Demand for cosmetic procedures in both primary care and aesthetic clinics continues to rise. Family physicians frequently encounter patients seeking these interventions, raising concerns about underlying mental health issues such as depression or body dysmorphic disorder (BDD). Yet, emerging evidence and clinical experience indicate that, for appropriately selected individuals, aesthetic interventions may enhance self-esteem, body image, and psychosocial functioning.To systematically review the impact of surgical and non-surgical cosmetic procedures on psychosocial well-being—specifically depression, anxiety, and self-esteem—and to examine how patient selection influences mental health outcomes.A systematic review was conducted using databases including PubMed, Embase, and PsycINFO for studies published between 2004 and 2024. The review included randomized controlled trials, meta-analyses, and prospective cohort studies that assessed psychological outcomes using validated scales (e.g., FACE-Q, SF-36, SCL-90) pre- and post-procedure. Studies focusing solely on reconstructive surgery for trauma were excluded to focus on aesthetic motivations.The analysis synthesized data from key studies, including meta-analyses using FACE-Q scales. Results consistently demonstrated that successful cosmetic procedures are associated with significant improvements in body image, self-esteem, and quality of life. Specific interventions, such as botulinum toxin injections, were linked to reductions in depressive symptoms in randomized trials. Improvements in social confidence and emotional stability were most pronounced in patients who had realistic expectations and lacked severe BDD. Conversely, poor outcomes were correlated with unaddressed preoperative psychopathology.Findings support a shift from viewing cosmetic patients primarily as psychologically vulnerable to recognizing the potential therapeutic benefits of aesthetic interventions when provided responsibly. Minimally invasive procedures offer a relatively low-risk means of enhancing psychological well-being. However, pre-procedural mental health screening remains essential to identify contraindications, align expectations, and optimize outcomes. This approach fits well within the holistic care model of family medicine.Aesthetic procedures, when offered to appropriately selected patients with realistic expectations, are associated with meaningful improvements in self-esteem, body image, depressive symptoms, and psychosocial well-being. Integrating mental health assessment and expectation management in primary care may enhance patient outcomes and support comprehensive aesthetic care.