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Psychiatry & Psychology--General/Suicidal and MDs don't understand

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I had jaw surgery last year, which included surgery to reposition my weak chin. The chin bone surgery went wrong, was disfiguring, and the Dr said he would fix it in a second surgery asap. This second surgery only partially alleviated the problem, and caused soft tissue and facial muscle deformities. I became suicidal. I saw other maxillofacial surgeons and they couldn't help me. I saw my original surgeon and he said he had fixed one of the soft tissue deformities before. I told him I wanted to reverse the chin surgery. He said he could, but he was tempted to shave it down instead. I said no and opted for the muscle reattachment with reversal of the bone to its original position. He did the third surgery but did what he was tempted to do instead, and lied to me about it. The soft tissue was not only not fixed but became much worse. Now the bone can never be reversed to what it was, and I am deformed. I cannot look in the mirror without crying. The original surgery was over a year ago and I've been suffering with chronic insomnia since then along with panic attacks. I cry for hours on end constantly. I had been lied to about risks and expectations of the surgery and doing it was the biggest mistake of my life. I'm terrified of Drs now but I'm still seeking a surgeon to reattach the muscle and set it back very close to how it used to be. I've become a shut-in and I'm a shell of the person I used to be. I barely go anywhere because I'm terrified to use a washroom and see my face, which will often make me cry in public. I am having such a hard time finding a surgeon to give me back a weaker chin that I have to do distance consults with surgeons who aren't local. They are so against it that my original surgeon  even did medical battery on me. My question to you is how do I explain all this to them without scaring them away because I'm a suicide risk? No matter what I say, they don't seem to care that my ability to live with myself is what matters, otherwise I'll just take my own life.  Would maybe getting a letter from a local psychologist and showing it to the surgeon help or not? I saw a therapist between my second and third surgery for 2 months, by the way, and she said I had anxiety and depression. I need any advice I can get as well. Thank you so much.

Answer
I am so sorry to hear of this series of problems. Please hang on and let's see if we can find a way to help you not only with this physical problem but also your body image, your sense of self, and your suicidal ideation.

I understand you saw a therapist for 2 months between surgeries. Did she have any other insights for you other than you are suffering from anxiety and depression?  Did she think these were symptoms/conditions that existed prior to the surgery or appeared as a result of the trauma? Did she have anything to say about possible body dysmorphia? This situation would cause symptoms of anxiety and depression, so that diagnosis alone gives us very little insight into what is going on in the bigger picture. If you felt you got some good therapy with that person, I would suggest you continue on with her IMMEDIATELY. I am worried about your state of mind and you need help to get through this. If you felt she was unhelpful, I would, without delay, get into therapy with someone else. This is a very difficult time and you are very unhappy with what has happened. The regret and loss must be addressed so you can move forward.

Back to the surgical issue...from your description, I understand this surgeon did THREE surgeries, each one more deforming that the other. I am appalled by his lack of skill, his lack of ethics, and his grievous behavior in lying to you. I believe it will be incredibly hard to go back and undo what has been done by this surgeon. No matter how skilled, there are already permanent changes that have been carried out so your original appearance may be very difficult to impossible to achieve.

You need to slow down and do some research. Find a very respected, reputable reconstructive plastic surgeon...one who has the experience and the skill to put faces back together. These surgeons help people who have been in serious accidents as well as helping infants who have facial deformities.  This is the quality of surgeon you now need.  Then you must respect her or his opinion and follow it. What you are looking for may not be doable but you may get some satisfactory result that you can live with.

Because I do not know you or your entire history, I have a question and I hope you do not mind my asking. I was wondering if you ever experienced this kind of situation in the past...the kind of situation where you go from doctor to doctor looking for a particular procedure and you are not happy. This is something I would need to know to help you with what might be happening in the here-and-now.

Lastly, I am curious why you continue to go to a surgeon who had already done a terrible job with the first surgery. Everyone can make a mistake but this seems like negligence. I very much realize this is an after-the-fact observation, but your return to a surgeon who has already proven he could not give you the result expected makes me wonder how much you value yourself and how well you take care of yourself. In thinking about this negligence, and this is not psychological advice but more practical guidance, have you consulted a lawyer specializing in malpractice? Your post states that your first surgeon performed a procedure for which you did not give permission. He also did not only give you the result he promised, he left you disfigured and continued to disfigure you with further surgeries. You will need him to pay for any procedure that might be able to restore form and function. I would immediately consult a malpractice lawyer who is reputable and recommended.

I wish you the best of luck.  

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Jacquelynn Cunliffe

Expertise

I would like to answer under the category of Psychiatry and Psychology. However, I would like to see a separate category for Psychotherapy/Psychoanalysis. I do not answer questions about medications as I do not prescribe. My expertise is in psychotherapeutic treatment.

Experience

I am a psychotherapist and psychoanalyst who specializes in the treatment of mental health issues caused by childhood trauma, domestic abuse, eating disorders, relationship difficulties, and a wide variety of psychological disorders. The kind of therapy I do is often referred to as deep therapy, talk therapy, or psychoanalytic therapy. Please note that I am not against medications and when managed well, medication can be an adjunct to psychotherapy intervention. I think it is important for the public to realize that psychodynamic or psychoanalytic psychotherapy DOESmake changes not only in people's minds but those changes can also be detected in their brain structure. Psychotherapy and psychoanalysis are powerful interventions to help people change their lives from the inside out.

Organizations
American Psychoanalytic Association American Psychiatric Nurse Association Member of Psychoanalytic Center of Philadelphia Member of National Eating Disorder Association

Education/Credentials
Ph.D.-University of Pennsylvania, Psychology and Education, Division of Human Development M.S.N. and R.N.-B.C. Board Certified Nurse in Psychiatric and Mental Health Nursing. 2-Year Adult Psychotherapy Program graduate 2-Year Child Psychotherapy Graduate Current: Candidate in Psychoanalytic Training at the Psychoanalytic Center of Philadelphia

Past/Present Clients
I have worked with clients who have experienced significant childhood traumas. These patients come with a variety of mental health issues, including anxiety, depression, suicidal ideations, relationship difficulties and diagnoses such as Personality Disorders, Adjustment Disorders, and, though rarely, Dissociative Identity Disorder (formerly multiple Personality Disorder)

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