This article discusses the psychology of cosmetic surgery. A review of the research on the psychological characteristics of individuals who seek cosmetic surgery yielded contradictory findings. Interview-based investigations revealed high levels of psychopathology in cosmetic surgery patients, whereas studies that used standardized measurements reported far less disturbance. It is difficult to fully resolve the discrepancy between these two sets of findings. We believe that investigating the construct of body image in cosmetic surgery patients will yield more useful findings. Thus, we propose a model of the relationship between body image dissatisfaction and cosmetic surgery and outline a research agenda based upon the model. Such research will generate information that is useful to the medical and mental health communities and, ultimately, the patients themselves. © 1998 Elsevier Science Ltd
EACH YEAR tens of thousands of persons undergo elective, cosmetic surgery to alter their physical appearance. In 1994, for example, the American Society of Plastic and Reconstructive Surgeons (ASPRS) reported its membership performed more than 390,000 cosmetic procedures, the most common including liposuction (fat removal from various body regions), breast augmentation, rhinoplasty (nose alteration), and rhytidectomy (face lift) (ASPRS, 1994). This is an underestimation of the actual number performed, as general surgeons and physicians from other specialities also perform cosmetic procedures. Ultimately, these procedures were undertaken to improve individuals' satisfaction with their appearance, and presumably, in many cases, their self-esteem. In this regard, cosmetic surgery can be considered a psychological intervention or, at a minimum, a surgical procedure with psychological consequences.
Remarkably little is known about either the psychological status of persons who seek cosmetic surgery or potential psychological changes following surgery. For example, do such individuals suffer from some degree of body image dissatisfaction, including the clinically significant Body Dysmorphic Disorder? Alternatively, are such individuals psychologically healthy and seek surgery to enhance an already favorable self-image? Perhaps such persons intuitively grasp what social scientists have learned over the last three decades — that people associate physical attractiveness with numerous highly favorable personality traits including intelligence, competence, and social desirability (e.g., Hatfield and Sprecher, 1986).
This article discusses the psychology of cosmetic surgery. It begins by reviewing the psychological research on cosmetic surgery patients and then discusses recent advances in the psychology of body image. Most contemporary theorists believe that body image concerns are central to understanding cosmetic surgery patients. However, there has been little formal study of this relationship. Thus, we propose a model of the relationship between body image dissatisfaction and cosmetic surgery, and provide recommendations for empirical research on this relationship. We note at the outset that research on the psychology of cosmetic surgery patients is generally of limited scope and quality, consisting largely of clinical reports. In light of the high number of procedures performed annually, and given the potential for psychological harm as well as benefit from a surgical alteration of appearance, advances in theory and research are urgently needed.
