Depression Is a Side Effect of Plastic Surgery That We Don't Talk About

Tightly edited videos on TikTok and Instagram may make elective plastic surgery look easy-breezy, but in reality, going under the knife entails multiple doctor consultations, often hours of travel time, and a lengthy recovery process. And while social media may have gotten you accustomed to seeing photos or videos of people with bandages, swelling, or bruises after leaving the operating room, it's significantly less common to hear patients share details about the psychological aspects of recovery — which, for many, can be just as grueling.

Post-plastic-surgery depression is more prevalent than you may think; while rates are difficult to pin down, one analysis of available data published in 2022 reported post-procedure depressive feelings in patients who had undergone breast augmentation, a facelift, or aesthetic rhinoplasty. Ahead, learn about why post-plastic-surgery depression occurs, who is most at risk, how to address the symptoms, and more.

Feeling sad, anxious, or depressed after plastic surgery isn't reserved for people who are dissatisfied with their results. "Post-surgical depression, or postoperative depression, is a psychological phenomenon that some individuals may experience after undergoing plastic surgery," Blair Steel, PsyD, a licensed clinical psychologist, tells POPSUGAR, adding that not everyone who undergoes plastic surgery will experience it.

The symptoms — such as insomnia, sadness, or not eating enough — their severity, and their duration can also vary from person to person. Luckily, there are numerous steps you can take to minimize your chances of experiencing post-procedure depression (more on that later).

Given the number of factors that are involved with plastic surgery — from prep to the procedure through to recovery — it's often difficult to determine a singular cause of these negative feelings.

"What is often the real issue is that patients' normal routines are disrupted," says Deniz Sarhaddi, MD, a board-certified plastic surgeon. "They often aren't sleeping well; they're potentially on activity restrictions, which can be difficult emotionally for people who work out every day; they're uncomfortable or in some degree of pain; and [they're] on medications. All of these things can create an emotional slump."

According to Erin Pash, a licensed marriage and family therapist and founder and CEO of Ellie Mental Health, those realities are particularly tough to deal with when you're waiting six months to a year to see the full effects of your surgery. "People will feel super frustrated that they went through this really expensive and painful procedure to find out that they're not going to get the results of it for over a year," Pash says.

Dr. Steel adds that if a patient has significant body image issues prior to plastic surgery, and if they are not already working with a mental health professional, the likelihood of post-op depression will increase. "Even if the surgical outcome is positive, individuals may still struggle with underlying body image issues that predate the surgery and contribute to emotional distress," Dr. Steel says.

As with any mental health condition, the signs of post-plastic-surgery depression are not one-size-fits-all for patients. However, Pash says that changes in your eating or sleeping patterns or a heightened emotional state post-surgery could indicate a mental health issue that needs support.

"Generally, the things that we'll see [with post-plastic-surgery depression] are increased agitation, isolation, and sadness," Pash says. "You can see regular depression symptoms, like eating a lot or not eating enough, and not sleeping enough or a lot."

Dr. Steel adds that depression can also manifest as physical symptoms such as headaches, muscle tension, or digestive issues. "It's crucial to understand that these symptoms can vary in intensity and may not necessarily indicate post-plastic-surgery depression," she says. "However, if these signs persist for an extended period or significantly impact the individual's daily life, it's important to seek professional help."

Dr. Sarhaddi says that she gives all her patients a heads up that their mood will likely take a hit post-surgery. "I talk about the 'emotional down' that comes around two to three weeks postoperatively for most patients during my consultation, and that it is really normal," she says.

However, patients with a history of anxiety, depression, or body dysmorphia are more likely to experience these symptoms following plastic surgery. Because of this, Dr. Sarhaddi says she has all her patients screened for a history of depression, anxiety, or other mental health challenges. She also checks whether "their symptoms are well controlled, and whether they are under the care of a professional," she says.

When evaluating your risk for post-plastic-surgery depression, it's also important to take into account the type of surgery that you're facing. Research into the psychological impact of aesthetic surgery is sparse, but the data that does exist indicates that certain procedures result in higher levels of post-surgery depression and anxiety. In a study of 50 facelift patients published in 1980 (and included in the 2022 meta analysis mentioned earlier), for instance, half of the participants experienced "adverse psychological reactions," with depression and anxiety being the most common.

This aligns with what Dr. Sarhaddi has seen in her practice. "Face procedures tend to have an emotional down during recovery," she says. "This may be because it is harder to hide the face and it is understandably difficult to look in the mirror and feel scared of the swelling or postoperative appearance."

Comparatively, for abdominoplasty (aka "tummy tuck") patients, a 2018 study of 22 patients found that 27 percent and 32 percent of patients had mild and moderate depression prior to surgery, respectively. Six months after their procedures, those stats dropped to 18 percent and 9 percent. "With body procedures, often patients are in compressive garments or bras that help to control swelling, and frankly, it's not as visible," Dr. Sarhaddi says.

This all suggests that the likelihood of developing post-plastic-surgery depression is complex and multifaceted, dependent on the procedure, the patient, and the healing environment.

While not a guarantee, Dr. Steel says that having an open dialogue with your medical providers from the first consultation could help some aesthetic-surgery patients avoid post-op depression. The surgeon should always be honest and clear about what is and what is not possible with your procedure; if they're not, and if a patient believes that their results are going to be significantly different than what they see when they remove their bandages, the stress of that underwhelming outcome can ultimately trigger depression, Dr. Steel says.

Dr. Steel suggests that prospective patients should thoroughly examine their motivations, expectations, and emotional readiness for a procedure prior to embarking on their plastic-surgery journey. "Open communication with qualified professionals, including both surgeons and mental health professionals, can contribute to a positive and fulfilling experience," she says.

If you do experience post-plastic-surgery depression, Pash says she recommends establishing a routine for your recovery time in order to help mitigate symptoms — even if it's just getting out of bed and performing basic tasks. "Make sure that [you're] not isolating yourself during recovery, [that you're] connecting with your physician on your mobility goals, eating a balanced diet, and talking to friends," she says. To help keep negative feelings at bay, she suggests utilizing coping skills like deep breathing or journaling, especially if you have limited mobility due to surgery.

And because plastic surgery patients are often (but not always) reluctant to discuss their procedures with friends or coworkers, Pash suggests having a confident narrative in place to address their questions after the fact. As she says, "For me, that means owning it. Don't let people talk about you — you talk about you. Like, yes, I had a nose job, and I'm really happy about it. Yep, I had a tummy tuck, and it was really painful, but I'm really grateful for the results. If you have any questions about it, talk to me." Just remember — you don't owe anyone an explanation for your altered appearance, so if you'd rather keep the details of your surgery private, then you do you.