Is the pursuit of beauty a recipe for happiness?

In an appearance-obsessed world, with its increasingly unrealistic standards of beauty, looking good has become too closely bound to our concepts of happiness and success.

More women in the UAE are seeking "facial enhancements", The National reported last week - be it for bigger lips, wrinkle-free skin, or other more extreme enhancements. In an appearance-obsessed world, with its increasingly unrealistic standards of beauty, looking good has become too closely bound to our concepts of happiness and success. The trend reminds me of the saying, "if you don't look good you don't feel good". But following the folk logic of that adage, can we also say, "if you do look good you must feel good too"? Have cosmetic procedures become a self-esteem boosting antidepressant?

Even with the current economic downturn cosmetic enhancements are increasingly sought, with people choosing the less expensive procedures, such as laser resurfacing, Botox and laser hair removal. Are the masses finding happiness under the knife or at the end of a needle? There are some in the medical community who say yes. They see cosmetic surgery as a quick-fix solution to boost self-esteem, and perhaps to even reduce reliance on antidepressant medication, especially for those with body image related woes. Dr Richard Stark, the author of Aesthetic Plastic Surgery, claims this as a valid reason for an individual to go ahead with such procedures: "If one has a poor self-image or is unhappy with the way they look, cosmetic and reconstructive surgery is their answer. Psychologically, patients receive a powerful boost from such surgery." Dr Bruce Freedman, a plastic surgeon in Washington DC, recently led a study into the psychological effects of cosmetic surgery, finding that 31 per cent of the sample was able stop taking antidepressant medication after undergoing elective cosmetic surgery. A study in Brazil reports much of the same. Dr Elvio Bueno Garci'a, a professor at the Federal University of Sao Paulo, followed the psychological outcomes of 35 women who had surgery to correct asymmetrical breasts. The participants in this study reported a better quality of life, and higher self-esteem six months after the surgery.

Another argument for the depression-defeating properties of cosmetic procedures is that physical improvement makes people more outgoing. More confident and outgoing people also tend to develop a better social life, and a thriving social life arguably leads to a better support network, a key factor that helps to prevent depression when times get tough. So is Botox the new Prozac, and is the pursuit of beauty really a recipe for happiness?

Of course not. For the unhappy customers of plastic surgery, a nose is not so easy to take back to the store like an ill-fitting dress or pair of shoes and many people who have surgery do not have their expectations met. Many patients report strong feelings of sadness, fatigue and loss of interest, which typically begins a few days after a surgery. This post-operative depression, which could be related to medications, called post-surgical traumatic stress syndrome, often results in long periods of fatigue and irritability, which can be made worse if expectations for a change in appearance are not satisfied. Imagine you didn't like the old you, but that you don't like the new you either. Beyond disappointment, research reveals that many patients with unmet expectations feel rage towards the medical personnel responsible for fashioning their unappreciated new look.

Doctors are also seeing and operating on a group of patients seeking elective cosmetic procedures who actually have a psychological disorder known as Body Dysmorphic Disorder, sometimes called imagined ugliness. With these patients (as many as 15 per cent of all people seeking elective surgery) research has shown that the surgery rarely works to appease their dissatisfaction, and that they soon begin to imagine and magnify new blemishes and defects after their first surgery. Body Dysmorphic Disorder may explain what appears to be a growing addiction to cosmetic enhancements.

Cosmetic surgery can have powerful positive effects. Indeed, for people with birth defects for example, or those left with scars after tragic accidents, it can be life-changing as the surgery can mask or reduce the disfigurement and allow a person to feel better about their physical appearance. However, undergoing surgery as a quick-fix solution to deep seated self-esteem and emotional issues is going to prove problematic in the long term, not just for an individual, but also for a society that promotes this idea. Beauty may be skin deep, but true happiness comes from a much deeper place.

Shaima Abdul Rahman is a student at Zayed University. This is an edited version of an essay that won the university's Best Essayist Award Psychology for autumn 2009