- What is Plastic Surgery Addiction?
- Understanding Body Dysmorphic Disorder (BDD)
- Statistical Overview of Plastic Surgery
- Risks of Plastic Surgery
- Other Co-Occurring Conditions
- Surgery’s Impact on Mental Health
- Negative Health Consequences
- Signs & Symptoms of Plastic Surgery Addiction
- Treatment for Plastic Surgery Addiction
- Don’t Be Afraid to Seek Help
- Key Sources
- Medical Disclaimer
From Botox to tummy tucks, plastic surgery procedures have become increasingly more common. No longer relegated to just celebrities and the rich, many people are turning to plastic surgery as a way to enhance or improve their appearance.
However, while plastic surgery can be a useful corrective procedure for the odd physical issue, for some, it can become an addictive compulsion. Individuals with plastic surgery addiction not only have a deep and ongoing dissatisfaction with their body, but they also undergo numerous surgeries in the quest to fix every perceived flaw. This compulsive behavior is often driven by an underlying mental health condition known as “body dysmorphic disorder” (BDD).
The good news is that while plastic surgery addiction can be difficult to stop, help is available. Before going into the treatment methods that are available, this article will provide an outline of what plastic surgery addiction is and how it is influenced by co-occurring mental health conditions.
What is Plastic Surgery Addiction?
Plastic surgery has become a popular way for people to enhance or fix an area of their appearance. Whether it’s smoothing out wrinkles or augmenting one’s nose and/or breasts, it is not unheard of for someone to go under the knife to amend a supposed defect.
But for some individuals, plastic surgery is an addiction. It is a compulsion and a behavioral disorder like an addiction to drugs, alcohol, sex, or gambling. Also, like most addictions, plastic surgery initially creates a pleasurable experience (similar to a drug high) for the individual. This causes a desire to re-create that experience over and over, leading to a cycle of ongoing surgeries in the pursuit of perceived perfection.
However, although people with plastic surgery addiction spend thousands of dollars on procedures, they are usually never fully satisfied with the result. These individuals are deeply insecure about how they look and will find more flaws to fix. This leads to a compulsive need to have more and more operations with no end in sight. To complicate matters more, people with plastic surgery addiction often have an underlying mental health condition known as body dysmorphic disorder.
Understanding Body Dysmorphic Disorder (BDD)
Body dysmorphic disorder (BDD) is a debilitating condition that affects roughly 1 in 50 Americans. Beginning largely during adolescence, BDD is characterized by persistent and intrusive preoccupations with perceived defects in one’s appearance. While the severity of this condition varies, it is exemplified by ongoing emotional distress that accompanies a person’s thoughts about their supposed flaws.
Similarities to Obsessive-Compulsive Disorder (OCD)
BDD has many similarities to obsessive-compulsive disorder (OCD), which is why the two conditions often occur together. People with BDD and OCD both have obsessive and uncontrollable thoughts and behaviors. The primary difference is that BDD focuses primarily on the body (e.g., chronic mirror checking, skin picking, and seeking reassurance about their appearance), whereas OCD will focus on other behaviors (e.g., seeking patterns, avoiding contamination, or obsessing about the death of a loved one).
While BDD only affects a small proportion of the population, it is found to be 15 times more prevalent in people seeking plastic surgery. While many people feel that surgery will alleviate their anxiety and perceived defects, it rarely resolves the symptoms of the disorder. Added to that are the dangers that these individuals put themselves in by having so many surgical procedures. Unsurprisingly, rates of suicide are quite high in people with BDD (roughly 1 in 300), and many are afraid to seek help because they are concerned about being viewed as vain or narcissistic.
Many young people are known to spend enormous amounts of time trying to perfect their image on websites like Instagram. In recent years, filters and other image enhancements are also enabling people to augment their image digitally in the quest to showcase the perfect body and face.
While social media cannot be solely blamed for rises in plastic surgery addiction, it is cited as a contributing factor to issues related to body obsession. Not only do these platforms influence body image perceptions through constant exposure, but the pressure to take the perfect “selfie,” for example, can deeply affect people with BDD.
Symptoms of Body Dysmorphic Disorder
There are key signs to watch out for when it comes to body dysmorphic disorder:
- Obsessive mirror checking.
- Cutting or combing their hair to make it perfect.
- Excessive distress over minor or nonexistent flaws.
- Picking skin to make it smooth while checking for imperfections and flaws.
- Constantly comparing themselves against models in magazines or friends/celebrities on social media.
- A disproportionate amount of discussion about their appearance.
