Matthew Linney is in his early 50s and last year had surgery to remove a malignant patch of skin from the side of his nose; the following day he had the hole — roughly the size of a dime — filled in with skin taken from his chest. (He asked that a pseudonym be used in place of his real name because he struggles with the word disfigurement. He doesn’t want to claim it “as some sort of badge of honor,” and neither does he feel comfortable taking ownership of it.) “I know that once my scar heals my life will more or less return to normal, if that’s the right word,” Linney said.

For a couple of weeks following the procedure, his nose was swollen, red, and, at times, gunky and seeping puss. Fourteen months later, his prognosis is good, but the scar is still fading gradually.

“The initial few months were hellish,” he said. “I was off work for a while, but recovering at home meant I was spending too much time dwelling on the negatives. It was festering away in my mind about how people would react. My wife was great at encouraging me to get out of the house, take the children to the park, do a weekly shop. For the most part I tried to block out any unwanted attention, yet there were times I could tell [that] people — usually parents with their children, when I was with my family — were staring intensely at me. It felt like they were scrutinizing me, questioning my ability as a husband and father. I kept on thinking that they must be wondering why my wife is with me.”

Linney admitted that such reactions from strangers made him question his masculinity. This is an issue that is seldom talked about but very much affected when a body part is lost or becomes torn, burned, or damaged.

Thanks to innovations in surgery, doctors can help make some disfigurements less noticeable, using anything from prosthetic ears sculpted from silicone, to false eyes, to noses reconstructed from cartilage grown on foreheads, to realigned jaws where bone has been transferred from the hip to strengthen it. High-tech imaging software means surgeons no longer have to rely on building 3D skulls by stacking 2D scans together — this can give a patient a better idea of what they’ll look like and allow them to prepare for the final outcome.

Yet fixing an aesthetic issue doesn’t address the underlying challenge of altered identity. Surgery is no magic wand. This is why not everyone is a good candidate for these types of procedures — especially transplant s— and why any potential candidates have to undergo a battery of tests beforehand.

Ten years ago, the recipient of the world’s first penis transplant had the procedure reversed soon after because he and his partner couldn’t cope. The New Zealand man who received the first hand transplant had it removed just a few years later — he had voluntarily stopped taking his immunosuppressive drugs. Jeff Kepner, the first man in the United States to receive a double-hand transplant, isn’t happy with his new body parts since they are more or less nonfunctional, but he was advised against having them amputated as it’s unlikely he’ll be able to receive prosthetics in their place.

Elisavet Moschopoulou, a Ph.D. student exploring factors associated with quality of life and impact of sickness in long-term head and neck cancer survivors, told me that regardless of the surgical techniques employed and the cosmetic outcomes, it’s possible surgery will reduce a patient’s quality of life and their psychosocial well-being.

“Having a supportive network plays a crucial role in navigating and dealing with the social and emotional challenges attached to disfigurement,” she said. “Family and friends can help buffer the impact the disfigurement can have on well-being.”

Moschopoulou’s Ph.D. is being supported by Saving Faces, a U.K. organization dedicated to improving research into treatments for all types of disfigurement. The founder, maxillofacial surgeon Iain Hutchison, said that in cases where surgery isn’t needed to restore physical functions, it might not make sense to operate on someone in their 60s who is, say, happily married with children and maybe grandchildren; however, it might make sense to operate on someone in their early 20s, because they are just starting out in life and shaping their adult self.

Martindale is of the same opinion, arguing that “appearance-related pressures may reduce with age, and more life experiences can give a greater sense of context.”

Still, it’s never easy to predict how people will react, regardless of preparedness or the support network in place. Moschopoulou added that there isn’t any specific link between the severity of a disfigurement and how an individual might react post-surgery.