Summary: Researchers show high rates of physical dysmorphia, depression, anxiety, and personality problems in those seeking cosmetic surgery procedures.
Although we cannot be sure of the exact number of Australians undergoing cosmetic procedures as there is no need for health professionals to report their statistics, the need for consensus is growing.
In 2015, the College of Cosmetic Physicians College of Australasia found that Australians spend more than $ 1 billion a year on non-invasive cosmetic procedures such as Botox and Fillers. This is 40% higher per person than in the United States.
In the United States, where statistics of procedures are reported, there is a 42% increase in the number of injection procedures and a 40% increase in Botox procedures performed in the previous year alone.
The rate of mental health problems in this group may be higher than the general population, but it seems that not enough is being done to ensure the mental safety of people requesting cosmetic procedures.
Physical dysmorphic disorders
Concerns about body image in general are a major motivator for finding all kinds of cosmetic procedures. These concerns usually focus on the body part where cosmetic intervention is sought, such as the nose for cosmetic surgery.
Worrying about a serious physical image is an important feature of some mental health conditions. The most prevalent in people seeking cosmetic procedures is physical dysmorphic disorders. In the general community, about 1-3% of people will experience physical dysmorphic problems, but in the population seeking cosmetic surgery this increases to 16-23%.
Physical dysmorphic disorders involve interest or obsession with one or more perceived defects in the body that are invisible or seem small to other people. In response to grief related to disadvantages, people with physical disabilities will engage in repetitive behaviors (such as too much physical examination in the mirror) and mental activity (such as comparing their appearance with other people). More).
These worries can have a very negative impact on people’s daily lives, with some finding it too difficult to leave home or even have dinner with family members for fear of being seen by others.
With the distress associated with physical dysmorphic seemingly physical problems, it makes sense that people with physical dysmorphic disorders are more likely to go to a cosmetic clinic for treatment than to a mental health clinic.
The problem is that cosmetic interventions usually make people with physical dysmorphic symptoms feel the same or worse after the procedure. They may become preoccupied with perceived flaws and seek additional cosmetic procedures.
Patients with physical dysmorphic disorders are also more likely to take legal action against their cosmetic therapist after believing they are not getting the results they want.
For these reasons, physical dysmorphic disorders are commonly referred to by health professionals as “red flags” or contraindications (reasons not going through medical procedures) for cosmetic procedures.
However, this is not entirely clear. Some studies have shown that people with physical dysmorphic disorders may improve their symptoms after cosmetic interventions, but hallucinations can move to other parts of the body and the diagnosis of physical dysmorphic disease remains. Yes.
What about other mental health conditions?
Physical dysmorphic disease is by far the best studied disease in this area, but is not the only mental health condition that can be associated with poor results from cosmetic procedures.
According to a recent systematic review, the rates of depression (5-26%), anxiety (11-22%) and personality disorders (0-53%) in people seeking corrective surgery. Beauty can be higher than the average person (estimated. 10%, 16% and 12%, respectively).
However, these rates should be interpreted with some caution as they are highly dependent on how the mental health diagnosis is made – doctor-led interviews (higher rates). Compared to the mental health questionnaire (lower rate). Some interview methods may indicate a higher rate of mental health problems because they may not have a clear structure and are therefore questionable compared to highly structured questionnaires.
In addition to physical dysmorphic disorders, research investigating other mental health conditions has been identified. This may be due to the fact that physical focus is at the core of physical dysmorphic disorders, making it a logical focus for cosmetic surgery research compared to other types of psychiatric disorders.
So what happened?
Ideally, all plastic surgeons and practitioners should be adequately trained so that they can conduct a brief routine assessment of all prospective patients. People with signs that they are unlikely to benefit from the procedure should undergo further evaluation by a mental health professional prior to the procedure.
This can include in-depth clinical interviews about motivation for the procedure and the completion of several standard mental health questionnaires.
If a person is found to have a mental health problem in the assessment process, it does not mean that a mental health professional will advise against continuing the procedure. They can recommend a course of psychotherapy to address the issue of anxiety and then undergo cosmetic procedures.
At this time, evaluation is recommended rather than required for cosmetic surgery (and not at all for injections such as Botox and Fillers). The guidelines say that an evaluation should be performed if there are signs that the patient has a “fundamental psychological problem”.
This means that we are relying on cosmetic medicine practitioners who are capable of detecting such problems when they can only receive basic psychological training in medical school and when their business can. Benefit from not participating in such a diagnosis.
An independent review in August 2022 by the Australian Health Practices Regulatory Authority and the Medical Council of Australia recommended that guidance on mental health assessments should be “strengthened” and emphasize the importance of teachers. Physicians who are further trained to diagnose schizophrenia.
Finally, because cosmetologists are treating patients who are seeking treatment for psychological rather than medical reasons, they must have the well-being of the patient in the face of both professional integrity and to protect themselves from legal action. . A mandatory evaluation of all patients seeking any type of cosmetic procedure is likely to improve patient satisfaction.
About this mental health research information.
Author: Gemma Sharp and Nichola Rumsey
Contact: Gemma Sharp and Nichola Rumsey – Conversation
Image: Image is in public domain