The psychosocial outcomes following cosmetic surgery are largely unknown: A systematic review

Introduction: Cosmetic surgery is marketed and widely considered to exert positive psychosocial outcomes, particularly in relation to body image, self-esteem, and mental health. The present systematic review aimed to conduct a timely, up-to-date assessment of the existing academic empirical literature, applying stringent inclusion criteria to summarize only the highest quality of evidence in the field. Methods: The following databases were systematically searched: EBSCO, Cochrane Library, Scopus, and ProQuest. Screening was completed by two independent reviewers. Prospective studies that utilized a control cohort to examine at least one psychosocial outcome using a validated measure after cosmetic surgery were included. Risk was double assessed using the Effective Public Health Practice Project Quality Assessment Tool. Results: Seventeen studies met the inclusion criteria. There was considerable heterogeneity across research designs, control groups, measures, and statistical analyses. Overall, the quality of studies was poor. Results suggest short-term improvements in some psychosocial outcomes after cosmetic surgery (particularly in relation to body-area-specific satisfaction, self-esteem, sexual well-being and physical well-being), with limited and inconclusive evidence for outcomes such as mental health, holistic body image, quality of life and social functioning. Very few studies have explored psychosocial outcomes beyond 6-months after the surgery. Conclusion: Current evidence regarding psychosocial outcomes following cosmetic surgery is weak. There is an urgent need to conduct high-quality research that will require collaboration among surgeons, research psychologists, and methodologists. Recommendations include pre registration, larger sample sizes, longer follow-up duration, and appropriate control group recruitment. Considering the increasing popularity of cosmetic surgery globally, this field of research should assume priority. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).