A solid, well-researched, and well-argued analysis of the behavior of plastic surgery patients.




A plastic surgeon presents insights into patients’ motivations based on his practice and empirical research.

In this medical book, Constantian (Rhinoplasty, 2009) analyzes patients who have undergone multiple cosmetic surgeries and are unsatisfied with the results, finding that their reactions can often be connected to disturbing childhood experiences. The author combines anonymous anecdotes from his patients with peer-reviewed research into the lasting impacts of traumatic events in childhood to show that many cases are the result of patients’ reactions to family dysfunction or abuse. He argues that the pursuit of elective cosmetic surgery—rhinoplasties, or nose jobs, in Constantian’s practice—should be understood in that context. The deeply researched book (each chapter includes several pages of endnotes, and full credit is given to existing rubrics like the Mellody model) takes readers through existing literature on human psychology, including body dysmorphic disorder, an exploration of how behaviors related to body image can be a response to trauma, and the physiological effects of painful experiences. He concludes that patients can be best served by developing a sense of resilience and dealing with the underlying issues as opposed to going to surgeons who simply accede to requests to lengthen or shorten their nose tips by a few millimeters. The author urges physicians to understand the “intensity of emotion” that may be involved in a case and to acknowledge the connections between emotional state and physical health. The writing here is strong, though certainly technical, and it is clear from the opening pages that the book is intended as a professional reference rather than casual reading material. The target audience is surgeons, and understanding that keeps the authoritative narrative tone from becoming overbearing (“Physicians see the effects of this neglect in patients who become childlike following surgery, or in Internet conversations where patients give medical advice to each other or pose questions that should be directed to their surgeons—or not even asked”). Although the patients who appear in the work’s many anecdotes may appear extreme (one’s “six-page letter read like the Unabomber Manifesto”), Constantian provides a level of detail and empathy that renders them entirely plausible, allowing readers to see how domineering parents, the lasting effects of physical abuse, or other childhood traumas can shape patients’ enduring unhealthy relationships with their bodies. The volume’s conclusions are based on solid science, and the author acknowledges socio-economic factors that may further shape patients’ responses. The occasional bits of humor (“If I were marooned with her for three days, she could probably turn me into Prufrock”) add a distinctive touch without detracting from the treatment of a serious subject. The concrete and actionable information provided gives readers useful takeaways, like comparisons of satisfaction rates between patients correcting real deformities and those having features that appear normal to a casual observer. There is some discussion of how patients can develop the resilience that seems to be the most effective way of managing these disorders, but the book remains focused on its readers, providing surgeons with guidance on improving their interactions with troublesome patients.

A solid, well-researched, and well-argued analysis of the behavior of plastic surgery patients.

Pub Date: Dec. 13, 2018

ISBN: 978-1-138-10030-5

Page Count: 342

Publisher: Routledge

Review Posted Online: Feb. 13, 2019

Kirkus Reviews Issue: March 15, 2019

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If the authors are serious, this is a silly, distasteful book. If they are not, it’s a brilliant satire.


The authors have created a sort of anti-Book of Virtues in this encyclopedic compendium of the ways and means of power.

Everyone wants power and everyone is in a constant duplicitous game to gain more power at the expense of others, according to Greene, a screenwriter and former editor at Esquire (Elffers, a book packager, designed the volume, with its attractive marginalia). We live today as courtiers once did in royal courts: we must appear civil while attempting to crush all those around us. This power game can be played well or poorly, and in these 48 laws culled from the history and wisdom of the world’s greatest power players are the rules that must be followed to win. These laws boil down to being as ruthless, selfish, manipulative, and deceitful as possible. Each law, however, gets its own chapter: “Conceal Your Intentions,” “Always Say Less Than Necessary,” “Pose as a Friend, Work as a Spy,” and so on. Each chapter is conveniently broken down into sections on what happened to those who transgressed or observed the particular law, the key elements in this law, and ways to defensively reverse this law when it’s used against you. Quotations in the margins amplify the lesson being taught. While compelling in the way an auto accident might be, the book is simply nonsense. Rules often contradict each other. We are told, for instance, to “be conspicuous at all cost,” then told to “behave like others.” More seriously, Greene never really defines “power,” and he merely asserts, rather than offers evidence for, the Hobbesian world of all against all in which he insists we live. The world may be like this at times, but often it isn’t. To ask why this is so would be a far more useful project.

If the authors are serious, this is a silly, distasteful book. If they are not, it’s a brilliant satire.

Pub Date: Sept. 1, 1998

ISBN: 0-670-88146-5

Page Count: 430

Publisher: Viking

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: July 15, 1998

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Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...


A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.

The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.

Pub Date: Nov. 1, 2011

ISBN: 978-0-374-27563-1

Page Count: 512

Publisher: Farrar, Straus and Giroux

Review Posted Online: Sept. 4, 2011

Kirkus Reviews Issue: Sept. 15, 2011

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