Caution: “Swan” Side Effects May Include Depression and Body Dismorphic Disorder

The terms “plastic surgery” and “self-esteem” have gone hand-in-hand for years in our societal discourse about altering the body through means of surgery. Typically, plastic surgery seems to be labeled as something that will boost self-esteem and make someone more comfortable with their appearance. This is assuming that the patient needs to have their self-esteem raised: if the person had high self esteem to begin with, would they need the surgery? Or would they be fine with themselves as it is?


A former Swan contestant, Lorrie Arias, had a compelling story: after losing 150 pounds and then grieving the death of her husband and left to raise to raise the children on her own, she felt insecure about the extra skin she had following her weight loss.

A Huffington Post article details the procedures that Arias underwent, even though all she had wanted originally was a tummy tuck:

“Once Arias got to the set of “The Swan,” doctors and producers set up a much more intensive transformation than she had expected. Over two and a half months of filming, she had a tummy tuck, buttock lift, inner thigh lift, dual facelift, upper lip lift, upper and lower eye lift, endoscopic brow lift, rhinoplasty, breast augmentation and breast lift — the most procedures of any contestant on the show.”


Following her extreme transformation, and unfortunately still true now, Arias suffers from depression, bipolar disorder, agoraphobia, and body dismorphic disorder.

Why? One would think that with such an extreme makeover (she does look great afterwards, in my opinion) she would be more content with what she looks like and who she is. However, that is the problem. She doesn’t know who she is anymore. The revealing is a surprise for the contestants as well – they can’t see what they look like until the big reveal to everyone else. For two and a half months, Arias did not know what she looked like. It was clearly jarring to not recognize the woman in the mirror:

“I was screaming for the executive producer,” she said. “I was screaming, ‘I want my face back!’ That’s how freaked out I was. Intelligently, I knew that was impossible. But it was so weird. It was like looking at somebody else, but it was you.”

Watch Lorrie’s Swan Excerpt here (another tv makeover video used as a promotional tool for her surgeon):

Though she did feel a bout of confidence shortly after the transformation, her old insecurities came back, but they were even worse this time. She wished there was some sort of coping or psychological help after undergoing such a dramatic change. Clearly, the change did not help Arias’ self-esteem, it seemed to only worsen it in the long run. She states herself that getting plastic surgery done will not fix low esteem and insecurities in all cases.

“I thought a tummy tuck would give me all the self-esteem in the world. Of course, it didn’t. All I want now is for my story to help others, so they won’t think that going under the knife is a cure-all,” she said. “For a while it may be, but everything still comes back up.”

Read her full story here:


4 thoughts on “Caution: “Swan” Side Effects May Include Depression and Body Dismorphic Disorder

  1. This post intrigued me, as I’m writing about something similar for my final project. There seems to be a misconception about plastic surgery which most people assume procedures will automatically “fix” low self esteem. It seems as though the negative impacts of plastic surgery weren’t often publicized until the recent release of the show, Botched, a reality series that specialized in fixing procedures that had gone wrong. Although the outcome of plastic surgery does not always worsen the patient’s situation, i think it’s important to consider the negative impacts it can have on a patient’s psychology. Going into a procedure the patient is almost always expecting the outcome to be positive, and that once they wake up all their problems will dissipate (much like the way extreme makeover portrays the subject’s before and after stories). When the results do not necessarily live up to what was anticipated, this leaves the patient stuck in a downward spiral that makes them feeling even more insecure than they were prior to the procedure. Its important to take a step back and understand how our societal discourse makes us think that participating in beauty work can solve one’s problems and will help you “remake yourself as an aesthetic citizen” and how significantly this can impact girls who feel the need to live up to this standard. The step towards a permanent change is something women think will make them a better or “more normal” version of themselves, yet it can often take a turn in the opposite direction.


  2. Hey Niki,

    I think this specific case is so interesting in light of the Edmonds reading and the emphasis on the way psychology intertwines with plastic surgery. The surgeons on this show were using Lorrie’s specific case (the tragedy of losing her husband and feeling insecure about the extra skin from her weight loss) as a justification for the massive amount of surgeries that took place. Edmonds speaks of this justification in her piece, remarking about the importance of patients’ psychological states, i.e., their self-esteem since it “enables surgeons to argue they are healing a psychological complaint” (78). It seems like this episode is a particularly over-exaggerated case of the way that medical professionals can profit off of the insecurities of others. In Lorrie’s case, the surgeons (or simply producers of the show) must have thought she was suffering tremendously for them to justify all of these surgeries in an attempt to raise her self-esteem.

