Top 4 Tips To Prepare Emotionally For Cosmetic Surgery

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Alisa Ruby Bash, MFT

1) Anxiety, Depression, and Guilt about Surgery
Many people who decide to do an elective cosmetic surgery can experience a multitude of emotions ranging from excitement, fear, depression, anxiety, guilt or anger. Making the decision to change one’s physical appearance is not something to take lightly. Make sure you have thought through your decision and discussed everything thoroughly with your physician. Of course anyone will be a little nervous before going under the knife. But, it may be helpful to discuss any intense or uncomfortable fear or anxiety prior to the surgery with a licensed therapist.
Also, one thing to consider is that postoperative depression or anxiety is not uncommon with any surgery. The anesthesia and effects of surgery may produce some temporary emotional changes. Also, people who are predisposed to depression, anxiety, personality disorders, and other psychological issues are more likely to experience an emotional letdown after a plastic surgery procedure without proper treatment. It can be difficult to feel good before you look good. Everyone has fears about what they will look like when the swelling goes down and it can be difficult to remain patient and not feel guilty or question your decision. However, many plastic surgeons provide preoperative and postoperative counseling or referrals to psychotherapists to help you thrive emotionally as your body improves physically.

2) What Are My Expectations For Surgery?
Choosing to undergo plastic surgery is most appropriate when the expectations are simply to improve the physical appearance of a bodily or facial feature. Expectations to improve the rest of your life can be a bit unrealistic. While the results of plastic surgery may positively affect your confidence; which in turn helps your relationships or career, try to remember changing the external will not necessarily change the internal.
A study in 2005 by the American Society of Plastic Surgeons found that 75 percent of the respondents indicated that they chose plastic surgery to gain an improved appearance and a more active lifestyle. Likewise, 70 percent sighted emotional and psychological rewards after surgery, with notable happiness and renewed self-esteem and confidence.
Also, make sure that you and your surgeon are on the same page with your vision of what the new body part will look like. Most plastic surgeons will be very clear with what they can and can not achieve and what will look most natural for your body type. It is up to you to communicate with your surgeon about your goals for your surgery and to listen to what your Dr. says.

3) Screening Yourself For Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD), a mental illness classified under the same category as Hypochondriasis in the DSM, occurs when a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, or nose. However, any part of the body may be the focus of concern (e.g. lips, genitals, breasts, teeth, facial hair, buttocks, or body build). Most people with BDD describe their preoccupation with their perceived physical flaws as devastating or intensely painful. They will often avoid social contact, check mirrors, store windows, and car bumpers to see their reflection and scrutinize their appearance excessively. They often go back and forth between excessive mirror checking and avoidance of mirrors. People with BDD tend to seek multiple cosmetic surgeries, and are often unhappy with the outcomes, regardless if the results are successful. Left untreated, BDD will cause difficulty in relationships, and all social interactions and may lead to hospitalizations and attempted suicide.

Unlike normal concerns about appearance, the preoccupation of Body Dysmorphic Disorder is excessively time consuming and associated with impairment in all areas of functioning including relationships, work, and friendships. BDD affects only 1-2% of the population but can be treated with medications so talk to your Dr. or therapist if you think you may have it.

4) How Will Plastic Surgery Affect my Relationship?
Studies have shown that people who are considered more attractive are often favored at work, receive more frequent promotions, are hired more easily, and are generally perceived at more intelligent and successful. Also, they are perceived as more honest and kind in research conducted at several universities.
Individuals who undergo plastic surgery may notice a difference in the way strangers treat them, although their relationships with family and close friends may not change much. In some cases though, just having greater self-confidence from cosmetic surgery can improve the way people deal with even their immediate peers and acquaintances.
However, with the changes, there is a possibility that underlying issues in relationships may be triggered. Plastic surgery can produce major positive changes in one’s appearance and self-esteem, which makes them realize they have more options for partners than they did when they first met their partner. This can trigger jealousy, insecurity, and resentment in the partner not receiving surgery.

Or, if the results are less than ideal, it can put an extra strain on a relationship as one partner feels guilty and the other feels resentment. It is imperative to communicate thoroughly with your partner about your plastic surgery beforehand and to consult with a therapist if your relationship is already challenged. These issues can be worked through and more often than not, relationships receive an extra boost of passion as the patient feels more confident, happier and sexier than ever before.

Alisa Ruby Bash, MFT is a licensed Marriage and Family Therapist in Beverly Hills, California. She is a frequent guest on “Extra” (NBC) as an “Extra Lifechanger” and has contributed to AOL,,, Figure Magazine, The Los Angeles Jewish Journal, and has a column with Los Angeles Family Magazine. Please see for more info.

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