to seeing which of my ‘friends’ will do this! Shows their true colours, I reckon.

    • Yeah. I’m perfectly fine if they ask me bluntly if my surgery was cosmetic… it just infuriates me when they don’t believe me after I explain it all to them! Guess their reactions are just something we have to learn to handle though

  2. Hey Kim, thanks for your post. Sounds like you’re going through the phase that I dread the most! Anyway, just remember why you did it and that it is over and it’s time to adapt. There was once in my life something about me changed drastically without my knowledge and it was a learning experience for me. Even though it was painful, at the end of it, I was really thankful for it because it was a time of sifting and testing for my friends and family – and at the end of it, those who truly love you and care for you for who you are couldn’t give a hoot about how you’ve changed, and will instead either not really bother too much about your change, or celebrate it positively. (It was a sifting from 800 to something like 10 friends whom I can now celebrate and know they are lifelong friendships :)). Enjoy the process, and don’t go into hiding if it gets too much for you yeah? This social adaptation pary, to me, is probably the hardest to overcome. But hey, you look beautiful and your bite is better. Just like it is insensitive for a person to judge a woman who had to go through a mastectomy or a man who had to amputate one of his limbs simply to be in better health, consider those who judge you insensitive and forgive them because they may not know how to respond and simply chose one which might be more hurtful than they realize. 🙂

    • Thanks Ariela 🙂 You’re right, I think many of them don’t harbour any ill-intent, they just don’t know how to react. I guess the aesthetic change is something very difficult to come to terms with when they don’t really understand the functional benefit of the surgery (though some of them seem to be unable to get it through their heads despite a very thorough explanation on my part… but never mind them.)

      Reminds me of something written by George Eliot: “I suppose one reason why we are seldom able to comfort our neighbours with our words is that our goodwill gets adulterated, in spite of ourselves, before it can pass our lips. We can send black puddings and pettitoes without giving them a flavour of our own egoism; but language is a stream that is almost sure to smack of a mingled soil.”

  3. Thank you so much for such an honest post about the very issue (and interaction with people) that I’ve been struggling with. I’m currently scheduled to undergo a Lefort I, BSSO, and genio on Thursday. While most of those close to me have come to understand my ‘reasons’ after much explanation, there are still ‘those’ who can’t seem to accept it. I have to look past the ‘I hope what you’re about to put yourself through makes you happy’ remarks and remember the end goal.

    • All the best!!! Wishing you a smooth recovery 🙂

      Yes, I guess in the end all that matters, really, is that the surgery is done for our own sake and not anyone else’s. Some people probably can’t accept our reasons because they have never known what it is like to not have a normal functioning bite. Though it’s kind of sad that some people can’t factor in their inability to empathise, and choose instead to judge us for going through with this surgery.

  4. Thanks for writing this! I am going for jaw surgery in 20 days time too, and I have experienced the same thing, so your post really struck a chord with me. You managed to express many things I felt, but couldn’t put down in words.

    Maybe it’s because you look so good now after your surgery, that the snarky comments started to come your way. Haha. 🙂 Perhaps I should hope to receive more of such comments after my surgery then!

    All the best for your recovery!!

    • Hahaha maybe I should start seeing those comments in that light! 🙂 Thank you and all the best for yours as well! Hope your post-op recovery is going well x

  5. You look beautiful by the way. Thanks for the post I think about this while preparing for surgery great to know that I am not the only one racking my brain about it. Hope I will heal quickly as you seem to be when I have mine

    • Thank you. Yeah a lot of jaw surgery patients go through the same thought process, but it’s a good thing to reflect on the reasons why we decide to go through with such a severe surgery. Hope you’ll have a smooth recovery! 🙂

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