    It also seems as though the surgeons were not considering a point that Edmonds touches on, “The ‘good patient’ must be ‘mentally suffering’ just enough to justify intervention, yet not suffering so much that her body image is too distorted which would jeopardize the plastica cure” (82). In my opinion, it’s seemingly impossible to know if a surgery will really help to “fix” the initial sufferings of a patient. As we mentioned in the last class, none of Lorrie’s real issues here were addressed through these plastic surgeries. Sure, there was an issue of extra skin (hence her desire for a tummy tuck), but it’s as if the producers of the show translated the loss of her husband into grounds for the surplus of surgeries to follow. I love how you’ve titled this post “Caution: Swan Side Effects May Include…” – it’s really such a brilliant point about plastic surgery, and one that is rarely spoken of. There’s this notion that a heightened appearance, especially in these makeover shows, is a complete solution to any sufferings prior…it’s the start of a new life. However, we are glossing over the fact that Lorrie’s new appearance does not take the place of her deceased husband.

    The issue of “suffering just enough” as grounds for performing plastic surgery is something I will be speaking about in my final project. I’m looking at cases of body dysmorphic disorder in relation to plastic surgeon. However, I’m specifically focusing on one plastic surgeon’s opinions when it comes to his particular patients, specifically, how is it possible to judge a patient who is psychologically healthy seeking plastic surgery vs. a patient who is mentally ill, i.e., with an image disorder and seeking plastic surgery? I’m interested in what a psychologically healthy individual who wants plastic surgery looks like when, as Edmond states, “The problem now is not that the patient is not sick, but that everyone is potentially a patient” (83).


  3. I definitely agree with what everyone is saying here. Thanks to the appropriation of psychoanalytic and psychological concepts (especially the idea of the inferiority complex), plastic surgery has become a panacea for issues of self-esteem, especially among women, as we’ve seen both in the Extreme Makeover clips we watched last week and in Niki’s blog post. What I think is truly dangerous, though, is that it is not just being used to cure the ills of older women, but increasingly, it is becoming a fix for teenagers too. Years ago (I think sometime in 2010, but I’m not a hundred percent sure), Seventeen magazine ran an article about a high school-aged girl who was bullied because of her appearance (specifically, the size of her nose). She decided to get plastic surgery in the hopes that it would end the bullying (and the self-esteem issues she experienced that derived from the bullying). But she actually got bullied MORE for getting a nose job. If you Google “teens getting breast implants,” you can find dozens of stories of girls ages 16, 17, 18 getting breast augmentations, often paid for by their parents. The number one reason the parents give for forking over the thousands of dollars these procedures usually cost? It increases their daughters’ confidence and makes them “happier”. But is it really a fix for the issues these girls have? And what kind of message are we sending young women when a completely valid high school graduation present is a cosmetic surgery procedure? I don’t know the answer. But I think we need to stop and really think about whether setting up a society where, rather than learning to accept themselves as they are, young women are taught conformity to narrow beauty standards benefits us all.


  4. My concern about this Arias case is more a question really, than a concern. How does one get chosen to be on one of these shows? I’ve always wondered, especially with Extreme Makeover (I’ve never seen one of the Swan episodes), what makes someone qualified for the show? Do they have to be really “ugly” (I’m using this language on purpose) to be chosen? Do the producers have to vote on who needs surgery more than someone else? Or is it a sob story? Does the contestant have to have had such a horrible life or at least a couple of horrible years to make it? Does a person being poor help, too? Can a rich person really be selected? Or would it seem pointless to have someone who can actually afford the surgery, get it for free on the show?

    This reminds me of the free surgeries done in Brazil on poor people. Plastic surgery is seen as charity for poor folk, who don’t make enough money to pay for it themselves. This is their way to boost the morale of the nation by having attractive people, even if they’re poor. This was the same premise for Extreme Makeover: Home Edition, with people who were destitute or near poverty. It was often a gigantic family, with say 8 or so kids, with or without both parents, and at least one of the children had special needs. But the family through it all was hardworking, very charitable donating their time when they couldn’t donate money, and great community members. People often saw how badly their living situation was and would write into the show to surprise these families with a brand new, luxurious home.

    I can’t imagine it was the same for plastic surgery. How would that letter even be written? “Hi, my name is So And So, and my friend Name Goes Here is having a really rough time. Her husband died, her child has been in a coma for three years, and she just lost her dog. Can you please help her by giving her surgery? She has a very large nose and droopy eyes that she complains about all the time, and I agree….” It just doesn’t sound as nice as it would if you were asking to fix your friend’s house. But it doesn’t seem all that great if the person themselves wrote in either. With all of this going on, you decide your best bet is to get a breast augmentation? That brings me back to Arias. Knowing that the point of shows like this is to be extreme, and for a complete makeover to take place, did she really think she was going to be featured on the show after only having one procedure done? Or did someone else write in for her and she accepted it and then was bamboozled by it all?


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