How Much Plastic Surgery Is Too Much?

Reviewed by Ronald E. Iverson, MD, FACS

In a Glamour magazine survey, 75 percent of women between the age of 18 to 35 believed they were fat. However, only 25 percent were medically overweight — the same percentage as overweight men (from Beauty Myth by Naomi Wolf). This kind of exaggerated self-criticism, called body dysmorphic disorder, can undermine your self-image. Body dysmorphic disorder has been defined as an obsession with a facial or body trait.

Some studies have determined that up to 12 percent of all plastic surgery patients have this disorder. Evidence shows that these patients are likely to seek multiple procedures for the same feature.

So then, the question becomes, how much cosmetic surgery is too much?

The Wrong Reasons for Getting Cosmetic Surgery

Pursuing cosmetic surgery for the wrong reasons may be what leads to excessive plastic surgery. Here are some examples.

  • Eternal Contentment. It is important to understand that cosmetic surgery does not lead to life contentment. Cosmetic surgery may positively impact many aspects of your life; however, that is not the reason for plastic surgery. In fact, cosmetic treatments and procedures do not last a lifetime. As time passes, aging will continue to affect your appearance. Aging can also affect the appearance of a plastic surgery procedure.
  • Life Problem Solution. Plastic surgery patients are exposed to varying degrees of life stresses. Some cosmetic surgery patients believe that plastic surgery will solve a domestic issue, increase employment opportunities or heal grief from loss of a job, loss of a loved one or transition to retirement. Plastic surgery procedures are designed to improve the appearance of a specific body area, not life's problems.
  • It Looked Good on TV! Some people may fixate on a procedure they saw on television. For example, they may ask for multiple lifts and tucks that looked good on TV, when they could achieve their desired outcome with a mini or micro procedure. It is also true that you may see mini procedures look good on TV, when the makeover you are looking for would require more extensive plastic surgery. Underestimating what you need can result in the coming back for additional procedures that otherwise would not have been necessary.

Follow-up Procedures Are a Legitimate Need

Having warned against overdoing it, remember that follow-up procedures are common. Non-invasive and minimally invasive procedures must be repeated in order to maintain the benefit. Plastic surgery procedures often require "touchups" in the form of secondary surgeries to maintain the cosmetic improvements to your body. There has been a 30 percent re-operation rate among women who had breast surgery. Many of these cases were to increase size or revitalize the aged appearance of the initial surgery. You should also be aware of your own emotional changes, which are a very important part of the plastic surgery territory.

Getting It Right the First Time

Doctors in plastic surgery help patients make informed decisions that focus on the specific bothersome feature, to reduce future surgery needs as much as possible. You can help your doctor to get it right the first time by understanding the true purpose of having cosmetic surgery and your treatment options, by receiving support from those around you, by being prepared for the recovery process, and understanding possible side effects.

More About Body Dysmorphic Disorder

Body dysmorphic disorder afflicts about 1 in 50 people. The disorder usually begins in teenage years or after the onset of psychological problems, such as eating disorders or obsessive compulsive disorder. The disorder may be a precursor to mental illness. Plastic surgeons frequently spend a significant amount of time in the initial consultation to identify red-flag indicators of the disorder.

Red-flag indicators for the disease include preoccupation with the perceived body or facial defect, avoiding social situations due to the perceived defect or destructive behaviors and thoughts about the perceived defect. Many times a person with body dysmorphic disorder may feel they have a defect when the doctor does not. There is treatment available today for people with body dysmorphic disorder. Recent reports have indicated that patients respond well to cognitive therapy, learning how to substitute thoughts about the perceived defect with positive habits. Oral medications have also been found to be beneficial.

About the Reviewer of This Article

Ronald E. Iverson, MD, FACS, is a board-certified plastic surgeon, a member and former president of the American Society of Plastic Surgeons, a member of the American Society for Aesthetic Plastic Surgery, and an American Medical Association delegate. Dr. Iverson received his medical degree from the University of California, Los Angeles, and performed his residency at Stanford University Medical Center, General Surgery and Plastic and Reconstructive Surgery.