"Should psychological tests be required before getting breast implants?"

Cosmetic surgery is a booming industry — and with bikini season fast approaching, thousands of Australian women are turning to surgery for what they see as a confidence boost.

With more than 40,000 people undergoing cosmetic surgery in Australia each year at last count, Australians are now spending about $1 billion a year on procedures and treatments intended to make them look and feel better.

But what about those women turning to surgery for all the wrong reasons — whose desire to change their body stems from a deep-rooted psychological disorder, or who seek cosmetic renewal as a “quick fix” to find or save a relationship?

In the UK, new assessments have been introduced at some clinics to try to stop people having cosmetic surgery they may later regret. The test, consisting of 11 warning signs to help cosmetic surgeons identify prospective patients with serious body image problem, was developed by psychologists who say patients are being put at risk by firms who don’t carry out enough checks, the BBC reports.

But in Australia, no such screening exists — and some experts think that needs to change.

Surgery “may cause the recipient to fixate on their looks as their primary source of self-worth”

The CEO of national self-esteem initiative Mind Shift, Elizabeth Venzin, has penned an open letter to health minister Peter Dutton, Royal Australasian College of Surgeons president Michael Grigg and assistant health minister Fiona Nash calling for the introduction of pre-surgery psychological screening.

“Research shows that cosmetic surgery does not make a woman feel any better about themself, and in fact, may cause the recipient to fixate on their looks as their primary source of self-worth,” the letter reads. “This only damages self-esteem in the long run, because women are constantly having to fix their ‘flaws’ to live up to society’s supposed idea of what beauty is.”

David Castle, a Professor of Pyschiatry at the University of Melbourne and St Vincent’s Hospital, told Mamamia some women “absolutely” are not suitable candidates for surgery.

“If they have unrealistic expectations of the outcome, if they’re doing it for someone else- to enhance a relationship or to save a relationship – or if they have distorted dysmorphic disorder (then surgery is not appropriate),” he said. “There should be screening mandated because it’s not difficult to do and people often slip through the nets.”

Karen* told Mamamia her best friend Brianna, who underwent breast augmentation surgery last year, is still “not satisfied” following surgery — and Karen believes it was wrong of the surgeons to carry out a surgery that could never have been expected to make her feel better about herself.

“She was initially happy after the surgery but all of her body issues continue to be a problem, because she didn’t address the core reason behind why she hates how she looks,” Karen said.

“She’s got body image issues and self-esteem issues that stem from abandonment, and I think that in her mind, the way she looks has a lot to do with making people love her. I think that any psychologist would have figured that out in about fifteen minutes.”

What screening procedures are already in place?

President of the Australian Society of Plastic Surgeons (ASPS) Dr Tony Kane told Mamamia while psychological screening prior to surgery is not mandatory in Australia, other procedures exist to control for potential post-surgical regret.

“The surgeon makes an assessment during consultation as to the mental and physical preparedness for the patient to undertake the surgery. The surgeon may recommend to the patient that he/she seek counselling before making a final decision about surgery,” he says.

He also points to the Australian Society of Plastic Surgeons’ Code of Conduct, which says that outside the public hospital setting, surgeons must have an established relationship with the patient prior to any treatment.

The code also specifies that at least two pre-operative consultations are appropriate prior to cosmetic surgery.

“With cosmetic surgery procedures it is particularly important that the patient is given sufficient time to think about whether the procedure is in their best interests,” Dr Kane adds. “ASPS members must ensure there is a ‘cooling off’ period of not less than ten days between the initial consultation and the cosmetic surgery procedure.”

Do those requirements go far enough?

But professor Castle insists that’s not enough — and that the current system may be failing vulnerable women.

He and his colleages have produced a brief screening test that he believes should be mandated for clinicians, along with compulsory training around the sort of psychological issues their patients may present with.

“It’s quite a generic screener, which is a self-rater, which takes a matter of 10-15 seconds, and we see that as a pretty good screener for body dysmorphic disorder,” he said.

“One of the problems is, some cosmetic physicians don’t want to ask the questions because they think it might scare people off…(some of these) operations or interventions make these people a lot of money,” he said. “That’s the minority, but there are some people who are like that.”

Karen believes that if she’d been subjected to such psychological screening, Brianna would “never” have been able to have her surgery.

“Abolutely not.” Karen said. “And it’s sad that someone made money off the back of her insecurities.”

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