The emotional side of plastic surgery

You're likely to be surprised by many complex emotions after plastic surgery. That's because, even when the change is positive, it can be difficult to process while you heal and wait for your final results. It's essential to prepare yourself for the feelings your operation could stir up and to know that they're normal.

We spoke with ASPS Member Surgeons Nia Banks, MD, and Praful Ramineni, MD, for their take on the emotional journey you might make during recovery and beyond.

You might have an identity change

"If you have a surgical process, it's quite sudden," said Dr. Banks. "You went to sleep one way and woke up another way. That is a real identity change."

Our identities are often tied to our appearance, and Dr. Banks said this is especially true if you're a woman who's lost lots of weight with GLP-1 medications, a gastric bypass or by other means.

"When you have gone through massive weight loss, your identity for a very long time was probably as someone in a larger body," said Dr. Banks.

You might feel complex postoperative emotions after you lose weight and undergo body contouring surgery to remove the excess skin.

"And now, when you present yourself to the world as a person of a more common size and not in the large body, that's different," said Dr. Banks. "And that can be scary for some people."

Banks warns her patients before body contouring surgery that they are going to experience something similar to a "second puberty," which might be emotional for them and their partners, too.

"You've gone from a body that might not have been considered traditionally attractive to one that is, and that brings attention that you may not have gotten in quite a long time," said Dr. Banks. "That can be a lot for the spouse to deal with."

You might need time to adjust mentally

It's not just massive weight loss patients and their partners who might undergo an emotional journey after plastic surgery. Any time you change your outward appearance through surgery, there is a chance that you'll need time to get used to your new look.

"There are patients where it takes months for their mind to adjust to the new reality of their anatomy change because they've seen something in one way for so long," said Dr. Ramineni.

He offered the example of women who undergo mastectomy.

"When we take off their vest in the office, the first time they see their chest from having breasts to having nothing, you get a mixed reaction," said Dr. Ramineni. "For some patients, it's almost like their brains can't calculate and they get a little lightheaded."

He said reactions to physical changes from plastic surgery are varied and "very patient-dependent."

Adjusting to the new reality of how your face or body looks doesn't always happen immediately. You might experience a period where you're getting used to your new look. It can happen even after a positive change that you want, like liposuction, rhinoplasty or a breast lift. On the other hand, you could be among the patients who seem to embrace their new physical reality instantly.

"We do vaginoplasty," said Dr. Ramineni. "The patients have a penis, and then, literally, it's gone the next day, and so a lot of those patients get a post-procedural euphoria with it where they're excited because they feel like that's the body they're meant to be in."

You might find waiting difficult

Everyone wants to look good after their procedure, but this isn't always immediately possible because surgery requires recovery. Sometimes you look worse before you look better. For example, if you've had a procedure like a facelift, you'll look swollen and bruised, with visible scars around your ears and hairline for some time.

You might experience negative emotions around the disappointment of having to wait out the healing process and not seeing positive results right after your operation. Dr. Ramineni said plastic surgeons must let patients know this so they can prepare themselves emotionally.

"It's about managing what the patient thinks is going to happen because there are some patients that think they're going to have surgery, and then they're going to look totally fine the next day," said Dr. Ramineni.

The reality is that after an operation, you're likely to look worse before you look better. Since it takes a while to heal before you see your final result, staying at home to recover from plastic surgery and waiting days, weeks or sometimes months for the final result is an emotional challenge when you're looking forward to that "after" picture you have in mind.

Recovering from plastic surgery isn't just about physical healing – it's an emotional process, too. Whether you're adjusting to a new identity, waiting for swelling to go down or wrapping your head around a significant change, it's completely normal to have mixed feelings.

The key is to be patient with yourself. Give your mind time to catch up with your body, and don't be afraid to lean on your support network if needed. Plastic surgery is a journey, not just a before and after moment, and just as the physical aspect is important, so is the emotional side.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.