Aussies are getting more and more work done, with lip fillers and Botox booming in popualtrity. But there’s a big danger behind the trend.

Published on The Advertiser 11th Feb 2021

A clinical psychologist has warned cosmetic procedures are now so normalised that many feel pressured to have enhancements they might not want or need.

Dr Ben Buchanan, a specialist in body dysmorphia, told expectations relating to cosmetic enhancements have changed dramatically in recent years.

“There’s a shifting line over the decades — as things become available, they become normalised,” Dr Buchanan said.

And certain Australians run the risk of falling into a vicious cycle of getting more and more work done, and never being satisfied with the results.

“There’s now a pressure on everyone to be consuming these services,” he said.

Australia’s spending on cosmetic procedures topped $1 billion in 2020 for the first time, according to figures from the Cosmetic Physicians College of Australasia (CPCA).

Spending on dermal filler injections increased by 25 per cent in the last year, and anti wrinkle injections also jumped 14 per cent over the same period.

Cosmetic procedures have been normalised in a similar way to getting braces, Dr Buchanan, who runs a body image clinic at Foundation Psychology Melbourne, said.

Once upon a time, orthodontics were almost purely cosmetic in nature.

“It’s become so accepted over the decades that if you weren’t to get braces people would think something was wrong,” he said.

“(Now) there’s minor procedures like skin peels or Botox, and then there’s major procedures like rhinoplasty and liposuction,.”

Dr Buchanan said cosmetic surgery offers a benefit to many and “actually does improve many people’s happiness and self esteem”.

But people with body dysmorphia disorder (BDD) are likely to be “very dissatisfied” after procedures, pulling them down a rabbit hole of seeking out more surgeries.

“Cosmetic procedures can be a reasonable thing for most people to do, unfortunately it’s very risky for someone with body dysmorphia disorder, to the extent where they think their surgery made them look worse or even that their surgeon did a botched job.”

The disorder can explain why some people having surgeries cannot stop at a single procedure.

Dr Buchanan said people with BDD have an “exceptionally detailed visual perception compared to most people” and are far more likely to see so-called flaws that others don’t see.

These heightened perceptions are coupled with overvaluing “how much appearance matters”.

“People with BDD often think if only they looked better they’d be in a better job, they’d have a better relationship, they’d be richer, that everything would fall into line.

“There’s this false idea that looking good leads to a good life.”

Those with BDD can be preoccupied thinking about their appearance “every moment of the day”.

“It’s really painful (for them). Often we think, they’re just vain, they should get over it.

“But it’s also not their fault. Studies show it’s about 50 per cent genetics that determine whether someone’s got it.”

Dr Buchanan said the illness has high comorbidity with depression and obsessive-compulsive disorder.

It’s also possible a recent “normalisation” of cosmetic procedures could be worsening BDD.

For those who don’t suffer BDD, it’s likely having cosmetic procedures will “increase their happiness”, he said.

But 84 per cent of cosmetic surgery patients who have BDD will be disappointed with the results.

Dr Buchanan said patients who get a procedure and are unhappy with the results should consider seeking out a psychologist who specialises in body dissatisfaction.

“It’s tempting to someone dissatisfied with a procedure to get another (cosmetic) procedure to fix it.

“But it can take people down a path they don’t want to go down.

“Seeing a psychologist to deal with the real distress caused by body dissatisfaction can be a good start.”