I Wasn’t Prepared For How Depressed I Was After Plastic Surgery

by Joseph K. Clark



Last week I made eye contact with my dog and experienced a jolt of oxytocin. In that moment I exhaled, realizing I was still capable of feeling. For the four weeks prior, I had been in a state of acute anhedonia. I’d just had plastic surgery so that I could regain my self-confidence. Instead, I lost my ability to feel anything.

As a comedian, I didn’t have to wait for the pandemic to experience the “Zoom effect,” the phenomenon of noticing facial flaws due to videoconferencing. I just had to perform on a show with a photographer who took photos from underneath the stage.

That was how, in 2018, I first became acquainted with what I came to refer to as my “neck vagina,” flaps of loose skin underneath my chin that may be a consequence of the bulimia I struggled with in my younger years.

For two years, I tried every nonsurgical procedure possible. Then, at what appeared to be the end of the pandemic, with my income returning and my 40th birthday looming, I found a surgeon who invented a procedure that is known as the “Zoom lift.” He came up with a plan for me that included skin removal, facial liposuction and tightening, and the permanent thread lift known as MyEllevate.

I was so relieved and excited. I knew that others didn’t notice my neck, but I couldn’t even go into a comedy club without running to the bathroom to see how visible it was that night. If I was getting surgery for what the world saw, I told my friends, I would get full-body liposuction. But this was a gift just for me.

I spent weeks preparing. I went to extra therapy sessions. I had my house professionally cleaned. I spent a week making and freezing soups for when I could only eat soft things. My finances were in order. My calendar was clear. My sheets were clean. My laundry was done. I hired a friend to drive me, care for me and tend to my pets in the first few days. I even knew what show I planned to binge in its entirety (“Gilmore Girls”).

I am a sober alcoholic, so I also did a lot of planning to take care of myself in the event that taking prescription painkillers activated my addiction. I had a plan to be held accountable with my sober support network. 

The one thing I didn’t expect or prepare for was the devastating repercussions that the surgery would have on my mental and emotional health.

I sat on the couch post-surgery, head bandaged, peas pressed to my face, Percocet obliterating my physical pain, my dog sleeping peacefully on my lap, a friend sitting nearby, knowing the surgery was a success, and instead of triumphant, I felt worse than ever. 

Here I was, having just given myself something I very deeply wanted. So why was I so unhappy?

I have lived a life in which real things have actually gone very wrong. Here I was, having just given myself something I very deeply wanted. So why was I so unhappy?

Thankfully, I live in Los Angeles, so I have friends who have also had cosmetic procedures. I texted two of them, who confirmed that they also were miserable after their surgeries. Why hadn’t they told me? They thought it was just a “them” thing too.

I thought it would lift after I went off pain medications. When it didn’t, I thought it would surely go away after my brain had adjusted to being on and then abruptly off narcotics. Then perhaps when the swelling went down and I could see some results? When I no longer had to sleep on my back, wear a neck brace? When I could start being productive again?

Surely when I was cleared to go to the gym and drive again. As I passed each mile marker that I hoped would break the spell, I grew more and more despondent.

According to the plastic surgery sites I consulted, I wasn’t the only person to experience post-surgical depression. Yet it is rarely talked about. If we don’t talk about something, we feel more alone in it. This only exacerbates the feelings of numbness, sadness and alienation.

A friend pointed out that no matter how much you may trust your surgeon, the fact of surgery is traumatic. When you are under, anything can happen to you and you’re not exactly sure what did. It can activate underlying PTSD. Apparently post-surgery blues can happen with any type of procedure, but with cosmetic, there are even more factors that can break our brains.

I had been fixated on the neck skin for so long that I put the idea of it being solved on a pedestal. As with anything external, there is no way that achieving the goal will ever match the fantasy of telling myself that I will be “happy if.” The same phenomenon happens when we tell ourselves that if we were richer, thinner or more popular, we would be happy, and the reality of manifesting those things falls flat. There is nothing outside of ourselves that can fill a hole within. It is like searching in the grass for a key you lost inside the house.

Although I am thrilled to have a smooth and rejuvenated neck and jawline ― well, at least now that my depression has lifted, I am ― it cannot fix the part of me that believed that my appearance is my worth.

My fixation shifted the day I had surgery. I stood in the mirror, my head bandaged so that I looked like a very large Q-tip, when I suddenly noticed my back fat. Where had this come from? Had my neck vagina just sneakily relocated around the corner? How much was this going to cost, and how long until I could pay off this surgery so I could go back into debt for that one? What else is wrong with me that I hadn’t noticed? Well, now that I am looking, I can see that my breasts at 39 aren’t as high as they were at 20. How dare they!

On the topic of finances, cosmetic procedures, especially ones with reputable doctors, are very expensive and, for most of us, require sacrifice. I don’t have a mortgage, student loans or credit card debt. I took out a line of credit with a company specifically for medical procedures to fund this surgery, feeling like I couldn’t wait. I didn’t realize how icky it would feel to be in debt, like this weight I’m under that keeps me from moving about freely.

All these thoughts and feelings contributed to the physical reality of my chemically depleted and off-balance brain.

A few positive things happened in my career and I watched them go by like ships in a harbor. Cool, I thought, when I can feel things again I will feel happy about that.

That was the shift I needed to make. To realize that this was not a permanent mental state, and to begin to force myself to do the things to set myself up for my life to be on track for when I feel good again. 

Once cleared, I started going to the gym every day. I forced myself through the rituals of journaling, meditation, 12-step meetings, reading nonfiction, talking with friends and making small, attainable goals. I forced myself to do the things I would enjoy, could I enjoy things. I learned that I don’t have to feel right to act right.

I accepted that this needed to run its course and that I wasn’t in charge of the timing. I also made a psychiatry appointment for antidepressants, just in case.

Two days out from a month post surgery, I began to feel a light breaking into the dungeon of my mind. The next day I woke up and noticed the palm trees outside my window, the smell of Jasmine in the air and the simple joy of drinking coffee, the promise of a day waiting to begin, in which anything can happen. My daily gratitude list came alive again.

If you, like I was, are suffering from post-plastic surgery depression, I can share with you these universal truths: It’s totally normal, and it isn’t forever. 

For the past year I’ve been meditating with the idea that my work is not my worth. This idea helps me detach from the jealousy in my industry, the fear that I’ll never be acknowledged for my talent. But I’ve been defining myself ― and my self-worth ― through my looks so much longer than I’ve been a comedian.

The idea that my looks are not my worth was something that never occurred to me, until I was grappling with my complicated feelings post-surgery. Throughout this process, I’ve learned that no surgery can fix that flawed thinking. (But I do still kind of want a Brazilian butt lift.)

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