Can plastic surgery indicate mental illness?

OP. DR. YUNUS DOĞAN

We all have our reasons

Your breasts are too small. Your butt is too big. You just lost a lot of weight and have excess skin that gets in the way. You’ve had children and those bastard angels have torn apart your abdominal muscles. The shape of your nose makes it difficult to breathe and/or find a new love interest. All cosmetic surgery patients have at least one thing in common: a reason or motivation that drives them to seek medical assistance.

What might be less-than-common is an underlying cause to feel like we “need” surgery. Granted, patients present with recognizable physical attributes that could be operated on and consequently and unarguably improved. Characteristics that are easily yet objectively viewed as flaws could include: a cleft palate that makes eating difficult, speech unrecognizable and breathing labored; a deviated septum resulting in respiratory distress; scars from trauma such as animal attacks or severe burns that inhibit bodily movement.

Medically necessary or wishful thinking?

Physical function aside, oftentimes cosmetic procedures are initiated by the patient’s own perception of themselves with the sole goal of improving appearance. Patients do not consider mechanical operation of the body part in question; they are only focused on outward images. It’s like buying a car based on the color and shape of the hood rather than how big the engine is or if it has power steering.

Plastic surgery and your personality

If we polled your friends and family, what would they say about you? What type of person are you? Are you relatively laid-back, not easily stressed? Are you a perfectionist who frets over every minute detail? Have you had that ONE physical flaw that’s bothered you your entire life and you have obsessed over it for years? Or maybe you had one flaw and already resolved it with surgery. Then to your surprise, another flaw suddenly surfaced and you are back to square one in your anguish.

While there have not been an excessive amount of behavioral studies corresponding to elective esthetic procedures, the information that has been published does give us a small glimpse into reasons why some patients vehemently seek medical intervention.

Body Dysmorphic Disorder

Perhaps the most examined and published mental disorder, body dysmorphia (aka body dysmorphic disorder or BDD,) indicates an extreme tendency to self-scrutinize. We wrote about it here when we talked about how plastic surgery can affect your mental health.

People with BDD usually have difficulty viewing themselves in a positive way, struggling with embarrassment, shame or anxiety over a minor detail that others cannot see. Their perception is flawed, overwhelmed with imagined flaws that expose them to others. They may go out of their way to avoid mirrors, cover the “flawed” body part excessively to hide it or take their exercise routine to extremes. This disorder affects about 2% of the world’s population and of that small sample, many people attempt to correct their flaws through plastic surgery.

Unfortunately surgery fails to fix the patient’s view of him or herself. Plastic surgery patients with BDD will always return for additional surgeries or revisions, as their interpretation of their appearance can’t be fixed physically. For more information about diagnosis and treatment of BDD, read this article by the Mayo Clinic. It also includes an international online appointment tool if you want to speak with a medical professional.

Do you like to say “yes”?

There are certain personality traits that are commonly found among cosmetic surgery patients. Studies have shown that many patients share the trait of agreeableness. In their overall lives, these people are usually polite, friendly and cooperative. They may have a tendency to act in a certain way based on the opinions of others, so if a friend or social media influencer suggests plastic surgery, an agreeable person has a higher probability of conforming.

Are you open-minded?

Open-minded people are also more likely to get plastic surgery because they are willing and sometimes eager to experience new things. They can view plastic surgery as a journey or life experience. These people may also possess a natural inclination toward beauty and esthetics, further motivating them toward esthetic procedures.

Are you a perfectionist?

If attention to detail is your middle name, you might be a perfectionist. Perfectionists can notice - and inadvertently criticize - the tiniest element of anything. In this case, the perfectionist who considers plastic surgery may constantly be annoyed by a slightly asymmetrical nose until rhinoplasty rectifies the situation.

The last stitch

You probably aren’t a stranger to research if you’re considering plastic surgery. Please take the time to also research the real reason and motivation for what you’re planning. Even the smallest procedure can present a large financial and physical hurdle. You will live with the results for the rest of your life; make sure you enter the operating room with all your cards on the table. Truly understanding your reason for surgery is the first step in healing.