Do clinical variables predict poor post-operative satisfaction in patients who demand cosmetic surgery?

Objectives: Although most patients are satisfied with cosmetic surgery and experience a positive psychosocial outcome, evidence suggests that some - known as “insatiable patients” or “polysurgical addicts” - are chronically dissatisfied despite technically satisfactory surgical results, leading to problems for both patients (i.e. social isolation, depressed mood, adjustment problems, familial dysfunction, self-destructive behaviors) and surgeons (harassment by patients for further surgical procedures, complaints and legal action). Body image disturbances and personality disorders were shown to be associated with patient’s dissatisfaction. However, as argued by Honigman et al. (2004), these conclusions are mostly based on clinical impressions, and no study so far has analyzed the predictors of poor satisfaction. Thus, this study is aimed at filling this gap and at assessing the impact of the following clinical variables on patient’s post-operative dissatisfaction: number of pathological personality traits; covert narcissism; severity of body uneasiness; worries about particular body parts and intensity of these concerns; psychological well-being. Methods: Seventy-seven patients (91% F), aged 18–57 (Mage = 32.68) scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals completed four self-report questionnaires before surgery and a measure of patient satisfaction 13 months after surgery. Results: Among all the variables considered, the number of pathological personality traits (cluster B’s in particular), the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ dissatisfaction. Conclusion: Our data suggest that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction.