Aestetic surgery may permanently improve patient’s well-being.
The journal Clinical Psychological Science recently published an article stating that patients undergoing plastic surgery benefit psychologically from the physical changes, with the improvement lasting at least a year.
But at the bottom of the research report there was a disturbing sentence. It said that the study was funded by Mang Medical One AG, a large provider of plastic surgery in Germany. So can we really trust the optimistic conclusion about the effects of cosmetic operations? Prof. Dr. Jürgen Margraf, leader of the study, answers some questions:
Who came up with the idea for this study?
The funder contacted me for scientific advice. They had the impression that their patients were on average quite happy with the outcome of surgery, on a medical and psychological level. They also thought that their patients became more self-assured. Yet, in the general discussion, especially in Germany, aesthetic surgery in their opinion was totally misrepresented. So they wanted to show that many patients would “be much happier” after surgery.
You ended up conducting the study, how did you protect your independence?
I told them that “happiness” as outcome would be difficult, but that satisfaction and self-assurance could be assessed reliably, if we would be a totally independent research team. We asked for a control group and for a representative comparison group from the general population, although this made the study much more expensive. The subjects had already been operated at one of the clinics of Mang Medical One AG. We were ensured that we would only be presented with consecutive cases with only the inclusion/exclusion criteria we set up. We analyzed the data, checked plausibility and were able to collect the reasons for people not participating. We had the right to publish the results and were in no way influenced (in fact not even contacted) during the article’s writing process.
You made use of a control group of participants who changed their minds about having plastic surgery. How did you find these people?
The control group was a very difficult part of the study. The scientifically best solution (i.e., random assignment to surgery or no surgery) was not possible for both ethical and practical reasons. We thus came up with the idea of looking at people who had shown interest in surgery but had not yet decided about it. These were recruited from people who had contacted the provider´s website, but had not made an appointment. We were able to recruit some 250 for the study and asked them why. The most frequent answer was financial reasons, if I recall right. The control group members typically were still thinking about an operation, at least as far as we knew.
What were your expectations?
I was personally surprised by several of our findings. I had expected to find more subjects with unrealistic goals, a greater share of subjects with clinically relevant anxiety/depression and a lower level of goal attainment. And – most of all – I suspected the improvement of psychological well-being of the subjects (including self-esteem, quality of life and mental health) to return to pre-intervention levels.
A large body of evidence shows that people go back to initial levels rather quickly, even after major life events (both positive and negative, see for instance Ed Diener´s work). We tested the patients up to a year after surgery. It is possible that we will see differences during a longer follow-up, but typically you should see at least the beginning of this during the first year.
So you state that “embodied changes via aesthetic surgery may produce more permanent psychological change than more temporary or malleable life events, such as relationship changes, relocations, and so on.” Isn’t that a bit too enthusiastic?
I don´t think it is enthusiastic and I am not sure what I would recommend to any given individual. In my clinical practice, I normally see people with mental disorders and for them I have not recommended aesthetic surgery. But, as our study showed, most people undergoing aesthetic surgery do not come with mental disorders and do not think that surgery will alleviate such disorders. Instead, they come with a circumscribed aesthetic problem and want exactly this to be changed (e.g., nose correction, but not a total change of the face or the personality). Our data show that that is what they get, with an average level of some 80% goal attainment. Embodiment is a particularly interesting candidate for possible explanation. This will require further studies, however.
Photo: Flickr, Arturo de Albornoz
Reference: Jürgen Margraf, Andrea H. Meyer and Kristen L. Lavallee (2013). Jürgen Margraf, Andrea H. Meyer and Kristen L. Lavallee
Well-Being From the Knife? Psychological Effects of Aesthetic Surgery Clinical Psychological Science DOI: 10.1177/2167702612471660
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