1. CHAPTER 9: Cosmetic Medical Procedures and Body Adornment

2. 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.

3. 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

4. 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

5. 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

6. 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

7. Type-Changing Cosmetic Procedures Rhinoplasty Facial skeletal surgeries – Lip, chin, cheek implants Cosmetic breast augmentation

8. 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.

9. 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”)

10. Other Procedures Tattoos and body piercing Genital enhancement

11. 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

12. 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.

13. 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.