Aesthetic Surgery and Psychosexual Issues

Abstract

Rebecca Cogwell Anderson, PhD, is a clinical psychologist in the Department of Plastic and Reconstructive Surgery at the Medical College of Wisconsin in Milwaukee. Over the years, mental health professionals and aesthetic surgeons have studied the motivation of individuals seeking aesthetic surgery. Recently, psychosocial and ethical issues have received increased attention. Frequently reported motivations for aesthetic surgery include the desire to look more attractive, to increase self-confidence, to appear more youthful, and to enhance or improve one's body image. Generally, a good candidate for aesthetic plastic surgery is free of emotional distress, has reasonable expectations, and is seeking a change for himself/herself rather than because of external pressures. This article addresses procedures that may hold sexual significance for patients: reduction mammaplasty, augmentation mammaplasty, and rhinoplasty. Historically, the literature suggests that both augmentation mammaplasty and reduction mammaplasty patients are generally quite pleased with their surgical outcomes; however, their motivations differ. The reduction mammaplasty patient frequently reports having been self-conscious regarding her large breasts since adolescence. She is often plagued with shoulder, back, and neck pain. She frequently reports that external responses to the size of her breasts create sexual difficulty for her. Barring complications, these patients frequently experience a positive surgical and psychologic result and report greater comfort with their body and sexuality. Potentially difficult psychologic adjustment after reduction includes the loss of the nipple. Some women may cope reasonably well with this loss if they do not link their nipple to their sense of femininity or sensuality. However, for many women the loss of …