PURPOSE: The majority of patients elect to undergo surgery because it is medically indicated.  Cosmetic surgery patients, however, have a much broader set of indications and complexities, as their procedures lie at the crossroads of psychology, sociology and morphology.  Despite the long history of aesthetic surgery, surprisingly very little is known about what motivates patients to pursue this endeavor and even less is known about specific personality types that may be inclined to pursue facial versus body cosmetic procedures. The purpose of this study was to assess the personality traits of cosmetic surgery patients undergoing either body or facial aesthetic procedures by administering the Big-Five Inventory (BFI) personality indicator to three groups of patients who had undergone either cosmetic rhinoplasty, breast augmentation or functional septoplasty. 

METHOD: Three groups of patients were identified who had had undergone either cosmetic rhinoplasty, breast augmentation or functional septoplasty and were then given a standardized self-administered Big-Five Inventory personality questionnaire.  This specific personality indicator provides age and gender normalized scores relative to a large population base for each of individual’s “Big-Five” personality traits. When scored for individual feedback, the BFI traits are presented as age and gender normalized percentile scores based on a large segment of the general population. For example, an openness rating in the 80th percentile indicates a relatively strong appreciation for art, adventure, unusual ideas, imagination and variety of experience. Extraversion rating in the 5th percentile indicates an exceptional an individual that is intraverted, quiet and shy.  The comparison of the BFI traits between the septoplasty, rhinoplasty and breast augmentation patients were analyzed using ANOVA.  If the P-value for a given trait was significant, then pair-wise comparisons were examined (Fisher's protected LSD).  P values less than 0.05 were considered significant.  This study was performed with IRB approval from the University of Wisconsin.

RESULTS: We assessed the Big Five Index in 15 cosmetic rhinoplasty patients (average age 32), 12 functional septoplasty patients (average age 44) and 15 breast augmentation patients (average age 31) who had surgery performed at the University of Wisconsin Hospital and Clinics.  All data was tabulated, scored and subjected to statistical analysis (see above).  The primary significant finding of this study was that the cosmetic rhinoplasty patients demonstrated statistically (p < .04) higher “openness” scores relative to the septoplasty patients or breast augmentation patients.  All other personality traits were similar amongst the 3 groups (extraversion, conscientiousness, agreeableness and neuroticism) with no statistical differences discovered.

CONCLUSION: Despite the growing popularity of cosmetic surgery little is known regarding the personality traits of patients seeking procedures.  The major finding of this study is that, when compared to control subjects, patients undergoing elective cosmetic rhinoplasty are significantly more open to experience.  As the BFI clusters specific characteristics within each personality trait, the cosmetic rhinoplasty patients therefore also demonstrate a higher appreciation for art, emotion, adventure, unusual ideas, imagination, curiosity, and appreciate a variety of experiences.  Patients who have had cosmetic rhinoplasty, with their appreciation of art and structure, may be more readily aware of the aesthetic changes that can be accomplished with facial plastic surgery. Surprisingly, the breast augmentation patients are not statistically different than the septoplasty patients with regards to openness or any other personality trait.  Also surprising was the finding that neither the breast augmentation patients nor the rhinoplasty patients are statistically different from the controls with regards to extraversion, or neuroticism.  While it’s unclear at this time if these findings apply to large cohorts undergoing other types of facial cosmetic surgery (e.g., facelift), it is clear that cosmetic rhinoplasty patients are a distinct group of patients with clearly identifiable and specific personality traits.