Full disclosure: I've had plastic surgery myself and don't regret it. But the plastic surgery boom seems increasingly bizarre. Are you afflicted with a flat rear end? You can have your buttocks surgically lifted as in a face-lift, or boosted with an implant or your own fat, three procedures that grew in popularity in 2014, according to the annual report from the American Society of Plastic Surgeons.
If you're fantasizing about lipo-ing dangling upper arms or spreading thighs, it may help to hear that people judge your looks mainly by your face. Your fat thighs, or that flat rear, are much more noticeable to you than anyone else.
Are plastic surgery patients looking for the wrong kind of help?
Sometimes. There seem to be three kinds of patients, according to anecdotal reports and small studies. One group is pessimistic, shy, and insecure. Others are impulsive, novelty-seekers—people who are likely to take drugs or have wild escapades. A third group are confident people who aren’t especially impulsive but chose to invest in their appearance. A good bit of evidence shows that as you move up the looks scale, both men and women do better in the workplace, says Dan Hamermesh, author of Beauty Pays: Why Attractive People Are More Successful.
There isn’t much sophisticated science—randomized, with control groups—about the psychological effects of optional cosmetic surgery. However, the existing studies back up what therapists say: it doesn’t address fundamental issues of self-esteem.
At least at younger ages, one large study found, cosmetic surgery patients are a more troubled group—and the procedure doesn’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."
In studies of older patients, people tend to be happy with the outcome of the surgery and have higher self-esteem about their looks for as long as five years, but not necessarily higher self-esteem overall.
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, a research review concluded. It’s also a bad sign if a patient hopes the procedure will save a relationship or if there’s disagreement within a couple over whether the surgery is a good idea.
Women who augment their breasts, the most popular cosmetic surgery in the United States for nearly a decade, may be more likely to be pleased than those who alter their noses or get face-lifts to look younger, the review found.
About 5 to 15 percent of plastic surgery patients have body dysmorphic disorder, an obsession with nonexistent or slight defects in appearance. These patients are most likely to ask for nose jobs, and usually aren’t happy with the results.
A version of this story appeared on Your Care Everywhere.