A Review of Psychosocial Outcomes for Patients Seeking Cosmetic Surgery

Abstract

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...

The Impact of Facial Aesthetic and Reconstructive Surgeries on Patients’ Quality of Life

“…In the recent studies on quality of life, a considerable number of people especially with the diagnosis of cancer have been reported to have psychological problems [14,22]. Any change in the body image perception resulting from facial deformity and dysfunction also affects the individuals negatively [23][24][25]. Cotterill drew attention to the fact that dissatisfaction with body image was a reason for misery or death [10].…”

A Comparison of the Psychological Outcomes of Cosmetic Surgical Procedures

“…Secondly, the six-month follow-up period may under-estimate benefits by reflecting cognitive dissonance, whereby patients report positive outcomes to fit the decision to undergo cosmetic surgery, or over-estimate benefits by allowing insufficient time for the interaction of changes that would lead to psychological improvement (Cook et al, 2006). Finally, similar to most studies in cosmetic surgery outcomes, there was a high loss to followup in this study, which may result in a sample bias of patients with superior outcomes agreeing to participate (Honigman et al, 2004). It is therefore recommended that future research replicates this study using larger samples, use of control groups with physical indications for surgery, longer follow-up periods, and high follow-up rates in order to fully establish the impact of cosmetic surgery on body image, self-esteem, and mental health outcomes.…”

“…However, patient satisfaction does not necessarily indicate improved psychological functioning (Cook, Rosser, & Salmon, 2006;Honigman, Phillips, & Castle, 2004). Two systematic reviews have derived somewhat different conclusions regarding improvements in the psychological outcomes of cosmetic surgery.…”

“…Two systematic reviews have derived somewhat different conclusions regarding improvements in the psychological outcomes of cosmetic surgery. Honigman et al (2004) conducted a review of 37 retrospective and prospective studies published from 1960 to 2002. Inclusion criteria included pre-operative and postoperative measures of psychological outcomes (such as distress, body image, Plastic Surgery: An International Journal 2 self-esteem, mood, social confidence, social interaction, and quality of life) and subjective ratings of patient satisfaction.…”

Cosmetic Surgery: When Fifty Doesn't Feel Fabulous

“…Although cosmetic surgery may have psychological benefits, it may not be a panacea for patients who need psychiatric care. In fact, studies suggest that such patients may be unhappy with their surgical result and face "postoperative psychological complications" [4,5]. Even if Dr. Holmes offers recommendations about cosmetic surgeons, he should also suggest that Ms. Wagner meet with a mental health professional and explain why he thinks such a consultation is in order.…”