Fifty female face-lift patients were evaluated preoperatively with psychological tests and psychiatric interviews. Their postoperative psychological courses were studied for up to 6 months. Approximately 30% had postoperative depressive reactions. These reactions were primarily correlated with a preexisting, clinically detectable depression, high depressive Beck scores, or a depression-prone personality pattern. There was no statistical correlation between postoperative depressive reactions and magical expectations, post-operative complications, marital status, recent bereavement, relationships with spouse and family, or concerns about death. Preoperative depression scores were often transiently intensified postoperatively, but usually eventually stabilized at a level lower than the preoperative scores. Many women showed postoperative psychological improvement. Twenty-eight percent had an increase in self-esteem, 8% felt better able to cope with life, and 8% were more assertive and confident in their work. The desire to improve self-image and to advance in a career were reasonably reliable predictors of psychological improvement.