Will Cosmetic Surgery Make Me Happier?
Individuals who undergo cosmetic surgery expect to look better or younger, of course, but they also want to feel different—happier or more confident. But does it work? Whether you think peels are just for bananas or you’ve been under the knife more than a chopped salad, this week Savvy Psychologist Dr. Ellen Hendriksen answers the question: Will cosmetic surgery make me happier?
Ellen Hendriksen, PhD
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Will Cosmetic Surgery Make Me Happier?
Joan Rivers once quipped, “I’ve had so much plastic surgery, when I die they’ll donate my body to Tupperware.” And if your breasts hang so low you can tuck them into your bikini bottom, or your nose rivals the neighborhood snowman’s, you may have considered cosmetic surgery, too.
Cosmetic surgery is by definition not medically necessary and is done simply to enhance your appearance. It’s different than reconstructive plastic surgery for, say, burn survivors, kids with a cleft lip or palate, or women who have undergone a mastectomy.
Many folks argue that cosmetic surgery is oppressive, homogenizing the normal range of human appearance across age and race and pathologizing those of us who weren’t born looking like Halle Berry or George Clooney.
But many others argue that cosmetic surgery is empowering. In a world where beautiful people are rewarded professionally and socially for their looks, cosmetic surgery levels the playing field. More than that, many people argue that it has psychological benefits—that cosmetic surgery enhances confidence and satisfaction.
But does it? Regardless of your point of view—whether you think peels are just for bananas or you’ve been under the knife more than a chopped salad—this week, by request from an anonymous listener, we’ll tackle the question, “Will cosmetic surgery make me happier?”
The answer, as you might expect, is more complicated than a straightforward yes or no. When I dove into the literature for this one, I found studies with completely opposing conclusions. Apparently this is one of those topics where arguments among researchers get as hairy as a follicular transplant. Therefore, here are four points of view:
Conclusion #1: Not at all. Not only will cosmetic surgery not make me happy, it will make me feel worse.
A really interesting study in Norway followed almost 1,600 young women for more than a decade. None of the women had had cosmetic surgery between the ages 14-21. But when the researchers followed up 11 years later, when they were 25-32, about 5% of the women had undergone cosmetic surgery, mostly breast surgeries or liposuction.
Interestingly, there was zero relationship between satisfaction with their overall appearance in early adulthood and having had surgery 11 years later.
So, if liking or disliking their looks didn’t predict cosmetic surgery, what did? The answers are: anxiety, depression, reporting at least one suicide attempt, and a history of self-harm. In particular, drug use at the beginning of the study more than doubled the likelihood of cosmetic surgery by the end of the study.
To make things worse, the women who did have cosmetic surgery didn’t get better. Quite the opposite, in fact, showing an increase in symptoms of depression and anxiety, disordered eating, suicide attempts, and alcohol use as time rolled on.
Another study in the journal Plastic and Reconstructive Surgery reviewed 37 different studies of both male and female cosmetic surgery patients and found that those at risk for an unhappy outcome were young, male, had unrealistic expectations of their surgery, were unhappy with a previous cosmetic surgery, or were motivated by relationship issues, meaning their partner disagreed with them about the necessity of the procedure or they had the surgery thinking it would save their relationship.
All in all, the studies painted a grim psychological picture of cosmetic surgery. But wait, it gets worse!
Conclusion #2: Definitely not, particularly with these two hot button surgeries.
Two particular procedures have been found to be red flags for mental health problems.
One is breast implants. No fewer than seven different studies have found higher suicide rates among women with breast implants, even compared to women who had other cosmetic surgeries, prompting several researchers to suggest that breast implants may be interpreted as a flag for mental health problems.
The second is rhinoplasty, or a nose job, which is the most commonly requested surgery of those with body dysmorphic disorder, or BDD.
Michael Jackson and Andy Warhol both battled BDD, which is a preoccupation with an imagined defect in physical appearance. Symptoms include frequently checking the perceived defect in a mirror, camouflaging with makeup or strategically placed hair or clothing, constantly comparing oneself to others, a need for reassurance, and believing oneself to be ugly or even repulsive.
