Understanding cosmetic surgery and the risks of surgery

Body image refers to how we perceive, think and feel about our own bodies. It influences self-esteem, confidence and decisions about appearance in both subtle and overt ways. In many cases, people who consider cosmetic surgery are responding not only to physical concerns, but also to emotional discomfort or dissatisfaction linked to how they feel in their bodies - and how they believe others perceive them.

Findings from our Body Perception Survey help to illustrate this connection. Among the 1,458 respondents, 46% stated that social media strongly affects how they feel about their body. Regular exposure to highly curated, edited and idealised images can shape expectations around appearance and encourage comparison, which may intensify dissatisfaction over time. 

For some individuals, this influence can blur the line between genuine physical concerns and pressures driven by external validation, contributing to the belief that cosmetic surgery may offer a solution to feelings of inadequacy rather than addressing the underlying emotional drivers.

Professor Markey highlights how cultural and social factors fuel these perceptions. In particular, she notes the influence of modern media: “Social media - and the broader social environment around it - plays a powerful role in shaping body satisfaction today. Platforms like Instagram, TikTok, and Snapchat expose users to constant images of idealised bodies, often filtered, edited, or curated to present perfection rather than reality.”

This environment often encourages comparison with unrealistic standards, which can lead people to view cosmetic surgery as a solution for perceived imperfections. While surgery can address specific concerns and offer improvements for some, research shows it is not a guaranteed route to long-term body confidence or happiness.

Her own research supports this: “People often believe a physical change will automatically create internal confidence... but it does not reliably improve global self-esteem, life satisfaction or problematic thinking patterns.”

It’s important to understand that the motivations behind cosmetic surgery can sometimes stem from deeper psychological factors - such as low self-worth, chronic dissatisfaction or the internalisation of narrow beauty ideals. In these cases, surgery alone may not address the underlying emotional drivers.

Recognising the connection between body image and cosmetic procedures allows individuals to make more informed, empowered decisions. In some instances, addressing emotional wellbeing and making practical lifestyle changes can improve body confidence significantly - without surgery. For others, these changes can complement surgery by ensuring the decision is made from a place of self-respect and awareness, rather than pressure or distress.

The role of lifestyle changes in supporting body image

Here is a slightly expanded version that incorporates the survey findings in a clear, measured way and keeps the focus on evidence rather than emphasis:

Many people consider cosmetic surgery in response to how they feel about their appearance, often believing that altering the body will lead to improved confidence and self-esteem. However, research consistently shows that positive changes in how a person feels about their body can also be achieved through non-surgical means - particularly through intentional lifestyle choices that support both physical and mental wellbeing.

Our Body Perception Survey supports this. Among respondents, 21% stated that lifestyle changes can influence their perception of their body for the better. This indicates that for a notable proportion of people, shifts in daily habits and self-care practices can improve body confidence without the need for physical alteration.

Lifestyle changes do not simply involve altering appearance. Rather, they help foster a more accepting, balanced relationship with the body - one that is based on self-care, not self-criticism. Improving sleep, eating in tune with the body’s needs, engaging in joyful movement, and developing more mindful mental health practices can all contribute to a stronger sense of self-worth and body respect.

Professor Markey emphasises the value of starting small: “What can you do for yourself that is a small step towards feeling better? Go to bed 15 minutes earlier? Take a 10-minute daily walk? Drink enough water? Make it a plan to call a good friend once a week to stay in touch? This isn’t just about body image but creating wellness and nurturing your identity as a happy, socially-connected person.”

These small, evidence-based actions help reframe the body not as a problem to be fixed, but as something to support and care for. Over time, this shift in mindset can reduce appearance-based anxiety and build a stronger foundation of confidence, regardless of physical changes.

For those still considering cosmetic surgery, making such changes beforehand can lead to better-informed decisions and healthier expectations. When a person feels mentally prepared and emotionally supported, they are more likely to approach surgery from a place of empowerment - rather than as a quick solution to deeper concerns.

In the next section, we’ll explore some of the most effective and sustainable lifestyle changes that can help improve body image and emotional wellbeing.

Key lifestyle changes that can improve body image

Adopting small but meaningful lifestyle changes can have a significant impact on body confidence and self-perception. These changes are not about transforming the body to meet unrealistic ideals but about building a healthier relationship with it - grounded in self-respect, balance and care.

