Cosmetic Surgery and Mental Health: Understanding the Psychological Considerations Before Surgery

Written By James Allan

If you’re considering cosmetic surgery, you may be surprised to learn that a mental health screening is now part of the process. This helps ensure that your decision is made with a clear understanding of the procedure and its impact on your well-being.

This is not meant to be intrusive, however your mental health is an important consideration when it comes to cosmetic surgery.

Ensuring cosmetic surgery is done for the right reasons 

Cosmetic surgery is a personal decision, and it’s important to have realistic expectations about what can be achieved. A discussion with your surgeon will help you understand the benefits, risks, and expected outcomes of the procedure.

When deciding to have cosmetic surgery, ask yourself:

  • Who are you doing this for? Is it really what you want or is your partner (or someone else) putting pressure on you to look a certain way?

  • Do you understand what’s involved? Surgery is a serious undertaking that involves risks, costs and time off work while you recover. 

  • Are your expectations realistic?  Your surgeon should give you a clear understanding of what you may look like after your surgery. You should also have time after your first appointment to carefully consider whether you want to proceed without feeling under any pressure. 

  • Do you have any underlying mental health conditions that might influence your decisions or affect your recovery? That includes conditions like anxiety, depression or body dysmorphic disorder. It’s vital to discuss these with your doctors.  

Body dysmorphic disorder screening

In 2023, the Australian Health Practitioners’ Regulation Agency (AHPRA) introduced new cosmetic surgery guidelines to enhance patient safety and support informed decision-making.

One key reform was to ensure that only properly trained and qualified surgeons (such as Dr James Allan) could perform cosmetic surgery. In addition to this, all patients considering cosmetic surgery must now undergo a mental health screening to assess their emotional well-being and suitability for the procedure.

A key reason for this requirement is  body dysmorphic disorder (BDD), a mental health condition where a person experiences intense distress over perceived flaws in their appearance, even if these are minor or unnoticeable to others. BDD can lead to significant anxiety, self-consciousness, and a strong urge to "fix" perceived imperfections.

While BDD affects an estimated 1-3% of the population, and is present in 16-23% of patients seeking cosmetic surgery.  

However, studies indicate that surgical procedures do not typically improve BDD symptoms—and in many cases, paitents feel the same or worse after their surgery. BDD is a serious mental health condition. Treating it requires psychological therapy rather than cosmetic surgery. 

Under AHPRA’s updated guidelines, all patients seeking cosmetic surgery must now be screened for BDD as part of the pre-surgical assessment process. This screening may be conducted by your GP when issuing a referral or by your surgeon during the initial consultation. If any concerns are identified, additional psychological support may be recommended to ensure that cosmetic surgery is the right choice for you.

Managing your mental health after surgery

Cosmetic surgery can be performed on many areas of the body, including the face, neck, arms, breasts, abdomen, and more. Every patient’s motivations and experiences are unique—for example, a middle-aged person undergoing abdominoplasty after significant weight loss may have different considerations to a younger individual seeking breast augmentation.

Because of these differences,  studies into the mental health of patients report that the impact of cosmetic surgery on mental health varies from person to person. 

Several factors can influence a patient’s emotional well-being after surgery, including:

  • Pre-existing mental health conditions such as anxiety or depression.

  • The reasons for undergoing surgery and expectations of the outcome.

  • Which area of the body was treated and how it relates to body image concerns

  • The recovery process, particularly if complications arise.

To support your mental health throughout the process, consider these three key steps:

  • Before surgery: Take time to address any underlying mental health concerns, such as anxiety or depression. Ensure that your decision is well-informed and based on realistic expectations of what the procedure can and cannot achieve.

  • During surgery: Now you have chosen  a surgeon with appropriate training and accreditation, follow all pre- and post-operative care instructions to help minimise risks and ensure a smooth recovery.

  • After surgery: Attend all scheduled follow-up appointments, and if you experience any physical or emotional concerns during recovery, don’t hesitate to seek support from your healthcare provider.

How can Dr James Allan help?

Dr. James Allan is a Specialist Plastic and Reconstructive Surgeon with accredited training in cosmetic and reconstructive procedures. He has undertaken advanced surgical training at major teaching hospitals in Sydney and is qualified through the Royal Australasian College of Surgeons (FRACS).

Dr. Allan provides consultations and performs procedures for the breast, face, and body. His approach prioritises patient education, informed decision-making, and comprehensive pre- and post-operative care to support both physical and emotional well-being.

If you're thinking about a procedure and would like to explore your options, you can book a confidential consultation with Dr James Allan. 

Disclaimer

Dr James Allan (MED0001204818), Registered medical practitioner, specialist registration in plastic surgery. Any surgical or invasive procedure carries risks. Results may vary. A second opinion may help you decide if a particular treatment is right for you.

References

  1. Jones HE, Faulkner HR, Losken A. The Psychological Impact of Aesthetic Surgery: A Mini-Review. Aesthet Surg J Open Forum. 2022 Oct 13;4:ojac077. doi: 10.1093/asjof/ojac077. PMID: 36447649; PMCID: PMC9687813. https://pmc.ncbi.nlm.nih.gov/articles/PMC9687813/, [Accessed 3 February 2025]


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