Identity as a driver for cosmetic interventions as palliative care

Abstract

This report describes the unusual phenomenon of cosmetic surgery in a palliative care setting and evaluates the appropriateness of these interventions. Four female patients, with a mean age of 57 years (range 48–67 years) and all with a diagnosis of metastatic cancer presented for cosmetic interventions over a three-year period. The first patient underwent non-surgical cosmetic interventions to address a tired appearance and volume loss from chemotherapy and radiotherapy. The second patient was treated with upper eyelid blepharoplasty in addition to non-surgical treatments after expressing a loss of identity. A third patient with a history of upper and lower eyelid blepharoplasty, malar implants and fillers underwent removal of the malar implants and dissolving of fillers as she wished to remove all artificial material from her body. The final patient who had undergone enucleation of her eye 20 years previously had eyelid surgery and fillers to the upper eyelid sulcus to improve the appearance of her artificial eye and to address the trauma of losing her eye as a young woman. Patients’ motivations for seeking treatment included diminished self-esteem, a loss of identity, wanting to take control and wishing to look healthy in the final stages of life. Our experience has been positive with patients reporting significant satisfaction with low-risk procedures, enhanced confidence and improved social interactions leading to a discernable benefit in quality of life.