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Will a nose job make you feel better about yourself?

By Kathryn Doyle

NEW YORK (Reuters Health) - Getting that nose job could boost your self-esteem and quality of life, according to a new report. But the evidence is a bit shaky, researchers looking at studies of people who had plastic surgery found.

The report's lead author said he knew of studies showing improvements in body image after cosmetic surgery. But those studies typically focused on procedures like breast augmentation instead of nose jobs and facelifts.

"The only justification that I could provide … of why we perform facial cosmetic procedures is that it has been my anecdotal experience that patients may sometimes feel better with even a slight improvement in appearance," Dr. Joseph F. Sobanko of the Hospital of the University of Pennsylvania in Philadelphia, said.

To find more evidence, he and his coauthors collected and reviewed 16 studies that asked people about their self-esteem and quality of life before and after procedures like nose jobs, eyelid lifts and Botox injections.

Most of the studies combined data from multiple cosmetic procedures. As a group they showed a slight improvement in how people rated their quality of life after surgery.

When studies focused on specific procedures, quality of life appeared to improve after nose jobs and facelifts, in particular. People rated their self-esteem higher after nose jobs and eyelid lifts and reported an improved body image after nose jobs.

Half of the studies combined results from facial and so-called body contouring surgeries like breast augmentation and most found improvements in all three areas.

However, the researchers noted many of the studies were lacking a comparison group of people who didn't get cosmetic surgery, which makes the improvements harder to interpret.

And few of them followed up with patients more than a year after their procedures.

Dr. Tina S. Alster, clinical professor of dermatology at Georgetown University Medical Center in Washington, D.C., agreed there is a lack of research in this area.

Studies on patient outcomes are difficult to do but will be important, Alster, who wasn't involved in the new research, told Reuters Health in an email.

Nose jobs and eyelid lifts have become less popular over the last decade, the authors write in JAMA Dermatology, while Botox and soft-filler injections have become more common.

According to the American Society for Aesthetic Plastic Surgery, doctors' fees average about $4,000 for a nose job and about $6,000 for a face lift.

Based on the results of the review, "It would be premature to say that facial cosmetic procedures truly improve the psychosocial health of our patients," Sobanko said.

"For our skin cancer patients, we know that treatment of facial skin cancer will improve quality of life," he told Reuters Health. But confirming his observations with cosmetic surgery will require more manpower and funding.

"Because there are still so few well-performed studies that address this question, I believe it is premature to confirm the science behind this notion of ‘looking better means feeling better,'" Sobanko said.

SOURCE: http://bit.ly/1eU28SN JAMA Dermatology, online September 25, 2013.

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