Psychology of plastic and reconstructive surgery: a systematic clinical review.
BACKGROUND
The authors sought to review the various types of patients with psychological abnormalities who may present to the plastic surgeon and the psychological impact of various plastic surgery procedures on these patients.


METHODS
After systematically searching the Embase and PubMed databases and following further refinement (based on the authors' inclusion and exclusion criteria), the authors identified 65 studies. In addition, the authors felt that important information was contained in four textbooks, two press releases, and one Internet database. The inclusion criteria were studies that investigated the psychological outcomes, background, and personality types of patients seeking specific plastic surgery procedures. In addition, studies that addressed the impact of plastic surgery on patients' psychological status and quality of life were also included. The authors excluded studies with fewer than 30 patients, studies that did not pertain to the particular plastic surgery procedures, and studies that addressed psychological sequelae of revision operations.


RESULTS
Narcissistic and histrionic personality disorders and body dysmorphic disorder are the three most common psychiatric conditions encountered in patients seeking cosmetic surgery. Overall, plastic surgery not only restores the appearance and function of the disfigured body unit but also alleviates psychological distress.


CONCLUSIONS
Identifying the psychologically challenging patient before surgical intervention will allow the patient to obtain the appropriate psychological assistance and may result in a healthier individual with or without associated plastic surgery procedures.
Baltimore, Md. From the Division of Plastic, Reconstructive, Maxillofacial, and Aesthetic Surgery, Department of Surgery, The Johns Hopkins University School of Medicine.
Sachin M
SM
Shridharani
Michael
M
Magarakis
Paul N
PN
Manson
Eduardo D
ED
Rodriguez
D000223:Adaptation, Psychological; D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000523:psychology*; D001828:Body Image; D006677:Histrionic Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D010348:Patient Care Team; D017060:Patient Satisfaction; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D019651:Plastic Surgery Procedures / Q000523:psychology*