Psychological assessment is vital in evaluating patients seeking cosmetic surgery, as outcomes depend not only on surgical skill but also on mental health and expectations. While many benefit with improved self-esteem and quality of life, poor results are often linked to psychiatric morbidity, unrealistic goals, or maladaptive motivations. This chapter outlines a structured approach for pre-operative assessment, including history taking, mental status examination, psychometric tools, and collateral information, to identify conditions such as body dysmorphic disorder, eating disorders, anxiety, and mood disorders. Such evaluations guide surgical suitability, highlight the need for psychiatric treatment, and help manage risks. Post-operative care focuses on expectation management, coping strategies, and early detection of psychological distress. Special emphasis is placed on body dysmorphic disorder, the most common psychiatric concern in this context. Collaboration between surgeons and mental health professionals ensures patient safety, enhances satisfaction, and reduces complications and repeated procedures.