Individuals who undergo cosmetic surgery expect to look better or younger, of course, but they also want to feel different—happier or more confident. But does it work? Whether you think peels are just for bananas or you’ve been under the knife more than a chopped salad, this week Savvy Psychologist Dr. Ellen Hendriksen answers the question: Will cosmetic surgery make me happier?
Joan Rivers once quipped, “I’ve had so much plastic surgery, when I die they’ll donate my body to Tupperware.” And if your breasts hang so low you can tuck them into your bikini bottom, or your nose rivals the neighborhood snowman’s, you may have considered cosmetic surgery, too.
Cosmetic surgery is by definition not medically necessary and is done simply to enhance your appearance. It’s different than reconstructive plastic surgery for, say, burn survivors, kids with a cleft lip or palate, or women who have undergone a mastectomy.
Many folks argue that cosmetic surgery is oppressive, homogenizing the normal range of human appearance across age and race and pathologizing those of us who weren’t born looking like Halle Berry or George Clooney.
But many others argue that cosmetic surgery is empowering. In a world where beautiful people are rewarded professionally and socially for their looks, cosmetic surgery levels the playing field. More than that, many people argue that it has psychological benefits—that cosmetic surgery enhances confidence and satisfaction.
But does it? Regardless of your point of view—whether you think peels are just for bananas or you’ve been under the knife more than a chopped salad—this week, by request from an anonymous listener, we’ll tackle the question, “Will cosmetic surgery make me happier?”
The answer, as you might expect, is more complicated than a straightforward yes or no. When I dove into the literature for this one, I found studies with completely opposing conclusions. Apparently this is one of those topics where arguments among researchers get as hairy as a follicular transplant. Therefore, here are four points of view:
Conclusion #1: Not at all. Not only will cosmetic surgery not make me happy, it will make me feel worse.
A really interesting study in Norway followed almost 1,600 young women for more than a decade. None of the women had had cosmetic surgery between the ages 14-21. But when the researchers followed up 11 years later, when they were 25-32, about 5% of the women had undergone cosmetic surgery, mostly breast surgeries or liposuction.
Interestingly, there was zero relationship between satisfaction with their overall appearance in early adulthood and having had surgery 11 years later.
So, if liking or disliking their looks didn’t predict cosmetic surgery, what did? The answers are: anxiety, depression, reporting at least one suicide attempt, and a history of self-harm. In particular, drug use at the beginning of the study more than doubled the likelihood of cosmetic surgery by the end of the study.
To make things worse, the women who did have cosmetic surgery didn’t get better. Quite the opposite, in fact, showing an increase in symptoms of depression and anxiety, disordered eating, suicide attempts, and alcohol use as time rolled on.
Another study in the journal Plastic and Reconstructive Surgery reviewed 37 different studies of both male and female cosmetic surgery patients and found that those at risk for an unhappy outcome were young, male, had unrealistic expectations of their surgery, were unhappy with a previous cosmetic surgery, or were motivated by relationship issues, meaning their partner disagreed with them about the necessity of the procedure or they had the surgery thinking it would save their relationship.
All in all, the studies painted a grim psychological picture of cosmetic surgery. But wait, it gets worse!
Conclusion #2: Definitely not, particularly with these two hot button surgeries.
Two particular procedures have been found to be red flags for mental health problems.
One is breast implants. No fewer than seven different studies have found higher suicide rates among women with breast implants, even compared to women who had other cosmetic surgeries, prompting several researchers to suggest that breast implants may be interpreted as a flag for mental health problems.
The second is rhinoplasty, or a nose job, which is the most commonly requested surgery of those with body dysmorphic disorder, or BDD.
Michael Jackson and Andy Warhol both battled BDD, which is a preoccupation with an imagined defect in physical appearance. Symptoms include frequently checking the perceived defect in a mirror, camouflaging with makeup or strategically placed hair or clothing, constantly comparing oneself to others, a need for reassurance, and believing oneself to be ugly or even repulsive.