[The role of plastic surgery in remodeling the body image]

On the basis of comprehensive information on the realistic possibilities and outcomes of esthetic corrective surgery, such operations can contribute to an effective and lasting improvement in the patient's quality of life and self-esteem. However, the esthetic surgeon's scalpel must never be considered an alternative to necessary psychotherapy. Exaggerated expectations, obsessions, and an absent sense of reality coupled with the projection of psychological and social problems on a certain part of the body must be interpreted as dysmorphophobia with a disordered personality structure. For a reputable plastic surgeon they must be considered a contraindication to esthetic surgery. Against a background of constantly changing social conditions and attitudes, too, surgical body sculpting should no longer be uncritically accepted as a legitimate field for esthetic surgery. Currently, the question as to where the lines are to be drawn for the performance of body-modeling surgical interventions remains unanswered.