Body Image Improvement after Cosmetic Surgery by Evaluating Postural Changes

The mental representation of one's physical appearance can be understood through the psychological construct of the body image, which is the construct that may best help us to understand the motivations of cosmetic surgery candidates. The dissatisfaction of such subjects with their body image can result in anxiety, reduced self-esteem and altered interpersonal relationships. Cosmetic surgery can modify the psychological status significantly improving image-related feelings and self-esteem. These high rates of patient satisfaction persist beyond the immediate post-operative period, resulting in a constantly improving body image. Neuropsychological studies indicate that the control of posture and locomotion are inter-dependent at many levels of the central nervous system, from the motor cortex to the basal ganglia, the brain stem and the spinal cord. Moreover, stimulation of specific areas of the hypothalamus or brain stem has been shown to trigger changes in posture. These afferent inputs are modulated by numerous factors, including mood state and anxiety. We assessed postural changes following breast augmentation, breast reduction and abdominoplasty by studding body position, orientation through space and centre of pressure. Posture was evaluated before surgery and during the first year post-surgery by quantifying the centres of mass using the FastrakTM system and the centre of pressure using stabilometry. The Wilcoxon signed-rank sum test was used to detect any changes. One hundred forty-six patients were enrolled. A new-positioning of the body, confirmed by the baropodometric analysis, was evident in the early post-operative period. We subsequently observed a reprogramming of the biomechanical system, which reached a state of equilibrium one year after surgery. We believe that the role played by psychological aspects in the control of posture is even more important than that related to changes in the distribution of body masses. The patients try to hide what they consider a deficiency. Following cosmetic surgery, the discovery of a new body image eliminates dissatisfaction, reduces anxiety and increases self-esteem, which provide psychological and physical benefits that improve the quality of life. This phenomenon is particularly evident in the first period following surgery, when the emotional component is most marked. Subsequently, as the emotional component diminishes and the psychological component on postural control become more stable, the patients' posture tends to stabilize.