The experience of teasing in elective cosmetic surgery patients.

The role of teasing as a motivator for patients undertaking elective cosmetic surgery was investigated. Pre-operative data were collected, using a range of standardized tests in addition to open ended questions about their experience of teasing, from 449 patients aged 18 to 70 undergoing elective cosmetic surgery in Australia. Just under half of the sample indicated that they had been teased or bullied about their appearance. Teased patients showed significantly higher levels of anxiety, depression and dysmorphic concern; lower levels of physical attractiveness and appearance satisfaction; and lower levels of satisfaction with discrete aspects of their appearance than nonteased patients. Teasing also contributed to longer periods of considering surgery as an answer to body dissatisfaction concerns, even when controlling for age. Prevention education initiatives on appearance-related teasing should be targeted at school students. This, along with earlier detection of the psychological impacts of weight and appearance-related teasing, fewer people, if offered strategies for coping through counseling, may contemplate surgery as a response to this teasing.

The PreFACE: A preoperative psychosocial screen for elective facial cosmetic surgery and cosmetic dentistry patients.

BACKGROUND: Currently no brief and objective screening protocol exists to assist surgeons and dentists in the identification of patients who are likely to report unsatisfactory outcomes after cosmetic surgery interventions. The aims of this study were to (1) investigate the relationship between postoperative dissatisfaction and preoperative characteristics (psychiatric disturbance, anxiety, depression, self-esteem, dysmorphic concern, and body image), and (2) empirically derive a preoperative psychosocial screening instrument to identify patients who may require preoperative assessment or counseling. METHODS: The sample composed of 84 patients (69 women and 15 men) undergoing elective cosmetic facial surgery or cosmetic dentistry. Before surgery, a self-report questionnaire was administered to the patients, which comprised questions designed to evaluate many of the psychosocial characteristics thought to be associated with unsatisfactory outcomes. Six months after surgery, a questionnaire was administered to the patients, which included items evaluating postoperative satisfaction. RESULTS: The findings revealed that preoperative psychiatric disturbance, anxiety, depression, low appearance evaluation, and body areas dissatisfaction are psychosocial risk factors that indicate an increased likelihood of patient dissatisfaction with surgical outcomes. The PreFACE (Preoperative FAcial Cosmetic surgery Evaluation), a brief objective preoperative screening questionnaire that can be easily and efficiently administered to elective facial cosmetic surgery and cosmetic dentistry patients, was empirically derived. It is able to identify most patients who are likely to express dissatisfaction and minimizes the selection of those who will express satisfaction. The PreFACE is recommended for validation using other cosmetic surgery populations. CONCLUSIONS: The routine use of PreFACE is recommended for identification of patients who may benefit from preoperative counseling.

Psychological characteristics and outcomes of elective cosmetic surgery patients: the influence of cosmetic surgery history.

The early cosmetic surgery literature suggested that individuals re-presenting for aesthetic surgical procedures (referred to as "insatiable patients") display poorer psychological functioning and satisfaction with surgical outcomes than those who request one procedure. The aim of the study was to compare 284 patients with and without a history of cosmetic procedures on demographic characteristics, appearance concerns, expectations of surgery, psychosocial dysfunction, and postoperative dissatisfaction. There were few differences between the groups, suggesting that the group of patients with a history of aesthetic surgeries did not represent the population that has been described as "surgery insatiable." Post hoc analyses of subgroups of patients with a history of surgeries also revealed few differences except for lower self-esteem and postoperative satisfaction. Further research is required to fully explore the applicability of the "insatiable patient" label in the context of increasing societal acceptance of cosmetic surgery.

The male cosmetic surgery patient: a matched sample gender analysis of elective cosmetic surgery and cosmetic dentistry patients.

Plastic surgeons have traditionally perceived male patients as more psychologically disturbed than female patients. This study employed a matched sample design to explore the psychosocial experiences of 50 male and 50 female elective cosmetic surgery and cosmetic dentistry patients. It also aimed to compare male and female patients on preoperative psychosocial dysfunction on standardized measures (psychiatric disturbance, anxiety, depression, low self-esteem, dysmorphic concern, and low body image) and postoperative dissatisfaction. The findings revealed that there were many similarities between the self-reported appearance concerns, motivations for surgery, and expectations of surgery between male and female patients. Although male patients did not report higher levels of preoperative psychosocial dysfunction than their female counterparts, they were more likely to report postoperative dissatisfaction. Preoperative screening is recommended to identify the minority of male patients who will report an unsatisfactory outcome despite a technically good result.

A review of psychosocial outcomes for patients seeking cosmetic surgery.

The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings.

Does cosmetic surgery improve psychosocial wellbeing?

Both men and women are becoming increasingly concerned about their physical appearance and are seeking cosmetic enhancement. Most studies report that people are generally happy with the outcome of cosmetic procedures, but little rigorous evaluation has been done. More extensive ("type change") procedures (eg, rhinoplasty) appear to require greater psychological adjustment by the patient than "restorative" procedures (eg, face-lift). Patients who have unrealistic expectations of outcome are more likely to be dissatisfied with cosmetic procedures. Some people are never satisfied with cosmetic interventions, despite good procedural outcomes. Some of these have a psychiatric disorder called "body dysmorphic disorder".