Pros and Cons of Increased Psychological Prescreening for Plastic Surgery


With the skyrocketing demand for cosmetic procedures, are plastic surgeons doing enough to prescreen clients?

Plastic surgery is more popular than ever. Elective cosmetic procedures are on the rise across the board, with both male and female patients undergoing various enhancements, including but definitely not limited to breast augmentation and rhinoplasty. This increase in popularity can be attributed to advancements in medical techniques, coupled with less invasive procedures and more affordable options.

But with this skyrocketing demand, are plastic surgeons doing enough to prescreen clients prior to procedures? This question is currently being raised in the United Kingdom with the introduction of a new psychological screening process for plastic surgery patients, which is still in its early stages.

There are various pros and cons associated with a heightened prescreening process. Some of the positive aspects include answers to the following questions from patients:

Why Plastic Surgery?

Patients have diverse reasons for desiring a plastic surgery procedure. While wanting to correct an embarrassing flaw or to boost self-esteem and confidence are great reasons to undergo a cosmetic enhancement, a patient may have many other motives, such as body dysmorphic disorder (BDD) that can result in obsession over a certain body flaw. Prescreening can help identify BDD and other psychological issues, and ultimately direct a person to a more appropriate course of action.

Are My Expectations Realistic?

By increasing psychological screenings, surgeons can ensure the patient fully understands the procedure and realistic results to expect. While plastic surgery can make great changes to a person’s body, we are not miracle workers and there is only so much a procedure can do.

Am I Ready to Make a Change?

While most patients understand that plastic surgery will change their appearance, sometimes this change can be jarring for those who are not properly prepared for it. Psychological prescreening can help identify potential issues early on so that they can be discussed. Preparation is the key to ensuring patients are truly happy with the results.

While those are all great reasons to consider increasing the psychological prescreening requirements for plastic surgery patients, there are several detrimental reasons to avoid it. Some of those negative aspects include:

More Hoops to Jump Through

For patients who are thoroughly prepared for a cosmetic procedure, additional psychological prescreening is another thing standing between them and their results. In many cases, patients have extensively thought about their procedure prior to acting on it, so added screenings are more roadblocks preventing them from reaching their aesthetic goals.

We’re All Adults Here

As adults, we take personal responsibility for our bodies and actions. The same holds true for plastic surgery. Some believe it is the patient’s responsibility to ask questions, do research, and generally prepare for the procedure, and many feel if the doctor and the patient both agree on a plan of action, then that should be enough.

Screening Is a Turnoff

Those who are against an additional screening requirement often feel it is a turnoff for clients. After patients have openly and honestly consulted with a trusted plastic surgeon and prepared to move ahead, probing into their reasons for moving forward can feel redundant.


Right now, the UK is testing a new prescreening process to determine how effective it is and how clients respond to it. If the UK deems it successful, then it is reasonable to believe some variation will eventually find its way to the US. How would you feel about additional psychological screenings prior to moving ahead with a cosmetic procedure?

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at

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