CHAPTER 9:Cosmetic Medical Procedures and

Body Adornment

Introduction

• 13.1 million cosmetic surgical and nonsurgical cosmetic treatments were performed in the United States in 2010.

• Majority of individuals who seek cosmetic procedures today are female.

Motivations for Cosmetic Procedures

• Increased acceptance of cosmetic medical treatments, due to:– Advances in surgical techniques– Availability of minimally invasive techniques– Direct-to-consumer marketing– Media exposure

Motivations for Cosmetic Procedures

• More favorable attitudes toward cosmetic surgery are related to:– Increased age – Greater use of makeup– Lower social self-esteem and body esteem– Higher body shame

Motivations for Cosmetic Procedures

• Dissatisfaction with body image• Attractive and youthful appearance standards

for women• Desire for a specific ideal (e.g., appearance of

a certain ethnicity)• Motivations vary by age

Type-Changing Cosmetic Procedures

• Type-changing cosmetic procedures include surgical procedures that noticeably alter the size, shape, or contour of an appearance feature.– Usually performed due to body dissatisfaction

Type-Changing Cosmetic Procedures

• Rhinoplasty• Facial skeletal surgeries– Lip, chin, cheek implants

• Cosmetic breast augmentation

Restorative Procedures

• Anti-aging cosmetic surgical procedures seek to restore or rejuvenate the appearance of facial features. – Differ from type-changing surgeries because they

do not change any major structures or shapes of the face.

Restorative Procedures

• Rhytidectomy (facelift surgery)• Blepharoplasty – Removal of fat and excess skin or muscle from the

upper and/or lower eyelids

• Botulinum toxin injections • Injectable soft tissue fillers • Lipoplasty (liposuction)• Abdominoplasty (“tummy tuck”)

Other Procedures

• Tattoos and body piercing• Genital enhancement

Psychiatric Disorders Among Cosmetic Surgery Patients

• Body Dysmorphic Disorder (BDD)– Preoccupation with an imagined or slight defect in

physical appearance that results in significant emotional distress and/or impairment in daily functioning

• Eating Disorders– Characterized by extreme body image

dissatisfaction, specifically with weight and shape

Psychological Assessment of the Cosmetic Patient

• A cognitive-behavioral assessment of psychosocial functioning is recommended for prospective patients.

• Focus on the patient’s motivations and expectations for cosmetic treatment.

• Obtain detailed psychiatric history.

Summary

• The popularity of cosmetic medical procedures warrants further investigation of the motivations and psychological aspects.

• Body dysmorphic disorder should be considered a contraindication for cosmetic treatments.