Body image as a predictor of outcome in facelift surgery

Nancy Spitzack (2004)

This study was intended to investigate body image as a possible predictor of psychosocial outcome in 31 facelift patients from the Cleveland Clinic Foundation. Previous psychological research related to cosmetic surgical and nonsurgical procedures was reviewed. A tremendous increase in requests for cosmetic procedures continues despite economic, physical, and psychological risks. Although many studies report positive psychosocial outcomes, negative outcomes occur despite good technical results. Factors repeatedly demonstrated to predict negative outcome following surgery include preexisting psychological disturbance, especially body dysmorphic disorder; and having unrealistic expectations or external motivations for surgery. However, body image in the absence of clinically significant distortion, including positive and negative ends of the spectrum for self-reported appearance evaluation and appearance orientation, has not been researched as a predictor of outcome. To reduce the risk of negative psychosocial outcome, participants were screened for body dysmorphic disorder, a condition which precluded them from surgery. Psychosocial outcome variables included general symptoms of psychological distress, interpersonal relationship and social role functioning, self-esteem, body image, and satisfaction. Data were collected prior to surgery and at a three-month follow-up to evaluate possible changes in psychosocial functioning and to assess satisfaction following surgery. A series of two-tailed, paired t tests revealed significant increases in self-assessed physical attractiveness, as a result of surgery ( p < .01). Other outcome variables remained relatively stable. A stepwise multiple regression analysis was conducted to evaluate body image as a potential predictor of satisfaction. Results indicated that satisfaction was not predicted by body image for this sample. Participants' satisfaction with their surgical procedure was consistently and uniformly positive, their satisfaction with the surgical result was largely positive, and no participants reported strong, negative feelings about their appearance prior to surgery. Furthermore, careful screening of participants likely reduced the range of both risk to surgical candidates and satisfaction ratings. Thus, the ability to predict satisfaction with surgery from presurgical body image was hampered by restricted variability in the criterion satisfaction variables. Possible directions for future research are discussed.