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Face value: the surprising psychology of cosmetic surgery

Photo: Face value: the surprising psychology of cosmetic surgery
Australians spend over $1 billion annually on cosmetic surgery, but do we really know what we're buying into? As most procedures are performed in the private sector, where there are minimal reporting requirements, data in the field are sparse and the psychological impacts of these treatments are more elusive still.

Fortunately the growing demand for cosmetic procedures has inspired ongoing investigation of their psychosocial concomitants and the intrepid researchers in this area have uncovered some interesting trends.

One in five women have considered labiaplasty

According to Dr Gemma Sharp of Monash University, approximately 20% of Australian women have contemplated labiaplasty, a surgical procedure which alters genital appearance.

Factors influencing this consideration included conversations with friends, negative comments from partners and media exposure, most notably to the internet and pornography.
Labiaplasty remains relatively uncommon compared to breast augmentation and liposuction, but patients do tend to report that they are satisfied with the results.

Men have high rates of body dissatisfaction

Given that 90% of cosmetic procedures are currently performed on women, it is somewhat surprising that body dissatisfaction, the primary motivator for seeking cosmetic surgery, is common in both genders and all age groups.

While the rates of dissatisfaction are still lower in men and boys than their female counterparts, the increase in social acceptability and marketing of cosmetic procedures to men may see more going under the knife in future.

Surgery might not improve your self esteem

While it is a key benefit touted by the industry, evidence that cosmetic surgery boosts confidence is mixed. American researcher David B. Sarwer of Temple University recently reported that although people are generally happy with their results (if they experience no complications), psychometric testing indicated no change in self esteem or depressive symptoms following cosmetic procedures.

Complications increase the risk of distress

For the 10% to 20% of patients experiencing complications following a cosmetic procedure, increased dissatisfaction and distress are likely outcomes.

This is also the case for people with body dysmorphic disorder, who are more likely to be unhappy with results, find their psychological symptoms are worsened or subsequently become dissatisfied with a different body part, even when the procedure has been successful.

Harm minimisation is a priority for all involved

Forty percent of cosmetic surgeons have been threatened with legal action or violence and in some rare cases have even been murdered by dissatisfied patients.

To ensure the risk of disappointment or other harm is kept to a minimum for everyone, psychological assessment can help to determine suitability and cooling off periods of seven days to three months now apply for all major procedures.

Cosmetic surgeons aren't plastic surgeons

Most of us are probably unaware of the difference between plastic and cosmetic surgery. Plastic surgeons in Australia currently require a minimum of five years post-graduate training and specialise in the reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease.

In contrast, any medical doctor can perform cosmetic procedures, which are elective and aim solely to improve the aesthetic appeal of healthy body parts.

Snapchat is changing our body ideals

Boston Medical Centre staff reported last year that there had been a rise in patients requesting surgery to look more like their filtered selfies on Snapchat. In particular, there was a shift in rhinoplasty from removing bumps to making noses smaller and more symmetrical, traits which are noticeable in selfies.

As unrealistic expectations of surgery lead to more adverse psychological outcomes, the doctors urged providers to consider cognitive-behavioural therapy as an alternative for patients with body concerns when surgery was not likely to achieve the desired effect.

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