Plastic Surgery and Self-Esteem: Beauty≠Confidence

This article is an excerpt from the Shortform book guide to "Psycho-Cybernetics" by Maxwell Maltz. Shortform has the world's best summaries and analyses of books you should be reading.

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Does plastic surgery improve self-esteem? Do people who undergo plastic surgery for aesthetic improvement see their self-esteem rise?

Not everyone sees their self-esteem rise after undergoing plastic surgery. According to plastic surgeon Maxwell Maltz, looks are only a small part of how you see yourself.

In this article, we’ll explore the link between plastic surgery and self-esteem, according to Maxwell Maltz.

Does Plastic Surgery Improve Self-Esteem?

Throughout his time working as a plastic surgeon, Maxwell Maltz realized that there was a discrepancy between how different patients responded to the correction of “physical flaws.” After surgery, some of his patients would display an immediate rise in self-esteem and self-confidence—he noticed that these patients were more comfortable with themselves and approached their goals more proactively than they did pre-surgery. This initially led Maltz to believe that transforming his patients’ physical appearance would lead them to think more positively about themselves—this rise in self-confidence would become apparent in their self-expression and personality, and it would have an impact on the level of success that they achieved.

However, this theory didn’t hold up, as he noticed that some patients showed no change in their personalities after surgery—they continued to think, feel, and act exactly as if the “flaw” was still there, and their inner feelings and attitudes remained the same. In other words, their outward appearance changed (sometimes drastically) but they still didn’t feel any happier or see themselves differently, and their level of success didn’t improve.

Through further research into plastic surgery and self-esteem, Maltz discovered that patients who responded positively to surgery (with a rise in self-esteem) correctly identified their flaws as the cause of their low self-esteem. On the other hand, the patients who failed to change often had expectations that were not satisfied by the surgery—they incorrectly identified their flaws as the cause of their low self-esteem and lack of success.

Don’t Rely on Cosmetic Surgery to Improve Your Self-Esteem

Psychological problems related to how people view their bodies are increasingly common. For example, a poll from the Mental Health Foundation revealed that one in eight UK adults are so self-conscious about their body image that they have suicidal thoughts. The charity identified social media’s representation of the “idealized body image” as a cause of this distress.

Consequently, research shows that cosmetic surgery patients are more likely to suffer from “Body Dysmorphic Disorder,” an obsessive-compulsive disorder centered on perceived physical flaws. It’s therefore vital that medical practitioners watch out for patients who rely on cosmetic surgery as a source of their self-esteem, particularly those who view cosmetic surgery as a quick fix to confidence.

Further, these patients are more likely to become addicted to cosmetic surgery—they have one procedure and feel an instant boost of confidence. Eventually, this confidence wears off and they find another “flaw” to fix, so they have another procedure, and so on.

While cosmetic surgery can help to promote a positive self-image, cosmetic surgeons do need to ensure that their patients are emotionally healthy before agreeing to undertake any procedures. Emotional health in this respect means that patients have a balanced opinion about their appearance. They understand that most of what they experience has nothing to do with how they look, and they realize that their lives won’t drastically change after cosmetic surgery.

Your Physical Appearance Doesn’t Define Your Self-Perception

After Maltz discovered that his patients responded differently to having their physical “flaws” corrected, he next realized that two people with the same physical flaw can respond in dramatically different ways to the same feature. One person may feel ashamed of this feature and use it as an excuse to withdraw from life, while the other person may not pay any attention to it and won’t let it affect her confidence (success).

For example, two people have the same physical feature, such as a large nose. The first person pays no attention to her nose, doesn’t think of it as particularly large, and doesn’t let it impact the way she perceives herself—her nose doesn’t impact her approach to life. The second person is obsessed with the size of her nose, feels insecure all of the time, and believes that she’d be happier with a smaller nose—she blames her nose for her inability to approach life confidently.

Why is it that two people can respond so differently to the same flaw? If the first person is able to feel confident with her nose, why is the second person allowing this same feature to make her feel so unconfident? Would surgery help her to feel more confident and successful or is there something else making her feel insecure?

These questions led Maltz to pursue the connection between the mind and the body and its impact on levels of confidence and success. He paid particular attention to the process the human mind goes through to achieve goals, and drew on a wide range of research, including Psychologist Prescott Lecky’s Self-Consistency theory.

(Shortform note: Lecky argued that you don’t simply act in response to the environment. Instead, your actions are motivated by the need to align your behaviors with your beliefs and ideas about yourself—in other words, your behavior always reflects what you believe about yourself.)

Eventually, Maltz concluded that self-perception is far more important to success than physical appearance: Your physical features don’t determine your approach to life and your levels of success and happiness—only your thoughts about yourself impact how you behave and your quality of life. He realized that the key to self-improvement and more success was not simply to change external circumstances, but to remove negative thought patterns that caused patients to view themselves as unsuccessful.

Self-Compassion Leads to Self-Acceptance and Happiness

Louise Hay, the founder of Hay House and bestselling metaphysical author, was a firm believer in the mind-body connection—like Lecky and Maltz, she argued that our beliefs about ourselves impact our ability to succeed and experience happiness.

She took Maltz’s idea about how our thoughts influence our perception of our physical features a little further by claiming that our bodies are a physical representation, or a mirror, of our thoughts and beliefs: The more you love your body, the more beautiful it is. In her book, Love Your Body, she argues that you should love your body regardless of your (perceived) flaws. This act of compassion towards your body will release all negative thought patterns and the psychological illnesses (such as body dysmorphia) that arise from them.

But can you make yourself love something that you believe is a flaw? Hay insists that our physical features are not good or bad—our judgments about our features simply label them as good or bad. This is why two people can perceive the same physical feature in opposite ways. The person who hates her nose has made a habit of choosing to think negative thoughts about her nose. But once she understands that her nose isn’t the real problem, she can work to change her thoughts about her nose.

If this person was to follow Hay’s advice, she would look in the mirror multiple times a day, focus on her nose, and tell it that she loves and accepts it exactly as it is. This process would initially bring up emotional resistance (crying, anger, feelings of self-hate) because her mind will want to reject the new thought patterns (this links back to Lecky’s self-consistency theory—your mind won’t instantly accept new thought patterns that contradict your current self-perception). But, with daily practice, this mental resistance will soften, and her mind will eventually come to accept these positive thoughts and release the negative thoughts.

Plastic Surgery and Self-Esteem: Beauty≠Confidence