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Cosmetic Surgery Addiction

​The tabloids are full of stories about celebrities and their ever-changing surgically altered bodies. Some may do it in an attempt to lengthen their careers by decreasing the signs of ageing, or to make themselves more bookable through their looks, but it is always something that the media likes to use to fill the pages of their glossy magazines.

​In recent years, the desire for cosmetic surgery has spread beyond the Hollywood bubble to become cheaper and more accessible to the general public, allowing everyday people to alter their looks and get closer to their ideal self. For many people, these will be small alterations that they will go through only once to improve how they feel about themselves. For some others, however, it is a constant process of adjusting and re-adjusting their bodies through surgical procedures due to perceived imperfections. 
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When this happens it may be that these individuals have developed a cosmetic surgery addiction.

Cosmetic surgery addiction, sometimes also known as plastic surgery addiction, is thought to be caused by a disorder called body dysmorphia. In Body Dysmorphic Disorder (BDD), the individual suffers from extreme anxiety based on the way they look and so the way they perceive themselves will be a distorted version of reality. Their cosmetic surgery addiction may start after they choose to “correct” an imagined fault in their appearance, such as getting lip fillers for what they see as a mouth that isn't full enough, but then their focus will shift onto a new problem shortly afterwards. Body Dysmorphic Disorder goes beyond simple dissatisfaction with looks and can severely impact the everyday life of the sufferer. This can then be compounded by the risks and expense associated with a cosmetic surgery addiction, which will not alleviate the anxiety of BDD.
​Prevalence

Around 28, 341 cosmetic surgeries were carried out in 2016. For women, who are the most likely to get these invasive procedures, breast augmentations were the most popular choice at 7732 surgeries. Over a fifth of male cosmetic surgery patients, meanwhile, showed a strong preference for nose altering rhinoplasties. The number of surgical cosmetic procedures being carried out in the UK did fall in 2016 by almost 40% but this is thought to be down to the current economy and the rise in popularity of non-surgical procedures, like chemical peels.

Body Dysmorphic Disorder is thought to affect approximately 1 in 100 people around the UK. The disorder is known to affect men and women equally and, while it impacts people of all ages, BDD normally starts in the teenage years or young adulthood. Not everyone with Body Dysmorphic Disorder will develop a cosmetic surgery addiction and there have yet to be any official statistics about how prevalent cosmetic surgery addiction is in the UK.

​Research by the University Hospitals Leuven in Belgium examined the relationship between patients who had received a rhinoplasty and Body Dysmorphic Disorder, distributing 266 questionnaires and surveys across sixteen months. They found that a third of the patients displayed moderate or severe signs of BDD, and this leapt to 43% when focusing on patients who were choosing to surgically alter their nose for purely aesthetic reasons. It was also found that 20% of participants had undergone a previous rhinoplasty. While some of these could have been down to unsuccessful surgeries prior to the study, the data does indicate that a significant number of cosmetic surgery patients are likely to go on to more procedures and perhaps is indicative of the addictive nature of plastic surgery.
​Dangers and Risks
  • Health:
Any form of surgery, cosmetic or otherwise, carries with it significant risks and these dangers will vary according to the particular procedure involved. Anaesthetic complications can range from general confusion upon waking to cardiac arrests and death. Blood loss, both during and after the operation, is another potentially deadly risk factor. Additionally, procedures like liposuction can cause serious damage to the internal organs because of the motions and tools involved. Tears and perforations because of liposuction can result in further surgery to repair the damage or may also have deadly consequences.

On a more aesthetic level, bruising and nerve damage are common issues with cosmetic surgery addiction, particularly following breast augmentations - around 15% of breast augmentations result in permanent loss of sensation in the nipples. While some scarring is to be expected, around 5% of breast augmentations result in thick raised scars known as Hypertrophic Scarring. And, of course, a small percentage of cosmetic surgeries do not result in the envisioned outcome and may result in asymmetry, contouring, or other issues. With many cosmetic surgery addicts thought to be suffering from Body Dysmorphic Disorder, these unwanted blemishes can cause further negativity in their relationship with their body.

For a cosmetic surgery addict, the health risks associated with surgical operations can be compounded by the fact that they may choose to squeeze multiple different procedures into short periods of time. Longer times spent under general anaesthesia increases the dangers associated with the drugs involved, increasing the expected recovery time and heightening the risk of heart attack or breathing problems. Some cosmetic procedures, when combined, are more dangerous and should only be undertaken after a thorough consultation with a medical professional.

