Let’s Talk About Mental Health and Facelifts

Then there’s the perception that plastic surgery itself is addictive—that getting a facelift is a slippery slope, one that leads to a desire for rhinoplasty, blepharoplasty, liposuction, etc. Plastic surgery addiction is not included in the DSM-5, unlike alcohol dependence and substance-use disorder. However, body dysmorphic disorder is included, and scientific discussions of plastic surgery addiction tend to characterize it as a symptom or result of BDD.

The surgeons I spoke to about the potential of plastic surgery addiction had a nuanced view of the idea. Sometimes “attention drift,” as Dr. Halaas calls it, does happen: “It’s like maintenance for your house: My bathroom is terrible, so I need to replace it. Then you’re like, My kitchen could really look better too. I painted the front of the house, but the landscaping is looking a little shabby.” Dr. Lee uses another analogy: “Just because you do a facelift doesn’t mean that you’re good to go for the rest of your life. It’s sort of like saying, ‘I want to be healthy and fit, but I’m only going to run one marathon, and that’s it.’ Is going to the gym addictive? I don’t think so. But it has to be in proportion.”

And again, it’s all very individual. Judy chose her surgeon—Dr. Lee—because she wanted a natural look, and two years after her surgery, her priorities haven’t changed. She’s done some injectables, including Daxxify and Botox, but no additional surgeries. “I never want to overdo anything,” she says. “I’m just not that type of person.”

Once the initial facial swelling and bruising have lessened, patients can see the results. While many patients are happy with their appearance after a facelift, some are not—either because they had unrealistic expectations or something went wrong, leading to a quote-unquote botched appearance. However, the regret rate is relatively small compared to other cosmetic plastic surgeries: A 2024 study of 2,153 facelift patient reviews found that 92.24% were positive and 7.76% were negative. Although rare, this risk is still worth considering because of the profound mental health effects it can have. Sagapolutele says being unhappy with the results could even lead to “psychological harm.”

Elizabeth Kanna, a brand and AI manager, has had two facial procedures—one she was happy with and one less so. First, she had a lower face and neck lift in 2017. Initially, she was mostly satisfied with the results, but she was left with some minor scarring on the side of her face that she disliked, and the results of the neck lift didn’t last as long as she had expected. She was also unhappy with the doctor’s bedside manner; she says that he rushed the procedure and had a trainee conduct much of the surgery. “I felt like I paid for the surgeon, but I ended up getting his junior person,” she says. “Would I do it again? With a different surgeon.”