On the surface, this news story from the UK Daily Mail offers a fairly balanced report on a young British woman whose hatred of her looks led her down a path of more and more aesthetic procedures… and none helped her feel better about herself. The way in which this story is written, the reader is supposed to feel sorry for the poor woman. And it is good that she finally recognized her self-loathing prior to acting on suicide thoughts.

The situation illustrated by the story of this unbalanced woman is also the plastic surgeon’s ultimate nightmare — to work with a patient who just got a bunch of procedures and ended up despising her looks even more when all was said and done. This article may serve as a good guide to what you should reject in a prospective patient. When looks can kill:

A study carried out for the Girl Guides recently found almost half of secondary school girls said they plan to have plastic surgery.

‘Girls and young women tell us they are finding it hard to accept their appearance, and it is starting at a much earlier age than we had ­previously thought,’ says Nicola ­Grinstead, of Girlguiding UK.

Experts such as ­Professor Nichola ­Rumsey, a director of the UK ­Centre For Appearance Research, fear the ­underlying ­psychological issues that ­trigger the desire for plastic surgery are not being addressed.

People seeking cosmetic surgery often believe that it will solve ­dissatisfactions with their lives.

Laura ­Pillarella, the woman driven to plan suicide after 15 ­unsatisfactory procedures, said: ‘I was manipulating my face to build a new self. I was lonely as a child. My ­parents split up when I was six. Mum would often say giving birth to me and my brothers had ruined her looks and body.

‘I was distant from my dad and lacked emotional security so I was ­trying to boost my self-esteem. But plastic surgery never worked and each ­operation ­strengthened my quest to fix myself.’

Mercifully, her suicide plans stopped when her brother asked her to speak at his wedding. Suddenly, she says, she felt valued and began, slowly, to realise her unhappiness came from emotional problems.

The solution, from the plastic surgeon’s point-of-view, is to refer the customer with unrealistic expectations to a counselor or psychologist. Apparently, the disillusioned customer does not always follow through with this referral.

‘Ethical ­surgeons spend a lot of time ­talking to patients about their motivations for surgery and what they will achieve,’ says Nduka, who runs the not-for-profit ­website safercosmeticsurgery.co.uk. He increasingly finds ­himself referring patients to psychologists.

Indeed, one survey found that surgeons refer about 20 per cent of patients to psychologists due to unrealistic expectations — they may believe it will improve their lives dramatically by ­getting them the glamorous job or the partner they want.

‘Vulnerable ­customers are initially pleased, but when the euphoria wears off, their ­disappointment with their looks returns. So they have another procedure’

But Nduka warns that often patients never go to the ­psychologist and seek out a less scrupulous cosmetic surgeon.

Such patients can get caught in a costly and traumatic spiral of serial surgery, says Professor ­Rumsey.

Read it all.