Plastic Surgery Doesn't Boost Self-Esteem

Your teenage daughter wants a nose job. And let's say you can see her point—her nose isn't her best feature. There's no arguing that good looks confer great advantages in life.

Maybe her nose looks fine to you but it's making her unhappy and you want to give her a boost in a confidence.

Don't count on it.

A new study (see citation below) seems to confirm the idea that at least at younger ages, plastic surgery patients are a more troubled group—and the surgery didn't help. This study is important because it followed more than 1,500 teenage girls for 13 years, and the researchers didn't know who would actually have surgery in that time. The 78 girls who did were more likely to be anxious or depressed and had a greater increase in those symptoms over the period than non-patients. "I think this is one of the best studies out there," says Viren Swami, an expert on body image and a psychologist at the University of Westminster, London. "And their findings seem quite clear: those who chose to have cosmetic surgery tended to have a history of poorer mental health to begin with, but having cosmetic surgery did not result in a positive outcome."

Whatever advantages accrue to better looks, they don't seem to make plastic surgery patients feel better.

Other research has shown that at all ages patients tend to be happy with the outcome of the surgery—they're more satisfied with the appearance of the area altered—but not any happier overall.

The most comprehensive of these studies followed 98 women and two men for two years but did not have a control group. Recruited from eight surgical practices across the United States, the patients filled out questionnaires probing their satisfaction, body image, self-esteem, and symptoms of depression before cosmetic surgery and again on four more occasions spread out over the two years. Each subject had undergone at least one of five popular procedures, including breast augmentations and rhinoplasty.

As expected, a large majority—89 percent—said they were either “somewhat satisfied” or “extremely satisfied” each time they filled out the researchers’ questionnaires. In fact, even after two years, 78 percent said they were “extremely satisfied” and 93 percent that they would have the surgery again. Patients were happier with their overall appearance and reported fewer negative emotions about it in various situations up to two years later.

However, they reported no significant changes in self-esteem or in symptoms of depression.

Patients who were dissatisfied with previous surgeries or who have a history of depression or anxiety are less likely to be pleased with the outcome. And an estimated 7 to 15 percent of plastic surgery patients have body dysmorphic disorder, an obsession with nonexistent or slight defects in appearance, according to a research review.

Soest, Tilmann M von; Kvalem, Ingela Lundin & Wichstrøm, Lars (2012). Predictors of cosmetic surgery and its effects on psychological factors and mental health: a population-based follow-up study among Norwegian females. Psychological Medicine. ISSN 0033-2917. 42(3), s 617- 626 . doi: 10.1017/S0033291711001267