Psychological Disorder and Patient Satisfaction in Aesthetic Surgery—A Systematic Review

Background and Objectives: This systematic review investigates the relationship between preoperative psychological disorders and postoperative satisfaction among patients undergoing aesthetic surgery. While aesthetic procedures can enhance self-image, growing evidence indicates that underlying mental health conditions, particularly BDD, depression, and anxiety, may compromise surgical outcomes. Materials and Methods: A comprehensive literature search was performed in PubMed, the Cochrane Library, and Google Scholar between January 2010 and December 2024. Eligible observational studies assessed preoperative psychological conditions—primarily body dysmorphic disorder, depression, and anxiety—using validated instruments, such as the Body Dysmorphic Disorder Questionnaire (BDDQ), Body Dysmorphic Disorder Examination (BDDE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), and structured clinical interviews, and reported postoperative patient-reported satisfaction following aesthetic surgery. Study quality was evaluated using an adapted QUIPS framework. Results: Across the 13 included studies, six reported a negative association between moderate-to-severe preoperative psychological symptoms and postoperative satisfaction, five found no significant association, and two described positive or conditional associations. Methodological heterogeneity in psychological assessment tools and satisfaction measures was a major source of divergence across studies. Despite these differences, the evidence underscores the need for standardized, validated psychological evaluation protocols in aesthetic surgery. Incorporating mental health screening into routine surgical planning can enhance ethical practice, reduce dissatisfaction, and improve long-term patient outcomes. Conclusions: These findings advocate for a multidisciplinary approach that includes psychological assessment as an essential component of patient care in aesthetic medicine.