Print this page

This month resident counsellor Douglas Holwerda answers questions about cosmetic surgery.

Dear Douglas,


I am a student from a Hanoi high school. Now I am doing a research project with a topic question which is: “Do social networks drive teenage girls to cosmetic surgery?”


To do this research project, I need to research whether social networking really influences the desire to have cosmetic surgery of teenage girls from the age of 13 to 19. Hence, I have some questions to ask to better develop my findings.


Should teenage girls have cosmetic surgery? Does the use of social media have good or bad impacts on their physical or psychological health?


— Teenage Researcher


Dear Teenage Researcher,


Your questions are good ones. I am not qualified to answer the questions that speak to the relationship between social media and social behaviour other than to put it into some perspective in broad terms.


I am more qualified to address the question of good or bad impacts on psychological health.


For most of the history of humanity a human being had no way to see what they looked like other than to catch their reflection in a still lake or pool of water… or later if someone painted or drew a picture of them. The only people they saw were people right around them. The mirror and the camera changed all of that. Mirrors allowed people to see themselves from all sides and cameras stopped time to create an image of what a person looked like.


Fast forward to the current relationship we have with cameras, mirrors and images, and we all can see the impact on modern culture and society. We all spend much time looking at images and the images we see are influenced by what we perceive to be attractive.


Magazines, movies, photos, videos, fashion, advertising, beauty contests, beauty products and fitness are all the result of this emphasis on the image that can be created with the camera. Social media takes this further, bringing the possibility of “marketing” oneself and the images one produces to everyone. Plastic surgery is a way to alter one’s appearance for the purpose of improving it.


Does this have a good or bad psychological impact?


In order to answer that question we have to look at the motivation behind it. Any self-improvement, whether it is learning something, like playing an instrument or how to create food, can be a sign of growth and development which leads to greater self-confidence and self-satisfaction. Learning, being creative, being physically active, and being productive are ways that we feel good about ourselves and stay engaged in the world we are in. Most of the time motivation is positive; it is natural to want to improve ourselves.


The problem comes in when we are operating from motivation that is driven by a fear-based sense of ourselves. If we feel we are not good enough, not attractive enough, not acceptable in the way we appear, we may be motivated to change for the wrong reasons.

It does not usually work very well because it is easy to fall into a trap that continues to set the standard higher and higher and to never be content with, or truly accept who we are. The truth is; aging itself creates physical decline in our appearance. It is better to accept ourselves, with our imperfections, than it is to compensate for our insecurities by trying to alter the image of ourselves.


Acceptance is the key word here. From a state of self-acceptance we will naturally grow and develop ourselves and value the whole of our being, including flaws. When people are non-accepting of themselves, the changes they make are coming from insecurity or self-hate. They discover that superficial changes do not help them to accept themselves fully, even though they may feel better temporarily.


Like most advertising and marketing, plastic surgery exploits peoples’ fears and insecurities with the desire to persuade. Of course, we know that there is a financial gain on the other side of that persuasion.


As a psychotherapist, I am always more interested in helping people accept themselves and their vulnerabilities. Images are superficial and subject to change. Being deeply comfortable with oneself and the person we are — even with our natural imperfections — gives us the confidence and freedom to live life fully.


I hope these thoughts are helpful,




Do you have a question you would like Douglas’s help with? You can email him at This email address is being protected from spambots. You need JavaScript enabled to view it.. Personal details will not be printed.


Douglas Holwerda

Douglas is an American trained psychotherapist, writer of the Dear Abby-esque monthly column in the Word, "Dear Douglas". He holds to the notion that the living of life is a creative endeavour... an eternal adventure without promises. And that we are both shaped by the journey and the shapers of what is possible. Our greatest hope is to find love and connection along the way. Live it all.