It’s not your fault, it’s the world we live in

The pressure to look a certain way has become constant. It’s no longer limited to magazines or TV - now it follows us through every scroll, swipe and filter. AI-generated filters, virtual models, and endless curated content on TikTok, Snapchat and Instagram shape how we think we should look. Advertising still plays a major role, often pushing edited and unrealistic ideals that many feel they need to live up to.

According to a study by Origym, Love Island alone has influenced one in six people to alter their appearance in some way. For Gen Z, social media filters were found to be the strongest influence on body image, with celebrities coming a close second. AI models are now regularly used in beauty and fashion campaigns, replacing real people with computer-generated versions of perfection.

These trends are affecting how people feel about themselves. In the UK, 21% of adults - including nearly a third of women - say advertising images have made them worry about their body image. This constant exposure to unrealistic standards can leave people feeling as though they’re falling short, even when they’re not.

We spoke with Michelle Elman, broadcaster, author and life coach who has undergone 15 surgeries for various medical conditions, including a brain tumour, punctured intestine, obstructed bowel, a brain cyst and hydrocephalus. These procedures left her with visible scarring, which had a lasting impact on her self-esteem throughout her younger years. Over time, however, Michelle developed a more compassionate relationship with her body and learned to value it as it is.

Michelle said:

Surgery likely won’t fix your lack of body confidence

Plastic surgery carries inherent risks, even when carried out by a skilled and experienced professional. While many procedures result in the desired outcome, complications can still arise - and the results may not meet your expectations. In some cases, this is due to physical issues such as infection, poor healing or asymmetry. In others, complications may stem from a breakdown in communication, where the surgeon has not clearly explained the likely outcome of the procedure, or the patient has misunderstood what the surgery can realistically achieve.

A 2024 systematic review into cosmetic surgery regret found that dissatisfaction rates can reach up to 47.1%, depending on the procedure. One of the most common contributors to regret is a mismatch between the patient’s expectations and the results achieved. If a surgeon has not clearly discussed the potential outcomes, scarring, recovery process or possible limitations of the procedure beforehand, patients may feel misled or unprepared for the reality of their results. This can lead to distress, dissatisfaction, and in some cases, emotional harm.

Complication rates for plastic surgery are estimated at around 5.8% overall, rising to 19.3% for more microsurgeries. These may include visible issues such as asymmetry or poor placement, or medical concerns such as infection or delayed healing. If a surgeon fails to identify signs of complications during follow-up appointments, does not offer appropriate aftercare, or performs the procedure using a poor technique, this may breach their duty of care.

An analysis of over 1,200 negative online reviews for non-surgical and minimally invasive procedures found that complications were the most common cause of dissatisfaction, accounting for 25% of all complaints. But other complaints often reflected a lack of proper communication, unmet expectations, or emotional distress post-treatment. 

However, not all complications are physical. In some cases, a patient may experience emotional or psychological distress after surgery due to pre-existing self-esteem issues or body dysmorphic disorder (BDD). BDD is a mental health condition where a person becomes preoccupied with perceived flaws in their appearance - often ones that are not noticeable to others. Individuals with body image concerns or unresolved insecurities may struggle to see any result as ‘good enough’. Even after a successful procedure, they may focus on small imperfections or seek further surgery, which can make their confidence worse over time.

Michelle Elman advocates for cultivating body confidence and belief in one’s own intrinsic value, rather than turning to surgery as a quick fix. She said:

With all these risks of further dissatisfaction after surgery, is it worth it? And what are the alternatives to surgery?

Lifestyle changes - the alternative to surgery

In our Body Perception Survey, 72% of the 1,458 respondents said they felt more self-conscious about their appearance than they did five years ago. This rising discomfort may lead many to believe that cosmetic surgery is the only solution. However, there are safer, more sustainable ways to improve both appearance and confidence - without undergoing surgery.

Numerous studies have shown that lifestyle factors play a major role in how we look and how we feel about ourselves. A 2023 peer-reviewed study in Cosmetics highlighted that proper nutrition, restful sleep, regular physical activity, and meaningful social connections are strongly linked with improved skin health, reduced signs of ageing, and a fresher, more vibrant appearance. These benefits extend beyond surface-level changes. Participants in the study also reported increased confidence, better mood and a more positive body image.

These types of changes are not quick fixes, but they offer long-term improvements that surgery cannot guarantee. For example, a balanced diet can help reduce inflammation and support collagen production, leading to clearer and more elastic skin. Regular exercise promotes blood flow, muscle tone and posture - all of which influence how someone looks and feels. Sleep plays a key role in cellular repair, and healthy social interaction has been shown to reduce stress, which in turn helps the body maintain a youthful appearance.

What sets these strategies apart from cosmetic surgery is that they carry no surgical risk, involve no recovery time, and often support wider health benefits beyond appearance alone. While surgery focuses on altering physical features, lifestyle improvements work from the inside out, supporting natural beauty and emotional wellbeing simultaneously.