The American Society of Plastic Surgeons reports a surge in interest in cosmetic plastic surgery since the COVID-19 pandemic led many people to video calls and made them hyper-aware of their own appearance.
In 2015, the Cosmetic Physicians College of Australasia found Australians were spending more than $1 billion a year on noninvasive cosmetic procedures such as Botox and fillers. This is more than 40 percent higher, per capita, than in the United States.
In the United States, where procedure statistics are reported, there was a 42 percent increase in the number of filler procedures and a 40 percent increase in Botox procedures in 2021 compared to 2020.
Rates of mental health issues in this group may be higher than in the general population, but, seemingly, not enough is being done to ensure the psychological safety of people requesting cosmetic procedures.
Body Dysmorphic Disorder
Body image concerns are generally the main motivator for seeking cosmetic procedures of all kinds. These concerns are usually focused on the body part where cosmetic intervention is sought, such as the nose for a rhinoplasty.
Severe body image concerns are a key feature of several mental health conditions. The most prevalent in people seeking cosmetic procedures is body dysmorphic disorder. In the general community, around 1 to 3 percent of people will experience body dysmorphic disorder, but in populations seeking cosmetic surgery, this rises to 16 to 23 percent.
Body dysmorphic disorder involves a preoccupation or obsession with one or more perceived flaws in physical appearance that are not visible or seem minor to other people. In response to the distress regarding the flaw, the person with body dysmorphic disorder will perform repetitive behaviors (such as excessively checking body parts in the mirror) and mental acts (such as comparing their appearance with other people).
These concerns can have a significant negative effect on the person’s daily life, with some people too distressed to leave their home or even eat dinner with family members out of fear of being seen by others.
With the distress associated with body dysmorphic disorder seemingly stemming from physical appearance issues, it makes sense that someone with body dysmorphic disorder is far more likely to turn up at a cosmetic clinic for treatment than a mental health clinic.
The problem is, cosmetic intervention usually makes the person with body dysmorphic disorder feel the same or worse after the procedure. They may become even more preoccupied with the perceived flaw and seek further cosmetic procedures.
Patients with body dysmorphic disorder are also more likely to take legal action against their treating cosmetic practitioner after believing they have not received the result they wanted.
For these reasons, body dysmorphic disorder is generally considered by health professionals to be a “red flag” or contraindication (a reason not to undergo a medical procedure) for cosmetic procedures.
However, this is not entirely clear-cut. Some studies have shown that people with body dysmorphic disorder can improve their symptoms after cosmetic intervention, but the obsession may just move to another body part and the body dysmorphic disorder diagnosis remains.
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