Here are five key areas where positive, sustainable change can support improved body image:

Nutrition and healthy eating habits

Eating well is often framed in terms of appearance or weight, but a healthier approach is one that prioritises nourishment and emotional wellbeing. Shifting away from restrictive dieting and towards intuitive eating - where individuals listen to their body’s needs - can improve both physical health and body confidence.

Professor Markey explains: “Engaging in joyful, flexible, intuitive eating... isn’t about dieting but about reducing shame and tuning in to your own body’s needs. Add foods instead of taking them away.”

This approach helps reframe food not as something to control or fear, but as a tool for energy, satisfaction and self-care. Over time, it can reduce body shame and reinforce body trust.

Regular physical activity

Physical movement can improve mood, boost energy, and build a sense of connection with the body - but only when approached in a way that is enjoyable and not punitive. Moving for wellbeing, rather than appearance, supports healthier body image outcomes.

“It can be empowering to shift from exercise for weight loss to movement for joy and well-being,” says Professor Markey. “Choose movement that feels enjoyable and energising... tune into internal cues like energy, strength and mood.”

Letting go of appearance-based goals and focusing on how the body feels during and after activity can help build appreciation for what the body can do, not just how it looks.

Improved sleep and rest

Quality sleep plays a key role in emotional regulation, stress reduction and ultimately body image. Lack of rest has been linked to negative self-perception and increased appearance-related anxiety.

Incorporating small sleep hygiene habits - such as consistent bedtime routines, reduced screen time in the evening or creating a calming sleep environment - can make a measurable difference in overall wellbeing and self-confidence.

Mindfulness and mental health practices

Mindfulness-based strategies, including journaling, meditation and breathing exercises, can help reduce body-focused anxiety and foster a more neutral, accepting view of appearance. Mental health support is also key for those with persistent body image concerns.

“Therapies that help reshape body image - such as cognitive behavioural therapy or compassion-focused therapy - can help people struggling with persistent dissatisfaction.” 

These tools offer practical ways to challenge self-critical thinking and shift focus away from appearance as a measure of worth.

Reduced social media exposure

Digital platforms can amplify unrealistic beauty standards and create constant opportunities for comparison. This has been directly linked to increased body dissatisfaction - particularly among women, teenagers and people who frequently engage with appearance-focused content.

Professor Markey advises: “Curate your media environment intentionally... unfollow accounts that trigger comparison or perfectionism. Follow creators who show diverse, realistic unfiltered bodies.”

This technique, known as protective filtering, helps reduce exposure to harmful content and reshapes your digital space into one that supports confidence, diversity and mental health.

Building a positive mindset and practising self-compassion

While physical habits such as sleep, movement and nutrition play a key role in improving body image, long-term confidence also depends on how we think and feel about ourselves. Developing a positive mindset and practising self-compassion are essential for strengthening body confidence from the inside out.

Self-compassion involves treating yourself with kindness, especially during moments of insecurity or doubt. For many people, body image issues are not just about appearance but about how harshly they judge themselves. Learning to respond to these thoughts with understanding rather than criticism can have a powerful effect on self-esteem.

As Professor Charlotte Markey explains: “Self-esteem grows when you practise treating yourself the way you’d treat someone you love. Small reframes like, ‘It’s okay to have a bad body image day,’ can help promote long-term confidence.”

This approach helps people acknowledge that negative thoughts may arise from time to time, but they do not have to define how one treats themselves or makes decisions about their body.

Another important step is building identity and value beyond appearance. Research shows that when people focus on personal strengths, relationships, goals and values - rather than how they look - they tend to develop greater self-worth and emotional resilience.

“Developing identity beyond appearance - such as through skills, relationships, and personal goals - can strengthen confidence from the inside out,” 

Surrounding yourself with people who support this mindset can also act as a buffer against body-related pressure. Choosing environments that avoid diet talk, embrace size diversity and encourage self-care helps reinforce body respect on a daily basis.

Together, these mindset shifts can lay the foundation for lasting change. They support people in feeling more comfortable in their own skin, making more empowered decisions and developing body confidence that isn’t dependent on external appearance.