Plastic Surgery Isn’t Just Skin-Deep--It Can Cut Into Relationships

Like the metamorphosis of a caterpillar to a butterfly, Holly McComas’ physical transformation was stunning. But unlike the life cycle of the butterfly, which takes weeks, McComas’ bodily change was nearly instant.

McComas, a 38-year-old title insurance assistant in Corona, underwent $25,000 worth of plastic surgery a little more than a year ago to alter her body. McComas, who had dropped from 245 to 215 pounds before surgery, had liposuction and a tummy tuck Jan. 3, 2001. One week later, the married mother of two had breast reduction surgery, which took her from a 44 F bra size to a 38 C.

The combined removal of fat, breast and stomach tissue reduced McComas, who is 5 feet 4, to a weight she hadn’t been since high school. Although McComas’ body falls short of what American cultural aesthetics dictate as an alluring weight for the female form, McComas feels irresistibly sexy.

“The change is beyond radical,” said McComas. “The surgeries changed me emotionally, physically and psychologically. I can stand in the shower and look at my feet. I can wear a potato sack and feel sexy. I went from being frumpy, fat and unattractive to taking my clothes off and prancing around in my bra and underwear.”

Still, there have been unintended consequences. McComas’ husband, F. Lynn McComas, who paid for the surgery, cared for his wife afterward and encourages her as she tries to lose 30 more pounds, is ambivalent--he appreciates the results but experiences pangs of jealousy over his wife’s admirers.

“I am only human,” said McComas, an apartment manager who likened his wife’s physical transformation to a bomb exploding. “I experienced jealousy a little bit. She is very nice to look at and she attracts more men than she used to. She is a tease. But I know where she is coming from,” he said, acknowledging his wife’s joy over the sudden attention.

While the mental adjustments may be more acute for the person changing his or her physique, spouses, partners and loved ones have their own coping to do.

“People may have cosmetic surgery with all the best of intentions but it may have implications that they never dreamed of,” said Rita J. Freedman, a clinical psychologist in Harrison, N.Y., and author of the 2000 book “Body Love: Learning to Like Your Looks and Yourself.” “A person may look in the mirror and see someone who looks different and that person has to incorporate that change internally. Loved ones may make the adjustment in a different way. A man may not be unhappy with the way his wife looks, but he may be unhappy with her newly awakened sexuality.”

Not surprisingly, breast reduction surgery isn’t always as popular with the men who are the mates of the women who seek it. Of all cosmetic surgeries, breast reductions bear some of the most positive results for women, many of whom have been taunted about their big breasts early in life, suffered from back and shoulder pain and been unable to engage in certain sports, said Freedman. But women’s breasts are so associated with sexuality that a woman’s decision to undergo breast reduction surgery may not sit well with her spouse or partner.

“My husband was not in favor of it,” said a woman who is an office administrator in Crystal Lake, Ill. She underwent a procedure 10 years ago that reduced her breasts from a double D cup to barely a B. “He was fine with them being huge. He tried to talk me out of it. When I went in to have the reduction done, I hadn’t settled it with him. I did it against his wishes.”

The woman, who asked not to be identified, had vitriolic fights with her husband, who opposed the surgery partly because he feared something might go wrong and partly because he liked her breasts. The woman, who had wanted the surgery since she was in her late 20s, bought the surgery as a 40th birthday gift to herself.

“To this day, my husband fondly remembers my large breasts,” said the woman, who added that she was “enormously pleased” with the results. “But he never complains because he is smart.”

American men tend to be territorial about their wives’ or partners’ breasts, said Freedman, who added that some men get “a vicarious pleasure” out of other men gawking at their wives’ breasts. “Breasts are for babies,” said Freedman, “but I have heard men say [that their own nursing] baby is horning in on their territory.”

Marcia Goin, a clinical professor of psychiatry at USC’s Keck School of Medicine, co-authored a book in 1980 with her late husband, plastic surgeon John Goin. In “Changing the Body: Psychological Effects of Plastic Surgery,” the couple followed eight women who had breast reduction surgery.

The sole unmarried woman in the group told her male friends of her plans for reduction--none of them could understand why she would go through with the surgery.

Conversely, the married women had supportive husbands. Some of the women took as long as six months to adjust to their smaller bust size, while others integrated their new physique immediately The study was too small to identify characteristics of women who adjusted better than others, said Goin, but at least one woman discovered after her surgery that she had used her breasts as a barrier.

“She realized she had used her breasts, psychologically and unconsciously, as a buffer between herself and her mother,” said Goin. “She had had a terrible relationship with her mother. When her mother came over after the surgery, the woman asked her husband to sit between herself and her mother. The woman realized that [without her large breasts] she felt vulnerable with her mother.”

Goin said that cosmetic surgery, which fundamentally changes the way one looks, as opposed to restorative procedures (such as a face-lift--same self, just a younger version) are most likely to lead to unexpected outcomes.

In a study of patients who’d had surgery on their noses, Goin said, a researcher noted that a few women who had not previously found themselves targets of male attention experienced some distress when they began to turn heads.

As for Holly McComas, the most important relationship that changed after the surgeries is the one she has with herself.

“It is not a question of whether or not my husband likes it or not,” said McComas. “It is a question of having to deal with men craning their necks to look at me when we go out dancing. Me? I am walking to the bathroom and doing the happy dance all the way.”

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Birds & Bees, a column about relationships and sexuality, runs Mondays. E-mail: kathykelleher@ adelphia.net.