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contouring’ was entered into PubMed. No new relevant literature was identified since 2010. · Search 2: Based on the review of Kosowski et al (2009), the term ‘patient reported outcome measures AND facial cosmetic surgery’ was entered into PubMed. One relevant article was identified since 2008. · Search 3: Based on the reviews of Rhee and McMullin (2008a; 2008b), the term ‘patient reported outcome measures AND facial plastic surgery’ was entered into PubMed. Two relevant articles were identified since 2007. · Search 4: Based on the review of Pusic et al (2007) the terms ‘patient reported outcome measures AND cosmetic breast surgery’ and ‘patient reported outcome measures AND reconstructive breast surgery’ were entered into PubMed. Three relevant articles identified since 2006. · Search 5: Based on the review of Ching et al (2003), the term ‘patient reported outcome measures AND aesthetic surgery’ was entered into PubMed. Ten relevant articles identified since 2002. This review summarises how people describe their experiences after undergoing a cosmetic procedure. It draws on evidence from academic literature between 2000 and 2016. Analysis includes: • an assessment of the levels of post-procedure satisfaction / dissatisfaction • why recipients of cosmetic procedures may be satisfied / dissatisfied with their results; • whether any dissatisfaction / satisfaction ‘lasts’; • whether recipients of cosmetic procedures would, hypothetically: o undergo a different cosmetic procedure in the future o undergo the same procedure again • whether cosmetic procedure recipients would recommend their procedure to other people. At the beginning of each section, summary boxes are provided which highlight overarching, broad conclusions of that particular area of investigation. However, in assessing these conclusions, the limitations of the evidence identified must be borne in mind. Evidence quality Where appropriate, this review highlights instances where studies may be subject to significant bias: for example, where participant samples are drawn from patient lists of cosmetic procedure clinics and/or where the research is undertaken by the professionals who undertook the original procedure itself. Most evidence identified by this review also draws conclusions from studies with small sample sizes, with selfselecting participants. In addition, authors’ analyses of results, and subsequent extrapolation of conclusions arising out of those results, are of varying quality. Therefore, in assessing conclusions drawn from this review, each of these caveats must be borne in mind. This review also draws on literature from a wide range of countries, contexts, and across a number of different types of cosmetic procedure. Researchers also vary from individuals who are practitioners who have undertaking cosmetic procedures with their research sample, to social science researchers based in university departments. Thus, in collecting this evidence together to make overarching conclusions, and in crosscomparing studies, caution must be exercised. 3 Satisfaction levels Section summary Literature on general levels of satisfaction / dissatisfaction among recipients of various types of cosmetic procedures suggests that most people who take part in research studies are satisfied with their procedure. In some cases, 100% of recipients who take part in research indicate satisfaction with the procedures. Although such very high levels of satisfaction are not observed across all procedures, the levels of satisfaction nevertheless remain high. Recipients of cleft palate procedures are the only group identified by this review where most research participants indicate dissatisfaction with the results of their procedure. Some literature relevant to this review is limited to assessments of general levels of satisfaction among people who have undergone various types of cosmetic procedures, rather than examining explanations of satisfaction / dissatisfaction. These reasons are varied, and are discussed in the sections below which focus on psychological and social explanations of satisfaction; and physical reasons, before examining the literature around explanations of dissatisfaction following cosmetic procedures. Unspecified / various cosmetic procedures Some studies do not focus on specific cosmetic procedures, but rather take a general approach in their samples, recruiting participants who have undergone a wide range of procedures. The overarching findings of these general studies - which span countries - indicate that those who have had a cosmetic procedure are predominantly satisfied with the results. For example, a Dutch study of 135 participants found that 86 per cent were pleased with the direct outcome of the procedure.1 A study of ten Brazilian cosmetic surgeons, reporting on the outcomes of 1,447 surgery recipients, also concluded that “over 97% of surgeons and patients were satisfied with the surgery results, with 84% of surgeons and 79.6% of patients rating the surgery results as excellent. Less than 1% of the surgeons and patients were not satisfied with the surgery results.” However, the reporting methods of this particular study – that is, patients feeding back to the surgeons who had treated them – must be borne in mind.2 High levels of post-operative satisfaction are also indicated by the results of a US study of 45 women who had received a
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