Happy To Have Surgery, or Surgery To Become Happy? A Psychologist’s View

As a Consultant Clinical Psychologist, doctors and patients often ask for my opinion on cosmetic surgery, from a psychological perspective.

Before we start thinking about suitability or appropriateness for cosmetic surgery, I try to encourage people to first explore their motivations, that is, what drives them to seek surgery, why now, and what they may hope to achieve. Exploring these issues may in some cases predict post-operative satisfaction with surgery and also identify any unmet psychological needs that could benefit from further professional help.

Seeking surgery is the result of complex and interrelated psychological processes, motivation being one of them.

For example, I have seen people who may seek surgery as a “medical solution” to an “emotional problem”. A person feeling down, with mild dysphoria or indeed clinical depression, may think that surgery will have an “antidepressant” effect, and that by feeling better about one part of one’s body, they may automatically improve happiness in all aspects of life.

Some people may feel incredibly anxious in social situations and may seek surgery as a “quick fix” to treat their chronic and debilitating shyness, their dire fear of negative social evaluation or to stop the relentless rumination about comparing themselves to idealised peers, which may have stemmed from past bullying or being unpopular during the formative years.

People with a body dysmorphia may have quite extreme views about one, or in some cases more than one, part of their body, and may believe that surgery can fix their perceived defect and ease their all-consuming preoccupation.

I have treated people with abusive or sexually traumatic pasts, who sought surgery to correct the violated body, hoping that this will stop the haunting memories of the past, or ease the current post-traumatic symptoms after all these years.

Furthermore, people’s personality may have something to do with their quest for surgery.

I have seen people with high levels of perfectionism, who may hold unrealistic standards and expectations of what their body “should” look like, and may place harsh demand upon themselves, or indeed their surgeon, and post-operatively they may still be dissatisfied if their exact expectations are not met.

People with narcissistic traits and a sense of entitlement, may feel that they deserve to have “the best” looking body because they are worth it, but if this is driven by a carefully masked, yet deep-rooted, lack of self-esteem, they may never feel “worthy enough”, with or without surgery.

Worryingly, some people with low assertiveness skills, dependency traits, or a fear of abandonment, may have considered surgery not because they themselves want to enhance one aspect of their appearance, but because they have felt the need to comply with the demands or expectations of others, for example thinking that surgery can save an ailing relationship.

However, there may be factors outside our immediate awareness driving a quest for cosmetic modifications. Is the need to look better driven by repressed anger, a need for revenge, jealousy, hurt, shame or anxiety after significant life events, transitions or disappointments? Does celebrity culture imply that there is a fixed definition of what everybody considers to be beautiful, irrespective of the fact that beauty is in the eye of the beholder, and that surgery is now the socially acceptable norm and is an absolute must, in order to obtain success, desirability and wealth? Is focusing on bodily appearance driven by an existential realisation that we are all growing older, and hence by looking younger one is delaying or defying ageing? Or is this all part of a wider compulsive need to take control of things that are out of our control?

People’s multi-faceted motivations are not all unhealthy. For some, with the right motivations, cosmetic surgery can lead to significant satisfaction with their looks. Clinical psychologists, in a non-judgemental way, have helped many people who have sought a confidential and private pre-surgical consultation, or in some cases a handful of therapy sessions, to confidentially explore their motivations, hopes, fears and aspirations, and in that way ensure they can make a thoughtful and calm choice, safe in the knowledge that they are happy to have surgery, rather than having surgery to become happy.


Dr Konstantine Loumidis specialises in the psychological assessment and treatment of difficulties such as non-clinical problems (for people seeking guidance, support, personal development or growth), common mental health problems (anxiety, stress, depression, OCD, PTSD, eating, relationship, marital, etc) as well as severe and complex psychiatric disorders. He offers individual therapies (counselling, CBT, interpersonal, marital, etc) and sees people of all ages. He also provides reports as an independent expert witness in the Midlands and at Harley Street in London.