Medical activity in recent years has experienced a marked expansion of possibilities for aesthetic surgery, usually requested by patients. Especially in dermatology, an increasing demand for and use of doctor/medical services by healthy individuals has resulted in a drastic change to cosmetic dermatology. The request for cosmetic surgery is emotionally or psychosocially motivated. Patients with psychological disturbances sometimes push aside possible risks and complications or deny side effects and interactions of the procedures. Subjective impairments of appearance, feelings of inferiority and social pho-bias may be in the background of somatizing disorders. These emotional disorders, such as body dysmorphic disorder, personality disorder or polysurgical addiction, often remain undiscovered but should be excluded in any patient receiving cosmetic procedures.