The study, which is to be presented today at an American plastic surgery conference, reveals that half of those seeking "nose jobs" suffer from clinical depression and nearly a third have attempted suicide. Its author, Dr Henri Gaboriau, of the Department of Otolaryngology, Head and Neck Surgery, at Tulane University, in New Orleans, said that the study was intended to help doctors decide in which cases plastic surgery was appropriate.
"The study attempts to describe the personality disorders of patients seeking facial plastic surgery to allow the specialist to make an informed decision to treat, or not to treat," he said. "Some of these patients may benefit from having surgery but the majority may not need cosmetic surgery to address their problems."
The findings showed that there was a high level of conflict between surgeons and patients suffering personality disorders after surgery and these patients were more likely to seek legal redress.
British cosmetic surgeons said that the findings were alarming and warned surgeons to investigate patients' motivations for having surgery before they operated.
"Our surgeons are always on the lookout for patients with a personality disorder or for patients who have got expectations that are far too high or cannot be corrected by surgery," said Peter Coles, the director of the Harley Medical Group, one of the largest private cosmetic and plastic surgery providers in Britain. "Surgeons see a lot of patients and can sense if they are unbalanced. Most of our patients are well-adjusted people and have just one small problem, such as their nose or ears, which they want to correct."
The American researchers reviewed a wide range of studies of patients who had undergone plastic surgery. They found that over two thirds of all cosmetic surgery was carried out on the face or neck and that nearly a third of these operations were on the nose.
Assessments of the patients prior to their operations showed that 50 per cent were clinically depressed, 70 per cent suffered from anxiety, 20 per cent had problems with substance abuse, and nearly 30 per cent had attempted suicide.
Further analysis of 133 patients revealed that two-thirds suffered from personality disorders. A quarter were categorised as narcissism and, one in twenty as having an obsessive-compulsive disorder. One in 40 showed schizophrenic or paranoid tendencies.
"`A person's self-image plays a key role in the development of personality. Young men and women with a subjective negative impression of their self image develop defence mechanisms to cope with low esteem", said Dr Gaboriau. "Later in life, they may request cosmetic surgery to "normalise" a perceived abnormal appearance but cosmetic surgery may not be the answer," he said.