Fulfilling the compulsion to surgically correct perceived faults does not help a cosmetic surgery addict with Body Dysmorphic Disorder as they will still see themselves in a distorted way. The anxiety associated with the disorder can result in depression and low moods, with the risk of suicidal ideation or behaviours. There is also a risk of eating disorders, like anorexia nervosa or bulimia, as the need for physical perfection becomes internalised.
  • Social:
The social issues of a cosmetic surgery addiction are variable according to the procedures involved but generally, as with any addiction, the time devoted to this kind of dependency can cause significant issues when it comes to work commitments, relationships, and friendships. The need to save up money may restrict a cosmetic surgery addict from social events and the recovery necessary for some procedures may result in absence from work.

In addition to the time constraints placed on the individual due to their cosmetic surgery addiction, there may also be social impacts due to the resulting look of their augmentations. While the person themselves may have a specific vision of how they should look, to the rest of society extensive surgery can very quickly begin to look bizarre. Any cosmetic procedure taken to the extreme can look noticeably fake and result in judgement from strangers, restricting the cosmetic surgery addict's potential for employment and their ability to build new relationships.
  • Criminal:
Cosmetic surgery addiction is not typically associated with crimes at the hands of the addict themselves but they are at risk of criminal acts. To fulfill the needs of their addiction, a dependent individual may visit less reputable doctors to get the treatments they want done as soon as they want. These professionals may be operating without a license, putting the patients financial and physical welfare on the line.

As with any dependency, the cost associated with a cosmetic surgery addiction can make the individual feel desperate for money and they may turn to less legal means to finance their body alterations. Theft from loved ones and fraud have both been reported in relation to this type of addiction. In 2014, a woman was convicted after spending more than £25, 000 on plastic surgery that was funded by selling counterfeit goods. Her addiction had begun at age six, with her ears being pinned back, and then had spiraled from that point.
Financial Costs

The cost of cosmetic surgery varies widely dependent on what is being altered and where the treatment is taking place. For example, the NHS suggests that liposuction can range from £2000 to £6000 in the UK, while a breast augmentation is upwards of £6500. To get similar treatments abroad can cost as little as £750 and £2500 respectively, though there are obviously greater risks associated with stepping out of the UK for treatment. One or two treatments are pricey enough, but a cosmetic surgery addict will feel compelled to keep having more treatments and the price will keep growing.

Details of how cosmetic surgery addiction impacts society are limited as many will be forced to go private to fund their need for body modification. With time spent off work and one individual reportedly getting a £50, 000 new nose after a failed cosmetic procedure, however, it can be assumed that the overall cost is substantial.
​Signs of Addiction

A cosmetic surgery addiction will be most noticeable due to the constant obsession the individual has around modifying their body through surgery. They may point out perceived flaws with some regularity, discussing what they would change without providing an understandable or rational reason for the treatment. Many cosmetic surgery addicts will have a particular focus to their obsession, whether this be aspects of their face or another body part that they are unhappy with, and may spend many hours in front of the mirror worrying about the perceived flaws they find there.

In addition to these signs, a cosmetic surgery addict will also be likely to display signs of Body Dysmorphic Disorder. This can include behaviours like constant comparison, obsessing over the differences between their bodies and what they see as the ideal, and they may be anxious around other people because of their relationship with their body. Some individuals with this disorder can be very secretive about the way they see their body, fearing that others will consider them vain, and they are also at risk of developing extreme behaviours when it comes to eating and exercising in an attempt to control the way they look.
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Treatment Options

More plastic surgery in an attempt to reach “perfection” will not help a cosmetic surgery addict recover from their obsessive need to fix the perceived faults within their body because each new augmentation will cause them to notice another aspect of themselves that could potentially be corrected. Instead the focus must be on the mental health aspect of cosmetic surgery addiction and Body Dysmorphic Disorder, as this will help the individual get to the root of their self-perception and begin making changes to improve their relationship with their body.

Cognitive Behavioural Therapy, or CBT, is one of the first choices when it comes to treating cosmetic surgery addiction. 
​This type of therapy aims to help the individual manage their addiction and self-perception issues by changing the way they think. Commonly this type of treatment will encourage exposure to situations where the patient would normally begin to obsess over the way they look and help them build better responses over time. There are CBT resources available on the internet but a CBT professional may help to give a more personalised treatment to help a cosmetic surgery addict come to terms with their problem.

For individuals whose body dysmorphia impacts their everyday life more strongly, anti-depressants known as SSRIs (or Selective Serotonin Reuptake Inhibitors) may be prescribed to help them escape their cosmetic surgery addiction. SSRIs, like the commonly prescribed fluoxetine, work by altering the way certain messages are sent in the brain to alleviate the symptoms of depression and this can be of great help to cosmetic surgery addicts with BDD.

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