It is said that if you want to be beautiful, you have to suffer. True to this motto, more and more people are undergoing complex cosmetic operations. Then the crooked nose – a family trait – is exchanged for a delicate nose, the wrinkles on the forehead, which tell of the life so far, are transformed into youthful skin and the belly fat, which is reminiscent of the last pregnancy, is sucked off – what is left is a flat belly. And these are just the more harmless methods that women in particular use to try to conform to the common ideal of beauty.

Going to the beauty doctor is no longer a phenomenon of the older generation; a current representative ZDF survey among 25 to 34 year olds shows that 42 of those surveyed are basically open to a corresponding operation; if you only ask women, they are it more than 50 percent. It almost seems as if the social trend towards self-optimization has reached a new peak. According to statistics from the Association of German Aesthetic Plastic Surgeons (VDÄPC), there were already 93,853 aesthetic operations in 2022, an increase of 15 percent compared to the previous year. And since then, demand has continued to rise, with estimates ranging from 400,000 to 700,000 procedures per year – in Germany.

But why do more and more people seem to think that they are not beautiful enough? And what does beauty actually mean? Questions that the psychological psychotherapist and psychoanalyst Ada Borkenhagen has been dealing with for years. She researches and teaches at the Otto von Guericke University Magdeburg on how we deal with beauty. She is certain: the importance of beauty is generally increasing. In an interview with the star, she says: “The reason for this certainly lies in the individualization tendency of our western societies.”

A phenomenon that we all know: We want to live as independently as possible, to realize ourselves and not to be put in a drawer with others. The core message: Everyone is unique. And that’s basically true. However, according to Borkenhagen, this also means that nowadays we no longer define our identity so much by belonging to a certain class or group, but increasingly by our appearance. And because in Western societies it is often about performance, a kind of race arises here too: beautiful, more beautiful, most beautiful.

But who actually decides what is beautiful? According to Borkenhagen, there are different parameters of attractiveness that subconsciously influence us. “For example, we find a certain degree of symmetry attractive, but not complete.” The reason: Perfection seems unnatural to us because no one naturally has a completely symmetrical face. In a scientific publication, attractiveness researcher Martin Gründl also adds other characteristics that are generally considered beautiful: health, youthfulness and gender-typical appearance.

That’s the theory anyway. In reality, however, we experience that beauty is in the eye of the beholder – at least when it comes to which people we enter into relationships with, which people become friends and who we trust. We often live a different truth, true to the motto: Every person is beautiful in their own way.

And yet we all know them, the Heidi Klums, Kim Kardashians or Kate Mosses of this world, who look disillusioned in the mirror in the morning and start the day with a fair amount of self-doubt. The media still shows us what today’s women and men should look like if they want to be someone. And most of the time it’s the measurements that all seem to come from the same catalog of perfection: women please slim and curvy, men please muscular and tall.

“Today, many people also find the childish pattern in women attractive with big eyes, a small nose and a pouty mouth,” adds psychoanalyst Borkenhagen to the star. This is partly due to the strong influence of social media on our view of the world. The beauty filters from Instagram, TikTok and Co. create an unrealistic image, which in turn is reflected in our perception of beauty. Borkenhagen explains it this way: “On the Internet we see a lot of women who have enlarged their eyes and softened their faces in order to appear younger and more childlike. And the more we see something like that, the more normal it seems to us that women look like that. “

And it actually starts early: According to a representative YouGov survey commissioned by the AOK Federal Association among 14 to 30 year olds, the use of social networks has a significant impact on the self-perception and body image of adolescents. According to this, 40 percent of young people feel a lot of pressure to look better and be more successful due to their consumption of social media.

If the pressure gets to your head, you can knock on the door of Felix Graf von Spiegel, for example. The plastic surgeon spoke to stern about his job – and is quite critical of the developments caused by social media in his industry. “The younger people are very oriented towards social media and are influenced by it. They perceive a body image as beautiful and normal, which is by no means normal, but was achieved through interventions, and then they want to look that way.” This sometimes leads to them no longer liking their own reflection in the mirror.

And that doesn’t happen all that rarely. The ZDF survey mentioned above shows that more than one in five respondents suffer psychologically from their appearance (22.4 percent). In the worst case, the whole thing can take on pathological traits. In technical terms, the whole thing is called dysmorphophobia – a disturbed self-perception. The serious mental illness usually occurs at a young age, often during puberty. Those affected have an objectively normal appearance, but perceive themselves as ugly or even disfigured. The focus on these supposed flaws takes over and is reinforced by comparison with supposedly flawless people.

A phenomenon that, according to a research team at Boston University School of Medicine, is at least encouraged by beauty filters. Accordingly, photo filters have a negative impact on self-perception and, when used regularly, cause strong self-doubt, dissatisfaction with one’s own reflection decreases and going to the beauty doctor becomes more and more realistic.

According to psychoanalyst Borkenhagen, this can even be advisable in some cases: “Cosmetic medical measures can also help you come to terms with yourself, i.e. increase self-acceptance,” she explains in an interview with stern. “If I have a certain ideal image of myself and approach this image through an operation, then I will probably experience myself in greater harmony with myself because my ideal self and my real self have come closer to each other.”

However, the line between a healthy desire for optimization and pathological self-loathing is fluid. According to Borkenhagen, it is completely normal to be dissatisfied with individual parts of your body and to have them surgically adjusted if necessary. But as soon as you desperately try to look like a different person, you should think about it and perhaps consider going to a psychotherapist instead of going to a beauty clinic.

And even otherwise, it shouldn’t be beauty that we give the top priority in our lives. Many people think that if they are beautiful, they will automatically lead a happy life. But Borkenhagen is certain: “What actually makes people happy is something else: fulfilling relationships.” And we even prevent this if we focus too much on our appearance. “If I just make sure that I look as beautiful as possible all the time, then I’ll build a wall around myself and won’t be able to engage with the person I’m talking to, and therefore won’t be able to connect with other people.” Sometimes it’s worth having a little more courage to be ugly.