Cosmetic Surgery: The facts & the psychology behind the process

In this piece we hope to close the circle on the conversation we originally had with The Breakdown Magazine and touch on more details as it applies to our potential patients. We must have an open discussion to the psychology and limitations of processes involved.

Studies show that more and more men and women are dissatisfied with the way they look, specifically the want here is to attain the youth once had using surgical and non-surgical cosmetic surgeries. We touch on the people seeking operations due to medical, pain, rehabilitation as well, but the main focus of this piece is to speak regarding the volunteered.

The most popular ones are breast augmentation, rhinoplasty or nose job, blepharoplasty or eyelid aesthetics, face-lift, brow-lift, hair transplantation, cosmetic dental operations, liposuction, and tummy tucks.

**How often do you consult with a patient regarding surgery or a non-surgical treatment and recommend a course of talking therapy before moving forward?**

My clients don’t expect for me to process his/her cosmetic surgery, but when in the process we are working on other psychological issues, I would definitely assist patients in helping them process their reasons, motives, and expectations for the surgery. Having realistic goals is very important in preventing disappointments. It is very important to think thoroughly the pros and cons of cosmetic surgery especially when it requires a more serious medical procedure and the psychology behind that choice.

**What are the indicators that someone may need a form of therapy before or instead of surgery?**

While most people are highly satisfied with end results of cosmetic surgery, there are many others who are not. If someone has a deeper need for self-confidence or the need for acceptance and approval and has issues of unworthiness despite countless operations they can never be satisfied with themselves and continue being disappointed with the surgical results.

I believe a more elaborate psychological counseling is needed with people who look very preoccupied with their physical appearance especially when there are no observable defects from outside, have very high or unrealistic expectations from the way they look (and the way they will look after the surgery), are involved in compulsive and repetitive behavior (e.g. checking one’s appearance in a mirror, excessive grooming, skin picking and seeking reassurance) or mental acts (e.g. comparing one’s appearance with that of others) in response to concerns about their appearance. This clinically significant distress or impairment is defined as “Body Dysmorphic Disorder (BDD)” in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Furthermore, the Body Dysmorphic Disorder is found to be highly comorbid in cosmetic- surgery-seeking patients with major depression, social phobia, eating disorders, and obsessive and compulsive disorder. Some of those patients change their minds when they get psychological or psychiatric support for their symptoms or set more realistic goals for themselves for the surgery they seek.

**Would all medical professionals take the same approach when recommending mental health services ahead of time or as an alternative to cosmetic surgery and treatments?**

I believe that it depends on the severity of the surgery and the extent it will change patient’s look/life. If medical professionals are aware of the possible psychological risks (e.g. the heightened risk of suicide among women following breast augmentation surgery and the high prevalence of BDD and the associated psychiatric comorbidities), refer those patients to appropriate psychological assistance before the surgery and explain the pre and post-operation processes as well as limitations of the operation in detail, everyone would be happy.

**How can someone know if surgery is right for them?**

First of all, one should consult the physician about his/her needs and expectations. If there is excessive concern, the person is already very dissatisfied with most aspects of her life and put a lot of hope into surgery like it will magically change everything (it will not!) seeking a psychologist/ psychiatrist is important before proceeding. Otherwise, no surgery will be satisfactory and the deeper and desperate need to change and self-acceptance will continue.

If one has carefully evaluated the choices of surgery, asked him/herself why she wants that operation and is aware of her expectations and motives, consulted a trustworthy physician who explained the pre and post -operation process in detail and that feels right, then the surgery should be right for her and she can deal with all the positive and negative consequences.

Conclusion:

We are being pulled by a lot of sides from social media, to social pressures, to family, to friends, to ourselves. The conversation must be had in order to keep our house and our mental health in order. People are exhausted from this lockdown, let’s maintain healthy goals.

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