The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings.Plastic and cosmetic surgeons regularly report high satisfaction rates among their patients, and they have provided clinical and empirical evidence supporting positive outcomes in terms of patient satisfaction with cosmetic surgery procedures. 1-4 Further, it has been assumed that a positive change in physical appearance for the patient will lead to an improvement in their psychological well-being, including their self-confidence and self-esteem. 5-8 However, patient satisfaction with procedures and changes in psychosocial status are two different, although related, issues. Patients can be satisfied with their appearance change following the operation but may experience no change in psychological characteristics. Scant literature on the topic of whether successful cosmetic intervention actually results in measurable and meaningful improvement in psychosocial functioning and psychological well-being in the long term 2,9,10 suggests this issue should be studied further.Most people seeking cosmetic surgery procedures appear psychologically healthy; however, some are not, and for these individuals cosmetic procedures may have a negative outcome, creating problems for both patient and surgeon. 1,11-13 Problems encountered by the patient can lead to requests for repeated procedures, depression and adjustment problems, social isolation, familial dysfunction, self-destructive behaviors, and anger toward the surgeon and his or her staff. 14 Problems encountered by the surgeon can include distress to themselves and This article reviews the literature on psychological and psychosocial...