More and more of my clients – straight, gay, whomever – are asking me if I think it’s wrong to get Botox or Restylene treatments to look younger. I’ve had clients go to Brazil, Mexico and even Asia for plastic surgery. A client who just had his eyes “done” told me, “I just want to look like myself, only fresher.” At a recent conference for psychiatrists and psychotherapists, some of my colleagues admitted that they had some work “done”. It’s pretty popular, but how does altering your appearance relate to your mental health?

Plastic surgery and less “major” forms of body altering are heavily promoted. Injecting Botox (a poison) into your body is considered perfectly normal. We don’t seem to care what the doctor injects into us, as long as we get fewer wrinkles. Let’s cut to the chase here (pun intended) and ask: why would I want to alter my body or face surgically? What would be my goal?

I get a lot of referrals from plastic surgeons who ask me to evaluate their clients for elective cosmetic surgery. When these clients come to my office, I encourage them to dig deep into their psyches and ask themselves: “What do I want to achieve from this procedure?” Is it to like myself better? To have the admiration of others? To look like the bodies I most admire in others?

Answering these questions gives people clarity into their motivation. And why not give it some thought? These procedures are typically very expensive and not without risk. Before you spend all that time and money, why not see if there are other easier and cheaper ways to achieve your goals.

For example, let’s say your goal is to like yourself better. I’ve had clients who actually felt worse about themselves after their plastic surgery, because they spent all that time and money and their self-esteem was still lousy afterwards, only now they were several thousand dollars poorer. They had hoped they’d like themselves more with a new nose, flatter stomach or less baggy eyes. They found out that changing the outside doesn’t necessarily change how you feel inside.

Consider these questions: If your goal is to like yourself more, are there better ways to do it than altering your appearance? Is self-esteem really based on physical appearance? If this were true, the most beautiful people would be the happiest people (and we know this is not true). Would working on raising your self-esteem be a better investment than a few thousand bucks for a “fresher” face? Would you be more likely to have the admiration of others if you were the type of person people liked, felt comfortable with and could emotionally connect with? If you want to have the kind of body that others admire, would exercise (lifting weights, yoga, jogging) and eating more healthily be more effective in the long run? If we are unhealthy, ill or vulnerable to disease, that’s one thing. But if we are none of these and just don’t like how we look, wouldn’t a more powerful question be: Why am I so dependent on what others think of my appearance?

Promoting body insecurity sells products that promise us the illusion of popularity and admiration. If you depend on externals like Botox or plastic surgery to feel good about yourself, you’re doomed to despair. This stuff is temporary. The only thing that really lasts – and is likely to improve as you age – is your mental health. Physically, we all age and eventually get sick and die. We can fight it for a while, but none of us gets out of here alive, and few of us do it looking “fresh” and youthful.

Hoping to achieve the perfect face and body is like going on a trip knowing we will never get to the destination. There is no real “perfection” out there, and even if we somehow manage to get there, it’s temporary. Today’s fashion model (our alleged cultural ideal) is typically passé in a few years. If the image of the perfect man/woman didn’t change, businesses couldn’t sell new products (clothes, skin care, cosmetics, hair color, etc.) The ideal standard of beauty is constantly in motion and the consumer product industry is always on the outlook for new things to sell us. A recent fashion magazine article talked about plastic surgery methods for altering elbows, stating that faces, hands and most other body parts are now easily alterable, and that elbows are the hip new target for plastic surgery.

In closing, I return to the original question: Is it wrong to get Botox or Restylene treatments to look younger? I suggest replacing it with two more practical questions: “Will this really make me feel better about who I am?” and “If it does, is this temporary or will it last?” If you want to feel better about yourself, perhaps there are other, more lasting and cheaper, ways to do so. Do your homework, ask yourself the tough questions, and make your decision. The choice is yours.