- Using make-up to camouflage and hide their appearance.
Statistical Overview of Plastic Surgery
Below are some statistics about plastic surgery and body dysmorphia in the U.S.
- Roughly 1.7% – 2.9% of the U.S. population (5 to 10 million people) has body dysmorphic disorder.
- According to the International Society of Aesthetic Plastic Surgery (ISAPS) annual report, 3.9 million surgical and non-surgical operations were performed in 2019.
- Of those, breast augmentation, liposuction, and abdominoplasty were the most common surgical procedures, while Botox, hyaluronic acid, and hair removal were the most common non-surgical procedures.
- Globally, ISAPS reports that in 2019, breast augmentations were the most common procedure at 1.8 million, followed by liposuction (1.7 million), and eyelid surgery (1.2 million).
- Globally, Brazil performs the highest number of plastic surgery operations (1.5 million), followed by the U.S. (1.4 million).
Risks of Plastic Surgery
Despite its reputation, plastic surgery does have its benefits. In some cases, these procedures can enhance and improve features of the body that may have been injured through accidents, traumas, or birth defects. Therefore, on a positive note, plastic surgery can help someone feel more attractive and confident about how they look.
However, the issue with plastic surgery addiction is that the behavior becomes compulsive. One surgery is never enough, and the person will often find more and more faults to correct. These repetitive surgeries are not only risky, but they can lead to irreversible consequences. While plastic surgery is generally deemed safe if you have no underlying medical issues, complications can arise, such as:
- Blood clots
- Bruises or hematoma (large pocket of blood)
- Collapsed muscles
- Excessive bleeding
- Nerve damage
- Organ damage
- Tissue death
- Infections, including pneumonia
- Delayed healing
- Anesthesia complications (e.g., shock, respiratory failure, allergic reactions, and cardiac arrest)
The Role of the Plastic Surgeon
One key question that lingers over plastic surgery addiction is the role of the surgeon. To what degree are they responsible for enabling a person’s dependence on these procedures? While this is a complicated issue, most surgeons are aware of body dysmorphic disorder, and they are expected to monitor this before agreeing to do a procedure.
However, as surgeons are not psychiatrists, it can be difficult to determine if someone has BDD. Therefore, many people with this condition remain undetected, and, in the end, it’s up to the surgeon to make the final decision. While surgeons are under an ethical obligation to weigh the risks and benefits for each patient, many people with BDD still find ways to go under the knife.
In cases where a surgeon suspects a person is suffering from BDD, they should ideally refer them to a doctor or consulting psychologist for a more in-depth interview and psychiatric history. People with BDD may also have other mental health conditions, like anxiety, depression, or substance abuse, so it’s important for surgeons to be aware of these potential underlying issues.
Other Co-Occurring Conditions
Body dysmorphic disorder (BDD) and plastic surgery addiction often co-occur with other mental health conditions. Some of the most common are:
Obsessive-Compulsive Disorder (OCD)
As mentioned above, OCD often co-occurs with BDD because the symptoms are very similar. While both involve obsessive and uncontrollable thoughts and behaviors, individuals with BDD are often less aware of the irrationality of their symptoms when compared with people with OCD. They are often so convinced by their thoughts that, clinically, they are sometimes considered to be delusional.
Anxiety is a mental health condition characterized by excessive worry and fear. As BDD is related to OCD (an anxiety disorder), it is no surprise that many individuals with this condition also struggle with anxiety. This is accompanied by feelings of fear and extreme worry about their body and appearance.
While depression is unlikely to be a symptom of BDD, it often co-occurs with it. Depression is characterized by low moods, low energy, and feelings of hopelessness. It is important for clinicians to recognize when depression is concurrent with BDD due to the risks associated with each condition.
During recovery from plastic surgery, many patients are prescribed opioids to manage the pain. However, the downside to this is that taking these drugs for long periods can lead to addiction (especially as opioids are highly addictive to begin with). Individuals with BDD also suffer from low self-esteem, so opioid abuse can easily become a natural part of their addiction to plastic surgery.
Eating disorders are another mental health condition that can commonly occur with BDD. As both share an obsession with the body, it is unsurprising that they often go hand in hand. According to some studies, as many as 32% of BDD patients have also reported an eating disorder. However, it’s important to note that not all individuals with BDD have an eating disorder and vice versa.
Surgery’s Impact on Mental Health
While many mental health conditions influence plastic surgery addiction, the opposite can also occur. What impacts on this even more is that surgery does little to alleviate a person’s mental health problems and they can be made worse by the surgery itself.
