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By Clinical Psychologist, Kathryn Smith

Cosmetic procedures are on the rise and with ‘bikini season’ approaching, I pose the question- does improving the outside make you feel better on the inside? This week is mental health week a time to reflect, check in and make sure our health and wellbeing is in balance. In the digitalised consumer based world we live in, it’s easy to get sucked into advertising gimmicks and marketing ploys that can make us feel insecure about ourselves and question our self worth. The beauty and cosmetics industry plays this card particularly well with a plethora of one stop clinic now offering a variety of solutions for aging, fat deposits, uneven skin tone, wrinkles, sun damage, hair removal and so on. Not to mention the burgeoning surgical industry with some even taking a cosmetic surgical holiday.

Rates of cosmetic procedures from lunchtime fixes to more extensive surgery have continued to rise significantly over the past decade in the UK, US and Australia. We seem to be increasingly pressured to fulfil an ideal and are reluctant to gracefully step into the aging process. Author and Activist Ashton Applewhite urges society to rethink our prejudice views on aging. “Aging is not a problem to be fixed or a disease to be cured,” she says. “It is a natural, powerful, lifelong process that unites us all,” Ashton says.

Social media and digital platforms make it easy to draw comparisons to others and to feel that “good enough” is now “not enough”. We are often sold the idea that improving our appearance will actually improve our psychosocial well being. In other words, not only will we will feel good about ourselves, our relationships, work and friendships will also significantly improve. Whilst some people do experience an improvement in self esteem, some studies have shown that most will return to their previous level of dissatisfaction and often those who have undergone more extensive procedures versus restorative procedures are more likely to have a poor adjustment.

So, how do you know if you are making the right choice about a cosmetic procedure?

As a clinical psychologist, I am increasingly concerned about the increase in these cosmetic procedures as individuals who are more susceptible may also be anxious or depressed with a long history of low self esteem. A particular sub-group, is also those who suffer from Body Dysmorphic Disorder or BDD. This is typically characterised by an excessive preoccupation in a perceived flaw or defect, which causes marked distress, a reduction in functioning and a number of ritualistic behaviours such as excessive checking, picking, internet searching and reassurance seeking. Individuals with BDD will often believe that their perceived defect is so noticeable that they will either avoid going out into public or conceal themselves when they have to. To others, the perceived defect may be non-existent or only slight but despite reassurance they do not feel convinced. It has times, been referred to as a “preoccupation with perceived ugliness” (APS reference). This subgroup may frequently seek cosmetic procedures ranging from non-invasive to major surgery. I will unfortunately see this subgroup after a number of cosmetic interventions and increasing distress due to complications or misconceptions about the desired outcome.

Now, back to the question of how do you know if you are making the right choice? The first thing to consider is what the risks are associated with the procedure, is it invasive or relatively non invasive? Are you aware of the risks of complications and the realistic outcomes? Do you suffer from anxiety, depression or long standing self esteem issues that you may need to seek assistance with first? Or are you frequently reassured by other people that your perceived defect is non-existent or minor but you are significantly preoccupied with this and it causes significant distress to the point you don’t want to be seen? If you answered yes to some or all of these questions, then this may be an indicator of BDD and it would be beneficial to speak to a psychologist to have this accurately assessed before drastic measures are taken.

As Brene Brown, a famous American scholar in social work aptly said… “Imperfections are not inadequacies, they are reminders that we’re all in this together”.