Cosmetic surgery continues to grow in popularity in the United States, perhaps stimulated by the impressive physical rejuvenations exhibited by media figures and/or the spate of provocative television shows illustrating the “miracle” of drastic surgical self-transformation. Regardless of the reasons, cosmetic procedures are on the rise—up 34 percent from 2005 to 2006.¹ According to the 2006 membership survey of the American Academy of Facial Plastic and Reconstructive Surgery,¹ these increases were largely attributed to non-surgical cosmetic procedures (e.g., Botox injections, microdermabrasion treatments, hyaluronic acid injections, chemical peels, dermal fillers, fat injections).

Additional findings of the 2006 membership survey¹ indicate that blepharoplasty was the most commonly performed cosmetic surgical procedure, followed by rhinoplasty and rhytidectomy. These procedures were followed, in turn, by hair transplantation, lip augmentation, laser resurfacing, forehead lifts, and breast enhancement. Nearly 80 percent of the recipients of these cosmetic undertakings were Caucasian. As for the prevalence of specific cosmetic procedures among other ethnic groups, rhinoplasty was most common among African-American and Hispanic subgroups, whereas blepharoplasty was most common among Asian Americans. Nearly 60 percent of the patients reported in this survey underwent multiple facial procedures in the same year.

Clearly, cosmetic procedures are on the increase in the US. As a result, these patients are not uncommon in primary care and psychiatric settings. But, how much do we really know about the psychological issues related to these individuals? In this article, we focus on two important psychiatric phenomena among cosmetic surgery patients: 1) the suicide risk among women who have undergone breast augmentation surgery and 2) body dysmorphic disorder (BDD).