Following surgery, some individuals report an increase in anxiety, depression, eating disorders, and substance abuse issues. Surgery is also a big process to undergo, and it can have lasting effects on a person’s psyche. For example, a person can experience medical trauma from the procedure, which will only worsen their mental health issues. In some cases, medical trauma can even lead to the development of post-traumatic stress disorder (PTSD), which can have devastating consequences, especially if a person is already struggling with BDD.
Negative Health Consequences
Aside from the risks and complications associated with plastic surgery, this type of addiction can lead to other mental health consequences, too. Addiction is a debilitating disease, and one that is accompanied by BDD can lead to chronic depression, anxiety disorder, and panic disorder, as well as social anxiety. You may also find it difficult to cope with work, family, and your social life, because of your chronic obsession with your body.
However, the biggest danger is the physical effects that so many surgeries can have on your body. People who undergo the knife multiple times are at risk of permanent damage to their skin and muscles, including excessive scar tissue and collapsed muscles.
Signs & Symptoms of Plastic Surgery Addiction
Like other addictions, there are behavioral signs that indicate someone is addicted to plastic surgery. They include:
- Seeking out multiple plastic surgery procedures in rapid succession.
- Seeking out plastic surgeries from different surgeons (so that their addiction remains undetected).
- Seeking out plastic surgery with surgeons who don’t have the proper credentials (out of desperation).
- Having unrealistic expectations about plastic surgery.
- Being unrealistically dissatisfied with the results of the surgery.
- Having an ongoing desire for more and more surgeries.
- Finding new flaws and defects to “fix” following surgery.
Treatment for Plastic Surgery Addiction
The good news is that plastic surgery addiction and BDD are highly treatable. If you find yourself struggling with these conditions, you are not alone. Below are some of the ways that you can reach out and seek treatment.
Stop on Your Own
Stopping a plastic surgery addiction on your own is possible, but not advisable. Since most people with this addiction also have co-occurring mental health conditions, ceasing surgery will not eliminate the underlying cause. While you can certainly stop yourself from undergoing plastic surgery, it is advisable to find a counselor, therapist, or doctor who can treat your emotional issues and triggers.
Cognitive-Behavioral Therapy (CBT)
One of the most successful therapies for plastic surgery addiction and body dysmorphic disorder is cognitive-behavioral therapy (CBT). CBT helps individuals change negative cycles of thought and behavior into more positive ones. This kind of therapy has shown to be especially effective for addiction and mental health conditions like OCD and BDD. Clients receiving CBT often learn how to recognize “automatic thoughts” and dysfunctional thinking patterns, how to understand the behavior and motivation of others, and how to develop a greater sense of self-understanding and confidence.
Rehab or Treatment Center
Many rehab centers do not offer specific plans for plastic surgery addiction. However, individuals who have co-occurring mental health conditions like BDD may benefit from outpatient treatment that offers dual diagnosis and a focus on topics like self-esteem and emotional triggers.
Other rehab centers that focus on behavioral addictions are also highly effective. Individuals can enroll in an inpatient or outpatient program and receive relevant treatment, such as cognitive-behavioral therapy (CBT), dialectical-behavioral therapy (DBT), trauma therapy, and other alternative therapy models.
Don’t Be Afraid to Seek Help
While it can be scary or frightening to reach out for help, remember that support is always available. Due to the physical and mental health risks that plastic surgery can pose, it is important to take the first step and seek treatment. There are many qualified counselors and therapists out there who are experienced in treating compulsive behavioral disorders and they can help you identify the reasons behind your behavior. Therapy can open the door to healing and help you learn to love yourself without going under the knife.
If you or a loved one are struggling with plastic surgery addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.
You can also find a list of treatment centers near you on our website to help get you on the path to recovery.
International Society of Aesthetic Plastic Surgery. (2019). ISAPS Global Survey Results 2019. https://www.isaps.org/medical-professionals/isaps-global-statistics.
Kelly, O. (2020). Comparing OCD and Body Dysmorphic Disorder Symptoms. Verwellmind.com https://www.verywellmind.com/ocd-and-body-dysmorphic-disorder-2510581.
Ladegaard, I. (2012). Mental Health Problems Worsen With Cosmetic Surgery. Sciencenorway.no. https://sciencenorway.no/cosmetics-forskningno-norway/mental-health-problems-worsen-with-cosmetic-surgery/1373674.
Stresing, D. (2011). When Cosmetic Surgery Becomes an Addiction. Everydayhealth.com. https://www.everydayhealth.com/addiction/recognizing-cosmetic-surgery-addiction.aspx.
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