Freud Gradiva and the Aesthetic Unconscious: Lessons for the Plastic Surgeon.

Despite recent regulatory reforms to improve the safety of cosmetic procedures in Australia, treatments involving non-ionizing radiation (NIR)-such as laser, intense pulsed light and radiofrequency-remain largely unregulated in most states and territories. Recent reviews have concluded that there is a lack of evidence of adverse effects, and insufficient evidence has also been cited as a barrier to regulatory reforms. We sought to characterize adverse effects from cosmetic treatments involving NIR reported in Australian media and to analyse associated regulatory themes. We searched for Australian news media disseminated between 2008-2023 reporting adverse effects from cosmetic treatments involving non-ionizing radiation (NIR). Identified case reports were coded and analysed to explore adverse effects and associated regulatory insights. One hundred unique media reports were identified that described ninety-five cases. One in five involved permanent effects with burns and scarring most frequently reported (sixty-five and fifty-four cases respectively). Reports concerned women more than men (eighty vs eight cases), most commonly following laser (sixty cases) or IPL (twenty-nine cases) treatment and in non-clinical rather than clinical settings (sixty vs eighteen cases). Six practitioners collectively accounted for almost one third of cases. Significant regulatory gaps were identified, including insufficient mechanisms for addressing poor professional practice, and barriers to consumers seeking compensation including minimum injury thresholds and uninsured providers. Media reports have documented cases of serious and permanent injuries following cosmetic NIR treatments in Australia. Nationally consistent regulations should be considered to ensure standards of care, protect consumers, and reduce barriers to redress.

This study was the first empirical investigation of body image dissatisfaction in male cosmetic surgery patients. Thirty men completed two body image measures prior to their initial consultation. Results were compared to the norms for each of the measures and with a sample of 30 women seeking similar cosmetic procedures. Results indicated that patients did not demonstrate greater dissatisfaction with their overall appearance than men in a normative sample. However, when asked about the bodily feature they were considering for surgery, they reported significantly greater levels of dissatisfaction than the normative sample. As compared to male patients, female patients reported a greater investment in their physical appearance. Implications of these findings are discussed with respect to the nature of body image dissatisfaction and the relevance of body image in the psychology of male plastic surgery patients.