Controlled studies of psychosocial outcomes from plastic surgical interventions

Author(s)	Study objective	Procedure	Sex (mean age)	Study design	Control group	Scales used	Follow-up period	Outcome	Factors associated with poor outcomes
Edgerton et al5	To survey patients requesting surgery to ageing face	Face-lift and blepharoplasty	8 M, 64 F (48 years)	Cross-sectional	7 patients age-matched to 7 of 8 patients selected to undergo psychological testing	Rorschach, JSC, TAT (only 8 patients had psychological testing)	2 months to 10 years	86% reported improved sense of wellbeing	Age under 40
Wright and Wright6	To study personality characteristics of people seeking cosmetic surgery, and degree of change in personality traits after the procedure	Rhinoplasty	90 M and F (30 years)	Longitudinal (only 25 patients followed up)	25 non-cosmetic surgical patients	MMPI	18–24 months	No major personality change; improved self-concept; socially more self-assured	Psychosis; neurosis; decisional discrepancies with partner; personality disorder(narcissism)
Shipley et al7	To examine the effect of breast augmentation on psychosocial functioning	Augmentation mammoplasty	19 F (30.5 years)	Retrospective	20 small-breasted women and 19 average-breasted women	CPI, ZSSET, DPAQ	3 months	Improved body image; no effects on personality or self-concept
Marcus8	To examine the psychiatric status of patients having rhinoplasty	Rhinoplasty	5 M, 15 F (23 years)	Longitudinal	25 dental patients(18 M)	SJBCS, ADS, SES	3 months	90% pleased with surgical outcome; increased ability to enjoy life; increased social confidence
Hueston et al9	To construct a psychological profile of cosmetic surgery patients and make a longitudinal evaluation of effects of surgery on psychosocial functioning	Augmentation and reduction mammoplasty, face lift, blepharoplasty, abdominoplasty	169 M and F (35 years)	Longitudinal	53 hand surgery patients	MHQ, LEQ, SAS, LCS, RSES	3 months	Psychosocial functioning of patients in both groups (aesthetic procedures, hand surgery) improved
Beale et al10	To determine whether it is possible to predict which women will benefit most from augmentation mammoplasty	Augmentation mammoplasty	61 F (age unspecified)	Subsample (n = 39) followed longitudinally	28 women from general population	CMPS	12 months	Personality testing is useful in predicting which women will benefit from the operation; 78% were satisfied with outcome	Psychiatric problems; unrealistic expectations; patients using surgery to “save relationship”
Hollyman et al11	To examine body perception before and after reduction mammoplasty	Reduction mammoplasty	11 F (22.4 years)	Longitudinal	19 women not seeking surgery	CCEI, body perception apparatus, visual analogue scales	At 2, 8, 16, and 26 weeks	Post-surgery relief of psychological distress; improved body image
Meyer and Ringberg12	To study preoperative personality, psychosocial and psychiatric characteristics	Augmentation mammoplasty	38 F (38.4 years)	Longitudinal	33 female surgical outpatients	CMPS, MNT	1 year	86% satisfied, and social and psychological expectations fulfilled	Unspecified personality characteristics
Robin et al13	To assess the psychological status of rhinoplasty patients	Rhinoplasty	31 M and F (25.8 years)	Longitudinal	31 matched controls	FAST, GHQ, RMFS	6 months	Marked reduction in psychiatric symptom scores(controls showed no change)
Klassen et al14	To assess health status before and after breast reduction surgery	Reduction mammoplasty	166 F (30.5 years)	Longitudinal	General population sample	SF 36, RSES, GHQ 28	6 months	Improvement in psychological wellbeing post-operatively; 86% highly satisfied with outcome
Klassen et al15	To assess health status after a variety of cosmetic interventions	Various cosmetic procedures	198 M and F (32.6 years)	Longitudinal	General population sample	SF 36, GHQ 28, RSES	6 months	Majority pleased with outcome; gains in psychological, social and physical function

ADS = Anxiety and Depression Scale. CCEI = Crown–Crisp Experimental Index. CMPS = Cesarec–Marke Personality Schedule. CPI = California Psychological Inventory. DPAQ = Dress, Popularity and Activity Questionnaire. FAST = Facial Appearance Sorting Test. GHQ = General Health Questionnaire. JSC = Johns Sentence Completion. LCS = Locus of Control Scale. LEQ = Life Events Questionnaire. MHQ = Middlesex Hospital Questionnaire. MMPI = Minnesota Multiphasic Personality Inventory. MNT = Marke–Nyman Test. RMFS = Rochford Masculinity/Femininity Scale. RSES = Rosenberg Self-Esteem Scale. SAS = Social Adjustment Scale. SES = Self-Esteem Scale. SF 36 = Short Form 36 health survey. SJBCS = Secord–Jourard Body Cathexis Scale. TAT = Thematic Apperception Test. ZSSET = Ziller Social Self-Esteem Test.