Psychological and Physiological Influences on Aesthetic Treatment Outcomes: A Systematic Review

Background: Aesthetic medicine increasingly recognizes the interplay between psychological well-being and treatment outcomes. This systematic review synthesizes evidence on how stress and mental health influence aesthetic procedure success, focusing on psychiatric disorders, physiological stress mechanisms, patient expectations, and interdisciplinary care. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and other databases (2015–2025) identified peer-reviewed studies on stress, mental health, and aesthetic outcomes. Data were extracted on study design, psychiatric prevalence, stress effects, and patient-reported outcomes, with quality assessed via AMSTAR 2. Results: Approximately 50% of aesthetic patients exhibit psychiatric disorders, with body dysmorphic disorder (BDD) prevalent in 5–15% (up to >50% in rhinoplasty), correlating with dissatisfaction. Physiological stress impairs wound healing via cortisol elevation, while psychological distress, often driven by social media-induced expectations, reduces satisfaction. Validated tools like the Cosmetic Readiness Questionnaire enhance screening, and interdisciplinary care improves outcomes. Conclusions: Stress and mental health critically shape aesthetic outcomes, necessitating robust preoperative screening and integrated care models. Future research should standardize patient-reported outcome measures and develop targeted psychological interventions to optimize patient-centered aesthetic practice.