Shrink Rap: Cosmetic Surgery: Swan or Ugly Duckling?
While Southern California is devoted to the nip, tuck, lift and augmentation with a fervor few areas of the country (or world) can equal, cosmetic surgery is booming everywhere, not just here in the OC. TV shows like "Nip/Tuck," "The Swan," and "Extreme Makeover" reveal more graphic detail than we need to see, but the results are tempting enough to make viewers wonder how they too might be transformed from ugly ducklings into beautiful swans.
Most people are motivated to undergo cosmetic surgery because of body-image dissatisfaction. They don't want to stand out in an obvious way or feel self-conscious. They also want their appearance to be more in line with their personalities.
According to the American Society of Aesthetic Plastic Surgery, the number of cosmetic procedures increased 44% from 2003 to 2004. Surgeons conducted a record 11.9 million procedures in 2004, including non-surgical procedures like Botox, laser hair removal and chemical peel (up 51%), and surgical procedures like breast augmentation and liposuction (up 17%).
How do these procedures affect patients psychologically? First, the good news: A recent analysis of 37 studies of psychological and social functioning before and after cosmetic surgery showed improvements in body image and some evidence of a gain in quality of life.
But the same research also found several predictors of poor outcomes, especially for those with unrealistic expectations or who have a history of depression and anxiety. Those who are dissatisfied with surgery may request repeat procedures or experience depression, adjustment problems, social isolation, family problems, self-destructive behaviors, and anger toward the surgeon.
There are few long-term studies regarding the effects of cosmetic surgery and many contradictory findings in those studies that have been done. Here's what we know so far: People report increased satisfaction with the body part they had surgery on, but results are mixed on whether cosmetic surgery boosts their self-esteem, quality of life, and relationships with others in the long term. One recent study found that 87% of patients reported satisfaction following their surgery, including their overall body image and the body feature altered. They also experienced fewer negative body image emotions in social situations.
We also know that those with more severe psychological problems before surgery are more likely to report a negative outcome after surgery. The biggest problems come from the 7% to 12% who develop body dysmorphic disorder. These people repeatedly change or examine the offending body part to the point of obsession, interfering with the rest of their life.
If I was anointed Czar of Mental Health, I'd abolish mindless high school graduation gifts of a breast enlargement (one of the most popular graduation gifts in Orange County for girls). Everyone considering complicated procedures such as breast augmentation or reduction, a nose job, or other facial/body-part reconstruction would be required to have at least one consultation with a psychologist before being permitted to go under the scalpel. Motivations for wanting the surgery, self-esteem and maturity issues, bodyimage distortions, and expectations would be identified and addressed before surgery was decided on. And for those who choose to go ahead, the consultation would aid in increasing their chances of post-surgery satisfaction.
