Susan Brinkmann, OCDS Staff Journalist Last week’s announcement that TV star Heidi Montag underwent 10 plastic surgeries in one day has raised serious concerns about the increasing number of American women whose obsession with physical beauty is fueling an addiction to the knife. The 23 year-old Hills star admitted to undergoing, among other things, breast enlargement surgery, a nose job, chin reduction and brow lift  - all on the same day. The revelation sparked a new debate over why so many women, especially those as young as Montag, are willing to go so far in order to look more beautiful. LiveScience spoke with Debbie Then, a California-based psychologist who specializes in women and appearance, who says say the media’s constant portrayal of perfect “Barbie-doll” women is behind the trend. "I think, fundamentally, when somebody goes on for many, many, many procedures, and starts at a young age, they're trying to change something about themselves, they want to become a new person, and you can't just do that through a scalpel," Then said.   "The bottom line is they want to in some way change who they are because they're not happy with it at the core," and that problem can be more of a psychological one, she said. An estimated 12.1 million cosmetic procedures were performed in 2008, according to the American Society of Plastic Surgeons (ASPS), which represents a 3 percent rise from the year before. The most common recipients of cosmetic surgery were women (91 percent) between the ages of 40 to 54. However, younger women are opting for surgery in larger numbers. An estimated 750,000 cosmetic procedures, 271,000 of which were surgical, were performed in people aged 20 to 29 in 2008, according to the ASPS. And 219,000 (81,900 surgical) procedures were done on children and young adults aged 13 to 19. Why do young women, especially those who are already physically attractive such as Montag, go to such extremes for the sake of beauty? In some cases, it could be due to a psychological condition known as dysmorphic disorder in which a person has an unrealistic perception of their features, Then said. “The thing they want to change, they fixate on, and it's not even visible to other people." Others undergo the knife because, in their view, physical beauty is the most valuable thing about them. "They've gotten by on their looks, and they haven't built up any other kinds of substance for themselves, and they're so afraid of losing their looks, that they feel like they have to go and do all these things to change them or to better themselves, because they think that's all they have," Then said. The fact that men comprised only nine percent of cosmetic surgical procedures in 2008 is not surprising Then said, especially in light of how women are viewed in society. "The fact that in our culture women are judged on their looks, is an absolute truism," Then said. The constant bombardment of unrealistic images of women by the media can cause women to develop a skewed idea of what is important in life.   “I  worry about the pressures, especially on young women in their 20's these days, because they look at women in the media, and they look at women on these reality shows, and they think that if they just look a little better, that they're going to get more of the goodies in life," she said, "And that's not necessarily true." Then is recommending that plastic surgeons screen patients, particularly younger women, to make sure they are not suffering from underlying psychological problems. © All Rights Reserved, Living His Life Abundantly®/Women of Grace®  http://www.womenofgrace.com