Reviewed by Norman Levine, MD, September 14, 2007.

Most people seek cosmetic surgery to feel better about themselves. Does it work? Studies suggest that patients are generally pleased with the outcome of their cosmetic surgery and report improvement in self-esteem, social confidence, and quality of life.

However, cosmetic surgery may not be appropriate for every person or every problem. If you are considering cosmetic surgery, take some time to contemplate these questions:

1. Why am I considering cosmetic surgery?
The healthiest reason to have cosmetic surgery is to improve your self-image -- the way that you feel about yourself. People who have a strong self-image are usually more confident, effective in work and social situations, and comfortable with their relationships. Cosmetic surgery is often thought of as psychological surgery. Its purpose is to enhance your feeling of well-being and to foster emotional health.

2. Am I having cosmetic surgery to please others or myself?
Make sure that you are considering cosmetic surgery for internal reasons having to do with yourself, and not external reasons. Cosmetic surgery cannot stop your boyfriend from leaving you. It cannot bring you new friends. It cannot get you a better job. You'll likely be disappointed in the results if you are having cosmetic surgery to please someone else.

3. Are my expectations realistic?
Having realistic expectations may be the single most important factor in achieving a successful result. Cosmetic surgery can dramatically improve your appearance, but it has its limitations. It is unwise to expect that cosmetic surgery can create the face of a celebrity (with the hope of acquiring a celebrity lifestyle) or restore the lost youth of decades past.

4. Am I emotionally prepared for cosmetic surgery?
There are certain circumstances under which cosmetic surgery may be inappropriate. These include a crisis or an emotional upheaval such as divorce, death of a spouse or loss of a job. Also, surgeons are reluctant to consider cosmetic surgery on patients who are depressed, have significant mental illness, are impossible to please or are obsessed with perfection.

5. Is now the best time for cosmetic surgery?
Even if you are emotionally prepared for cosmetic surgery, you may want to delay surgery if you are under external pressure or preoccupied with other matters. Plan your surgery when you are relaxed and can afford the time to convalesce and heal afterwards. Otherwise, you may face longer and more difficult recovery periods.

6. How will I adjust to the change in my body image?
It may take some time for you to adjust to your new body image. This is especially true for procedures that create a major change to your face, such as nose surgery (rhinoplasty). Procedures such as Botox injections, which merely create a younger looking you, are easier to accept.

7. Am I prepared to handle unexpected results?
Cosmetic surgeons, like all surgeons, cannot offer you guaranteed results. Unexpected results occur rarely, but when they do occur they create emotional distress for both the patient and the surgeon. You must be prepared for the worst case scenario and realize that it will require time, patience and a mutual trust between you and your surgeon to work toward improvement.

8. Do I have a support network?
It's important to have someone to support you physically and emotionally during your recovery. Realize that you may have days when you feel depressed as you go through the healing period. Beware of negative comments from friends or family members who may have issues with your decision to change your appearance. Graciously decline offers of help from those who may be critical of your decision.

9. Have I considered and accepted the risks?
There is risk involved with any surgery. In addition to the general risks related to anesthesia, blood loss, and infection, specific risks for cosmetic surgery include skin loss, asymmetry, slow healing, numbness and minor dimples and puckers. You must consider and accept all of the risks for each procedure before making your decision to have cosmetic surgery.

10. Can I afford cosmetic surgery?
Cosmetic surgery is usually not covered by health insurance. You are choosing to accept the costs in exchange for surgery that will help you feel better about yourself. If you can't afford the cost, the added financial stress could actually make you feel worse about yourself.

SOURCES: Michael Powell, MD, a specialist in otolaryngology and facial plastic surgery in Athens, Georgia. Aesthetic Facial Plastic Surgery 2000, Thieme Medical Publishers, Thomas Romo III, Arthur Millman. Measuring Outcomes in Aesthetic Surgery: A Comprehensive Review of the Literature. Plastic and Reconstructive Surgery, 111(1): 469-480, Jan 2003, Ching,Shim MD; Thoma, Achilleas MD; McCabe, Randi; E PhD; Antony, Martin M. PhD.

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