Defying aging and to look younger and better is an age old practice in all cultures. Physical “makeovers” exhibited by media personalities have made cosmetic surgery popular. Therefore it is not surprising to note that there is an increasing trend of people undergoing cosmetic procedures especially non-surgical cosmetic procedures like Botox injections , Chemical peels , Dermal fillers etc. Of course, the ultimate aim of undergoing these procedures is to obtain a greater level of self –esteem and confidence and be satisfied with the outcome of such a procedure.
For some people however, such procedures only gives them self-confidence for a short period of time and after that they may continue to feel inadequate in other areas and their self-esteem takes a plunge again . Many psychiatric conditions prevent a person from having satisfaction after a surgery. About 10% of people resorting to cosmetic surgery may have what is known as Body Dysmorphic Disorder, a condition that is characterised by an individual’s intense preoccupation with an imagined defect in appearance. If a physical anomaly is actually present, the individual’s preoccupation with it is markedly excessive. The prevalence of Body Dysmorphic Disorder is even higher in cases of those undergoing surgical procedures like Breast augmentation and Rhinoplasty (Nose job). Since they are never satisfied with the aesthetic success, they undergo repeated surgeries, suffer from anxiety and depression and can be suicidal. Several studies have shown a strong correlation between breast augmentation surgeries and suicidal attempts.
Cosmetic surgery can also be addictive, as in many cases people have had one procedure and have had further surgery on the same body part or other body parts. This is seen not only in those with Body Dysmorphic Disorder but also in those with Borderline Personality Disorder and Obsessive Compulsive Personality Disorder. In all these disorders, they are not capable of feeling the complete satisfaction of the outcome of the procedure. Often they would “doctor shop”, complaining of the “incompetency” of the previous doctor. This “addiction” can sometime prove to be fatal when one of the numerous surgical procedures becomes botched and results in irreversible consequences. Extreme disappointment can also lead to suicidal attempts.
Movie stars and glamorous media personalities have greatly contributed to people wanting to conform to this new yardstick of what constitutes beauty. Aggressive advertisement, many of which are unscrupulous, have also resulted in “motivating” many to undergo cosmetic procedures especially non-surgical procedures.
It is perfectly natural to want to look good but one must ask oneself, what is the true motivation for wanting to undergo a particular cosmetic procedure? It is good to understand that for some, their self-esteem and confidence will not drastically improve by undergoing cosmetic procedures. For many, it may, so it really depends on the individual. For some individuals, their outward alignment of appearance to their body image would mean the world to them.
Should men and women pick cosmetic procedures to change their looks or to look younger? Well, every individual is different. For some, external appearance aligning to their body image has a tremendous bearing on their confidence and self-esteem. If one appreciates the fact that we are all made differently and there is no such thing as the “perfect” looks, there might be less interest in cosmetic procedures, especially surgical procedures. As a psychiatrist, I am also concerned that many fall prey to the enticement of substandard or dubious services mushrooming all over country. The medical profession should also act more responsibly by discouraging those with psychiatric conditions like body dysmorphic disorder or specific personality disorders from insisting on needless cosmetic procedures.
For surgical procedures, pre-operative discussion with the patient on the risks, benefits, limitations and expected results of the surgery must be done. A discussion on the motivation of the individual to undergo such a surgery, would be beneficial in ruling out underlying psychiatric causes. It is important to treat the underlying psychiatric cause to prevent unnecessary complications of repeated surgeries or procedures. More often than not, after the surgical procedure, such individuals will continue to manifest depression, anxiety and even take to substance and alcohol abuse.
Dato’ Dr Andrew Mohanraj Chandrasekaran
Consultant Psychiatrist & Deputy President of Malaysian Mental Health Association.
Dr. Andrew Mohanraj 