The Psychological Impact of Reconstructive Plastic Surgery


People who undergo cosmetic surgery often feel happier and better about themselves. However, some patients may not experience these positive psychosocial effects.

Many of these people suffer from psychological issues such as body dysmorphic disorder. Sarwer and his colleagues have developed questionnaires that help plastic surgeons screen for BDD so they can refer patients to mental health professionals.

Body Dysmorphia

Body dysmorphic disorder (BDD) is a mental illness that causes people to be preoccupied with an imagined flaw in their appearance. They will change their appearance or constantly check and examine the offending body part to the point that it interferes with their life. People with BDD often seek cosmetic surgery to fix their appearance, but research suggests that fewer than 10% will be satisfied with the results.

People with body dysmorphia feel upset about their appearance to the extent that it can cause problems at work and in their relationships. They may also be more prone to depression and suicidal thoughts. Some people with body dysmorphia focus so much on a perceived look flaw that they ignore their other health needs, like eating well and exercising regularly. They may also use drugs or turn to self-destructive behaviors, such as eating disorders, bulimia and anorexia. They are often referred to mental health professionals for treatment.

Postoperative Depression

Depression is often a result of disappointment or dissatisfaction with the surgery results. It is also possible that it is triggered by factors associated with the surgery, such as pain, scarring, and loss of function. It is often exacerbated by well-meaning family and friends who comment, “I liked you better before,” or, “You didn’t need that surgery.”

The most effective way to combat post-surgery depression is to fully understand the recovery process and what you can expect from your surgical procedure. Finding a doctor like Dr. Joel Aronowitz, who isn’t afraid to be honest and tell you what to expect from the surgery regarding healing, pain, and expectations for your outcome, can help avoid unnecessary depression.

If you are depressed for over a week following your surgery and can’t seem to lift it, request a referral to a psychiatrist or therapist. It may be that the root cause of your depression is not related to a recent surgery and needs to be addressed separately.

Postoperative Anxiety

Anxiety is a normal part of the human experience. However, some patients are particularly anxious about their upcoming surgery. Having the right support team, getting accurate information about an operation, and trying relaxation techniques can help alleviate these feelings.

One study of 200 people who underwent ambulatory hand surgery showed that preoperative anxiety was significantly associated with postoperative nausea and vomiting (PONV) at 12 hours after surgery, even when controlling for age, gender, body mass index (BMI), type of procedure, and comorbidities like diabetes and hypertension.

Surgical patients should have all their recovery supplies in place before their surgery, including books and magazines to read, music to listen to, a pitcher of water, warm slippers, a comfortable chair, and plenty of medication that your Specialist has prescribed. A well-stocked recovery station will also help reduce post-surgical discomfort and anxiety levels. In addition, having family and friends nearby will keep you company and help with logistics before and after surgery.


Having cosmetic surgery is an extremely personal decision, and you should always discuss the details with your partner. Some couples may find that the change in their appearance improves their relationship, while others may experience a negative impact on it. It’s also important to remember that plastic surgery is not a magic bullet—it can only fix certain things about your body.

Psychologists often perform presurgical psychological evaluations of surgery candidates. They check for red flags such as body dysmorphic disorder and look for indications of past psychiatric diseases that could complicate surgery. They also ensure patients have clear, realistic goals for their surgery. Nikolaidis, for example, is especially leery of adolescent patients who have questionable motivations for seeking surgery or unrealistic expectations for their outcomes.

Many plastic surgeons, including Joel Aronowitz MD, are implementing these types of behavioral checks into their practices. They’re also referring patients with psychological red flags to mental health professionals to help them healthily navigate recovery.


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