Psychology of Surgery

The emotional impact

Cosmetic surgery is far from simply a ‘cosmetic’ process. While ostensibly about looking good, it seems to be about feeling good too. According to a recent report about Botox users, for example, over 50 percent of patients reported actually 'feeling' younger following the procedure, rather than just 'looking' younger.

Many people undoubtedly seek cosmetic surgery to achieve a specific result and, once that’s been attained, remain satisfied with the result. However, as more information is gathered about those who undergo cosmetic treatments and the reasons why they do so, a number of worrying trends have begun to appear.

Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a psychological condition in which a sufferer obsesses over barely noticeable or imagined physical flaws. In 2006 science journal Psychological Medicine drew attention to a German study that indicated that while the most extreme form of the condition affected one to two percent of the population, a significantly higher proportion experienced it in a milder form. Even where BDD isn’t suspected, trends suggest that physical appearance is an area of increasing concern. Indeed, a survey of 5,000 UK women by Grazia magazine revealed that almost a third worry about how they look 'every waking minute'.

Much of this is put down to the current social climate. A celebrity-led culture means that success and physical beauty have become inextricably linked, and experts increasingly believe that many people fail to separate the idealised images they see on film or in magazines (many of which have been visually manipulated to iron out flaws) with the reality of physical appearance.

Another concern is that the increasing popularity and accessibility to cosmetic surgery and related procedures is fuelling this trend. To BDD sufferers in particular, promises of a change to a patient’s physical appearance are enormously appealing, even while the satisfaction to be gained from any such treatment is largely fleeting (studies suggest that, post-surgery, sufferers invariably find something else about their physical appearance to fret about).

Addiction

Even where BDD is not to blame, there is a growing belief that undergoing cosmetic procedures fuels a certain kind of addictive behaviour. According to a paper presented at the British Association of Aesthetic Plastic Surgeons (BAAPS) earlier this year, over 40 percent of users 'expressed a compulsive motive for using Botox repetitively'.

More worrying still are the issues raised in a recent edition of New Scientist suggesting that people who go under the knife are more likely to be suffering from 'psychiatric problems' than those who don’t.

Managing expectations

A growing body of evidence suggests that there may be a common psychological ‘type’ who seeks to undergo cosmetic surgery in the hope that the improvement in their physical appearance will improve self-image and self-esteem as well. To that end, practitioners need to not only be alert to the signs of possible BDD or related disorders, but the issues surrounding a patient’s psychological processes and expectations in general. Likewise, it’s vitally important that those opting for treatment are clear about their own reasons for doing so (and to be able to justify this to a consultant when – and it should be when rather than if – asked). Before opting for any kind of cosmetic treatment, patients should be well versed about what a particular surgery can achieve and adjust expectations accordingly. If either doctor or patient is in any doubt, the best advice is to wait it out.