“I did it for me,” we often hear people say about their cosmetic surgery decisions. But what does this mean? And for mental health?
We strive to share knowledge based on diverse experiences without stigma or shame. This is a powerful voice.
I had plastic surgery for reasons other than medical necessity. I did it because my body had flaws that I just couldn’t accept and there was an option available to change it.
So, I did it. That’s the unadulterated truth, but that’s not how I frame the conversation when I talk to others.
I recently had a conversation on the “Inside Mental Health” podcast with a plastic surgeon Dr. James Marotta. As I explained my history with cosmetics, it revealed some common feelings as well as some psychology behind those decisions.
Because of my conflicted – or embarrassing – feelings about cosmetic surgery, I feel the need to explain my reasoning further.
I lost over 300 pounds after gastric bypass and had a lot of excess skin. I had a lot intense chest tissue which made me look – and feel – terrible. I have to admit that I like the way I look now better than before.
Marotta says the internalized shame of being ashamed of plastic surgery is not unusual. He explains that the majority of his patients ask him if they are vain and confide that their friends and family tell them it is absurd to consider plastic surgery.
“When you have a physical flaw that bothers you, you know that people perceive you in a certain way,” says Marotta. “It’s something that if it bothers you, you want to do something about it because you don’t want to live like that.”
A 2012 study of the young women’s plastic surgery market in Brazil noted that most of the “shame” women expressed was in their pre-surgery appearances. Their reluctance to talk publicly about their raises had more to do with their feelings about their former selves.
In fact, in his book “Modernity and Self-Identity”, sociologist Anthony Giddens notes that shame is due to insecurity about social acceptance.
Simply put, our shame has less to do with the surgeries than the need to explain what previous features started our surgeries.
Less vanity, more willingness to change
Marotta goes on to explain that many things in our lives can be cultivated and changed. We don’t just have to accept the baseline of what we are born with.
“You can read more books, you can study more. You can become a more interesting person,” he emphasizes.
“My point is that you can take advantage of everything medical science has to optimize your appearance as well. It’s a healthy, encouraging way to look at plastic surgery, instead of always being a vanity,” says Marotta.
Is it good for mental health, though?
According to 2020 data from American Society of Plastic Surgeonspeople aged 40 to 54 received the most cosmetic procedures in 2020. With 6.1 million cosmetic procedures, this age group received 45% of all cosmetic procedures.
- people aged 70 and over had about 246,000 cosmetic procedures
- people aged 55 to 69 had 3.9 million cosmetic procedures
- 30 to 39 year olds had 2.1 million cosmetic procedures
- 20 to 29 year olds had 768,000 cosmetic procedures
- teenagers had about 230,000 cosmetic procedures
The American Society of Plastic Surgeons notes that men make up 8% of all cosmetic procedures and women make up 92% of the market.
The agency further notes that from 2019 to 2020, the following groups received fewer plastic surgeries:
- white Americans (down 20%)
- Asian Americans (5% decrease)
- Hispanic Americans (4% decrease)
The same number of African Americans had plastic surgery (1.7 million).
The most popular types of surgery were also notable:
A 2016 study analyzed more than 80 surgical instructions. Check out the cosmetic surgery mod:
- reinforces polarized gender norms
- it perpetuates racially one-sided norms
The study found that natural markers of gender and race are subject to reconstruction. Physical characteristics of whiteness were also found to be used as a standard.
Using this 15-item scale, the researchers found that acceptance of cosmetic surgery was most associated with fears fetching unattractive than hopes to become more attractive.
The researchers found that as the women got older, the more favorable their attitudes toward plastic surgery became. Men endorsed it more when they were younger and less so as they got older.
Repetitive cosmetic surgery is not officially listed as an obsessive-compulsive or behavioral addiction per se, but it can be a feature of body dysmorphic disorder: when what you perceive about your appearance is psychologically, and sometimes overtly, to the point that someone may repeatedly receive measures to correct the defects they believe exist.
No surgery creates an “addiction” any more than a single alcoholic drink qualifies someone as having a substance use disorder. However, the media can paint a stigmatizing picture.
The reality is that everything has a satanic side. It’s what gets our attention.
“People love plastic surgery nightmares… This plays in the tabloids… and that’s the first thought that comes to people’s minds is plastic surgery, the nightmares, the disfigurement, the corruption, the extremes, the plastic surgery circus,” says Marotta. “Like watching a car wreck: You can’t help but turn your head.”
In fact, Marotta says that “99.9% of my practice is everyday normal people [who] they do a procedure, they love the results, they get on with their lives.”
In talking with Marotta, I noted that he never said “fix something” but used the terms “change” or “change”.
For the vast majority of people, plastic surgery is a viable option to change something they are unhappy with about their body.
The guilt or shame we feel about the procedure is an unfortunate byproduct of how society views our motivations for plastic surgery.
For those managing body dysmorphic disorder or another mental health condition fueled by cosmetic surgery, like any other mental health condition, it may be best to tailor talk therapies and treatment plans that support you.
There are many reasons a person may choose to have plastic surgery. Every reason is personal and precious to them. Punishing ourselves emotionally for a change we believe has merit, or allowing ourselves to be shamed by others, serves no useful purpose.
We must remember that these decisions are solely ours. We are free to do whatever we want with our bodies. Getting cosmetic work done only means that you are open to change. The rest of the narrative is up to you.
Gabe Howard is an award-winning author and speaker living with bipolar disorder. He is the author of the popular book Mental Illness Is an Asshole and Other Observations, available from Amazon. Signed copies are also available directly from the author. Gabe is the host of Healthline Media’s weekly podcast, “Inside Mental Health.” You can listen and learn more here. Gabe can be found online at gabehoward.com.
