Introduction

Reconstructive surgery to normalize congenital abnormalities or repair injuries following trauma has a long and venerable history (Harris, 1997), however, until relatively recently, elective plastic surgery for cosmetic purposes was often sought covertly (Macgregor, 1979) and was considered an option accessible only to the wealthy. Currently, cosmetic surgery is considered a boom industry, and is increasingly accepted as an additional tool in the armoury of beauty enhancement techniques in Western societies. In the USA, the rates for procedures such as breast augmentation and rhinoplasties have increased by 700% in the past decade (Sarwer, 2002) and figures for the UK also show a dramatic increase in uptake. The increased popularity is fuelled by greater levels of disposable income amongst segments of the population, ever increasing media coverage of appearance-enhancing techniques and advertisers promoting myths and dreams associated with beauty.

The jury is still out in relation to whether people derive significant long-term psychological benefits from cosmetic surgery (Sarwer & Crerand, 2004). Most seek surgery as a solution to social and psychological problems. In addition, it is widely accepted that psychological factors play a significant role in every stage of treatment, including the decision to seek surgery, coping in the postoperative phase and in longer-term adjustment to changes in appearance (Pruzinsky, 2004), yet the input of psychologists into preoperative assessment and postoperative support is very much the exception rather than the rule.