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CHAPTER 9: Cosmetic Medical Procedures and Body Adornment Introduction • 13.1 million cosmetic surgical and nonsurgical cosmetic treatments were performed in the United States in 2010. • Majority of individuals who seek cosmetic procedures today are female. Motivations for Cosmetic Procedures • Increased acceptance of cosmetic medical treatments, due to: – Advances in surgical techniques – Availability of minimally invasive techniques – Direct-to-consumer marketing – Media exposure Motivations for Cosmetic Procedures • More favorable attitudes toward cosmetic surgery are related to: – Increased age – Greater use of makeup – Lower social self-esteem and body esteem – Higher body shame Motivations for Cosmetic Procedures • Dissatisfaction with body image • Attractive and youthful appearance standards for women • Desire for a specific ideal (e.g., appearance of a certain ethnicity) • Motivations vary by age Type-Changing Cosmetic Procedures • Type-changing cosmetic procedures include surgical procedures that noticeably alter the size, shape, or contour of an appearance feature. – Usually performed due to body dissatisfaction Type-Changing Cosmetic Procedures • Rhinoplasty • Facial skeletal surgeries – Lip, chin, cheek implants • Cosmetic breast augmentation Restorative Procedures • Anti-aging cosmetic surgical procedures seek to restore or rejuvenate the appearance of facial features. – Differ from type-changing surgeries because they do not change any major structures or shapes of the face. Restorative Procedures • Rhytidectomy (facelift surgery) • Blepharoplasty – Removal of fat and excess skin or muscle from the upper and/or lower eyelids • • • • Botulinum toxin injections Injectable soft tissue fillers Lipoplasty (liposuction) Abdominoplasty (“tummy tuck”) Other Procedures • Tattoos and body piercing • Genital enhancement Psychiatric Disorders Among Cosmetic Surgery Patients • Body Dysmorphic Disorder (BDD) – Preoccupation with an imagined or slight defect in physical appearance that results in significant emotional distress and/or impairment in daily functioning • Eating Disorders – Characterized by extreme body image dissatisfaction, specifically with weight and shape Psychological Assessment of the Cosmetic Patient • A cognitive-behavioral assessment of psychosocial functioning is recommended for prospective patients. • Focus on the patient’s motivations and expectations for cosmetic treatment. • Obtain detailed psychiatric history. Summary • The popularity of cosmetic medical procedures warrants further investigation of the motivations and psychological aspects. • Body dysmorphic disorder should be considered a contraindication for cosmetic treatments.