Cosmetic surgery may not be suitable for some patients with psychological issues

Cosmetic surgery may not be suitable for some patients with psychological issues

A greater percentage of people with psychological problems or who have suffered from domestic violence undergo cosmetic surgery compared to the rest of the population. A team from the Institute of Education, UK, suggests that in some cases, patients' psychological conditions could get worse rather than better following cosmetic surgery.

The team was commissioned by the UK Department of Health to carry out a systematic review of research into cosmetic surgery procedures in the wake of the PIP (Poly Implant Prothese) controversy which came to a head in 2012.

The researchers gathered and examined data from 192 studies, including 13 systematic reviews and found that many cosmetic surgery patients were (or had been) in an abusive relationship, or had some kind of relationship issue. However, they could not confirm whether their circumstance drove them to opt for cosmetic surgery.

A much greater proportion of patients who undergo cosmetic surgery have psychological problems, such as depression or BDD (body dysmorphic disorder) compared to people who never underwent such procedures.

Head researcher, Ginny Brunton and colleagues found that cosmetic surgery tended not to improve these conditions. In fact, some people became psychologically worse after their operation.

CBT (cognitive behavior therapy) and medical therapies are better at reducing depression and other mental health issues in patients with BDD than cosmetic surgery, they found.

It is important that patients who are interested in cosmetic surgery, and are known to or appear to have psychological issues, are offered alternative treatments, the researchers said.

Ginny Brunton said:

"These issues must be discussed with patients before they undergo treatments such as face lifts or nose reconstruction. It is crucial that at-risk patients are aware that their mental health may be affected for the worse, rather than the better.

Doctors must be aware of issues underlying requests for cosmetic surgery, who is at risk of poor outcomes, and explore fully with patients the reasons for seeking cosmetic procedures, all potential results, and possible alternative solutions".

Some of the studies showed that there was a greater risk of death among patients who underwent breast enhancement surgery, including suicide. Further studies should be done on this, Brunton said.

Brunton added "It should be emphasised that while the evidence did not allow us to conclude that the surgery had caused these problems, or that the relationship or mental health issues were what led the patient to seek cosmetic procedures, the findings are strong enough to suggest the need for further investigation."

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