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How surgery affects patient psyche

Article-How surgery affects patient psyche

A new study indicates that patients experience improved body image after undergoing common cosmetic surgery procedures, but the research did not suggest that participants experience decreased depressive symptoms or improvements in their body image-related quality of life.

Up to 12 months post-surgery, the 72 women in the study reported satisfaction with their outcomes, improvements in their overall appearance and improvements from specific changes from plastic surgery — as well as improvements in overall body image. They also reported a reduction in their degree of dissatisfaction with the features altered by surgery and in their frequency of negative body image emotions in specific social situations.

According to lead author David B. Sarwer, Ph.D., associate professor of psychology in psychiatry and surgery at the Center for Human Appearance at the University of Pennsylvania School of Medicine, the findings indicate that people's motivations for surgery may be different than they used to be.

"My colleagues and I have speculated that the primary motivation for cosmetic procedures is body image dissatisfaction — unlike 20 and 30 years ago, when many believed that people sought plastic surgery because they were addressing some deep-seated psychologic issues," Dr. Sarwer says.

Motivation for surgery

Dr. Sarwer adds that the motivation of many patients who undergo cosmetic surgery may simply be that they do not like a specific part of their physical appearance.

"We now have a growing body of evidence that suggests that not only do patients report heightened body image dissatisfaction prior to surgery, but they also report improvements in body image after surgery," he says.

But the fact that respondents did not report an enhanced body image-related quality of life after surgery was a surprise.

"We are interested to see if we are going to replicate that finding, or if patients will report improvements in body-image quality of life two years after surgery," Dr. Sarwer says.

New issues

This study, funded by the Aesthetic Society Education and Research Foundation of the American Society for Aesthetic Plastic Surgery (ASAPS), addresses issues that previous research did not fully cover.

"A number of studies have shown high rates of patient satisfaction following cosmetic surgery. Fewer studies, however, have documented changes in psychosocial functioning in the years following surgery and (have) used reliable and valid measures of those domains," Dr. Sarwer says.

"Most of those studies also focused on a single cosmetic surgery practice. One of our goals was to conduct a study using plastic surgery practices throughout the country."

Study particulars

Dr. Sarwer and colleagues collaborated with eight plastic surgery practices located around the United States — including Florida, Illinois, Pennsylvania, New York, Oregon, Georgia and Missouri. They surveyed participants before surgery, at three months post-op and then again at six and 12 months. Before surgery, participants answered questions about body image, depressive symptoms and self-esteem. They answered additional questions about postoperative satisfaction and self-rated attractiveness post-surgery.

The researchers focused on the five most common plastic surgery procedures: rhinoplasty, breast augmentation, liposuction, blepharoplasty and facelift.


They found that 87 percent of patients reported being satisfied with their cosmetic surgery outcomes. A year after surgery, 97 percent reported that they would recommend surgery to others ,and 93 percent say they would have the surgery again.

"(Patients) also reported a significant reduction of the degree of negative emotions in social situations related to their appearance," Dr. Sarwer says.

The results help to confirm the notion that patients come in for these procedures because they are unhappy with their appearance and not necessarily because of some deep-seated psychological problem, according to Dr. Sarwer.

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