But what about the exceptions who didn't change? The
Duchess who all her life had been terribly shy and selfconscious
because of a tremendous hump in her nose?
Although surgery gave her a classic nose and a face that
was truly beautiful, she still continued to act the part of
the ugly duckling, the unwanted sister who could never
bring herself to look another human being in the eye. If
the scalpel itself was magic, why did it not work on the
Duchess?
Or what about all the others who acquired new faces
but went right on wearing the same old personality? Or
how explain the reaction of those people who insist that
the surgery has made no difference whatsoever in their
appearance? Every plastic surgeon has had this experience
and has probably been as baffled by it as I was. No
matter how drastic the change in appearance may be, there
are certain patients who will insist that "I look just the
same as before—you didn't do a thing." Friends, even
family, may scarcely recognize them, may become enthusiastic
over their newly acquired "beauty," yet the patient
herself insists that she can see only slight or no improvement,
or in fact deny that any change at all has been made.
Comparison of "before" and "after" photographs does
little good, except possibly to arouse hostility. By some
strange mental alchemy the patient will rationalize, "Of
course, I can see that the hump is no longer in my nose
—but my nose still looks just the same," or, "The scar
may not show any more, but it's still there."