But because the surgery doesn’t change the perception, patients with BDD are seldom satisfied and often become hopeless or angry after surgery, sometimes even taking it out on their surgeon. Indeed, one survey found that 40% of plastic surgeons have been threatened by a patient with BDD, whether legally, physically, or both.
So is everyone who’s undergone cosmetic surgery or considered breast implants or a nose job doomed to be a neurotic, unhappy mess? Not at all. Which brings us to Conclusion #3:
Conclusion #3: Yes, cosmetic surgery will make me happier, plus the boost will stand the test of time.
In a 180-degree turnaround from the previous studies, a study in the journal Clinical Psychological Science followed a group of about 800 people considering cosmetic surgery. The study compared the 544 people who ultimately went ahead with the surgery to those who didn’t one year later. Unsurprisingly, those who underwent the surgery were more satisfied with the feature that was operated on than those whose noses, breasts, or tummies remained the same.
But more surprisingly, for those who had surgery, many other things improved too, including positive attitude, joy in life, self-esteem, even life satisfaction. Even anxiety improved, in contrast to the previous studies.
The researchers even noted that cosmetic surgery seemed to be an exception to the hedonic treadmill. The hedonic treadmill is a phenomenon whereby major life events have surprisingly short-term effects on happiness. For instance, people who have good things happen, like winning the lottery, or bad things, like becoming paraplegic, go through a period of adjustment but generally settle back into their own personal happiness-as-usual set point no matter what occurred.
Therefore, one would think that after the lifted face or thinner thighs, your happiness would sink back to wherever it hovered before. Not so, according to this study. The researchers hypothesized that positive “embodied changes” like cosmetic surgery might produce more permanent psychological change than “malleable” changes like a new relationship or a move.
Conclusion #4: Cosmetic surgery may not make me happier, but it will take away one of my problems.
This follows the Jay-Z ninety-nine problems philosophy: after surgery, you’ll still have problems, but hating your muffin top won’t be one.
The stereotype of people who get cosmetic surgery is that of shallow, insecure types who are obsessed with their looks. They’re thought to be off the charts on something called body image investment, which is defining yourself and your self-worth by your physical appearance and how far you’ll go to uphold it.
Satisfaction with a procedure and overall happiness are completely different things.
Interestingly, in an exploratory analysis in the same Clinical Psychological Science study, body image investment decreased in those that had surgery, indicating that once their protruding ears or saggy neck was a non-issue, they became less preoccupied with and invested in their looks.
When you think about it, this makes sense—once a need is met, it’s not a need anymore. It’s the same reason why people who are naturally slim don’t often think about their weight, or men with a full head of hair don’t think about their hairline. And if you don’t spend time thinking about it or comparing yourself to others, you might conclude—mistakenly or not—that it’s not important to you.
To wrap it all up, will cosmetic surgery make you happier? The answer is: maybe. Most people are satisfied with the outcome of their surgery. But satisfaction with a procedure and overall happiness are completely different things. Cosmetic surgery will likely make you more satisfied with your tummy or your eyelids, but may or may not extend beyond that to whatever else you don’t like about your life. All in all, don’t rely on it to make your life better, improve your relationships, or make you happy.
After all, even Joan Rivers eventually had enough of plastic surgery, stating, “No more Botox for me: Betty White’s bowels move more than my face.”
About the Author
Dr. Ellen Hendriksen was the host of the Savvy Psychologist podcast from 2014 to 2019. She is a clinical psychologist at Boston University’s Center for Anxiety and Related Disorders (CARD). She earned her Ph.D. at UCLA and completed her training at Harvard Medical School. Her scientifically-based, zero-judgment approach is regularly featured in Psychology Today, Scientific American, The Huffington Post, and many other media outlets. Her debut book, HOW TO BE YOURSELF: Quiet Your Inner Critic and Rise Above Social Anxiety, was published in March 2018.