Studying the Psychology of Cosmetic Plastic Surgery

How could a cosmetic procedure improve your happiness? Recent discussions in both the media and the medical community have brought this question into focus.

It’s a good question for patients to ask, according to plastic surgeon Robin Yuan, MD, whose new book, Behind the Mask, Beneath the Glitter, explores the psychology of cosmetic surgery patients and their decision-making processes. Dr Yuan tells Plastic Surgery News that before a procedure, patients should “know the truth about themselves in the broadest sense.”

By knowing oneself, a patient will be more able to partake in a successful doctor-patient relationship – one in which she is able to articulate her own personal motivating factors for cosmetic surgery. The doctor then becomes more able to focus on specific goals that will make her happy with the result.

Patients who have psychological problems, such as body dysmorphic disorder, pursue cosmetic surgery for the wrong reasons. They are not likely to find increased happiness from a procedure. That’s the commonsense view in the medical community: that cosmetic surgery – enhancement of beauty – can’t cure any serious psychological problem.

A radically opposed view is held by Brazilian plastic surgeon Dr. Ivo Pitanguy. A recent editorial in The New York Times explains Dr. Pitanguy’s philosophy, and his argument that beauty and mental health are linked, so the real goal in surgery is to heal the mind.

A recent study, with empirical evidence, seems to counter Pitanguy’s claim. “Psychosocial changes after cosmetic surgery: a Five-Year Follow-up Study” was designed to find a link between certain “pre-existing patient characteristics” and “poor psychosocial outcomes.” Currently an abstract “sneak peak,” it will be included in the September 2011 issue of Plastic and Reconstructive Surgery.

With questionnaires from 130 female cosmetic surgery patients, the authors measured characteristics like self-esteem, appearance satisfaction, psychological problems, and self-evaluation of the surgical results. Five years after cosmetic surgery, patients showed more satisfaction with their general appearance and more satisfaction with the operated body part. They also reported “a small increase in self-esteem.”

However, patients in the study who had psychological problems or low self-esteem were less likely to be satisfied with their results.