Q&A with Jackson Hill

Registered Psychologist specialising in pre-cosmetic surgery mental health screenings.

Why is a psychological assessment recommended before undergoing cosmetic surgery?

A pre-surgical psychological assessment serves multiple important functions. It ensures that individuals are making informed decisions based on realistic expectations and sound mental health.

Research shows that patients with clear, internally motivated reasons for surgery—such as enhancing confidence or body congruence—report significantly higher satisfaction post-operatively (Von Soest et al., 2012).

Conversely, those seeking external validation or undergoing surgery during periods of psychological instability are at higher risk for poor psychological outcomes.

What kinds of psychological factors are assessed during the pre-surgery evaluation?

We look at a range of domains, including self-esteem, body image satisfaction, coping strategies, mood (depression, anxiety), and history of trauma or significant life stressors.

We also explore motivations for surgery and assess for conditions like Body Dysmorphic Disorder (BDD), which can complicate post-surgical satisfaction (Sarwer et al., 1998).

The aim is not to “deny” surgery, but to ensure the best possible outcome, emotionally and physically.

How do self-esteem and body image influence surgical outcomes?

They’re strongly linked. Individuals with stable self-esteem and a generally positive body image tend to use surgery as a complement to their identity, not a fix-all. They’re more likely to report improved confidence and life satisfaction afterward.

However, individuals with chronic dissatisfaction or global low self-worth may struggle to adjust even after an objectively successful procedure (Cash & Pruzinsky, 2002). Surgery can't heal internal emotional wounds, it can only refine the external.

How important is understanding someone’s ‘ideal self’ when considering cosmetic surgery?

Understanding a patient’s ‘ideal self’ helps us assess alignment between personal identity and desired change.

If the surgery is intended to bring someone closer to their authentic self, outcomes tend to be more fulfilling. However, if the ideal self is shaped primarily by societal or partner expectations, or is highly perfectionistic, there's a risk of chronic dissatisfaction even post-procedure (Tignol et al., 2007).

What are the psychological risks of undergoing cosmetic surgery without assessment?

Without assessment, patients with untreated psychological vulnerabilities, such as depression, anxiety, or BDD, may struggle with post-operative adjustment. They may experience ongoing dissatisfaction, regret, or social withdrawal.

Studies show that individuals with underlying psychiatric conditions have poorer satisfaction rates and are more likely to seek repeat or revision surgeries (Veale et al., 2016).

Psychological screening mitigates these risks by identifying areas that might benefit from therapeutic support pre-surgery.

Is it normal to have emotional fluctuations after surgery, even if the result is what I wanted?

Absolutely.

Post-operative emotional responses vary widely. While many patients experience relief and increased confidence, others may feel vulnerable, regretful, or unexpectedly emotional during the healing process.

These responses often subside with time, but understanding them beforehand helps normalise the experience and reduce distress.

Studies also indicate that psychological preparation helps individuals adjust more smoothly, post-surgery (Honigman et al., 2004).

What happens if concerns come up during the assessment—could that delay my surgery?

If concerns arise, such as signs of significant distress, unrealistic expectations, or poor social support, it doesn’t necessarily mean surgery won’t happen. Rather, it’s a signal that supportive steps, such as therapy or clarifying expectations, might enhance your readiness.

Many surgeons actually appreciate patients taking these steps first, as it improves both patient and surgical outcomes (Sarwer & Crerand, 2004).

How does psychological readiness improve post-surgery satisfaction and well-being?

Psychological readiness—marked by clear motivations, emotional stability, and realistic expectations—is the best predictor of post-operative satisfaction.

Patients who are well-prepared mentally often report improved body image, confidence, and overall quality of life (Pikoos et al., 2021).

Psychological assessments are not gatekeeping tools, but a part of holistic patient care designed to support long-term satisfaction and well-being.