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Instances of plastic surgery have recently decreased, with 15,405 men and women undergoing procedures in 2021, which has fallen by 27% in comparison to 2020. The most popular procedures amongst men in the UK were rhinoplasty, eyelid surgery, and ear correction, compared to female preferences for breast augmentation, breast reduction, and eyelid surgery. It is difficult to know the exact number of non-surgical treatments in the UK as regulations have only recently been introduced; however, in global terms the most popular nonsurgical procedures consist of Botox, lip/dermal fillers, and hair removal. Although the total surgical procedures has decreased, nonsurgical procedures have increased by 5.7% (injectables have decreased by 2.6%).
In a 2022 survey of 2,000 people, one third of UK participants had or considered facial cosmetic surgery, and this was most prevalent in the 18–24-year-old cohort. Whilst 75% of this younger cohort had considered or undertaken facial surgery, 60% of those over 65 years old reported that they had not. The younger cohort attributed their reasonings to peer influence, social media influencers and filters, whereas the older cohort reported their desire to fix an injury or prevent bullying. This survey also reported that eye socket, under eye and lip surgery were the most considered procedures for women, compared to lip and hairline surgeries for men.
Plastic surgery and mental health
Plastic surgery also has implications for the patient’s mental health, with several studies implicating higher suicide rates in women with breast implants. Patients who seek out cosmetic surgery are more likely to have body dysmorphic disorder (BDD), with 1% of the general population having BDD compared to 7-15% in those that pursue cosmetic surgery. BDD is also associated with other psychiatric disorders such as clinical depression, social anxiety, and obsessive-compulsive disorder as well as personality disorders including borderline, avoidant, paranoid, and schizotypal. However, some studies suggest that minimally invasive aesthetic procedures with injectables can significantly improve psychological and social functioning of patients, decrease appearance-related distress, and increase quality of life.
Plastic surgery and COVID-19
There are also physical difficulties associated with plastic surgeries, such as with dermal fillers; COVID-19 can cause a delayed inflammatory response to hyaluronic acid that should be treated with corticosteroid, hyaluronidase, and/or antibiotics. This means that painful nodules, swelling, thickening of the skin, and discolouration can occur. The exact interactions between COVID-19 and hyaluronic acid are at this time unknown, as well as the process of delayed inflammatory response itself. The long-lasting effects of COVID-19 and dermal fillers are currently not fully understood and require further research. Reported side effects associated with dermal fillers include pain, redness, swelling, papulopustular lesions (rash with pimples and pustules), bruising, bumps, discolouration, vascular complication, necrosis, blindness, and stroke.
Choosing a plastic surgeon
Currently, the most popular influence in a selecting a surgeon is social media, but only 6% of social media plastic surgery posts were made by board-certified plastic surgeons. When asked, 96% of participants were unaware of the types of certifications needed for plastic surgeons to perform legally. If you are considering plastic surgery (both surgical and nonsurgical), it is important to check the General Medical Council online register whilst researching an appropriate plastic surgeon.
Conclusion
Humans have had an interest in plastic surgery since approximately 800 BCE, but we have learned so much since then about how our bodies function, and the integration of the body and the mind. Many factors should be considered before plastic surgery – helpful guidelines can be found on the British Association of Aesthetic Plastic Surgeons, as well as information on the benefits and risks of each procedure available.